About Us
The passage of Proposition 63 (now known as the Mental Health Services Act or MHSA) in November 2004, provided the first opportunity in many years for the California Department of Mental Health (DMH) to provide increased funding, personnel and other resources to support county mental health programs and monitor progress toward statewide goals for children, transition age youth, adults, older adults and families. The Act addressed a broad continuum of prevention, early intervention and service needs and the necessary infrastructure, technology and training elements that effectively supported the system. This Act imposed a 1% income tax on personal income in excess of $1 million. Statewide, the Act was projected to generate approximately $254 million in fiscalyear 2004-05, $683 million in 2005-06 and increasing amounts thereafter. Much of the funding was provided to county mental health programs to fund programs consistent with their local plans
In March 2024, California voters passed Proposition 1, resulting in significant changes to the Mental Health Services Act. The proposition repurposes the Mental Health Services Act, changing the name to Behavioral Health Services Act, also known as BHSA, re-structuring the use of funding and expanding on existing requirements.
The Behavioral Health Services Act (BHSA) is the first major structural reform of the Mental Health Services Act (MHSA) since it was passed in 2004. The MHSA was designed to serve individuals with serious mental illness and individuals that may be at risk of serious mental health issues.The MHSA has been a crucial resource to increase access to mental health services for all populations in our community.
With the reform of MHSA, the BHSA has expanded and increased the types of behavioral healthsupports available to Californians in need by focusing on historical gaps and emerging policy priorities.
The key goals within the BHSA include:
- Reaching and Serving High Need Priority Populations
- Restructures funding allocations for BHSA program components by focusing allocations on the areas of most significant need among Californians, including individuals across the lifespan at risk of or experiencing justice and system involvement, homelessness, and institutionalization.
- Prioritizes early intervention, especially for children and families, youth, and young adults, to provide early linkage to services and prevent mental health conditions or substance use disorders from becoming severe.
- Prioritizes serving individuals experiencing homelessness or at risk of homelessness, especially individuals and families experiencing long-term homelessness.
- The BHSA provides revenue for counties to assist those with severe behavioral health needs to be housed and provides a path to long-term recovery, including ongoing capital to build more housing options.
- Updates Full Service Partnerships (FSP) requirements to better serve individuals with the most significant needs by requiring FSP programs to include specified, evidence-based delivery models, community-defined evidence practices, and standardized levels of care
- Aligns with initiatives aimed at improving care for Medi-Cal members living with significant behavioral health needs.
- Increasing Access to Substance Use Disorder Services, Housing Interventions, Evidence-Based and Community-Defined Practices, and Building the Behavioral Health Workforce
- Expands services that may be funded with BHSA dollars to include treatment for substance use disorders.
- Provides ongoing funding for counties to assist people with serious behavioral health needs with housing and provides a path to long-term recovery, including ongoing capital to build more housing options.
- Increases investments in the behavioral health workforce, including efforts to provide more culturally and linguistically appropriate care.
- >Requires implementation of specified evidence-based and community-defined evidence practices improving outcomes for youth and adults with complex behavioral health conditions.
- Focusing on Outcomes, Transparency, Accountability, and Equity.
- Requires counties to complete a county Integrated Plan for Behavioral Health Services and Outcomes, which will include information on all local behavioral health funding and services, including Medi-Cal and non-Medi-Cal specialty behavioral health programs and funding streams.
- Requires counties to complete an annual county Behavioral Health Outcomes, Accountability, and Transparency Report (BHOATR) to provide public visibility into county spending, disparities, and results.
- Utilizes data through the lens of health equity to identify racial, ethnic, age, gender, and other demographic disparities and inform disparity reduction efforts.
Funding
BHSA continues to impose a 1% income tax on individuals with incomes over $1 million.
Local Planning
Under the MHSA, prior to receiving funding, counties were required to submit a Three-Year Program and Expenditure Plan focused exclusively on MHSA dollars. With the transformation of BHSA, counties are now required to submit a Three-Year Integrated Plans for Behavioral Health Services and Outcomes (Integrated Plans) focusing on a prospective global spending plan that describes how counties plan to use all available behavioral health funding within the community. Counties must engage with local stakeholders to develop each element of their Integrated Plan
Plans must be developed with a wide array of local stakeholders, be reviewed through a public hearing convened by the County Mental Health Board, subjected to a 30-day public comment period and be updated annually.
State Oversight
MHSA established a new Mental Health Oversight and Accountability Commission (MHOAC) to ensure the new funds are utilized properly throughout California. MHOAC will be collaborating with the California Department of Health Care Services (DHCS) to continue oversight of all BHSA funds.
With BHSA going into effect January 1, 2025, the MHOAC will be changing their name to Behavioral Health Oversight and Accountability Commission (BHOAC).