Board Of Supervisors — Tuesday, January 27, 2026

Mobile Crisis is a statewide Medi-Cal benefit that supports field-based behavioral health crisis response, stabilization, and linkage to care. The County Behavioral Health Directors Association of California (CBHDA) has requested county support and stakeholder input related to a state budget proposal that would eliminate Mobile Crisis as a statewide benefit and convert it to an optional benefit. If adopted, the change would shift the non-federal share of the benefit from the State to counties and create significant cost pressure, particularly for small and rural counties. Lake County Behavioral Health Services views this potential change as a serious risk to community access and public safety. Mobile Crisis is a core component of the County's crisis continuum and supports reductions in unnecessary law enforcement involvement and avoidable emergency department utilization, while improving timely access to behavioral health crisis services. IMPACTS TO LAKE COUNTY: If Mobile Crisis becomes optional and the non-federal share is shifted to counties, it may create an unsustainable cost shift that would force counties to scale back crisis response capacity. In rural counties, even modest funding instability can affect the ability to maintain 24/7 coverage, response time standards, and the staffing model necessary to operate safely and effectively. This issue also has direct implications for emergency response system capacity and cross-system partners, including dispatch operations, law enforcement, EMS, emergency departments, and the jail. WORKFORCE SAFETY / SYSTEM RELIABILITY: Mobile Crisis and crisis response staff routinely serve in high-acuity field settings and respond to volatile incidents. Maintaining stable statewide funding is important not only for access and outcomes, but also for workforce stability, recruitment/retention, and the supports necessary to sustain safe operations. Lake County Behavioral Health Services has requested additional fiscal analysis regarding the projected non-federal share/IGT exposure that may be required to maintain Mobile Crisis under the proposed change. Based on preliminary claims review and program utilization, the County anticipates the potential local cost exposure could be in the low single-digit millions annually, pending final fiscal validation. This estimate reflects a conservative planning assumption and does not include secondary impacts associated with increased law enforcement involvement, emergency department utilization, or jail involvement if service capacity were reduced. NEXT STEPS: If the Board authorizes the Chair's signature, Lake County will submit the letter to state decisionmakers and provide a copy to CBHDA to support statewide advocacy efforts.

Authorize the Chair to sign a letter in support of protecting Mobile Crisis as a statewide Medi-Cal benefit and opposing the proposed budget change that would shift the non-federal share of the benefit to counties.