REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
November 17, 2026
FROM
JOSHUA DUGAS, Director, Department of Behavioral Health
ROB GILLIAM, Acting Director, Community Development and Housing Department
SUBJECT
Title
Behavioral Health Services Act 2026-29 Integrated Plan Intermittent Update for 2026-27
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to Agreement No. 26-420 for the Behavioral Health Services Act 2026-29 Integrated Plan Intermittent Update 2026-27, including the Behavioral Health Services Act Compliance Certification forms for the Board of Supervisors and Behavioral Health Director, as required by the California Department of Health Care Services, amending projected expenditures to include $16,562,653 in Housing Interventions funding for Capital Development expenditures.
2. Approve the updated Behavioral Health Services Act funding allocations and Mental Health Services Act carryover funds, including $240,737,231 in Mental Health Services Act funds transitioning to Behavioral Health Services Act funding, as reflected in the Behavioral Health Services Act 2026-29 Integrated Plan Intermittent Update, in accordance with the requirements prescribed by the California Department of Health Care Services.
3. Authorize the Director of the Department of Behavioral Health to sign the Behavioral Health Services Act County Compliance Certification form, and electronically transmit the Behavioral Health Services Act 2026-29 Integrated Plan Intermittent Update 2026-27, in addition to the Certification Forms, and execute and submit non-substantive amendments and supplemental documentation related to the Behavioral Health Services Act 2026-29 Integrated Plan Intermittent Update 2026-27 as required by the California Department of Health Care Services, subject to review by County Counsel.
4. Direct the Director of the Department of Behavioral Health to transmit the Certification Form and any non-substantive amendments to the Clerk of the Board of Supervisors within 30 days of execution.
5. Authorize the Auditor-Controller/Treasurer/Tax Collector to post the necessary budget adjustments as detailed in the Financial Impact section (Four votes required).
(Presenter: Joshua Dugas, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote and Fulfill the Countywide Vision.
Operate in a Fiscally-Responsible and Business-Like Manner.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of additional Discretionary General Funding (Net County Cost). The $16,562,653 transfer from the Department of Behavioral Health (DBH) to the Community Development and Housing Department (CDH) for capital development is supported by Behavioral Health Services Act (BHSA) Housing Interventions funding as outlined in the BHSA 2026-29 Integrated Plan Intermittent Update 2026-27 (2026-29 IP Update).
DBH and CDH request the following adjustments to their respective 2026-27 budgets at this time. Additional adjustments related to the capital projects to be supported by this funding may be brought to the Board of Supervisors (Board) at a later date.
|
Fund Center |
Commitment Item |
Description |
Action |
Amount |
|
9200002200 |
52002445 |
Other Professional & Specialized Services |
Decrease |
$16,562,653 |
|
9200002200 |
55305030 |
Operating Transfers Out |
Increase |
$16,562,653 |
|
6210003110 |
40909975 |
Operating Transfers In |
Increase |
$16,562,653 |
|
6210003110 |
55305030 |
Operating Transfers Out |
Increase |
$14,832,676 |
|
6210003110 |
55305030 |
Operating Transfers Out |
Increase |
$1,729,977 |
|
6210002476 |
40909975 |
Operating Transfers In |
Increase |
$1,729,977 |
|
6210002476 |
55405010 |
Salaries & Benefits Transfers Out |
Increase |
$962,725 |
|
6210002476 |
55305030 |
Operating Transfers Out |
Increase |
$767,252 |
BACKGROUND INFORMATION
In March 2024, California voters approved Proposition 1, initiating a major transformation of the state’s behavioral health system. The measure modernizes the Mental Health Services Act (MHSA) by replacing it with BHSA, expanding its focus to address both mental health and substance use disorders while responding to California’s homelessness crisis. Proposition 1 authorized a $6,380,000,000 bond to increase behavioral health treatment capacity and supportive housing statewide, including dedicated resources for veterans and individuals experiencing homelessness.
BHSA prioritizes housing interventions, Full Service Partnerships, and comprehensive behavioral health services, with an emphasis on equity, accountability, and improved access to care for high-need populations, including individuals with co-occurring conditions. These reforms promote a more integrated, whole-person approach to care and strengthen the continuum of behavioral health.
The BHSA Integrated Plan (IP) is a required three-year strategic and expenditure plan that outlines how the County will use all behavioral health funding to improve access to care, reduce homelessness, support recovery, and address serious behavioral health needs. The County will align its efforts with six statewide behavioral health goals: improving access to care, reducing untreated behavioral health conditions, reducing homelessness, reducing justice system involvement, reducing institutionalization, and reducing the removal of children from their homes. Informed by local data and community input, the County also identified two additional priorities: reducing suicides and reducing overdoses.
