Alameda County presents MHSA annual update as state Prop 1 shifts focus toward housing and higher‑acuity care

Alameda County health officials delivered the Mental Health Services Act (MHSA) annual update on June 10, outlining community engagement results, projected fiscal resources for 2024–25 and the county’s planning steps as state Proposition 1 (BHSA) changes take effect.

Tracy Hazleton, director of the county’s MHSA division, said the county conducted 36 listening sessions with 394 participants and expanded its public comment process and executive summary to make the plan easier to use. “We have done 36 listening sessions attended by 394 community members,” Hazleton said, noting the county had more public comment in Spanish than in previous years: “This is the first time in almost 20 years of working in MHSA that I have seen public comments come in Spanish.”

Hazleton presented fiscal estimates the county included in the plan: an estimated $163 million in unspent funds from prior years, a state allocation of approximately $96 million, a planned transfer of $14 million for workforce, capital facilities, technology and the prudent reserve, total available funding near $253 million and projected expenditures around $206 million that would leave an estimated carryover of about $46 million.

Hazleton said roughly $17 million of the carryover is already encumbered by two five‑year innovation plans focused on reentry services, including peer respite and recovery coaching. She also described performance metrics showing 83% of full‑service partnership clients received more than one type of staff visit within a two‑week period, above a 60% benchmark used in evidence‑based community treatment models.

Presenters warned the state’s adoption of Proposition 1 and the Behavioral Health Services Act (BHSA) will produce significant shifts in where funding is directed. “There is the significant and philosophical shift from prevention and early intervention to people who are most… severely mentally ill,” Dr. Tribble said, and the county will need to reconcile statutory requirements while ensuring community priorities are reflected in planning.

Supervisors pressed staff on timing and community impacts. Supervisor Tam underscored the need to begin transition planning early so prevention‑focused nonprofits have time to adapt; staff said planning commonly begins about a year in advance and that the county will aim to notify and coordinate with providers preemptively. Hazleton and Dr. Tribble also stressed that the county has decided that for fiscal year 2024–25 it will make no program reductions: “We are making no program changes… All of our contracts that we have are all intact,” Hazleton said.

County staff explained aspects of the housing bond tied to BHSA funding, noting an initial summer application window for treatment‑linked sites and later allocations for supportive housing. Treatment sites, they said, must integrate specialty mental health or substance use treatment with housing and cannot be solely preventive or respite services; examples cited included crisis residential programs, detox facilities and psychiatric treatment for children.

Officials acknowledged uncertainty in state guidance and the administrative challenges community‑based organizations face in applying for bond funds. Supervisors and staff discussed the need for partnerships or capacity building so community‑centered groups can compete for or partner on treatment‑site proposals.

The presentation concluded with staff commitments to continue community engagement, monitor state guidance and return to the full Board of Supervisors with a finalized MHSA annual plan and any recommendations for the board’s consideration. The Health Committee took no formal votes on this item.