Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Behavioral Health topic
No spam. Unsubscribe anytime.
Behavioral health director: CalAIM and placement costs drove sharp service and budget growth; staff propose vacancy reductions
Summary
Director Jones told supervisors that CalAIM reforms led to more than 200% growth in billable service units and a substantial rise in contracted placement costs; the department projects combined mental health and substance use disorder budgets of about $63.6 million for 2026–27 and proposed eliminating vacant positions as a cost control measure.
Director Jones and fiscal program manager Amber Luch presented the behavioral health budget and said service volumes have grown dramatically under CalAIM payment reforms. Jones said that since CalAIM implementation the department has seen more than 200% growth in billable service units and that the payer mix requires the county to share a portion of costs for many services.
"From the initiation of CalAIM... we have seen our service unit growth of over 200%," Jones said, explaining how intergovernmental transfer (IGT) and share‑of‑cost calculations increase county exposure for purchased services. Jones said the department has already issued about $25.1 million in contracted payments this fiscal year and has matched roughly $7 million so far in county share‑of‑cost payments.
Jones told the board the county projects closing the combined mental health and substance use disorder funds near $63.6 million for fiscal year 2026–27, with contracted services (including out‑of‑county hospital placements and state hospital placements) being the primary driver of the increase. To control costs, staff proposed eliminating a number of vacant positions (the presentation referenced reducing staff allocations by nine positions) and pursuing administrative‑claiming back‑revenue (a $1.3 million submission was noted to recover prior‑year administrative costs).
Supervisors asked for metrics linking service growth to community impact and quality; Jones said those outcome metrics are new under CalAIM and that the department can present external quality review findings and beneficiary interviews in the upcoming deeper briefing. The board deferred final votes on the larger behavioral health package pending the more detailed presentation scheduled for the next day, though it approved a small DUI/alcoholism budget unit (4018) on a separate vote.
