Counties Advocate Against Budget Proposals that Threaten County Behavioral Health Programs 

Over the last week, budget subcommittees in both the Senate and the Assembly convened hearings on budget proposals impacting county behavioral health services, including the proposed elimination of the statewide Medi-Cal Mobile Crisis Benefit and proposed changes to county fiscal management of Behavioral Health Services Act (BHSA) funding.  

Counties Oppose Governor’s Budget Proposal to Eliminate Statewide Medi-Cal Mobile Crisis Benefit  

Following the passage of the American Rescue Plan Act of 2021, which authorized enhanced federal matching funds for qualifying community based mobile crisis intervention services over a five-year period, the 2022 Budget Act established the community based mobile crisis intervention services as a mandatory, statewide Medi-Cal benefit, with the state providing the non-federal match. Since then, the state and counties have made significant investments to stand up the infrastructure, workforce, and partnerships necessary to operate 24/7 field-based mobile crisis teams that successfully divert individuals experiencing behavioral health crises away from emergency departments and law enforcement interactions.  

The Governor’s January Budget proposes to eliminate the Medi-Cal mobile crisis benefit as a statewide benefit, and instead make it a county-optional benefit. Under the proposal, counties would be required to provide the 50 percent non-federal match in order to continue operating these life saving teams. The County Behavioral Health Directors Association (CBHDA) estimates that counties would face costs of approximately $169 million annually to maintain the benefit statewide.  

CSAC joined a large coalition lead by CBHDA in urging the Legislature to reject the Governor’s Budget proposal to eliminate the statewide Medi-Cal Mobile Crisis Benefit. Counties are currently under substantial fiscal pressure due to the resent federal passage of H.R. 1, with up to $9.5 billion in new annual costs to counties once fully implemented as it fundamentally shifts certain fiscal responsibilities for safety net programs to counties, as well as pressures from relatively flat realignment funding, and changes to the funding structure under the Behavioral Health Services Act.  

Recognizing the substantial fiscal pressure counties are under, members in both the Senate and Assembly questioned the Administration’s rationale for these cuts. “We are hoping the county will continue all of it,” said Senator Caroline Menjivar, Chair of the Senate Budget and Fiscal Review Subcommittee No. 3. “We have not taken on a single thing the federal government has cut from us,” Sen. Menjivar continued, “That is a bit hypocritical from us to say ‘I think you can do it, county,’ but we’re not doing a single one of them.” 

Assemblymember Dawn Addis, Chair of the Assembly Budget Subcommittee No. 1, noted the widespread opposition to the proposal, stating “This is probably one of the least popular proposals that we have received feedback from on this budget subcommittee. There are dozens of members who have reached out to us as well as probably every single county across all 58 counties has reached out to express their disappointment.”  

CSAC will continue advocating for the inclusion of a mandatory statewide Medi-Cal Mobile Crisis Benefit in the final 2026 Budget Act. 

Counties Oppose Administration’s BHSA Revenue and Stability Trailer Bill Language Unless Amended  

Both budget subcommittees also discussed the Administration’s proposed budget trailer bill language to implement the Department of Health Care Services’ Behavioral Health Services Act Revenue Stability Workgroup Report, published in May 2025.  

CSAC, along with the Urban Counties of California (UCC) and the Rural County Representatives of California (RCRC) oppose the proposal unless amended. Counties call for changes to the language that allow counties to effectively manage BHSA revenues, including maintaining existing prudent reserve levels and greater flexibility for counties to access prudent reserves.