PASSAGE OF PROPOSITION 1 PAVES WAY FOR FURTHER BEHAVIORAL HEALTH TRANSFORMATION IN CALIFORNIA
SACRAMENTO — California is taking another step forward in Governor Gavin Newsom's effort to modernize and transform the state's behavioral health care system. Behavioral Health Transformation will help improve accountability, increase transparency, and expand the capacity of behavioral health care facilities across California.
“This is a historic moment for Californians and our behavioral health care system," said Department of Health Care Services (DHCS) Director Michelle Baass. “The state is taking steps to ensure everyone has equitable access to the care they need, regardless of their background or location. This work brings greater transparency to behavioral health care, allowing Californians to see how their state and local governments are working to ensure people can thrive in their communities."
“Housing is the most basic foundation every human being needs to achieve and maintain stability in life," said California Department of Housing and Community Development Director Gustavo Velasquez. “This is especially true for people with mental health challenges who need regular, consistent access to health care providers or counselors. The passage of Proposition 1 will allow California to expand on the successes achieved by programs like Homekey that give our most vulnerable residents that foundation, directly connected to the critical supportive services that can help us make homelessness rare, short-lived, and non-recurring."
WHY THIS MATTERS: The passage of Proposition 1 evolves the Mental Health Services Act into the Behavioral Health Services Act and allocates funding to provide services to those with, or at risk of, the most serious mental health conditions and substance use disorders, including people experiencing homelessness, at risk of incarceration, re-entering the community from a justice-involved setting, at risk of conservatorship, in foster care, and/or at risk of institutionalization.
The Behavioral Health Services Act will update Mental Health Services Act funding allocations by increasing available funding for housing interventions and workforce investments, continuing local flexibility to use resources to address local needs, and strengthening county oversight and fiscal accountability.
The passage of this initiative also includes up to $6.4 billion in bonds to build 11,150 new behavioral health treatment beds and supportive housing, as well as outpatient capacity to help serve tens of thousands of people annually – from intensive services for people experiencing homelessness who also have severe mental illness, to counseling for children with depression, and everyone in between.
WHAT COMES NEXT: DHCS will begin developing policy and guidance to support counties in fulfilling the statutory requirements in the initiative. Guidance will be released in phases to allow counties adequate time to leverage the policy for local administration. DHCS aims to bring behavioral health funding streams into alignment and break down silos to improve the delivery of services to Californians who need this life-saving behavioral health care. There will be opportunities for stakeholder engagement throughout the policy development process to guide the most effective use of this vital funding.
Visit the Behavioral Health Transformation webpage for additional information on when listening sessions will be held. Additional feedback may also be shared by emailing BHTinfo@dhcs.ca.gov.
The Behavioral Health Continuum Infrastructure Program (BHCIP) will be the program to distribute the roughly $4 billion in bond funds for which DHCS is responsible. This current initiative is a successful model for distributing hundreds of millions of dollars in the behavioral health infrastructure space.
DHCS will work to release the first Request for Applications for the Behavioral Health Bond in fall 2024.
For more information about BCHIP, please see the BHCIP website.
HOW WE GOT HERE: Despite the tremendous investments of the Mental Health Services Act, significant challenges remain, and new needs have surfaced that either did not exist or were under-realized. Behavioral health challenges are among the most common health conditions faced by Californians, and rates of mental illness and substance use disorders continue to grow while access to care cannot keep pace. Meeting the growing demand for behavioral health care and housing has strained our infrastructure, and the weight of this crisis is not carried equally. Communities of color, people involved with the justice system, and those who are LGBTQ+ carry the heaviest burden. Older adults and children and youth are also facing significant behavioral health challenges.
The passage of Proposition 1 will address remaining gaps in the continuum of care for the most vulnerable Californians, including new funding for housing, community-based residential care settings, and the behavioral health workforce, refining the Mental Health Services Act to better leverage our dollars and meet the needs of those with the most severe mental health and/or debilitating substance use conditions, and strengthening county accountability and statewide access to behavioral health services.
BIGGER PICTURE: Proposition 1 builds upon Governor Newsom's unprecedented Mental Health Movement that is increasing access to mental health care for all, whether insured through Medi-Cal or private insurance; providing treatment and housing to those in crisis and with serious mental illnesses; supporting and serving kids and young adults; and building our health care workforce. California has invested more than $10 billion in resources to strengthen the continuum of community-based care options for Californians living with the most significant mental health conditions and substance use disorders. These programs and proposals complement California's other major behavioral health initiatives, including, but not limited to, the California Advancing and Innovating Medi-Cal (CalAIM) initiative, California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Demonstration proposal, Children and Youth Behavioral Health Initiative (CYBHI), Medi-Cal Mobile Crisis and 988 expansion, and BHCIP.