State outlines 988 crisis continuum plan, flags gaps in mobile response and warmline funding

Cal HHS officials gave commissioners a wide-ranging briefing on California's crisis care continuum, saying the 988 lifeline has become an important entry point but that the state must shore up mobile crisis teams, warmlines and post-crisis services to make it work reliably.

"We've introduced 988 in the past three years," said Dr. Buouie, Cal HHS's presenter to the commission, describing the state's 988 implementation and the agency's five-year plan under the Miles Hall Lifeline and Suicide Prevention Act. "Most calls are resolved during the contact — about 95 to 98 percent — but we still need to connect the small share of people who need mobile response or a safe place for help."

The presentation described the architecture of the crisis continuum: statewide 988 centers (California has 11), county hotlines, mobile crisis teams, crisis receiving and stabilization facilities, and post-crisis step-down care such as peer respites and short-term residential programs. Cal HHS staff said the administration invested roughly $30 million in the current fiscal year to support 988 centers and that MHWA (the Mental Health Wellness Act) provides the commission roughly $20 million per year in grant funding to invest in crisis-related services.

Why it matters: Commissioners will soon help set priorities for the commission's next MHWA funding cycle (for awards that begin in July 2027). Dr. Buouie told the Commission the state's five-year plan includes 16 recommendations and 65 potential implementation activities, and that planning and community engagement are ongoing.

Key details from the briefing: - 988 routing has been implemented with geographic routing for most major cellular carriers, but smaller carriers and rural areas face more difficulty with precise geo-routing; California centers have built in-state backups and some calls still roll to national backup centers when local centers cannot answer within target time frames. - Cal HHS cited an in-call resolution rate it described as roughly 95'98 percent for 988 contacts, with about 2— percent of contacts routed onward to community mobile crisis response and under 1 percent referred to 911 for emergency dispatch. - AB988 (the Miles Hall Lifeline and Suicide Prevention Act) established an 8-cent-per-line monthly fee that supports the 988 fund and created advisory groups and reporting requirements; Vibrant Emotional Health is the national administrator that helps route calls.

Commissioners and providers pressed for specifics. Sheriff and Commissioner Brown of Santa Barbara County said clinicians paired with law enforcement in co-responder teams are being denied medical reimbursement in some counties, a situation he called "an injustice" and asked state staff to escalate to the Department of Health Care Services. "Our clinicians don't want to be in a program that doesn't include this," he said; Dr. Buouie said she would take the question to DHCS for follow-up.

Multiple commissioners and community members described local examples where 988 connected to an out-of-county center or where mobile teams were temporarily unavailable. Public commenters and several commissioners also warned that cuts to peer-operated warmlines and prevention programs have eroded on-the-ground capacity in some regions; Laurel Ben Hameda of Mass Social Services Foundation told the commission that peer-run warmlines are "trusted community partners" and urged the body to include warmline funding in its planning.

What's next: Cal HHS said it expects to publish a progress report by the end of the fiscal year and reconvened policy advisory meetings in April; commission staff said they will use the briefing and community input to help shape MHWA priorities and aim to produce procurement plans for awards by July 1, 2027.

The commission asked staff to return with clearer options for using MHWA funds to strengthen 988 center capacity, mobile crisis teams, and community-based warmline and peer respite services.