Title
a. Adopt and approve the County of Monterey Behavioral Health Services Act (BHSA) Three-Year Integrated Plan and Budget for Fiscal Years 2026-27 through 2028-29 (Integrated Plan);
b. Authorize the Chair of the Board of Supervisors to execute the official Board of Supervisors Certification (attached), as recommended by the Behavioral Health Director, attesting that the Board of Supervisors has reviewed and approved this Integrated Plan and the County will meet its realignment obligations pursuant to Welfare & Institutions Code section 14197.71 or other applicable guidance, without utilizing waitlists;
c. Authorize the Behavioral Health Director and the County Administrator Officer or their designee to submit the approved Integrated Plan to the California Department of Health Care Services (DHCS), and to execute all required DHCS certifications, assurances, and related documents necessary for submission and approval; and
d. Authorize the Behavioral Health Director to execute non-substantive, technical, or clerical amendments, revisions, and corrections required by DHCS, provided that such changes do not materially alter the scope, funding priorities, or policy direction of the approved Integrated Plan.
Report
RECOMMENDATION:
It is recommended that the County of Monterey Board of Supervisors:
a. Adopt and approve the County of Monterey Behavioral Health Services Act (BHSA) Three-Year Integrated Plan and Budget for Fiscal Years 2026-27 through 2028-29 (Integrated Plan);
b. Authorize the Chair of the Board of Supervisors to execute the official Board of Supervisors Certification (attached), as recommended by the Behavioral Health Director, attesting that the Board of Supervisors has reviewed and approved this Integrated Plan and the County will meet its realignment obligations pursuant to Welfare & Institutions Code section 14197.71 or other applicable guidance, without utilizing waitlists;
c. Authorize the Behavioral Health Director and the County Administrator Officer or their designee to submit the approved Integrated Plan to the California Department of Health Care Services (DHCS), and to execute all required DHCS certifications, assurances, and related documents necessary for submission and approval; and
d. Authorize the Behavioral Health Director to execute non-substantive, technical, or clerical amendments, revisions, and corrections required by DHCS, provided that such changes do not materially alter the scope, funding priorities, or policy direction of the approved Integrated Plan.
SUMMARY:
In March 2024, California voters approved Proposition 1, which enacted the Behavioral Health Services Act (BHSA), significantly restructuring the former Mental Health Services Act (MHSA) and establishing a unified framework for mental health and substance use disorder (SUD) services. The reform also introduced new planning, accountability, and fiscal requirements for counties, including a consolidated Integrated Plan structure and expanded statewide reporting and oversight requirements. The BHSA Three-Year Integrated Plan and Budget is a state-required standardized template used by counties to document service strategy, funding allocations, and compliance with California Department of Health Care Services (DHCS) planning requirements.
Pursuant to DHCS requirements, the final BHSA Three-Year Integrated Plan and Budget (Integrated Plan) must be submitted no later than June 30, 2026. In preparation for implementation, the County of Monterey Health Department Behavioral Health Bureau has engaged in a multi-phase planning and transition process to align services, contracts, workforce development, and fiscal systems with BHSA requirements.
The BHSA Three-Year Integrated Plan and Budget for Fiscal Years 2026-27 through 2028-29 (Integrated Plan) is the County’s first comprehensive plan under the BHSA framework and replaces the prior MHSA planning and expenditure reporting structure.
DISCUSSION:
Consistent with applicable Community Program Planning Requirements and DHCS guidance, the County of Monterey Health Department Behavioral Health Bureau (BHB) conducted a comprehensive Community Program Planning (CPP) process to inform development of the BHSA Three-Year Integrated Plan. The CPP process included community listening sessions, stakeholder meetings, monthly Behavioral Health Treatment (BHT) Collaborative meetings from November 2025 through March 2026, meetings with providers of Prevention and Early Intervention (PEI) services impacted by BHSA-related funding transitions in early 2026, public outreach, and opportunities for written public comment throughout Monterey County. Major planning milestones included stakeholder engagement and community outreach conducted from Fall 2024 through Spring 2025, release of the Draft BHSA Three-Year Integrated Plan on April 3, 2026, a 45-day public comment period from April 3, 2026, through May 18, 2026, and the Behavioral Health Commission public hearing held on May 28, 2026.
The BHSA Three-Year Integrated Plan establishes Monterey County’s strategic framework for the delivery of behavioral health services across mental health and substance use disorder systems for Fiscal Years 2026-27 through 2028-29. The Integrated Plan includes a comprehensive community needs assessment analyzing behavioral health needs and disparities across Monterey County populations, geographic regions, and service systems using epidemiological data, stakeholder feedback, and community planning input. The Integrated Plan also outlines the County’s behavioral health service delivery strategy, including Full-Service Partnerships (FSPs), prevention and early intervention services, outreach, crisis response, and substance use disorder treatment services. Additional components include workforce, education, and training strategies focused on recruitment, retention, peer support development, and culturally responsive workforce initiatives; innovation and quality improvement activities emphasizing evidence-based practices and outcome measurement; a three-year budget projection for BHSA revenues and expenditures; and a compliance strategy for statewide behavioral health accountability, reporting, and transparency requirements.
Consistent with BHSA priorities, the Integrated Plan emphasizes services for individuals with the highest behavioral health needs, including those experiencing homelessness, serious mental illness, co-occurring serious mental health and substance use disorders, justice-system involvement, and repeated utilization of acute care systems. Priority populations identified through the CPP process include adults with serious mental illness, particularly individuals experiencing homelessness or instability; transition age youth with co-occurring behavioral health needs; children, youth, and families in need of prevention and early intervention services; older adults experiencing isolation, chronic illness, and behavioral health challenges; individuals requiring integrated mental health and substance use disorder treatment; and rural, agricultural, Spanish-speaking, and Indigenous-language-speaking communities experiencing barriers to behavioral health access.
