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Regular-Health & Human Services   # 38.
Board of Supervisors
Meeting Date:
03/24/2026
Brief Title
Behavioral Health Services Act (BHSA) Update
From:
Monica Morales, Director, Health and Human Services Agency
Staff Contact:
Tony Kildare, Behavioral Health Director, Health and Human Services Agency, x2929
Supervisorial District Impact:
Countywide

Subject

Receive overview presentation of draft Behavioral Health Services Act (BHSA) Integrated Plan for FY 2026-2029 on programming and services, receive feedback from Board on draft plan, and authorize the County Chief Administrative Officer (CAO) to provide endorsement for submission of the draft BHSA Integrated Plan to Department of Health Care Services (DHCS).  (No general fund impact) (Morales) (Est. Staff Presentation: 10 min)

Recommended Action

  1. Receive overview presentation of draft Behavioral Health Services Act (BHSA) Integrated Plan for FY 2026-2029 on programming and services, receive feedback from Board on draft plan; and
     
  2. Authorize the County Chief Administrative Officer (CAO) to provide endorsement for submission of the draft BHSA plan to the Department of Health Care Services (DHCS).

Strategic Plan Goal(s)

Thriving Residents

Reason for Recommended Action/Background

In March 2024, voters approved Proposition 1 to reform the Mental Health Services Act (MHSA) and replace it with the Behavioral Health Services Act (BHSA). It reforms behavioral health care funding to prioritize services for people with the most significant mental health needs while adding the treatment of substance use disorders (SUD), expanding housing interventions, increasing the behavioral health workforce, and accountability and transparency for county administered, publicly funded behavioral health programs. These reforms also significantly increase county responsibilities for planning, reporting, and stakeholder engagement. Proposition 1 changes the way in which Proposition 63 revenues are expended by county behavioral health plans and marks the transition from the “Mental Health Services Act (MHSA)” to the “Behavioral Health Services Act (BHSA).”  The most notable aspects of this shift are:
  • County allocations will be reduced from 95% to 90%
    • Additional 5% (~$1M) redirected to California Department of Public Health for Population Prevention
  • New BHSA Components (replaces MHSA CSS, PEI, and INN):
    • Full-Service Partnerships (35%; FY 26-27 Projected Revenue $6.8M)
    • Behavioral Health Services and Supports (35%; FY 26-27 Projected Revenue $6.8M)
    • Housing Interventions (30%; FY 26-27 Projected Revenue $5.8M)
BHSA New Metrics: Statewide Population Behavioral Health Goals
We have 14 specific goals that guide our work.  These goals fall into two main categories: things we want to see more of, and things we want to see less of. Goals for Improvement - these are about building up what's working. Goals for Reduction - these are about reducing the problems we see. Each of these goals has specific targets we're working toward, and we'll be tracking our progress together as a community. Out of these 14 goals, the state has identified six priority areas that need our immediate attention. These are the goals where we can make the biggest difference for most people in our community.  Counties must identify programs, initiatives, or partnerships that align with each of these goals and will support improvement in the outcomes. The State has identified these six areas as immediate priorities. Counties may identify BHSA funded programs, or other programs/initiatives to address these goals. Our work this year is to align with these six areas, as the state will be requesting metrics and reporting on these.
  1. Access to Care: Ensuring early identification and connection to behavioral health services through screening, assessment, and referral systems.
  2. Homelessness: Preventing and addressing housing instability among individuals with behavioral health needs.
  3. Institutionalization: Reducing unnecessary psychiatric hospitalization through community-based care in least restrictive settings.
  4. Justice-Involvement: Preventing and reducing criminal justice system involvement through targeted interventions and supports.
  5. Removal of Children From Home: Preventing out-of-home placements through family-centered, community-based interventions.
  6. Untreated Behavioral Health Conditions: Reducing duration of untreated mental illness and substance use disorders through early intervention.
BHSA Integrated Plan (IP)-Fiscal Year 2026-2027 Approach
On March 3, 2026, HHSA leadership presented to the Yolo County Board of Supervisors (BOS) with updates on the BHSA Integrated Plan, including the Community Planning Process (CPP) and proposed program budget scenarios for Fiscal Year 2026–27, and sought Board approval regarding budget approach for development of the required BHSA Integrated Plan. The complete March 3, 2026, presentation materials (staff report and presentation) and recording for BOS item #32 are available to the community online. The Board approved FY 2026-27 budget approach Scenario 3d which includes the following:

