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Approve the Mental Health Services Act Annual Update for FY2024/25 including a review of services rendered in FY2023/24
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Published Notice Required? Yes _____ No _X___
Public Hearing Required? Yes _____ No __X__
DEPARTMENTAL RECOMMENDATION:
The Department of Health and Social Services (H&SS) recommends that the Board of Supervisors approve the Mental Health Services Act (MHSA) Annual Update for FY2024/25 including a review of services rendered in FY2023/24.
SUMMARY:
In November 2004, California voters passed Proposition 63, which imposes a one percent income tax on personal income in excess of $1 million to provide funding to support county mental health programs through five funding streams: Prevention and Early Intervention (PEI), Community Services and Supports (CSS), Innovation (INN), Workforce Education and Training (WET), and Capital Facilities and Technological Needs (CF/TN). Using this funding, MHSA programs address a broad continuum of prevention, early intervention, and direct services, along with the necessary infrastructure, technology, and training elements to effectively support the mental health system. Counties administer MHSA programs and are required to create and implement, with the local community input, three-year integrated plans.
On September 12, 2023, the Board approved the MHSA Three-Year Plan FY2023-2026, which covers FY2023/24, FY2024/25, and FY2025/26. On May 23, 2025, the FY2024/25 Annual Update (Attachment A) was posted online for a mandatory 30-day public review and comment period, and a public hearing was held on June 17, 2025, in partnership with the local Behavioral Health Advisory Board.
In March 2024, voters approved Proposition 1, which makes significant revisions to the Mental Health Services Act and renamed the Mental Health Services Act (MHSA) to the Behavioral Health Services Act (BHSA). Proposition 1 stated objective is to improve access to behavioral health services and expand services to include substance use disorder treatment. The planning process for full implementation of Proposition 1 began in January 2025 and implementation will begin July 1, 2026.
FINANCIAL IMPACT:
All programs and services described in the Annual Update of the Three-Year Integrated Plan are primarily funded with MHSA revenue and revenues generated through Medi-Cal billing. The FY2024/25 MHSA program budget is $43,806,635, of which $35,051,543 is funded with MHSA revenue. The remaining expenditures in the amount of $8,755,092 are funded through federal and State Short-Doyle Medi-Cal revenues, other third-party payors, and County General Fund. There is no additional impact to County General Fund.
DISCUSSION:
The MHSA Three-Year Plan for Fiscal Years 2023/24 through FY2025/26 and the current Annual Update outline a continuum of care which is comprised of prevention, early intervention, intensive treatment, and recovery services, as well as targeted strategies to improve the system, to reduce disparities and to develop and train the workforce. The MHSA Plan outlines a system of care across five components:
Prevention & Early Intervention (PEI): Early intervention and anti-stigma programs for all ages, particularly youth under 25.
Community Services & Supports (CSS): Intensive services for individuals with serious mental illness, with 51% funding dedicated to Full Service Partnership programs.
Innovation (INN): Community-identified pilot projects to improve access and outcomes. Solano currently has no active INN projects.
Workforce Education & Training (WET): Training for behavioral health professionals and peer workforce development.
Capital Facilities and Technological Needs (CF/TN): Facility and technology infrastructure. Though unfunded by the State since 2014, counties may reallocate CSS funds to this component.
Effective July 1, 2026, PEI, CSS, INN, WET, AND CF/TN funding components will be replaced by the following BHSA components: Housing Interventions, Full Service Partnership Programming, and Behavioral Health Services and Supports.
Under these BHSA components, counties will implement a new Three-Year Plan (FY2026/27-FY2028/29). The H&SS Behavioral Health Division will continue engaging stakeholders, monitoring fiscal impacts, and adjusting services as needed.
ALTERNATIVES:
The Board may choose not to approve the annual MHSA update. This is not recommended as the Annual Update has been developed in accordance with the provisions of the MHSA, including community input and the involvement of the Behavioral Health Advisory Board. Not approving the update would make the County non-compliant with MHSA requirements.
OTHER AGENCY INVOLVEMENT:
The MHSA Annual Update was developed in collaboration with community partners, which include consumers, family members, county and community-based providers, law enforcement, local educational agencies, veterans, faith-based organizations, and the local Behavioral Health Advisory Board.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION