Behavioral Health Services Act (BHSA)

California voters approved Proposition 1 in March 2024, reforming the Mental Health Services Act (MHSA) through the Behavioral Health Services Act (BHSA). BHSA introduces new requirements for how counties plan, fund and deliver behavioral health services.

San Mateo County Behavioral Health and Recovery Services (BHRS) is implementing these changes to strengthen mental health and substance use disorder services, expand housing supports and improve accountability for outcomes.

San Mateo County’s Three-Year Integrated Plan

Under BHSA, counties are required to develop a Three-Year Integrated Plan that brings together behavioral health priorities, strategies, services and funding into one comprehensive plan.

The San Mateo County Board of Supervisors approved the county’s BHSA Three-Year Integrated Plan for fiscal years 2026-29. The plan outlines how BHRS will address community needs and implement BHSA requirements.

View San Mateo County BHSA Three-Year Integrated Plan, FY 2026-29 in the resource library below.

How BHSA Affects Behavioral Health Services

BHSA introduces changes to behavioral health funding and services, with an emphasis on expanding access to care, addressing housing needs and improving coordination between mental health and substance use disorder treatment.

Key areas of focus include:

• Housing Interventions: Increasing access to permanent supportive housing for people with serious mental illness and/or substance use disorders who are experiencing homelessness or are at risk of homelessness.
• Early Intervention: Identifying and addressing behavioral health concerns earlier for individuals at higher risk, before conditions become more severe or chronic.
• Full-Service Partnerships: Aligning intensive, coordinated behavioral health services with updated requirements, including housing-related supports and care for people with co-occurring mental health and substance use disorders.
• Peer Support Services: Strengthening the role of peer support across behavioral health services and expanding opportunities for certified peer support specialists.
• Mental Health and Substance Use Disorder Integration: Improving access to coordinated care for people with co-occurring needs and expanding the use of BHSA funding for substance use disorder treatment, including when a person does not have a primary mental health diagnosis.
• Prevention Services: Shifting responsibility for population-based behavioral health prevention programs and their funding to the state.
• Outcome Reporting and Accountability: Strengthening the use of data and standardized outcome reporting to measure performance and support continuous improvements in behavioral health services.

BHSA also changes how behavioral health funding is allocated to support these priorities.

Community Planning and Input

Community participation is an important part of behavioral health planning in San Mateo County. Through the Community Program Planning (CPP) process, BHRS gathered input from clients, family members, staff and community partners to help identify priorities and inform the Three-Year Integrated Plan.

Learn More About BHSA

For additional information about Proposition 1 and statewide behavioral health transformation, visit the California Department of Health Care Services’ Behavioral Health Transformation website.