Behavioral Health Transformation Performance Measures Report
Delivering on California’s commitment to modernize the behavioral health system and bolster transparency and accountability, the Department of Health Care Services (DHCS) is publishing the inaugural set of Behavioral Health Transformation Performance Measures rates.
This release represents a major milestone for the Behavioral Health Services Act (BHSA) and the state’s Mental Health for All modernization journey, marking a historic shift in the completeness and quality of behavioral health metrics used in California.
This first‑of‑its‑kind set of quality and equity measures combines data from Medi‑Cal, social services, and public health to assess behavioral health services and outcomes across the state. A combination of existing measures developed by national measure stewards and novel DHCS measures, the measure set was designed to reflect the outcomes that matter most to Californians aligned to 14 statewide behavioral health goals. Key outcomes include reducing homelessness, strengthening follow‑up after hospitalization, improving access to behavioral health care, and closing disparities in service delivery.
The rates reported this year largely focused on the state fiscal year (FY) 2024-2025 (July 1 to June 30) measurement period, establishing baseline performance on these measures prior to the July 2026 launch of the BHSA.
How These Measures Will Advance Behavioral Health Transformation
The Behavioral Health Transformation (BHT) performance measures are foundational tools for strengthening transparency, planning and population health management, accountability, and equity. They help DHCS and partners understand what services people receive, identify where gaps exist, and guide how resources should be allocated to address local needs.
The performance measures will advance BHT in several key ways:
- Transparency and Accountability: The measures make it possible for counties, managed care plans, and DHCS to understand service delivery and outcomes. This helps ensure resources are allocated where they’re most needed and that programs are held accountable for results.
- Better Planning and Outcomes: By tracking these measures, DHCS and its partners can identify gaps in care, target interventions more effectively, and improve population health. Over time, the data will help guide policy, enforce requirements, and drive continuous improvement in behavioral health services.
- Equity and Quality: The measures are designed to support statewide goals for quality and equity, making sure that all Californians, especially those with the greatest needs, get timely, respectful, and effective behavioral health care.
- Data-Driven Decisions: Having consistent, statewide data allows for smarter planning, more informed decision-making, and improved strategies for prevention and early intervention.
These performance measures have replaced population-level behavioral health measures used to support planning in advance of the July 2026 launch of the BHSA. Going forward, the performance measures will be used in county planning and reporting to DHCS, including: the Behavioral Health Services Act Integrated Plan (IP), Annual Updates (AUs) and the Behavioral Health Outcomes, Accountability, and Transparency Report (BHOATR) for county behavioral health; and the annual PHM Strategy Deliverable for Medi-Cal MCPs. More information on these reports can be found in the BHSA County Policy Manual.
Over time, these measures will support enforcement of policy and contractual requirements that county behavioral health and Medi‑Cal managed care plans (MCP) must meet, reinforcing accountability across the behavioral health delivery system.
Rates will be published annually.
How the Novel Performance Measure Set Was Designed
To create this measure set, DHCS established the Quality and Equity Advisory Committee and hosted public meetings to establish 14 statewide behavioral health goals focused on the outcomes that matter most to Californians. DHCS collaborated with county behavioral health and MCP leaders, advocates, experts, and members of the public to select 51 performance measures that track statewide and local progress toward these 14 goals and include three cross-goal equity measures designed to close racial, ethnic, and language disparities in utilization of behavioral health services and evidence-based practices.
This measure set is a combination of 15 existing measures developed by national measure stewards and 36 novel measures created by DHCS where existing measures did not capture the services and outcomes of interest for the state. The new DHCS measures take a novel and unique approach for evaluating behavioral health that is grounded in the following three principles:
- Understanding who has behavioral health needs. DHCS developed a first-of-its kind approach to identify Californians living with behavioral health needs, whether or not they are currently receiving services. It captures the full spectrum of need (mild, moderate, and significant) and more precisely pinpoints people living with significant behavioral health needs. DHCS leveraged data on diagnoses, prior service utilization, medications, system involvement, and other administrative records across multiple systems of care. While the measures cannot yet capture needs for individuals without historical Medi-Cal records indicating a behavioral health need, this represents a major step toward a population-health model that considers the entire population eligible for public behavioral health services, not only those actively engaged in care.
