Health Services director flags steep behavioral‑health funding shifts, Measure O constraints and service risks

Sonoma County’s new Health Services director, Nolan Sullivan, used his first budget workshop presentation to lay out a complex operating picture: behavioral health is the department’s largest cost driver, state and federal funding provide more than 40% of the agency’s revenue, Measure O currently funds dozens of local positions and programs, and major state policy changes and uncertain federal priorities could produce substantial short‑term revenue shifts.

Sullivan told supervisors Health Services’ operating expenditures were about $346 million in the department’s internal operating account, and the department’s total budget (including transfers and reimbursements) is roughly $545 million. Behavioral health accounts for more than half of the department’s operating budget and is growing fastest because of demand for mental‑health and substance‑use services.

Key policy and funding concerns - Prop 1 conversion (MHSA → Behavioral Health Services Act, BHSA): Sullivan said the statewide…