Scenario 3d
Use of fund balance to preserve BH capacity and increase support for Permanent Supportive Housing

  • Transfer 7% from Housing Intervention to Behavioral Health Services and Supports.
  • Board allocated approximately $9 million over a 3-year period to add 8 case management positions to FSP to support permanent supportive housing, offset other BH reductions/deficits and invest in Medi-Cal billing/revenue generation.
  • Per the plan’s requirements, remaining $5.2 million fund balance will be allocated to align with the distribution of the $9 million (1/3 to FSP, 2/3 to BHSS)
Summary of Proposed BHSA Programming and Services by Component
The draft Integrated Plan includes the following services and programs, with the details below focused on Year 1 (FY 2026–27).

FY 2026-2027 (Year 1)

Full-Service Partnerships (FSP)
FSP programming will address statewide behavioral health goals: increase access to care & reduce institutionalization
  • FSP programs provide individualized intensive recovery-focused, age-appropriate care for individuals with significant behavioral health needs
  • Services are delivered by multidisciplinary teams in partnership with families of the individual's natural supports and are anchored in a "whatever it takes" philosophy. 
    • Therapy, peer-support, transportation, medication support, case management
    • Adult, Older adult and youth
    • Supported Employment
  • NEW Mandated Evidence Based Practices (EBPs)
    • Assertive Community Treatment (ACT)
    • FSP Intensive Case Management (ICM) (incl. Transition and Relapse Prevention
    • Forensic ACT
    • High Fidelity Wraparound (HFW)
    • Individual Placement & Supports (IPS)
    • Assertive Field Based Substance Use Treatment (2029)
FSP Evidence Based Practice estimates
The Department of Health Care Services (DHCS) provides each county with an estimated number of individuals living with a behavioral health need who may have a clinical need for FSP and the total number who may have a clinical need for each required evidence-based practice.
Program/Evidence Based Practice Yolo Estimate
Assertive Community Treatment (ACT) 62
Forensic ACT 30
FSP Intensive Case Management (ICM) 433
High Fidelity Wraparound (HFW) 170
Individual Placement and Support (IPS) Supported Employment 765

Based on the current baseline programming, required evidence-based practices, and the above estimated client threshold, below are the draft program encumbrances.

FSP Programs and Services FY 2026-2027
Program Costs $2,500,000 FSP-ICM, ACT, FACT, Psychiatry & Overtime costs
FSP Services & Supplies $800,000 Includes direct-to-client supports
Residential Treatment/Acute Services $1,000,000 Costs for residential and hospitalization for FSP clients
High Fidelity Wraparound (HFW) (expansion) $1,000,000 New EBP, increase capacity
Individual Placement & Supports (IPS) $300,000 New EBP
*FSP PSH Case Managers $1,000,000 Per 3/3/26 Board direction
BHSA FSP Administration $1,200,000  
Total $7,800,000  
*HHSA continues to research and consult with DHCS on whether any of these costs can be covered under Housing Interventions. Source: DHCS Policy Manual - Housing Interventions