- Assessing whether behavioral health needs are met across delivery systems. Using a person-centered approach, these performance measures assess whether individuals receive services aligned with their identified behavioral health needs, regardless of which delivery system provides them. In California, MCPs generally deliver Medi-Cal non-specialty mental health services, while county behavioral health departments generally deliver specialty mental health and substance use disorder services to a subset of Medi-Cal members with a higher level of need as well as eligible Californians not enrolled in Medi-Cal. Historically, most behavioral health measures evaluated these systems separately; the new measures instead reflect service delivery across both systems. This unified approach promotes joint accountability and collaboration, ensuring people receive appropriate services no matter where they enter the system.
- Using multiple data sources to capture a more complete picture of needs and care. The Behavioral Health Transformation performance measures draw on data beyond Medi-Cal alone to create a more complete understanding of behavioral health needs and service delivery for Medi-Cal members. The 2026 rates incorporate data from public health and housing services systems, with future releases expected to integrate data from the education system and non-Medi-Cal county behavioral health services. This broadened data foundation strengthens transparency, enhances the completeness of statewide behavioral health information, and supports more effective planning under the BHSA.
For now, these measures are limited to Californians enrolled in Medi-Cal, a public health insurance program which provides needed health care services for low-income individuals including families with children, seniors, persons with disabilities, foster care, and pregnant people. DHCS is exploring calculating these measures for additional populations over time.
About The Inaugural Rates
In July 2026, DHCS calculated the inaugural set of Behavioral Health Transformation performance measure rates, largely for the FY 2024-25 measurement period (with some exceptions where 2025 data was not yet available to calculate the rate). From 2026 to 2028, DHCS will calculate and publish 34 of the performance measures; an additional 17 measures will be published no earlier than 2028.
See the tables below for the latest Behavioral Health Transformation performance measure rates, and click on the link for each individual measure to access background information, the statewide rate stratified by demographics, and county behavioral health and MCP rates. County behavioral health and MCPs can access more detailed measure data and individual-level data within Medi-Cal Connect, DHCS’s data analytics and population health management platform.
Seventeen of the Behavioral Health Transformation performance measures were not calculated in 2026, in part due to data availability. This includes measures for goals listed above as well as the following goals: Improve Social Connection and Improve Engagement in Work. Those measures will be calculated no sooner than 2028. For more information on those measures, please see the Performance Measures Supplement.
Anticipated Publication Schedule:
| Release | Primary Measurement Period |
|---|---|
| 2026 | FY24-25 |
| 2027 | FY25-26 |
| 2028 | FY26-27 |
| 2029 | FY27-28 |
More information on BHT, the statewide behavioral health goals, and measures can be found in the following resources:
Improve Access to Care Measures
| Measure Name | Description | Statewide Rate | Additional Rates and Information |
|---|---|---|---|
| BH-1. One or More Behavioral Health Services for People with Mental Health Needs (BHSRV1-WMH) | Novel DHCS measure: Percent of people enrolled in Medi-Cal and living with mental health needs who receive one or more core clinical services to address behavioral health in a 12-month period | 65.93% | BH-1 Overview and Rates |
| BH-2. One or More Behavioral Health Services for People with Significant Mental Health Needs (BHSRV1-WSMH) | Novel DHCS measure: Percent of people enrolled in Medi-Cal and living with significant mental health needs who receive one or more core clinical services to address behavioral health in a 12-month period | 71.43% | BH-2 Overview and Rates |
| BH-3. Initiation of SUD Treatment (IET-I) | NCQA HEDIS measure: Percent of new substance use disorder (SUD) episodes in a 12-month period for Medi-Cal members 13 years of age and older that result in treatment initiation within 14 days | For release later this year | For release later this year |
Reduce Untreated Behavioral Health Conditions Measures
| Measure Name | Description | Statewide Rate | Additional Rates and Information |
|---|---|---|---|
