Skip to main content Skip to site navigation
San Mateo County Health
Helping everyone in San Mateo County live longer & better lives.
Menu
Search

Behavioral Health Services Act

Overview

Prop. 1 – Behavioral Health Services Act (BHSA) Transition

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. Learn more here: BHRS Transformation Journey Roadmap Overview

BHSA goes live July 1, 2026!  

Questions? Please email MHSA@smcgov.org.

    Three-Year Integrated Plan Now Available!

      The BHSA Integrated Plan will be presented at the Behavioral Health Commission and open for 30-day public comment.  Details below: 

      Behavioral Health Commission
      Wednesday, February 4th 3:30-5:30pm
      2000 Alameda de las Pulgas, Room 201
      San Mateo, CA 94403
      Zoom link: https://smcgov.zoom.us/j/94275521280?pwd=ZnRUTDFSMGI5VVVPTkdiS3NaZW9MQT09
      Passcode: 457259

      How to Give Public Comment
      Quick Tips – How to Give Public Comment at a public meeting
      Online Form 
      Email to mhsa@smcgov.org
      Leave a phone message at (650) 573-2889

          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.

          Community Program Planning (CPP) Materials

          Input from clients, family members, staff and community partners was gathered through various sessions.

          1. BHSA Transition Taskforce.  See the flyer: English/Spanish/Chinese
          2. Information Session deep dives on how Prop. 1 is impacting behavioral health services
          3. Community Input Session to provide input on strategies moving forward

          BHSA Transition Taskforce:

          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. /
          • 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.
          • 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. ​
          • Peer-Based Services value across the Behavioral Health Care Continuum of Care is re-enforced by Prop. 1 and funding allocations. ​
          • 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.  
          • Outcome Reporting aims to increase accountability, standardization for reporting behavioral health service outcomes and creating data-informed approaches to performance management including continuous improvement.  

          Impacts to Programs and Services

          Prevention programs impacted by Prop 1/BHSA

          Proposition 1/BHSA shifts the responsibility of delivering population-based prevention programs to the State. In Spring 2025, BHRS notified all contracted providers of prevention programs that will be impacted by Prop 1 that their BHRS contract will sunet prior to start of Prop 1/BHSA on July 1, 2026. List of programs and services to be closed

          What is BHRS doing to address the impacts of Prop 1?

          Aside from facilitating comprehensive community input, BHRS identified internal leads to drive the implementation of the required changes. These leads have developed implementation plans noting key milestones and activities.

          BHRS has identified 11 areas of focus that require additional effort to prepare for Prop 1/BHSA. The following dashboard displays the progress being made on the milestones associated with each area of focus.

          Legend Not started In progress, on track Experiencing barriers, not on track Complete

           

          Areas of Focus Implementation Plans Milestone 1 Milestone 2 Milestone 3 Milestone 4 Milestone 5
          CPP & 3-Year Integrated Plan Taskforce engagement 10/2/25 Align BHRS & state goals 6/30/26 Use local data to inform planning decisions 10/2/25 Submit Draft 3Yr Integrated Plan 3/31/26 Submit Final 3Yr Integrated Plan 6/30/26
          Early Intervention (EI) Identify aligned EI programs 1/30/26 Add EI reqs. to existing programs 2/28/26      
          Evidence-Based Practices (EBP) Address BH-Connect & FSP EBP needs 6/30/26        
          Fiscal Strategies Create BHSA trust fund & subaccounts 1/31/26 Develop 3 Yr Expenditure Plan 6/30/26  Implement New Tracking for BHOATR 6/30/27 Funding strategies for new BHSA reqs 11/30/26 Develop procurement timeline for BHSA reqs 10/31/25
          Full-Service Partnerships (FSP) Define tier-based model & standard services 12/31/25 Expand MH/SUD co-occurring capacity 6/30/25 Define housing interventions for FSPs 2/28/26 Align FSP with BH-Connect Requirements 12/31/27 Maximize MediCal billing 6/30/26
          Housing Co-create MCP Transitional Housing for SMI/SUD 6/30/26        
          Outcome Reporting Integrate pop-level BH data into CPP 12/31/25 Improve process for integrating pop-level data 6/30/26 Establish performance mgmt system 6/30/27    
          Peer Support Services Standardize role of peers across BHRS 12/31/25 Increase # of certified peers 12/31/25 Develop co-occuring capcity for peers 6/30/26 Expand billable peer services 1/31/26 Identify non-MediCal peer services funding 6/30/26
          Prevention Co-develop CHIP MH Workgroup Action Plan 6/30/25 Develop framework & Communication Visual 12/31/26 Strengthen CBO/Community Engagement 6/30/26 Align with other CHIP Workgroups 12/31/26 Identify funding opportunities for CHIP 6/30/27
          SU/MH Integration Define SU/MH Integration for BHRS Spring 2027 Define process for increasing SUD access 12/31/26 Add assertive field-based SUD services to FSPs (TBD) Maximize billing for co-occuring services 6/30/26 Include SUD services in 3Yr IP    6/30/26
          Workforce Development Bolster staffing for WET activities 1/30/26 Conduct workforce needs assessment 6/30/26 Launch recruitment/ retention strategies (ongoing) Increase trainings & TA providers (ongoing) Increase BH career opportunities (ongoing)