Title
a. Approve and authorize the Director of Health Services or designee to execute a retroactive Mental Health Services Agreement between the County of Monterey and CF Merced Behavioral, LLC DBA Merced Behavioral Center for the provision of mental health services to gravely disabled Monterey County adult residents with severe psychiatric disabilities in a Skilled Nursing Facility as an Institution for Mental Disease (IMD), for a maximum County obligation of $4,006,098 for the term of July 1, 2026 through June 30, 2027; and
b. Approve and authorize the Director of Health Services or designee to execute up to three (3) future amendments that do not exceed 10% ($400,610) of the original Agreement, do not significantly change the scope of services, and do not increase the total not to exceed amount over $4,406,708.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Director of Health Services or designee to execute a retroactive Mental Health Services Agreement between the County of Monterey and CF Merced Behavioral, LLC DBA Merced Behavioral Center for the provision of mental health services to gravely disabled Monterey County adult residents with severe psychiatric disabilities in a Skilled Nursing Facility as an Institution for Mental Disease (IMD), for a maximum County obligation of $4,006,098 for the term of July 1, 2026 through June 30, 2027; and
b. Approve and authorize the Director of Health Services or designee to execute up to three (3) future amendments that do not exceed 10% ($400,610) of the original Agreement, do not significantly change the scope of services, and do not increase the total not to exceed amount over $4,406,708.
SUMMARY:
The County of Monterey Health Department, Behavioral Health Bureau, requests approval of a new agreement with CF Merced Behavioral, LLC dba Merced Behavioral Center which provides mental health services to gravely disabled Monterey County adult residents with severe psychiatric disabilities in a secure Skilled Nursing Facility as an Institution for Mental Disease (IMD).
DISCUSSION:
CF Merced Behavioral, LLC dba Merced Behavioral Center is a Short-Doyle Skilled Nursing Facility for psychiatric care of adults as an Institution for Mental Disease (IMD). The Center serves adults with psychiatric impairment that has led to their grave disability and requires a locked skilled nursing level of care. CF Merced Behavioral provides services to assist clients in the development of new skills and in modifying behaviors that exclude them from living in a lower level of care facility. The Behavioral Transitional Care Unit (BTCU) at Merced Behavioral Center is a specialized unit designed to offer an elevated level of psychiatric care for conservatees, distinct from the Main Housing Unit (MHU), with advanced services for those conserved clients needing more intensive care and behavioral management. This Agreement with CF Merced Behavioral, LLC dba Merced Behavioral Center is for one (1) fiscal year term from July 1, 2026 to June 30, 2027, for Monterey County residents with psychiatric impairments and disabilities, which historically is limited.
This agreement was previously approved on a Delegated Authority list by the Board of Supervisors on June 23, 2026, for an amount not to exceed $5,566,998. Ongoing rate negotiations required additional time to review and agendize the agreement. The revised not-to-exceed amount is $4,006,098. As a result, the agreement is presented as retroactive, with an effective date of July 1, 2026.
Approval of this Agreement meets the requirements of the State Welfare and Institutions Code 5600 (Bronzan-McCorquodale Act) and the California Code of Regulations Titles 9 &22 and sustains the continuity of core services to seriously mentally ill clients of Monterey County.
This Agreement contains the County’s standard 30-day “no cause” provision (Section V, B) and an additional defunding provision (Section V, D), which provides the County the ability to amend or terminate the Agreement in the event of a reduction and/or termination of funding.
This work supports the following County of Monterey Health Department 2025-2028 Strategic Plan Goal(s): 2) Provide Exceptional Person-Centered Care through Accessible, Community-Focused Health services. It also supports one of the ten essential public health services, specifically: 7) Link people to needed personal health services and assure the provisions of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT/COMMITTEE ACTIONS:
The Offices of County Counsel and Auditor-Controller have reviewed and approved this Agreement as to form and fiscal provisions, respectively.
FINANCING:
This Agreement is funded by 1991 Realignment funding. The funds for this Agreement for Fiscal Year 2026-27 are included in the Health Department’s Behavioral Health (Fund 1310, Department 400005) Fiscal Year 2026-27 Adopted Budget.
BOARD OF SUPERVISORS STRATEGIC PLAN GOALS:
This agreement will ensure access to culturally and linguistically appropriate, customer-friendly, quality health services, will link people to needed personal health services, and will assure the provision of healthcare when otherwise unavailable. This agreement aligns with the Board of Supervisors Strategic Plan Goal of well-being and quality of life.
Mark a check to the related Board of Supervisors Strategic Plan Goals:
_X_ Well-Being and Quality of Life
____ Sustainable Infrastructure for the Present and Future
____ Safe and Resilient Communities
____ Diverse and Thriving Economy
____ Dynamic Organization and Employer of Choice
Prepared by: Jacqueline A. Goetz, Management Analyst II, 755.8419
Approved by: Elsa Mendoza Jimenez, Director of Health Services, 755.4526
Attachments:
Board Report
Agreement