| BH-5. Three or More Behavioral Health Services for People with Mental Health Needs (BHSRV3-WMH) | Novel DHCS measure: Percent of people enrolled in Medi-Cal and living with mental health needs who receive three or more core clinical services to address behavioral health in a 12-month period | 36.19% | BH-5 Overview and Rates |
| BH-6. Three or More Behavioral Health Services for People with Significant Mental Health Needs (BHSRV3-WSMH) | Novel DHCS measure: Percent of people enrolled in Medi-Cal and living with significant mental health needs who receive three or more core clinical services to address behavioral health in a 12-month period | 50.20% | BH-6 Overview and Rates |
| BH-7. Engagement in SUD Treatment (IET-E) | NCQA HEDIS measure: Percent of new SUD episodes in a 12-month period for people enrolled in Medi-Cal that result in treatment engagement within 34 days of treatment initiation | For release later this year | For release later this year |
| BH-12. Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) | NCQA HEDIS measure: Percent of Medi-Cal members 12 years of age and older who were screened for clinical depression using a standardized instrument in a 12-month period and, if screened positive, received follow-up care within 30 days | 75.80% | BH-12 Overview and Rates |
| BH-14. Follow-Up After Emergency Department Visit for Substance Use — 7 Days (FUA-7d) | NCQA HEDIS measure: Percent of emergency department visits in a 12-month period among Medi-Cal members 13 years of age and older with a principal diagnosis of SUD or any diagnosis of drug overdose for which the person received follow-up within 7 days after the emergency department visit | 26.91% | BH-14 Overview and Rates |
| BH-15. Follow-Up After Emergency Department Visit for Mental Illness — 7 Days (FUM-7d) | NCQA HEDIS measure: Percent of emergency department visits in a 12-month period for Medi-Cal members 6 years of age and older with a principal diagnosis of mental illness or intentional self-harm for which the person received a follow-up service within 7 days after the emergency department visit | 37.07% | BH-15 Overview and Rates |
Improve Access to Care Measures
| Measure Name | Description | Statewide Rate | Additional Rates and Information |
|---|---|---|---|
| BH-9. Perception of Care with Respect to One’s Cultural Background: Specialty Mental Health Services (PC-SMHS) | UCLA ISP and SMHSA Measure: Percent of people who completed the Mental Health Statistics Improvement Program (MHSIP) Consumer Survey in a 12-month period who responded with “strongly agree” or “agree” to Q18 asking if “staff were sensitive to my cultural background (race, religion, language, etc.)” | 86.9% | BH-9 Overview and Rates |
| BH-10. Perception of Care with Respect to One’s Cultural Background: DMC-ODS (PC-DMCODS) | UCLA ISP and SMHSA Measure: Percent of people who completed the Treatment Perception Survey in a 12-month period who responded with “strongly agree” or “agree” to Q7 asking if “staff were sensitive to my cultural background (race/ethnicity, religion, language, etc.)” | 90.4% | BH-10 Overview and Rates |
| BH-11. Perception of Care with Respect to One’s Cultural Background: Non-Specialty Mental Health Services (PC-NSMHS) | AHRQ Measure: Percent of people who completed the MCP Consumer Assessment of Healthcare Providers and Systems (CAHPS) Experience of Care & Health Outcomes (ECHO) BH Survey in a 12-month period who responded with “Yes” to Q27 asking “was the care you received responsive to [language, race, religion, ethnic background, culture] needs” | 80.27% | BH-11 Overview and Rates |
Improve Prevention and Treatment of Co-Occurring Physical Health Conditions Measures
| Measure Name | Description | Statewide Rate | Additional Rates and Information |
|---|---|---|---|
| PH-1. Adults’ Access to Preventive/Ambulatory Health Services: Significant Behavioral Health Needs (AAP-WSBH) | NCQA HEDIS Measure, calculated for people with significant behavioral health needs: Percent of adults 20 years of age and older enrolled in Medi-Cal and living with significant behavioral health needs who have one or more ambulatory or preventive care visits in a 12-month period | 82.11% | PH-1 Overview and Rates |
| PH-2. Child and Adolescent Well-Care Visits: Significant Behavioral Health Needs (WCV-WSBH) | NCQA HEDIS Measure, calculated for people with significant behavioral health needs: Percent of children and youth 3 to 21 years of age enrolled in Medi-Cal and living with significant behavioral health needs who have at least one comprehensive well-care visit in a 12-month period | 57.20% | PH-2 Overview and Rates |
| PH-3. Dental Visits for People with Significant Behavioral Health Needs (ADV-WSBH) | Novel DHCS Measure: Percent of members enrolled in Medi-Cal dental benefits and living with significant behavioral health needs who receive at least one dental visit in a 12-month period | 37.60% | PH-3 Overview and Rates |
Reduce Homelessness Measures
