Sonoma County adopts BHSA plan as state shifts mental health dollars to housing; board signs attestations

The Sonoma County Board of Supervisors on June 2 approved the county's three-year Behavioral Health Services Act (BHSA) integrated plan and authorized county attestations required by the state to receive next year's allocation.

Director of Health Services Nolan Sullivan told the board that the shift enacted by Proposition 1 (effective July 1) means the state will take 10% off the top of formerly local MHSA funds and that roughly 30% of the remaining BHSA funds must be devoted to housing for people with severe behavioral health conditions. "There is not new or additional money," Sullivan said, adding that the change forces counties to "create a whole new slice on the pizza for housing," which shrinks funds available for other behavioral health services.

The plan lays out four strategic priorities: expanding access and engagement, increasing housing stability, reducing institutionalization, and advancing equity and culturally responsive care. Staff said the county will invest in full-service partnerships, expand crisis response and stabilization services and scale early-intervention youth programs. Mary Anne Lee, presenting budget figures, said the plan lists about $52 million in proposed spending for 2026-27, of which about $38 million is expected from BHSA funds and the remainder from existing fund balances and other sources.

Public commenters and advocates urged more clarity and protections for prevention programs and smaller community-based providers that have relied on prior MHSA flexibility. Adrienne Laube of the Homeless Action Organization urged the board to amend the plan to ensure interoperable HMIS and coordinated entry for housing placements; Don O'Brien, a behavioral health board member, said the process felt rushed and the plan remained confusing to many stakeholders. Supporters such as Chase Overholt of Positive Images said staff outreach had been extensive and praised efforts to center equity in the plan.

Sullivan and other staff emphasized a tight state timeline: three attestations are required (the CEO, the county behavioral health director, and the board chair) to confirm the county will spend BHSA funds on eligible Medi-Cal recipients, will not supplant other funding, and will cooperate with Medi-Cal managed care plan requirements. Sullivan said the attestations must be signed by June 19 for the county to be eligible for the full $38 million next fiscal year.

After board discussion about the impacts to prevention, workforce development and the county's reliance on fund balance, Supervisors pressed staff to continue outreach and deeper follow-ups with stakeholder groups. The board voted to approve the staff recommendations and to move forward with the required attestations. The vote was unanimous.