On June 9, 2026 (Item No. 134), the Board approved Agreement No. 26-420 for the 2026-29 IP, including BHSA Compliance Certification forms for the Board, Chief Executive Officer, and Behavioral Health Director, as required by the California Department of Health Care Services (DHCS), with total projected expenditures of $2,344,759,538 across all Behavioral Health funding sources, for the period of July 1, 2026 through June 30, 2029. The Board also approved the BHSA funding allocations and MHSA carryover funds totaling an estimated $915,671,425, as outlined in the 2026-29 IP, and authorized $798,913,521 in BHSA expenditures, in accordance with the requirements prescribed by DHCS.
Counties may prepare intermittent updates during the three-year IP period when changes are necessary to ensure that planned expenditures, programs, and projects remain accurately reflected in the approved IP and budget. Since the Board’s approval of the 2026-29 IP, DBH has identified programmatic changes and planned capital development projects that require revisions to the IP. Accordingly, DBH is returning to the Board with the 2026-29 IP Update to incorporate these changes into the previously approved plan and maintain alignment with BHSA and DHCS requirements.
The 2026-29 IP Update includes changes to program information, funding, and planned projects, reflecting how BHSA funds will be used for current and updated services. The 2026-29 IP Update also reflects funding adjustments identified through additional fiscal review, including $240,737,231 in unspent MHSA funding transitioning to BHSA, with corresponding adjustments within the BHSA components to align funding with program needs. These adjustments do not involve transfers between BHSA components and do not change the total BHSA expenditures previously approved by the Board.
The 2026-29 IP Update also adds two capital development projects under the Housing Interventions component to address housing needs throughout the county. The projects are currently under development, and specific project details will be finalized through applicable County approval and procurement processes. To support implementation of these projects, DBH is requesting a budget adjustment to transfer $16,562,653 in BHSA Housing Interventions funding for capital development to CDH, which will manage the projects in coordination with DBH. Housing developed with these funds will serve individuals and families who meet applicable Housing Interventions eligibility requirements, including BHSA-eligible individuals who are at risk of homelessness, experiencing homelessness, or chronically homeless, with a focus on individuals living in encampments.
The 2026-29 IP Update also includes programmatic changes to better align programs with applicable BHSA categories and the services provided. These changes include reclassifying several programs from the Children’s System of Care to Early Intervention; reclassifying Children’s Residential Intensive Services from the Children’s System of Care, with the program remaining within previously designated classifications; and adding Crisis Intervention Training and the Community Engagement Program under Workforce Education and Training.
DBH developed the 2026-29 IP Update in accordance with DHCS requirements. This included a 30-day public comment period from October 9, 2026, through November 9, 2026. No substantive comments were received during the public comment period.
The 2026-29 IP Update reflects DBH’s continued implementation of BHSA and its commitment to responsibly aligning available resources with community needs. The proposed changes strengthen housing investments, support program sustainability and growth, and improve alignment of services with BHSA requirements, while maintaining the total BHSA expenditures previously approved by the Board and requiring no additional Discretionary General Funding. Upon Board approval, DBH will submit the 2026-29 IP Update to DHCS and the Behavioral Health Services Oversight and Accountability Commission within 30 days.
Delegated authority is requested to allow DBH to submit the 2026-29 IP Update to DHCS and to execute and submit any subsequent non-substantive amendments requested by DHCS during its review. This authority will enable DBH to respond to required revisions and resubmit the updated materials, as necessary, without returning to the Board for additional approval, provided the revisions do not substantively alter the 2026-29 IP Update.
DBH will return to the Board, as needed and in accordance with DHCS requirements, to present annual or intermittent updates to the 2026-29 IP for consideration throughout the 2026-29 planning period.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Vanessa Esparza, Administrative Supervisor I, 388-0858) on October 20, 2026; Community Development and Housing (Rob Gilliam, Acting Director, 382-3983) on October 16, 2026; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455 and Suzanne Bryant, Deputy County Counsel, 387-5455) on November 10, 2026; Auditor-Controller/Treasurer/Tax Collector (Mima Ugbo, Chief Controller, 382-3195) on October 30, 2026; and County Finance and Administration (Lizveth Varela, 387-4883, and Paul Garcia, Administrative Analysts, 388-0218) on October 30, 2026.