| Measure Name | Description | Statewide Rate | Additional Rates and Information |
|---|---|---|---|
| HO-1. Homelessness Among People with Significant Behavioral Health Needs (PEH-WSBH) | Novel DHCS Measure: Metric 1. Rate (per 10,000) of people enrolled in Medi-Cal and living with significant behavioral health needs who are identified as experiencing homelessness in a 12-month period based on available data compared with Metric 2. Rate (per 10,000) of all people enrolled in Medi-Cal who are identified as experiencing homelessness in a 12-month period based on available data | Metric 1 (members with significant BH needs): 988.67 Metric 2 (all members): 263.03 | HO-1 Overview and Rates |
| HO-2. Housing Services for People with Significant Behavioral Health Needs at Risk of Or Experiencing Homelessness (HOUSSRV-WSBH) | Novel DHCS Measure: Percent of people enrolled in Medi-Cal who are living with significant behavioral health needs and are identified as at risk of or experiencing homelessness in a 12-month period based on available data, who receive at least one Medi-Cal housing Community Support in a 12-month period | 27.09% | HO-2 Overview and Rates |
Reduce Institutionalization Measures
| Measure Name | Description | Statewide Rate | Additional Rates and Information |
|---|---|---|---|
| IN-4. Follow-Up After Hospitalization for Mental Illness — 7 Days (FUH) (FUH-7d) | NCQA HEDIS Measure: Percent of discharges for people 6 years of age and older enrolled in Medi-Cal who were hospitalized for a principal diagnosis of mental illness, or any diagnosis of intentional self-harm in a 12-month period, for which the person received a mental health follow-up service within 7 calendar days after the discharge | 44.12% | IN-4 Overview and Rates |
Reduce Justice-Involvement Measures
| Measure Name | Description | Statewide Rate | Additional Rates and Information |
|---|---|---|---|
| JI-3. Post-Release BH Services for Justice-Involved Reentry Enrollees with Significant BH Needs | Novel DHCS Measure: Percent of releases from a correctional facility in a 12-month period among Medi-Cal members 12 years of age and older with a significant behavioral health need enrolled in 90-day pre-release services through the California Advancing and Innovating Medi-Cal (CalAIM) Justice-Involved Reentry Initiative for which members received at least one core clinical service to address behavioral health within 14 calendar days of release | Not Eligible for Publication in 2026 | This measure was calculated in 2026, but did not meet publication criteria because the CalAIM Justice-Involved Reentry Initiative was not fully implemented in FY 2024-25 and the denominator size is too small for publication |
| JI-4. Continuation of Medications for Addiction Treatment (MAT) for Justice-Involved Reentry Enrollees | Novel DHCS Measure: Percent of releases from a correctional facility in a 12-month period among Medi-Cal members 16 years of age and older that received MAT for Opioid Use Disorder (OUD) or Alcohol Use Disorder (AUD) as part of their 90-day CalAIM Justice-Involved Reentry Initiative pre-release services for which members continued MAT within 30 calendar days of release | Not Eligible for Publication in 2026 | This measure was calculated in 2026, but did not meet publication criteria because the CalAIM Justice-Involved Reentry Initiative was not fully implemented in FY 2024-25 and the denominator size is too small for publication |
Reduce Overdoses Measures
| Measure Name | Description | Statewide Rate | Additional Rates and Information |
|---|---|---|---|
| OD-1. Deaths by Drug Overdose (ODDEATH) | Novel DHCS Measure: Age-adjusted rate (per 100,000) of people 10 years of age and older enrolled in Medi-Cal who die from an unintentional drug overdose during a 12-month period | 60.95 | OD-1 Overview and Rates |
| OD-2. Repeat ED Visit or Hospitalization for Drug Overdose (ODRPT) | Novel DHCS Measure: Rate (per 100,000) of people 10 years of age and older enrolled in Medi-Cal who had two or more unintentional drug-related overdoses resulting in treatment in an emergency department or hospital in a 12-month period | 16.84 | OD-2 Overview and Rates |
| OD-3. Recovery Incentives – Contingency Management (CM) | Novel DHCS Measure: Percent of Medi-Cal members 12 years of age and older living with a moderate or severe stimulant use disorder who receive CM in the Recovery Incentives Program in a 12-month period | 4.55% | OD-3 Overview and Rates |
| OD-4. Pharmacotherapy for Opioid Use Disorder (POD) | NCQA HEDIS Measures: Percentage of OUD pharmacotherapy events that lasted at least 180 days among people enrolled in Medi-Cal who are 16 years of age and older with a diagnosis of OUD and a new OUD pharmacotherapy event | For release later this year | For release later this year |
