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Behavioral Health Department outlines $770M budget and warns MHSA-to-BHSA shift could cut prevention funding by about $26M
Summary
Alameda County's Behavioral Health director presented a $770 million departmental snapshot and said state shifts from MHSA to BHSA would reorient funding toward housing and high-need services, potentially reducing local prevention dollars by about $26 million; Care Court and EHR/EPIC implementation were also highlighted.
Alameda County's Behavioral Health Department presented a sweeping overview March 10 of its organization, priorities and the near-term fiscal implications of state policy changes.
Dr. Bridal, who addressed the Health Committee, said the department is operating on roughly $770,000,000 in budgetary resources this fiscal year and relies heavily on community-based organizations (CBOs) and contracted providers. He described five systems of care (adult/older adult, child/young adult, substance-use continuum, crisis services and a forensic diversion/reentry system) and highlighted recent expansions such as an Eastmont Wellness Center dental and ophthalmology increase.
On the state policy front, Dr. Bridal emphasized that the transition from the Mental Health Services Act (MHSA) to the Behavioral Health Services Act (BHSA) will change how prevention and early-intervention dollars are allocated statewide. "Specifically for BHA'to shift from MHSA to BHSA, it will mean a $50,000,000 approximately," he said, and later quantified the local impact: "about $26,000,000 in prevention dollars" will be affected in Alameda County. He warned this reorientation will tilt funds toward housing supports and high-need full-service partnerships and could reduce resources for upstream prevention programs unless the county fills some gaps.
Dr. Bridal highlighted other major initiatives: continued rollout of CalAIM implementation, participation in the Care Court program (Alameda County was an early adopter and the state has requested site visits to study the county's results), an EHR modernization plan with Epic for improved billing and coordination, and ongoing work on forensic services redesign and SB43 implementation (changes to psychiatric hold procedures for adults effective Jan. 1, 2026).
Committee members asked whether Measure W or other county resources could be directed to preserve prevention efforts that BHSA will not fund; Dr. Bridal said the department is mapping programs to state eligibility and will bring more specific budget requests or options forward as part of the county budget process. He also noted the department will host listening sessions for CBOs and stakeholders as the state transitions funding structures.
The presentation included operational details: the department contracts with roughly 300'500 CBOs and 4,000'6,000 individual providers depending on program year, and about 65% of the Behavioral Health budget flows through partner organizations. Dr. Bridal said the department is preparing external quality reviews and state accountability reporting tied to access, quality and outcomes.
Supervisors requested follow-up materials on forensic services financing, hiring status, and the location/use of treatment capacity related to jails and reentry services; staff agreed to return with those details.
The committee did not take formal action on funding at the meeting.
