Title
Consider a preliminary analysis report in response to Board Referral No. 2026.05 (Root Askew) requesting for discussion of the Behavioral Health Services Act (BHSA) Draft Plan at a Board of Supervisors' meeting during Public Comment Period.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Receive a preliminary analysis report in response to Board Referral No. 2026.05;
b. Provide direction on a preferred referral processing option:
i. Proceed with completion of referral as outlined in preliminary report;
ii. Proceed with completion of referral based on modifications by Board;
iii. Return to Board with a more comprehensive analysis of referral and anticipated effort for completion; or
iv. Rescind referral.
c. Provide further direction, as appropriate.
SUMMARY:
Board Referral No. 2026.05 requests that the Board of Supervisors schedule a discussion of the draft Behavioral Health Services Act (BHSA) Three-Year Integrated Plan for Fiscal Years 2026-27 through 2028-29 during the public comment period. The referral seeks an opportunity for the Board to review the draft plan, provide policy direction, and consider revisions before the closing of the public comment period on May 18, 2026, and final approval is anticipated before June 30, 2026. This preliminary report outlines the scope of work, estimated staffing impacts, implementation considerations, and proposed timeline for response.
PRELIMINARY ANALYSIS:
Background: Board Referral No. 2026.05 was submitted on April 7, 2026, by Supervisor Wendy Root Askew, District 4, requesting that the Board schedule time to review and discuss the draft Behavioral Health Services Act (BHSA) Three-Year Integrated Plan during the public comment period and provide policy direction prior to final adoption.
The Behavioral Health Services Act was established through the passage of Proposition 1, which was approved in March 2024 by a margin of 0.4% or 26,223 votes. Proposition 1 restructured portions of the former Mental Health Services Act (MHSA) framework and created new statewide requirements intended to modernize behavioral health systems, improve accountability, expand housing and treatment capacity, and prioritize services for individuals with serious behavioral health needs, including those experiencing homelessness.
Under the BHSA framework, counties are required to develop and adopt a local Three-Year Integrated Plan identifying priorities for behavioral health funding, program design, community engagement, outcomes, and compliance with state spending requirements. Counties must conduct a public comment process, consider stakeholder input, and obtain approval from the Board of Supervisors before submitting the final plan to the State. Monterey County’s draft plan for Fiscal Years 2026-27 through 2028-29 is currently under public review from April 3, 2026, through May 18, 2026, with final Board consideration anticipated before June 30, 2026.
Project Description: The requested work would include preparing a Board report and presenting it to facilitate discussion of the draft Behavioral Health Services Act (BHSA) Three-Year Integrated Plan during the public comment period. Staff efforts would include reviewing the draft plan, summarizing key policy components, identifying areas where Board policy direction may be warranted, and outlining applicable statutory requirements and implementation timelines.
The project may also include evaluating alignment between the draft BHSA Plan and existing County priorities, plans, and initiatives, including behavioral health system goals, housing strategies, and homelessness response efforts. In addition, staff may summarize stakeholder feedback received during the public comment period and identify potential revisions for Board consideration before final adoption.
Estimated Project Cost: At this preliminary stage, no significant direct fiscal impact is anticipated beyond existing staff time associated with agenda preparation, policy review, and presentation. Should the Board request expanded analysis or revisions to the draft plan, additional staff and consultant resources may be required.
Staffing Level Estimate: Completion of the referral is expected to require moderate staff effort from the Health Department’s Behavioral Health Bureau and County Counsel, as needed. Estimated staff time may range from 25 to 50 hours, depending on the scope of the requested analysis and revisions.
Departmental Challenges: Challenges may include the compressed timeline to provide this referral response by April 28, 2026. Additional considerations to submit the Integrated Plan by June 30, 2026, include balancing ongoing operational workloads, incorporating stakeholder feedback, and ensuring compliance with evolving state BHSA guidance associated with Proposition 1 implementation.
Proposed Response Date: April 28, 2026.
This referral supports the County of Monterey Health Department 2025-2028 Strategic Plan Goal 4 to Deepen Organizational Effectiveness and Support Long-Tem Sustainability. It also supports the following of the ten essential public services, specifically: 4) Mobilize community partnerships and action to identify and solve health problems and 9) Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
BOARD OF SUPERVISORS STRATEGIC PLAN GOALS:
Implementation of the BHSA Plan is in alignment with Strategic Goal A, Well-Being and Quality of Life, Key Objective, provide service enhancements to support well-being and quality of life and Strategic Goal B, Safe Resilient Communities, Key Objective, provide for essential justice-focused activities.
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
X Safe and Resilient Communities
____ Diverse and Thriving Economy
Prepared by: Fabricio Chombo, Assistant Bureau Chief, 755- 4578
Approved by: Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Preliminary Analysis Report
Board Referral No. 2026.05
Board Referral No. 2026.05 PowerPoint Presentation