MHSA
The MHSA was passed by California voters in 2004 and funded by a one percent income tax on personal income in excess of $1 million per year. It was designed to expand and transform California's behavioral health system to better serve individuals with, and at risk of, serious mental health issues, and their families. MHSA addressed a broad continuum of prevention, early intervention, and service needs and the necessary staff training, technology, and resources that make these services possible.
BHSA / Proposition 1
The Behavioral Health Services Act (BHSA) of 2024 replaces MHSA, effective July 1, 2026. 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, and increasing the behavioral health workforce. BHSA guides counties to look at their whole behavioral health systems of care in their community planning process. It also improves oversight, transparency, and accountability at the state and local levels. Additionally, the Behavioral Health Services make care more fair and accessible by promoting equity and reducing gaps in services for people with behavioral health needs.
California Department of Health Care Services (DHCS) has given counties a Behavioral Health Services Act Policy Manual to serve as regulations. This document will be continually updated with changes implemented by DHCS.
BHSA was the first part of Proposition 1. The second part, the Behavioral Health Bond, authorizes $6.4 billion in bonds to finance behavioral health treatment beds, supportive housing, community sites, and funding for housing veterans with behavioral health needs.
Reporting and Integrated Plans
Instead of creating separate plans, BHS will build one Integrated Plan to report on all BHS programming and expenditures for three year periods, with updates at least annually. These Integrated Plans and the Annual Updates to these plans will be created with community input, including a 30-day posting and public comment period for draft plans and updates and permanent posting of approved plans and updates on the BHS Reports & Workplans page. These plans and updates will be reviewed by our Sacramento County Board of Supervisors, by the California Department of Health Care Services (DHCS), and by the Behavioral Health Commission. BHSA further requires that DHCS shall establish requirements for the content of these plans/updates.
Using the expanded reporting requirements, BHS will define specific outcomes and reporting on progress. This will allow a view of what is working, opportunities to make adjustments, and will strengthen community trust by showing that public dollars are being used thoughtfully.
Community Planning Process
Sacramento County's BHSA Community Planning Process includes enhanced community engagement efforts intended to bring together a broad range of voices to provide input on mental health and substance use services, policies, program planning, implementation, budget allocation, and others.
Counties are required to engage with specific community partner groups as part of their Community Planning Process. Read the Stakeholder Involvement section in the Behavioral Health Services Act County Policy Manual for more details.
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