To: Board of Supervisors
From: Dr. Ori Tzvieli, Interim Health Services Director
Report Title: Mental Health Services Act Program and Expenditure Plan - Fiscal Years 2024-26; Annual Update to the 2023-26 Three-Year Plan
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
ACCEPT the recommendation of the Behavioral Health Services Director to adopt the Mental Health Services Act Fiscal Year 2025-26 Annual Update to the Three-Year Plan;
APPROVE the Psychiatric Advance Directives (PADs) Multi-County Collaborative, Mental Health Services Act Funded Project, Fiscal Year 2024-2029, and the Program Improvements for Valued Outpatient Treatment (PIVOT) Innovation Project; and
AUTHORIZE and DIRECT the Chair of the Board of Supervisors to send a letter to that effect to the Department of Health Care Services (DHCS) and the Behavioral Health Services Oversight and Accountability Commission (BHSOAC) to inform of their approval of the adoption of this Plan Update and attached Innovation Projects.
FISCAL IMPACT:
Adoption of the Mental Health Services Act (MHSA) Fiscal Year (FY) 2025-26 Annual Update to the Three-Year Plan assures continued MHSA funding in the amount of $84,501,000.
BACKGROUND:
Proposition 63 was passed by California voters in the November 2004 election. Now known as the Mental Health Services Act (MHSA), the legislation provides public mental health funding by imposing an additional one percent tax on individual taxable income in excess of one million dollars. There are a total of five MHSA components which have been enacted out over time by the State with the goal of creating a better program of mental health services and supports in California’s public mental health systems. There are multiple programs operated within each component. This is a state mandated program under Welfare & Institutions Code.
In March 2024, California voters approved Proposition 1, which introduces significant changes to the MHSA and transforms it to the Behavioral Health Services Act (BHSA). Under the BHSA, there are significant adjustments to the funding allocations and regulatory requirements. Regulatory and funding requirements affecting services under BHSA go into effect July 1, 2026. The plan update for Fiscal Year 2025-26 aligns with current mandates under existing regulations which are in effect until June 30, 2026.
The BHSA restructures the five historical MHSA components of Community Services and Supports; Prevention and Early Intervention; Workforce Education and Training; Capital Facilities and Technological Needs; and Innovation into three components. Those three components are:
• Full-Service Partnership (FSP) Programs with 35% of funds aimed at providing comprehensive care for individuals with the most complex needs
• Housing Interventions (HI) with 30% of funds designated for rental subsidies, operational support, shared housing, family housing for youth, and covering non-federal portions of transitional rental assistance
• Behavioral Health Services and Supports (BHSS) with 35% of funds, focused on general behavioral health programs
CONSEQUENCE OF NEGATIVE ACTION:
If this action is not approved, it would result in the loss of mental health programs and related services (including Full-Service Partnerships, Assisted Outpatient Treatment (AOT), Forensic Mental Health Services, Housing Services, Prevention and Early Intervention (PEI), Workforce Education and Training and more) which serve Contra Costa residents of all ages who reside in every region of the County.
CHILDREN’S IMPACT STATEMENT:
Mental health impacts people of all ages and impacts entire family systems and communities.
This recommendation supports all the following children's outcomes:
- Children Ready for and succeeding in School;
- Children and Youth Healthy and Preparing for Productive Adulthood.
- Families that are Safe, Stable and Nurturing; and
- Communities that are Safe and Provide a High Quality of Life for Children and Families.
Additionally
- Preventing mental health problems in children and youth from developing and becoming severe and disabling.
- Children and youth recovering from impact of trauma, severe emotional disturbance, and mental illness.