Behavioral Health Services Act

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• How is BHSA different from MHSA?

  BHSA updates and replaces the Mental Health Services Act. Key changes include: 

  • New funding requirements and updated service categories 
  • Greater focus on outcomes and accountability, with extensive reporting requirements for counties
  • Expanded stakeholder engagement and collaboration
  • State allocation doubles from 5% to 10%, reducing county funding by 5%
  • Transition of population‑based prevention and statewide workforce initiatives to State management
  • Stronger emphasis on health equity and improving access to services

   

• Which stakeholders are counties required to engage in developing the BHSA Integrated Plan?

  The DHCS BHSA Policy Manual outlines the stakeholder groups that counties are required to engage as part of the Community Planning Process (CPP).

  Effective January 1, 2025, stakeholder groups for engagement include, but are not limited to: 

  • Eligible adults and older adults (individuals with lived experience) 
  • Families of eligible children and youth, eligible adults, and eligible older adults (families with lived experience) 
  • Youths (individuals with lived experience) or youth mental health or substance use disorder (SUD) organizations 
  • Providers of mental health services and SUD treatment services 
  • Public safety partners, including county juvenile justice agencies 
  • Local education agencies 
  • Higher education partners 
  • Early childhood organizations 
  • Local public health jurisdictions 
  • County social services and child welfare agencies 
  • Labor representative organizations 
  • Veterans 
  • Representatives from veterans’ organizations 
  • Healthcare organizations, including hospitals 
  • Healthcare service plans, including Medi-Cal Managed Care Plans
  • Disability insurers (a commercial disability insurer that covers hospital, medical or surgical benefits as defined in Insurance Code section 106, subdivision (b)) 
  • Tribal and Indian Health Program designees established for Medi-Cal Tribal consultation purposes
  • The five most populous cities in counties with a population greater than 200,000
  • Area agencies on aging 
  • Independent living centers
  • Continuums of care, including representatives from the homeless service provider community
  • Regional centers 
  • Emergency medical services 
  • Community-based organizations serving culturally and linguistically diverse constituents 
  • Representatives from youth from historically marginalized communities 
  • Representatives from organizations specializing in working with underserved racially and ethnically diverse communities 
  • Representatives from LGBTQIA+ communities 
  • Victims of domestic violence and sexual abuse 
  • People with lived experience of homelessness

   

• What focus areas do stakeholders provide input on?

  BHSA requires counties to involve stakeholders in discussions around mental health and substance use disorder policy, program planning and implementation, monitoring, workforce, quality improvement, health equity, evaluation, and budget allocation.

  In addition, BHS is expanding opportunities to discuss specific topics including accessibility, care coordination and navigation, community outreach and education, crisis response services, culturally appropriate and affirming care, support for people experiencing homelessness, services for youth and transition age youth, and workforce capacity and diversity.

• What is the BHSA Integrated Plan 30-day public comment period?

  BHSA requires counties to provide a 30-day public comment period for the Integrated Plan and Annual Updates. During this time, community members, providers, and partners may review the draft plan and submit feedback. Feedback is reviewed by BHS and used to inform the plan that is presented to the San Diego County Board of Supervisors for approval and later submitted to DHCS.

• How does BHSA fund Prevention and Early Intervention?

  Under BHSA, prevention funding and services are managed by the State, California Department of Public Health (CDPH). This shift uses a portion of the State’s 10% BHSA allocation. CDPH will use this funding to implement programs that support population-based behavioral health prevention strategies.

  Early Intervention services are still funded locally and administered by the County through the Behavioral Health Services and Supports (BHSS) funding category. 

  Early Intervention services administered by the County are now more focused on providing evidence-based services that are sustainable and integrated with intensive treatment services as part of a comprehensive continuum that aligns with State requirements and priority populations. BHS will continue administering substance use prevention services, as these have dedicated funding through Substance Use Block Grants (SUBG). 

• How will the CDPH use BHSA Prevention funds?

  A minimum of 4% of BHSA funds will go to CDPH for population-based mental health and substance use disorder (SUD) prevention programs.

  CDPH has released the BHSA Population-Based Prevention Program Final Plan, which outlines implementation strategies and funding for Fiscal Years 2026–2029. The Plan includes Phase 1 and Phase 2 Guides and incorporates input from stakeholders, community members, and Tribal consultation.

  To learn more about the CDPH BHSA Population-Based Prevention Program Final Plan, visit the CDPH website.

• How will the County use Early Intervention funds?

  BHSA Early Intervention focuses on identifying and addressing behavioral health conditions early to prevent them from worsening. This category includes services for individuals experiencing a behavioral health crisis, mental health and substance use treatment services, and evidence-based practices for individuals experiencing a first-episode of psychosis.

• What are the requirements and goals of county-level Early Intervention programs?

  Counties must offer Early Intervention programs under the Behavioral Health Services and Supports (BHSS) category.

  • 51% of BHSS funds are dedicated to Early Intervention programs. These services may include targeted outreach, screenings, access and linkage, and treatment services for individuals of all ages. 
  • Of those funds, 51% must be directed to are dedicated to children, youth and young adults 25 and under.

  The goal of County Early Intervention programs is to stop mental health conditions and substance use disorders from becoming severe and disabling, and to reduce behavioral health disparities. These programs identify and address behavioral health concerns early, to reduce adverse outcomes in alignment with State behavioral health goals, including: 

  • Suicide and self-harm
  • Incarceration
  • School Failure or disciplinary actions
  • Unemployment
  • Prolonged suffering
  • Homelessness
  • Family Separation
  • Overdose
  • Mental illness in children and youth 

   

• How is the County using BHSA to support people experiencing chronic homelessness with significant behavioral health needs?

  BHS uses BH-CONNECT and BHSA funding to increase behavioral health treatment beds, outpatient services, and supportive housing options.

  Under BHSA, the Housing Interventions category is required to dedicate 50% of funds to people experiencing chronic homelessness. Full Service Partnership programs like Assertive Community Treatment also support this population. These programs work alongside statewide initiatives like transitional rent and Homekey+ to create permanent and short-term housing for people with behavioral health needs experiencing homelessness. 

• How is the County using BHSA Housing Intervention funds?

  BHS is committed to maintaining and expanding housing supports, which are a key part of the specialty care system. BHSA Housing Intervention funds help provide a full range of housing options including short-term, transitional, and permanent housing. Operating subsidies, also funded by BHSA Housing Intervention, help keep housing affordable and accessible. 

  BHSA Housing Interventions support broader state and local housing strategies, including programs like Homekey+ and Medi-Cal housing supports.​ Efforts to enhance BHSA housing priorities include expanding housing interventions to support Homekey+ and establishing a flexible housing pool to assist with the Managed Care Plan transitional rent benefit.