Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health and Recovery Services
Subject: Agreement with the State of California Department Health Care Services for the County Performance Contract for Behavioral Health Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement and/or subsequent amendments with the State of California Department of Health Care Services for the County Performance Contract for behavioral health services, for the term of July 1, 2026 through June 30, 2029, for a zero-dollar ($0) amount, and authorizing and directing the Chief of San Mateo County Health to execute the agreement on behalf of the County.
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BACKGROUND:
California has undertaken historic efforts to re-envision the State’s publicly funded mental health and substance use disorder (SUD) services, with a special focus on county-administered specialty mental health and SUD services. In March 2024, voters approved Proposition 1, the Behavioral Health Services Act (BHSA), to reform the Mental Health Services Act and fund needed behavioral health facility infrastructure and services. The efforts to implement Proposition 1 are referred to as Behavioral Health Transformation (BHT).
The primary goals of BHT are to improve access to care, increase accountability and transparency for publicly funded, county-administered behavioral health services, and expand the capacity of behavioral health care facilities across California. Under BHT, county reporting will be uniform to allow for comprehensive and transparent reporting of the BHSA funding in relation to all public local, state, and federal behavioral health funding.
DISCUSSION:
The State of California Department of Health Care Services (DHCS) administers county-delivered behavioral health services through the BHSA, Lanterman-Petris-Short Act, Projects for Assistance in Transition from Homelessness, Community Mental Health Services Block Grant, Substance Use Prevention, Treatment, and Recovery Services Block Grant, and Crisis Counseling Assistance and Training Program and oversees county provision of community mental health services pursuant to the Bronzan-McCorquodale Act.
San Mateo County must meet certain conditions and requirements to receive funding for these programs and services, as set forth in this County Performance Contract (hereafter referred to as the Contract or Agreement), as required by Welfare and Institutions Code (W&I) sections 5650(a), 5651, and 5897. DHCS will monitor this Contract to ensure compliance with applicable federal and State law and applicable regulations.
The agreement and resolution have been reviewed and approved by the County Attorney as to form.
It is anticipated that Behavioral Health and Recovery Services (BHRS) will meet 80% of the National Committee for Quality Assurance (NCQA) behavioral health accreditation standards (factors) in FY 2026-27. NCQA is an independent, nonprofit organization that evaluates and accredits health care organizations based on quality, safety, and performance standards.
PERFORMANCE MEASURES:
|
Measure |
FY 2025-26 Actual |
FY 2026-27 Estimated |
|
Percentage of NCQA behavioral health accreditation standards that are met |
N/A |
80%* 74 NCQA factors (2026) |
* This is a new Performance Measure. Data will be available in FY 2026-27
Fulfillment of this performance measure will demonstrate BHRS follows evidence-based clinical practices and has strong quality management and improvement, population health management, utilization management, credentialing, and member experience processes.
COMMUNITY IMPACT:
BHRS prioritizes care for County residents with the most serious mental health and substance use conditions, especially those at risk of homelessness, hospitalization, or justice system involvement, including vulnerable youth and young adults. Through a network of county- and community-based providers, BHRS delivers accessible, bilingual, and culturally responsive services to underserved populations, many of whom experience complex, co-occurring needs. These services improve community well-being by helping individuals stabilize, access treatment, and achieve long-term recovery, while reducing reliance on emergency and justice systems.
FISCAL IMPACT:
This is a zero-dollar ($0) amount agreement. The term of the agreement is July 1, 2026 through June 30, 2029. This agreement does not allocate funds for these programs; funding allocations are instead contained in separate agreements with DHCS. Should State funding for any of these programs be discontinued, the County will not be obligated to meet the performance goals for the affected programs. No Net County Cost is associated with this agreement.