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Approve the Behavioral Health Services Act Integrated Plan for FY2026/27 - FY2028/29 as required by Proposition 1; and Authorize the Director of Health and Social Services to make non-substantive, technical, or Department of Health Care Services-required revisions to the Integrated Plan, as necessary to ensure timely finalization and submission by the June 30, 2026 deadline
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Published Notice Required? Yes __X___ No __ __
Public Hearing Required? Yes __X___ No _____
DEPARTMENTAL RECOMMENDATION:
The Department of Health and Social Services (H&SS), Behavioral Health Division, recommends that the Board of Supervisors:
1. Approve the Behavioral Health Services Act Integrated Plan for FY2026/27 - FY2028/29 as required by Proposition 1; and
2. Authorize the Director of Health and Social Services to make non-substantive, technical, or Department of Health Care Services-required revisions to the Integrated Plan, as necessary to ensure timely finalization and submission by the June 30, 2026 deadline.
SUMMARY:
In March 2024, California voters passed Proposition 1, which modified the Mental Health Services Act of 2004 (MHSA). The Proposition, renamed the Behavioral Health Services Act (BHSA), prioritizes services for people with the most significant mental health needs while adding the treatment of substance use disorders (SUD), and substantially changing funding categories. The State expects that changes within the BHSA will enhance oversight, transparency, and accountability at the State and local levels.
Previously, MHSA required the Board of Supervisors to approve a Three-Year Plan. With BHSA, the plan still covers three years, but now uses the name to “Integrated Plan” instead of “Three-Year Plan” and requires a spending plan that describes how behavioral health will spend all available behavioral health funding, including BHSA, 1991 and 2011 Realignment, federal grant programs, federal financial participation from Medi-Cal, opioid settlement funds, and other local funds.
On March 31, 2026, the draft version of Solano County’s BHSA Integrated Plan (IP) for FY2026/27 - FY2028/29 was submitted to the Department of Health Care Services (DHCS) for review, with approval from the County Administrator. On April 10, 2026, the draft IP was posted online for a mandatory 30-day public review and comment period. A public hearing, held in partnership with the local Behavioral Health Advisory Board, occurred on May 19, 2026, to present and review the draft IP. Recommended changes provided by the DHCS following its review period, along with all public comments submitted in writing or offered during the public hearing, will be included as supporting documentation in the submission of the final version of the IP. Per DHCS policy, the Board of Supervisors’ approval of the final IP is required for submission by June 30, 2026.
FINANCIAL IMPACT:
The IP projects anticipated expenditures and revenues for BHSA-funded programs and services for a three-year period beginning July 1, 2026 and ending June 30, 2029. Projected expenditures and revenues for BHSA are $42,429,243 in FY2026/27; $48,696,505 in FY2027/28; and, $47,942,803 in FY2028/29. If estimates do not materialize as projected, H&SS will need to amend the IP through the required community and State approval process and report back to the Board through an Annual Update or Intermittent Update.
Appropriations for programs discussed in the IP are included in the Department’s FY2026/27 Requested Budget. There is no anticipated financial impact to the County General Fund.
DISCUSSION:
California’s implementation of Proposition 1 is part of a broader statewide initiative known as Behavioral Health Transformation (BHT). Through the Behavioral Health Services Act (BHSA), the State aims to strengthen accountability and transparency, expand access to behavioral health services, and increase behavioral health treatment and housing capacity across California. Solano County Behavioral Health, in partnership with community providers, stakeholders, and system partners, leads local BHSA implementation to support a coordinated, responsive, and sustainable behavioral health system.
