Alameda County health committee advances BHSA plan and seeks Measure W bridge to shore up prevention programs

Alameda County's Health Committee advanced the county's draft three-year Behavioral Health Services Act (BHSA) integrated plan on May 11 and asked staff to pursue a one-year bridge to restore funding cut under the new law.

Dr. Karen Tribble, Alameda County's Behavioral Health director, told the committee the state's plan template contains a calculation error that doubled reported carryover in some cells and is likely to reduce the county's usable carryover by about $20 million to $25 million. Tribble said counties must resubmit corrected templates to the state soon and that staff will return with revised numbers after the state's correction.

Why it matters: Under Proposition 1 (the BHSA), funding and eligibility rules shift heavily toward services for people with severe mental illness and for housing interventions. That change removes many prevention and early-intervention programs from the locally fundable categories; county staff said the change will affect thousands of beneficiaries and risk destabilizing community-based providers who do outreach, suicide-prevention training and culturally tailored prevention programs.

Vanessa Baker, deputy director and plan administrator, described the integrated plan structure and the new funding buckets: the state will take 10% for administration, then counties must allocate 30% of remaining funds to housing interventions, 35% to full-service partnerships and 35% to discretionary behavioral health services and supports, with additional subrequirements for youth and early intervention.

Tracy Hazleton, director of the county's BHSA division, told the committee staff had identified about $52.7 million in program reductions tied to the transition and about $32 million in internal solutions; the department's working target is to restore roughly $35 million through a combination of departmental reallocations and Measure W. That leaves a remaining gap the county now expects to address with additional county funding authority.

Public pleas and risks: More than 100 people submitted formal comments during the plan's comment period; dozens of speakers at the meeting described immediate programmatic impacts. Providers and community groups urged the board to preserve Underserved Ethnic Language Population (UELP) prevention programs, warning that programs that reduce suicide risk, provide culturally specific outreach, and keep people connected to services could end as early as next month without bridge funding. Sarah Kim of Scribe Support Services said two evidence-based post-hospital suicide follow-up programs would end without funding.

Staff'recommended approach and legal constraints: County officials said some local solutions are possible, but that BHSA rules limit how MHSA-era carryover can be used under the new framework. Staff warned that shifting MHSA carryover from later years into year 1 to cover immediate prevention needs would require resubmitting and rebalancing the county's three-year plan to the state and could force new cuts in years two and three unless the county identifies other replacement revenues.

Board action: The committee voted to forward the BHSA integrated plan to the full Board and directed county staff to develop a bridge funding package that could restore reductions for impacted providers. The committee specifically asked staff to pursue up to $17 million from Measure W (and other county sources as appropriate) to stabilize providers for one year, and directed staff to return with a detailed list of providers and funding mechanics at a special Board meeting set for May 19. Supervisors Tam and Miley voted Aye.

Next steps: County staff must submit corrected plan templates to the state by the state's revised deadline and will present a proposed Measure W funding package and implementation options to the Board next week. Staff said the bridge funding, if approved, would be one-time for fiscal year 2026'27 and that off-ramp plans would be required of recipients by Dec. 2026 so the county and providers can plan for longer-term sustainability.

Key quotes from the meeting: "There is an error in the state's template that doubles the amount in our carryover; we expect about a $20 to $25 million reduction," said Dr. Karen Tribble, Alameda County Behavioral Health director. "The elimination of prevention programming affects approximately 13,000 beneficiaries," said Tracy Hazleton, BHSA division director. "We are among the providers whose programs will be shut down due to cuts in prevention," said Chris Cara of Filipino Advocates for Justice during public comment.

What the county will monitor: staff emphasized continuing uncertainty tied to statewide BHSA implementation, future Medi-Cal billing benchmarks, and federal policy changes that influence county Medicaid drawdown. The county also committed to posting more program-level budget detail online and to returning to the Board with an itemized housing and program list to clarify how BHSA funds will be spent locally.

The meeting adjourned after the committee approved advancing the plan and asking the Board to consider bridge funding to stabilize the county's behavioral health safety net.