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Big Steps Toward Better Behavioral Health Care

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In March, voters will cast ballots on Proposition 1, a package made up of CHA-supported legislation passed this year that will transform the state’s mental health system to better meet the growing needs of Californians. 

The package incorporates two bills: Senate Bill 326 (Eggman, D-Stockton), which modernizes the Mental Health Services Act, and Assembly Bill 531 (Irwin, D-Thousand Oaks), a $6.38 billion bond to build new behavioral health housing and treatment settings.  

If approved, the measure would have a positive impact on hospitals’ ability to enhance care for people needing behavioral health services. Here’s how: 

Housing and Treatment Expansion 

This legislation includes a $6.4 billion general obligation bond for behavioral health housing and treatment infrastructure. Of this, $2.9 billion will be available for grants for behavioral health treatment and residential settings authorized under the Behavioral Health Continuum Infrastructure Program. This program accepts grant applications from hospitals, as well as counties, cities, and others.  

Advocacy from CHA and NAMICalifornia led to the late removal of a restriction that would have limited these resources to only unlocked, voluntary settings. This was a critical change that opens the doors for hospitals to invest in these needed services, and one that bolsters the work of the 34 licensed psychiatric hospitals and nearly 90 general acute care hospitals that currently provide inpatient psychiatric care in California. 

Even though Medi-Cal covers inpatient psychiatric services, more capacity is desperately needed. A recent report published by the RAND Corp. found that California has a shortfall of nearly 8,000 behavioral health beds at all levels of patient need. 

These bond-funded resources are in addition to the $200 million annually for hospitals providing inpatient psychiatric services to Medi-Cal beneficiaries that would be generated by the managed care organization tax measure, Protect Access to Healthcare Act of 2024, which will be voted on in November.  

Mental Health Services Act Modernization 

Along with financial resources, Proposition 1 will make meaningful updates to the law governing the treatment of people with behavioral health needs. This includes: 

  • Permitting MHSA funds to be used to treat people with substance use disorders. 
  • Requiring counties to expand their MHSA spending on wrap-around treatment slots (Full-Service Partnerships).  
  • Requiring counties to expand their spending on projects that reduce homelessness among people with behavioral health needs. 
  • Providing $36 million to the Department of Health Care Access and Information to administer a behavioral health workforce initiative. 
  • Directing state health plan regulators to develop a plan for achieving parity between commercial and Medi-Cal for behavioral health service benefits. 
  • Improving state oversight of county planning and spending of MHSA and other public funding for behavioral health. 

It’s notable that at a time when budgets are tighter than ever, California has not only recognized the behavioral health challenges we face but also taken major steps toward addressing these problems head-on. The hospital voice was there every step of the way as these policy solutions began to take shape, just as you and the organizations you lead will be there every step of the way to build a better system for the millions of Californians with behavioral health needs.