| OD-5. Follow-Up After High-Intensity Care for Substance Use Disorder — 7 Day (FUI-7d) | NCQA HEDIS Measures: Percent of acute inpatient hospitalizations, residential treatment, or withdrawal management visits for a diagnosis of substance use disorder in a 12-month period among people 13 years of age and older enrolled in Medi-Cal for which the person received follow-up within 7 days after the visit or discharge | 35.95% | OD-5 Overview and Rates |
Reduce Removal of Children From Home Measures
| Measure Name | Description | Statewide Rate | Additional Rates and Information |
|---|---|---|---|
| RC-1. Children and Youth in Foster Care (FC) | Novel DHCS Measure: Rate (per 10,000) of children and youth 0 to 20 years of age enrolled in Medi-Cal who are in foster care during a 12-month period | 116.47 | RC-1 Overview and Rates |
| RC-2. Specialty Behavioral Health Services for Children and Youth in Foster Care (FCSRV) | Novel DHCS Measure: Percent of children and youth in foster care 0 to 20 years of age and enrolled in Medi-Cal who receive at least three core clinical services to address behavioral health needs delivered by the specialty mental health system (SMHS) within a 12-month period | 41.05% | RC-2 Overview and Rates |
| RC-3. Behavioral Health Services for Parents, Guardians, and Pregnant People with Significant Behavioral Health Needs (PARSRV-WSBH) | Novel DHCS Measure: Percent of pregnant and postpartum people and parents or guardians 12 to 64 years of age who are enrolled in Medi-Cal and are living with significant behavioral health needs who receive at least one core clinical service for behavioral health in a 12-month period | 66.60% | RC-3 Overview and Rates |
Reduce Suicides Measures
| Measure Name | Description | Statewide Rate | Additional Rates and Information |
|---|---|---|---|
| SU-1. Deaths by Suicide (SUIDEATH) | Novel DHCS Measure: Age-adjusted rate (per 100,000) of people 10 years of age and older enrolled in Medi-Cal who died by suicide at any point in a 12-month period | 15.15 | SU-1 Overview and Rates |
| SU-2. Repeat ED Visit or Hospitalization for Self-Harm (SUIRPT) | Novel DHCS Measure: Rate (per 100,000) of people 10 years of age and older enrolled in Medi-Cal who had two or more self-harm or suicide attempts resulting in treatment in an emergency department or hospital in a 12-month period | 13.13 | SU-2 Overview and Rates |
Improve Engagement in School Measures
| Measure Name | Description | Statewide Rate | Additional Rates and Information |
|---|---|---|---|
| SL-4. Developmental Screening in the First Three Years of Life (DEV-CH) | OHSU and CMS Measure: Percent of children 1 to 3 years of age enrolled in Medi-Cal who are screened for risk of developmental, behavioral, and social delays using a standardized screening tool in the 12 months preceding or on their first, second, or third birthday | 50.63% | SL-4 Overview and Rates |
Equity Measures
| Measure Name | Description | Statewide Rate | Additional Rates and Information |
|---|---|---|---|
| EQ-1. Disparities in Behavioral Health Services for People with Mental Health Needs (EQ-BHSRV1-WMH) | Novel DHCS Measure: Metric 1. Percent of Native Hawaiian/Pacific Islander, Black, or Asian people enrolled in Medi-Cal and living with mental health needs who received one or more core clinical services to address behavioral health compared with Metric 2. Percent of people enrolled in Medi-Cal and living with mental health needs who received one or more core clinical services to address behavioral health | Total population: 65.93% Native Hawaiian or Pacific Islander: 58.33% Black of African American: 62.13% Asian: 62.07% | EQ-1 Overview and Rates |
| EQ-2. Disparities in Behavioral Health Services for People with Significant Mental Health Needs (EQ-BHSRV3-WSMH) | Novel DHCS Measure: Metric 1. Percent of Spanish-speaking people enrolled in Medi-Cal and living with significant mental health needs who received three or more core clinical services to address behavioral health compared with Metric 2. Percent of people enrolled in Medi-Cal and living with significant mental health needs who received three or more core clinical services to address behavioral health | Total population: 50.20% Spanish-Speaking: 46.93% | EQ-2 Overview and Rates |
| EQ-3. Disparities in Pharmacotherapy for Opioid Use Disorder (EQ-POD) | NCQA HEDIS Measure, stratified by race/ethnicity: Metric 1. Percentage of OUD pharmacotherapy events that lasted at least 180 days among people enrolled in Medi-Cal who are 16 years of age and older and are [racial/ethnic group to be determined later in 2026] with a diagnosis of OUD and a new OUD pharmacotherapy event compared with Metric 2. Percentage of OUD pharmacotherapy events that lasted at least 180 days among people enrolled in Medi-Cal who are 16 years of age and older with a diagnosis of OUD and a new OUD pharmacotherapy event | For release later this year | For release later this year |