Behavioral Health Services and Supports (BHSS)
Counties are required to allocate 35 percent of their total local Behavioral Health Services Act (BHSA) allocations for Behavioral Health Services and Supports (BHSS). Of the 35 percent of funds allocated to BHSS, counties are required to use 51 percent of funds for Early Intervention Programs, and of that, 51 percent of the funds for Early Intervention Programs must be used to serve BHSA eligible individuals who are 25 years of age and younger. Early Intervention programs must include:
  • Outreach
  • Access & linkage to care
  • MH and SUD early treatment services & supports and must emphasize a reduction in the likelihood of the following adverse outcomes: suicide & self-harm, incarcerations, school suspensions/expulsions, unemployment, prolonged suffering, homelessness, removal of children from homes, overdose, mental illness in children/youth
  • 49% or less Non-Early Intervention
    • System of Care Services (children's, adult & older adult, non FSP)
    • Infrastructure & Capacity Building
      • Workforce Education & Training (WET)
      • Capital Facilities & Technology (CFTN)
      • Outreach & Engagement (O&E)
BHSS Programs & Services
BHSS Programming will address statewide behavioral health goals: increase access to care and reducing removal of children from home. 

Early Intervention Services
  • Children's Outpatient Services
  • Coordinated Specialty Care for First Episode Psychosis (mandated EBP)
  • Crisis Intervention Training (CIT)
  • Behavioral Health Access Services (call center, assessments, linkage to treatment)
  • K-12 School Partnership (year 1)
  • Early Childhood MH Access & Linkage (year 1)
  • Child/Youth Early Intervention Programming TBD (RFP year 2-3)
Non-early Intervention Services
  • Adult Outpatient Services
  • Crisis Continuum of Care (co-responders, 24/7 mobile crisis response)
  • Workforce Education & Training (WET)
  • Capital Facilities & Technology (CFTN)
BHSS Investments
Early Intervention (EI) Services EI BHSA Expenditure Non- Early Intervention Services Non-EI BHSA Expenditure
Children's Outpatient Treatment Services $2,175,000 Adult Outpatient Services $2,086,000
Coordinated Specialty Care for First Episode Psychosis (mandated EBP) $300,000 Crisis Continuum of Care (co-responders, 24/7 mobile crisis) $1,065,000
Crisis Intervention Training $86,000 Workforce Education & Training (WET) $219,000
Behavioral Health Access Services $1,560,000    
K-12 School Partnership $1,299,000    
Early Childhood Mental Health Access & Linkage $408,000    
BHSA BHSS Administration $643,000   $371,000
 Total $6,471,000   $3,741,000

Housing Interventions and Chronically Homeless
In California, 82% of people experiencing homelessness reported having a serious mental health condition (California Department of Health Care Services, 2024). In Yolo County, individuals experiencing homelessness has increased by 26.3% since 2022. BHSA invests in permanent supportive housing, integrating housing with behavioral health services, AND prioritizes chronically homeless individuals. Thirty percent (30%) of BHSA funds must be spent under Housing Intervention to increase access to permanent supportive housing for individuals meeting BHSA eligibility and who are chronically homeless, experiencing homelessness, or are at risk of homelessness.  The results of such investments may significantly reduce psychiatric hospitalizations, costly emergency room visits, and law enforcement response and incarcerations. Individuals must meet the BHSA eligibility requirements, identified in this policy manual and meet the definition of:
  • At-Risk of Homelessness, or
  • Experiencing Homelessness or
  • Chronically Homeless, with a focus on those in encampments.
Furthermore, BHSA outlines specific program requirements, including:
  • Housing Interventions shall not be limited to individuals enrolled in either a Full-Service Partnership or Medi-Cal.
  • Counties shall not discriminate against or deny access to housing for individuals that are utilizing medications for addiction treatment or other authorized medications, or individuals who are justice-involved.
  • Housing Interventions shall comply with the core components of Housing First, as defined in subdivision (b) of W&I Code section 8255, and may include recovery housing.
  • All Housing Interventions settings must be combined with access to clinical and supportive behavioral health care and housing services that will promote the individual’s health and functioning and long-term stability. Access does not cessitate co-location.
  • Housing Interventions may not be used for behavioral health services; however, these activities can be covered under Behavioral Health Services and Supports or other behavioral health funding sources.
Current Housing and Homelessness Supports
Yolo County HHSA has continued to support a regional response to address homelessness and access to affordable housing; utilizing state, federal, and local funding and strengthening partnerships to expand critical programs. These activities include but are not limited to:
  • Homeless Outreach/Encampment In-reach
  • Housing Navigation
  • Rapid Rehousing
  • Transitional Housing/Interim Housing
  • Rental Subsidies and other direct client supports
  • Permanent Supportive Housing for Individuals with SMI/SUD
  • Homeless Prevention
  • Transitional rents, Enhanced Case Management, and Community Supports in partnership with Managed Care Plans
Housing Interventions FY 2026-2027
With BHSA funds, Yolo County HHSA is proposing to continue current investments and expand investments in Housing and Homelessness support through rental subsidies, operating subsidies, and interim and permanent housing development. Per State guidelines, Yolo County HHSA will further expand access to housing by utilizing 6 months of transitional rents through the Yolo County Transitional Rents provider (Turning Point Community Programs), as well as create stability by utilizing all local non-profits and community partners who provide ECM/CS to increase both access to housing and ensuring clients retain housing.

