Behavioral Health Services Act

The Behavioral Health Services Act, also known as BHSA, is a state law passed by voters in March 2024. BHSA updates the Mental Health Services Act (MHSA) by:

  • Expanding service access to include treatment for people with substance use disorders,
  • Prioritizing care for people with the most serious mental illness,
  • Providing ongoing resources for housing and workforce development, and
  • Continuing investments in prevention, early intervention, and innovative behavioral health pilot programs.

BHSA aims to close service gaps and ensure equitable access to quality care across the state. New BHSA requirements will also enhance oversight, transparency, and accountability at the state and local levels.

To learn more about BHSA:

To receive updates about BHSA, subscribe to these statewide sites:

Community Planning Process

BHSA requires counties to look at their whole behavioral health system of care through a formal Community Planning Process (CPP). The CPP supports the County of San Diego’s goal to involve communities in meaningful conversations and decision-making about local behavioral health services to ensure programs reflect their unique needs and voices.

Upcoming Engagement Activities


BHSA’s CPP process includes enhanced community engagement efforts intended to bring together a broad range of voices to provide input on mental health and substance use services, policies, program planning, implementation, budget allocation, and others.

Counties are required to engage with specific stakeholder groups as part of the CPP. Expand the section below or read the Stakeholder Involvement section in the Behavioral Health Services Act County Policy Manual for more details.

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  • BHSA Stakeholder Groups
    1. Eligible adults and older adults (individuals with lived experience) 
    2. Families of eligible children and youth, eligible adults, and eligible older adults (families with lived experience) 
    3. Youths (individuals with lived experience) or youth mental health or substance use disorder (SUD) organizations 
    4. Providers of mental health services and SUD treatment services 
    5. Public safety partners, including county juvenile justice agencies 
    6.  Local education agencies 
    7. Higher education partners 
    8. Early childhood organizations 
    9. Local public health jurisdictions 
    10. County social services and child welfare agencies 
    11. Labor representative organizations 
    12. Veterans 
    13. Representatives from veterans’ organizations 
    14. Healthcare organizations, including hospitals 
    15. Healthcare service plans, including Medi-Cal Managed Care Plans
    16. Disability insurers (a commercial disability insurer that covers hospital, medical or surgical benefits as defined in Insurance Code section 106, subdivision (b)) 
    17. Tribal and Indian Health Program designees established for Medi-Cal Tribal consultation purposes
    18. The five most populous cities in counties with a population greater than 200,000
    19. Area agencies on aging 
    20. Independent living centers
    21. Continuums of care, including representatives from the homeless service provider community
    22. Regional centers 
    23. Emergency medical services 
    24. Community-based organizations serving culturally and linguistically diverse constituents 
    25. Representatives from youth from historically marginalized communities 
    26. Representatives from organizations specializing in working with underserved racially and ethnically diverse communities 
    27. Representatives from LGBTQIA+ communities 
    28. Victims of domestic violence and sexual abuse 
    29. People with lived experience of homelessness 
       

The goal of the CPP is to identify unmet needs, service gaps, and the best ways to meet the diverse mental health needs of our community.

Circular flow chart showing the activities of the BHSA CPP: Stakeholder input and recommendations; integrated plan/annual update draft; public postings, public hearings, and approval; implementation and monitoring.

The following activities make up the CPP:

  • Stakeholder Input & Recommendations: We invite community members, local organizations, and other stakeholders to share their input and recommendations. 
  • Integrated Plan/Annual Update Draft: The feedback gathered helps shape the department’s BHSA Integrated Plans and Annual Updates. 
  • Public Postings, Public Hearings, & Approval: Once a proposed Plan/Update is drafted, it’s posted publicly for additional input. A public hearing is held at the end of a Public Comment period. The input received is vital to ensuring stakeholders’ perspectives are incorporated into service planning and reflected in updates presented to the San Diego County Board of Supervisors for review and approval.
  • Implementation & Monitoring: Once approved, the plan is submitted to the Department of Health Care Services by June 30.

Stakeholder engagement will continue throughout the year to better understand what's working and where things can be improved. The insights gained help refine future plans and make sure that behavioral health support in our county continues to evolve to meet the needs of our San Diego County residents. 

Frequently Asked Questions

See below for frequently asked questions regarding BHSA. If you have a question that is not answered here, please email Engage.BHS@sdcounty.ca.gov.

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  • What is BHSA?

    In March 2024, California voters passed Proposition 1, a two-bill package, to modernize the state’s behavioral health care system. One component of this is the Behavioral Health Services Act (BHSA), which updates the 2004 Mental Health Services Act. BHSA updates funding to support those with the greatest needs, expands the behavioral health workforce to better serve California’s diverse communities, and prioritizes outcomes, accountability, and equity.

  • When does BHSA take effect?

    New BHSA requirements will be fully implemented by July 1, 2026. However, planning and coordination to prepare for the shift to BHSA is ongoing, including the Community Planning Process to develop the BHSA Three-Year Integrated Plan which officially began in January 2025. 

  • What changes will be implemented?
    • Updates allocations for local services and state-directed funding categories.
    • Broadens the target population to include individuals with substance use disorder.
    • Focuses on the most vulnerable and at-risk groups, including children and youth.
    • Advances community-defined practices (community-based practices that have reached a strong level of support within specific communities) as a key strategy for reducing health disparities and increasing community representation.
    • Revises county processes and improves transparency and accountability.
       
  • What types of activities will be conducted as stakeholder engagement?

    Stakeholder engagement involves gathering input from providers, local partners, and residents with unique perspectives across San Diego County through various engagement activities such as listening sessions, focus groups, key informant interviews, workgroups and committees, community trainings, education and outreach, and more.

  • What focus areas will stakeholders be involved in?

    BHSA requires counties to involve stakeholders in discussions around mental health and substance use disorder policy, program planning and implementation, monitoring, workforce, quality improvement, health equity, evaluation, and budget allocation.

    In addition, based on learning from previous engagement efforts, Behavioral Health Services is expanding opportunities to discuss specific topics including accessibility, care coordination and navigation, community outreach and education, crisis response services, culturally appropriate and affirming care, support for people experiencing homelessness, services for youth and transition age youth, and workforce capacity and diversity.

  • Will the Public Comment Period change?

    No. Under BHSA, counties are still required to provide a 30-day minimum public comment period for their Integrated Plans or Annual Updates. Counties will also continue to conduct Public Hearings on the draft of Integrated Plans or Annual Updates at the close of 30-day public comment periods.

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