One major policy change associated with Proposition 1 is the shift in county funding requirements for BHSA. Instead of the five funding streams historically allowed under MHSA, BHSA requires that counties align their BHSA-funded programs and strategies to fit within three funding allocation thresholds: 35% Full-Service Partnership programs (FSP), 35% Behavioral Health Services and Supports (BHSS), and 30% Housing Interventions (HI). The BHSS and HI funding components each have additional sub-allocation requirements. At least 51% of BHSS funds must prioritize early intervention programs and services, of which 51% must serve individuals ages 25 and younger. For Housing Interventions (HI), at least 50% of these funds must focus on people experiencing chronic homelessness, and the county may allocate up to 25% towards capital development housing projects.
BHSA also significantly expands the list of stakeholder groups that counties must engage during the community planning process. The H&SS Behavioral Health Division worked in conjunction with the Public Health Division and Solano County’s managed care plan providers to gather community feedback. From August 2025 to November 2025, 65 people attended in-person and virtual events. Participants were informed about the BHSA changes and given opportunities to provide input on behavioral health priorities and needs. Feedback was also gathered through a community health needs assessment survey, a joint effort between the H&SS Public Health and Behavioral Health divisions, that successfully reached over 350 respondents.
The BHT takes a population health approach to align and set expectations for behavioral health systems of care across the state. In line with this approach, H&SS Behavioral Health Division conducted a comprehensive review of state-provided primary and secondary quality and performance measures related to six statewide population health categories (Access to Care, Homelessness, Institutionalization, Justice-Involvement, Removal of Children from Home, and Untreated Behavioral Health Conditions). The BHSA Integrated Plan highlights Solano County’s health disparities in these areas and outlines strategies planned to address them locally over the next three fiscal years.
Findings from the comprehensive review of local data revealed that, compared to statewide averages, Solano County had lower specialty mental health and substance use disorder penetration rates, meaning a lower percentage of Medi-Cal eligible individuals accessed county specialty behavioral health treatment services than expected under Department of Health Care Services (DHCS) benchmarks. The analysis also identified higher rates of involuntary detention and institutional utilization, disparities in homelessness and child welfare involvement, elevated justice system involvement, and suicide-related disparities. Community feedback received during the community planning process, together with local suicide and self-harm data, further reinforced the need to prioritize suicide prevention and reduction as a key behavioral health goal.
In response to these findings, the BHSA IP outlines a broad range of strategies focused on early intervention, treatment, housing, crisis response, and system coordination to reduce disparities and improve outcomes. Planned efforts include expanding culturally and linguistically responsive outreach, peer support, and early intervention services; strengthening referral pathways and coordination with Medi-Cal managed care plans, Child Welfare, Probation, juvenile justice systems, hospitals, and community-based organizations; advancing psychiatric advance directives; and expanding supportive housing capacity to reduce reliance on institutional placements.
Proposition 1 also included authorization of a statewide behavioral health infrastructure bond to expand treatment and housing capacity across California. A portion of these voter-approved bond funds supports the Behavioral Health Continuum Infrastructure Program (BHCIP), which provides competitive grant funding to counties and behavioral health providers for community-based behavioral health infrastructure projects.
To support this work locally, H&SS Behavioral Health was recently awarded approximately $37 million through BHCIP to expand Solano County’s continuum of community-based behavioral health care. These funds will support expansion of the County’s Crisis Stabilization Unit and development of new peer respite and sobering center services, further strengthening access to less restrictive, community-based treatment options consistent with the goals of Behavioral Health Transformation.
H&SS Behavioral Health will continue seeking opportunities to strengthen data collection, performance measurement, and continuous quality improvement efforts to ensure services remain responsive to evolving community needs.
ALTERNATIVES:
The Board may choose not to adopt the BHSA IP for FY2026/27 through FY2028/29. This is not recommended as the IP has been developed in accordance with the provisions of the BHSA as required by Proposition 1, including significant community input and a public hearing with the local Behavioral Health Advisory Board. Not approving the new BHSA IP would result in failing to meet State mandates and could put BHSA funds at risk.
OTHER AGENCY INVOLVEMENT:
The BHSA IP was developed in collaboration with community partners, which included service recipients, 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