Santa Barbara County to pay $28 million to settle lawsuit with Department of Justice
SANTA BARBARA COUNTY, Calif. – Santa Barbara County on Tuesday announced that it will pay $28 million to settle a lawsuit with the U.S. Department of Justice for reimbursement of specialty mental health services through the state's Medi-Cal program.
A former county employee from the Department of Behavioral Wellness filed a federal complaint alleging that the county made "false claims" for Medi-Cal reimbursements from a 20-year period between 2008 and 2018, according to Suzanne Grimmesey, spokeswoman for the Department of Behavioral Wellness.
The employee, Judith Zissa, claimed that the county failed to complete treatment plans for Medi-Cal clients before providing them services, submitted claims for medication support without required client interaction, and billed for non-reimbursable inmate mental health services.
Zissa also claimed she was filed in retaliation for reporting the issues.
The Santa Barbara County Board of Supervisors approved the $28 million settlement, allowing the county to avoid a "potentially lengthy and expensive trial defending itself," Grimmesey said, adding that the claims resolved by the settlement are "allegations only" and there was no determination of liability.
“While the County does not concur with the tenor of the allegations made, it’s true that documentation requirements were not met in all instances,” said Assistant County Executive Officer Terri Maus-Nisich.
Antonette Navarro, director of the Behavioral Wellness Department since December 2021, said that the department provided "professional and proper treatment" to all of its clients and that, while some "documentation requirements were not met," the treatment met all professional medical standards.
The county will fund the settlement using litigation reserves, and officials said that it will not impact the county's operating budget and that neither the Behavioral Wellness Department nor any other county department will see a funding reduction.
"At a department and County level, new systems and staff are being put into place to ensure that these types of issues aren’t repeated," Grimmesey said. "Behavioral Wellness is adding staff to provide enhanced oversight of quality control and the contract monitoring process."
Additionally, the department will be transitioning to a new electronic health record system over the next year to align with the state's Medi-Cal system and improve coordination of client records, Grimmesey said.
