DATE: December 9, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Retroactive Memorandum of Understanding with California Mental
Health Services Authority (CalMHSA) and Department of State
Hospitals
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive Memorandum of Understanding with the California Department of State Hospitals and the California Mental Health Services Authority for the purchase of state psychiatric hospital beds on behalf of the County, effective July 1, 2025 through June 30, 2027 ($4,700,000);
2. Adopt Budget Resolution increasing the FY 2025-26 appropriations for the Department of Behavioral Health Org 5245 in the amount of $1,700,000 (4/5 vote); and
3. Adopt Budget Resolution increasing the FY 2025-26 appropriations and estimated revenue for Department of Behavioral Health Org 5630, in the amount of $1,700,000 (4/5 vote).
REPORT
Approval of the first recommended action will authorize a two-year Memorandum of Understanding (MOU) with the California Mental Health Services Authority (CalMHSA) and the California Department of State Hospitals (DSH) for the purchase of psychiatric hospital beds for County residents, retroactive to July 1, 2025. The second and third recommended actions will increase appropriations and estimated revenues to the Department of Behavioral Health Orgs 5245 and 5630. Pursuant to Welfare & Institutions Code (W&IC), section 5000 and following, the MOU will provide mandated beds and services for Lanterman-Petris Short (LPS) conservatees who are gravely disabled mentally ill persons served, as ordered by the Fresno County Superior Court. The MOU will be funded with Mental Health Realignment funds. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternatives. Should your Board not approve the recommended actions, the Department will be out of compliance with W&IC section 5600, as counties are manda...
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