BHSA

CHANGES TO MHSA

The Behavioral Health Services Act (BHSA) is a major structural reform of California's mental health system passed by voters in March 2024 as part of Proposition 1. It modernizes the 2004 Mental Health Services Act (MHSA) to address the state's current challenges with homelessness, substance use disorders (SUD), and untreated serious mental illness. 

While the BHSA took effect on January 1, 2025, counties are currently in a transition period; the new funding rules and requirements are scheduled to be fully implemented on July 1, 2026. 

Key Reforms under BHSA

The act shifts California's behavioral health focus toward three primary pillars: 

Expanded Scope for Substance Use Treatment: For the first time, funds can be used to treat individuals with a substance use disorder alone, even if they do not have a co-occurring mental illness.

Mandated Housing Interventions: Counties are now required to dedicate 30% of their funding specifically to housing interventions. This includes rental subsidies, operating costs for supportive housing, and capital projects.

At least 50% of these housing funds must be prioritized for individuals experiencing chronic homelessness.

Dedicated Funding for Full-Service Partnerships (FSP): The act sets aside 35% of funding for FSPs, which use a "whatever it takes" model to provide intensive, wraparound care for individuals with the most complex needs. 

New Funding Structure

The BHSA replaces the five old MHSA components with three simplified categories: 

Housing Interventions (30%).

Full-Service Partnerships (35%).

Behavioral Health Services and Supports (35%): This category covers workforce education, early intervention, and capital facilities. Notably, 51% of this portion must be used for early intervention programs, with a majority of those funds specifically targeting people aged 25 and younger. 

Accountability and Oversight

To ensure results, the BHSA introduces stricter transparency measures for counties: 

Integrated Plans: Every three years, counties must submit a comprehensive spending plan that includes all local, state, and federal behavioral health funding.

Annual Outcome Reports: Counties must report annually on their spending and, crucially, on performance metrics and their success in reducing health disparities.

State Reallocation: The state now retains 10% of total funds (up from 5%) to manage statewide workforce initiatives and population-based prevention efforts administered by the California Department of Public Health (CDPH). 

For more details on implementation timelines and county resources, you can visit the DHCS Behavioral Health Transformation portal at   https://www.dhcs.ca.gov/BHT/Pages/home.aspx