Governor Proposes Mental Health Bond and Changes to the Mental Health Services Act

More details have been released regarding the Administration’s plans to modernize the Mental Health Services Act (MHSA) and to seek bond funding to support behavioral health treatment capacity. The Administration is planning for a November 2024 ballot measure that will include three primary elements:
Address the current shortage of nearly 6,000 behavioral health treatment beds through a$3 to $5 billion general obligation bond to fund behavioral health care expansion in distinct community residential settings: 

  • Multi-property: unlocked and community-based, campus-like settings with robust onsite supportive services. 
  • Cottage style: smaller residential settings with access to existing community benefits and services. 
  • Home-like: Permanent Supporting Housing and Scattered Site Housing, which would include home-like or single units to integrate individuals into the community and offer long-term housing stability. 
  • Veterans: Some unspecified portion of the bond funds would be used to address housing for homeless veterans. 

Propose reforms to the Mental Health Services Act (MHSA) of 2004 to: 

  • Redirect up to 30 percent annually to pay for housing and other community-based residential solutions and serve as an ongoing source of funding for new and existing housing and residential settings, with a focus on homeless individuals. 
  • Recast local categorical funding buckets and focus 35% of funding on Full-Service Partnerships and other services for the most seriously ill. 
  • Require counties to bill Medi-Cal first, prior to MHSA, for reimbursable services. 
  • Expand target population to include those with substance use disorders. 
  • Make various changes to county accountability and overall transparency, including (1) paring back the Three-Year County Plan, (2) reducing the “prudent reserve” (from 33% to 20% for large counties and 25% for small counties), and (3) moving the Mental Health Services Oversight Act Oversight and Accountability Commission (MHSAOAC) under CalHHS. 

Seek reforms to stabilize and strengthen core behavioral health systems

  • Align behavioral health benefits across all health plans. 
  • Increase accountability for services provided and outcomes achieved through increased reporting by county behavioral health plans. 

The proposals are still in development, and the Administration will be seeking input on how various mechanisms are structured. 

Learn More:

  • CalHHS Website: More information about the Administration’s policy objectives
  • Policy Brief: Understanding California’s Recent Behavioral Health Reform Efforts
  • Fact Sheet: Modernizing Our Behavioral Health System

Another interesting development on this front? State wants Medicaid to cover 6 months of rent.

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