Behavioral Health Services Act

A Transformation Journey
Prop. 1 brought together a vision for behavioral health transformation across the state and has been a catalyst for San Mateo County Behavioral Health and Recovery Services (BHRS) to kick off an exciting new journey, a strategic vision aimed at reshaping the way care is provided across behavioral health. With the changing behavioral health landscape driven by many new state laws and local needs,  BHRS aims to continue local priorities including our commitment to continuous improvement, equity and trauma-informed efforts, and serving the most vulnerable individuals living with substance use and mental health challenges. Read more about the BHRS Transformation Journey here: BHRS Director’s Newsletter.

Prop. 1 Transition Timeline

Locally, BHRS is taking significant steps to implement Prop. 1 requirements and the transition from Mental Health Services Act (MHSA) to the new Behavioral Health Services Act (BHSA) funding and services requirements.  BHSA goes live July 1, 2026!  

Following is information to provide an understanding of Prop. 1, the impacts to BHRS strategies and services, how you can get involved in the planning and what BHRS is doing as an organization to support the system-level changes. Click on each section below to learn more.

Questions? Please email MHSA@smcgov.org.

What Is Prop. 1?

Prop. 1 – Behavioral Health Services Act (BHSA) was approved by voters in March 2024 to reform the Mental Health Services Act (MHSA) and includes new service and funding requirements for county behavioral health systems. View this short BHSA Overview or learn more about the statewide vision by visiting the Department of Health Care Services site.

BHSA Planning and Funding Shifts

Counties are now required to develop a Three-Year Integrated Plan that consolidates all BHRS priorities, strategies, services and funding streams into a single, transparent plan. 

Additionally, BHSA millionaire’s tax funding is being re-allocated to maximize impact and ensure resources are directed towards the key priorities of Prop. 1. View the changes in funding allocation.

 

How Do I Get Involved?

To ensure a smooth transition to BHSA by the July, 1 2026 implementation deadline, we are actively engaging in organizational and system changes and gathering input from clients, family members, staff and community partners.  Join us and provide input on the transition to BHSA!

1. Join the BHSA Transition Taskforce for overall understanding.  See the flyer: English/Spanish/Chinese
   • April 3, June 5, August 7, October 2, 2025 (hybrid meetings)
     3:00 PM – 4:30 PM
     Redwood Shores Library, Meeting Rooms A/B
     399 Marine Pkwy, Redwood City
     Zoom: https://us02web.zoom.us/j/83635203327
     Dial in: +1 669 900 6833 / Mtg ID: 836 3520 3327
2. Join an Information Session deep dive on how Prop. 1 is impacting behavioral health services
3. Join a Community Input Session to provide your input on strategies moving forward

Meeting Materials and Presentations

BHSA Transition Taskforce:

• Meeting #1 (4/3/25): Agenda, Slides, Minutes
• Meeting #2 (6/5/25): Agenda, Slides, Minutes
• Meeting #3 (8/7/25): Agenda, Slides

The following presentation slide decks cover specific topic areas impacted by Prop. 1 – BHSA requirements: 

• Overview of Impacts to Services - Prop. 1 has wide-ranging impacts at the local level, driving changes and improvements across housing, early intervention, peer-based services, and the integration of substance use disorder (SUD) treatment and mental health. 
  • Prop. 1 Impacts to Services - 5/8 BHSA Transition Taskforce 
• Housing Interventions aim is to increase access to permanent supportive housing for individuals living with serious mental illness and/or substance use disorders, who are chronically homeless, experiencing homelessness, or are at risk of homelessness.
  • Housing Interventions Deep Dive - 7/10 Housing Operations and Policy (HOP) Committee
  • Permanent Supportive Housing - 5/23 Nonprofit Housing Association of Northern California
  • Transitional Rent Flex Pool - 6/12 BHSA Planning meeting
• Early Interventions goal is to identify and address behavioral health concerns in their early stages for high-risk individuals, before they escalate into more severe, disabling or chronic conditions. ​
  • Early Interventions Deep Dive - 6/18 Behavioral Health Commission Youth Committee
• Peer-Based Services value across the Behavioral Health Care Continuum of Care is re-enforced by Prop. 1 and funding allocations. ​
  • Peer-Based Service Deep Dive - 7/1 Lived Experience Education Workgroup
• Substance Use and Mental Health Integration is a priority under Prop. 1 that builds upon CalAIM to expand access to comprehensive care for individuals by developing co-occurring capacity and expanding BHSA funding to include substance use disorder treatment regardless of a primary mental health diagnosis.  
  • Substance Use and Mental Health Integration Deep Dive – 7/9 Behavioral Health Commission AOD Committee
• Outcome Reporting aims to increase accountability, standardization for reporting behavioral health service outcomes and creating data-informed approaches to performance management including continuous improvement.  
  • Outcome Reporting Deep Dive - 8/6 Behavioral Health Commission

What is BHRS Doing to Address the Impacts to Services?

Aside from facilitating comprehensive community input, BHRS has been  conducting comprehensive reviews with existing MHSA-funded programs and contracted providers to identify areas where alignment with BHSA requirements can be increased. 

Additionally, BHRS has identified internal leads to drive the implementation of the required changes. These leads have developed implementation plans noting key milestones and activities; a progress dashboard will be shared here in the near future.