Proposed BHSA Funded Programs Under Housing Interventions (2026-2027)
HHSA will release a competitive procurement (RFP) for Housing Interventions (Capital Development and Operating Subsidies) in late summer 2026, with anticipated contract start date winter 2027.
Housing Intervention Housing Chronically Homeless Total
Capital Development (RFP) $559,135 $559,135 $1,118,270
Operating Subsidies (RFP) $727,000 $727,000 $1,454,000
Rental Subsidies $340,000 $340,000 $680,000
BHSA HI Administration $578,602 $578,602 $1,157,204
 Total     $4,409,474

County Behavioral Health is committed to boldly taking action to provide Yolo County residents with quality, culturally responsive behavioral health services when, how, and where they need them. The new BHSA plan offers Yolo County the opportunity to coordinate across service delivery systems, including community-based organizations, hospitals, law enforcement, Medi-Cal MCPs, commercial plans, commercial regulators, public health, and other key service delivery partners. By working together across all these systems, we will be better prepared to ensure people with the highest behavioral health needs are served and we deliver measurable, integrated behavioral health services that are financially sustainable.

Next Steps
  • Staff will submit Draft BHSA Integrated Plan to DHCS by March 31, 2026
  • Post Draft Plan for 30-day public comment period (April 1, 2026-April 30, 2026)
  • Convene a Public Hearing with the Local Behavioral Health Board (May 6, 2026)
  • Review DHCS feedback for plan revise
  • Return to Board for final plan approval by June 2, 2026
  • Submit final plan to State by June 30, 2026
Outlined below is the current timeline for the BHSA Integrated Plan:


Background
For additional BHSA details, please refer to the Department of Health Care Services BHSA County Policy Manual, BHSA County Reporting timeline (infographic), and informational MHSA vs BHSA funding overview.

Collaborations (including Board advisory groups and external partner agencies)

Local Behavioral Health Board

Fiscal Impact

No Fiscal Impact

Fiscal Impact (Expenditure)

Total cost of recommended action:
$   
Amount budgeted for expenditure:
$   
Additional expenditure authority needed:
$   
On-going commitment (annual cost):
$   

Source of Funds for this Expenditure

General Fund
$0

Attachments

Form Review

Inbox Reviewed By Date
Tony Kildare Tony Kildare 03/16/2026 04:06 PM
Evis Morales Evis Morales 03/17/2026 08:50 AM
Laura Galindo Laura Galindo 03/19/2026 09:33 AM
Tony Kildare Tony Kildare 03/19/2026 12:15 PM
Laura Galindo Laura Galindo 03/19/2026 12:37 PM
Form Started By:
Jonathan Bartlett
Started On:
01/05/2026 09:29 AM
Final Approval Date:
03/19/2026