The BHSA Three-Year Integrated Plan includes projected revenues and expenditures for Fiscal Years 2026-27 through 2028-29. BHSA funding continues to be derived from the statewide 1% income tax on personal income above $1 million established under Proposition 63 and modified through Proposition 1. The Integrated Plan's budget reflects projected state allocations, required prudent reserve funding, maintenance of effort obligations, and anticipated expenditure across BHSA service categories. The Integrated Plan's budget serves as a planning document and does not constitute final appropriation authority. Annual appropriations will continue to be incorporated through the County’s annual budget process and remain subject to approval by the Board of Supervisors.
During the 45-day public comment period, the County received feedback from consumers, family members, providers, advocates, and community stakeholders through written comments, community meetings, and public engagement activities. Common themes identified through public comment included support for expanded crisis response and stabilization services, requests for increased culturally and linguistically responsive services, expansion of peer support and lived-experience-informed services, increased outpatient and step-down services following psychiatric hospitalization, and improved coordination between behavioral health, housing, and homelessness systems. All comments received during the public comment period were reviewed and considered during finalization of the Integrated Plan. A summary of public comments and County responses was presented to the Monterey County Behavioral Health Commission during its public hearing on May 28, 2026, and is included beginning on page 68 under table “7. Stakeholder Input” of Attachment A.
On May 28, 2026, the Monterey County Behavioral Health Commission conducted a public hearing on the Draft BHSA Three-Year Integrated Plan and Budget. Following receipt of public testimony, presentation of the public comment summary and County responses, and staff presentation, the Commission confirmed that the public hearing was held in accordance with applicable requirements.
Following the close of the public comment period and the Behavioral Health Commission public hearing, MCBH reviewed all comments and recommendations received from community members, stakeholders, providers, advocates, and Commissioners. Where appropriate and consistent with BHSA requirements, DHCS guidance, available funding, and the scope of the Integrated Plan, feedback-informed revisions, clarifications, and enhancements to the final Integrated Plan were made. The final Integrated Plan presented to the Board reflects consideration of public input received through the Community Program Planning process, written public comments, testimony provided during the Behavioral Health Commission public hearing, recommendations made by the Behavioral Health Commissioners at the public hearing, and technical feedback received from DHCS during its review of the draft Integrated Plan. Revisions incorporated into the final Integrated Plan are highlighted in Attachment A for ease of reference.
The County submitted a draft BHSA Three-Year Integrated Plan to DHCS on March 30, 2026. Following DHCS review, the draft Plan was returned twice for technical corrections, clarifications, and required updates associated with evolving state guidance and implementation requirements. The proposed final BHSA Three-Year Integrated Plan and Budget incorporates these DHCS-required revisions and updates and is being presented to the Board for approval and subsequent submission to DHCS for final review and certification.
The Board of Supervisors, as outlined DHCS’s policy manual, is required to confirm in each integrated plan that the County will meet their realignment obligations (WIC section 14197.71, subdivision (c)(2)). Accordingly, the Board of Supervisors is asked to attest that the County is meeting their realignment obligations, including but not limited to time and distance standards and appointment time standards as set forth WIC section 14197.71, or other applicable guidance, without utilizing waitlists. The Behavioral Health Director has confirmed the County is meeting these requirements.
Upon Board adoption and approval, the final Integrated Plan will be submitted to the DHCS for review and certification consistent with BHSA statutory and regulatory requirements. Pursuant to DHCS guidance, counties are required to submit their final BHSA Three-Year Integrated Plans and Budgets to DHCS no later than June 30, 2026.
This work supports the County of Monterey Health Department 2025-2028 Strategic Plan Goal: Deepen organizational effectiveness and support long-term sustainability. It also supports Essential Public Health Service No. 6: Utilize legal and regulatory actions designed to improve and protect the public’s health.
OTHER AGENCY INVOLVEMENT:
The Monterey County Behavioral Health Commission reviewed the Draft BHSA Three-Year Integrated Plan and Budget and conducted the required public hearing on May 28, 2026, with engagement from community-based organizations, contracted providers, stakeholders, and system partners throughout the planning process.
County Counsel has reviewed and approved as to legal form.
FINANCING:
There is no additional impact to the County General Fund associated with the recommended action. The BHSA Three-Year Integrated Plan is funded through Monterey County’s BHSA allocation derived from statewide Proposition 63 and Proposition 1 revenues.
BOARD OF SUPERVISORS STRATEGIC PLAN GOALS:
The recommended action supports the Board of Supervisors Strategic Plan goal of promoting community well-being through coordinated behavioral health planning, service delivery, accountability, and long-term system sustainability.
Mark a check next to the related Board of Supervisors Strategic Plan Goals:
X Well-Being and Quality of Life
____ Sustainable Infrastructure for the Present and Future
____ Safe and Resilient Communities
____ Diverse and Thriving Economy
____ Dynamic Organization and Employer of Choice
Prepared By: Melanie Rhodes, Behavioral Health Bureau Chief/Director, 755-1742
Fabricio Chombo, Behavioral Health Assistant Bureau Chief, 755-4579
Approved By: Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
Attachment A: Monterey County BHSA Three-Year Integrated Plan (FY 2026-27 through FY 2028-29) - Full Document Including Summary of Public Comments
Attachment B: Monterey County BHSA Three-Year Integrated Plan Budget (FY 2026-27 through FY 2028-29)
Attachment C: Behavioral Health Commission Letter (May 28, 2025)
Attachment D: Board of Supervisors Certification Form
Attachment E: PowerPoint Presentation