County seeks to sustain Mental Health Services Act programs as state reforms shift funding to new Behavioral Health Services Act

San Diego County staff presented the Mental Health Services Act (MHSA) annual update for fiscal year 2025–26 and requested the board’s authority to submit the plan to the state. The Board voted to approve the submission.

County behavioral health leaders described MHSA as a major funding source for specialty behavioral health services (about one quarter of behavioral health revenues locally) and said MHSA investments helped an estimated 66,000 people during fiscal year 2023–24. Staff presented a recommended MHSA budget for 2025–26 — roughly $303 million — and outlined planned program enhancements across the MHSA components: Community Services and Supports (CSS), Prevention and Early Intervention (PEI), Workforce Education and Training (WET), and Innovation.

Key proposed investments include funding for two crisis stabilization units (CSUs), expanded Assertive Community Treatment teams and assisted outpatient treatment supports, medication clinics for youth transitioning from juvenile settings, and school‑based full service partnerships for children and youth. Staff also proposed expanding housing supports and short‑term rental assistance for clients enrolled in intensive case management programs.

On prevention and early intervention, staff recommended enhanced community outreach and a new youth engagement ambassador program to support a youth‑focused campaign. Workforce initiatives include an “Elevate” behavioral health workforce fund — a five‑year, $75 million innovation investment to support training, tuition reimbursement, certifications and incentives designed to recruit and retain around 2,500 public behavioral health workers over five years.

Transition to BHSA: Staff said implementation of the state’s new Behavioral Health Services Act (BHSA), effective July 1, 2026, will shift some prevention and administration responsibilities to the state and change the MHSA funding mix and components. Under BHSA, counties will have different component percentages (e.g., full service partnerships, behavioral health supports, housing interventions), and staff warned that the county may not be able to sustain certain existing MHSA programs as funding flows and eligibility change. Staff committed to continued stakeholder engagement and to pursuing alternative funding where possible.

The board approved the annual update and authorized submission to the state. Supervisors and staff emphasized the county’s ongoing efforts to protect core services while preparing for the BHSA transition.