California launches $4.5 billion Children and Youth Behavioral Health Initiative to transform services

The Joint Hearing of the Assembly Health Committee and Assembly Budget Subcommittee No. 1 on Health and Human Services convened on February 28, 2023, to discuss significant funding initiatives aimed at enhancing behavioral health services in California. The meeting focused on several key programs designed to improve mental health care delivery and address the needs of vulnerable populations.

The first item on the agenda was the Children and Youth Behavioral Health Initiative (CYBHI), a substantial multi-year funding package totaling $4.5 billion, with $3.4 billion sourced from the general fund. The initiative aims to transform service delivery by adopting a prevention-oriented approach. Notable features include a Virtual Services and Econsult platform for youth under 25, which utilizes interactive tools to identify and refer those with significant behavioral health needs to licensed providers. Additionally, the initiative expands coverage for dietetic services, integrates physical and behavioral health care, and allocates over $200 million for the Mental Health Student Services Act to enhance school-based services.

Next, the committee discussed the Behavioral Health Continuum Infrastructure Program, which addresses gaps in the behavioral health care system. With $2.2 billion allocated for facility construction, acquisition, or renovation, the program aims to increase the availability of care. As of the meeting, four of six funding rounds had been completed, with an expected $1.7 billion awarded by the end of the fiscal year. However, the Governor's budget proposes delaying the sixth round of grants, totaling $480 million.

The Behavioral Health Bridge Housing Program was also highlighted, which provides transitional housing for individuals experiencing homelessness and facing behavioral health challenges. The program received $1.5 billion over two fiscal years, with $908 million recently announced for counties. Similar to previous programs, the Governor's budget suggests delaying $250 million of this funding until 2024-2025.

Will Owens from the Legislative Analyst Office presented on the Community Assistance, Recovery and Empowerment (CARE) Program, which offers behavioral health treatments for individuals with acute mental health needs. The program is currently funded at $52 million, with an estimated full implementation cost of $214 million annually. However, uncertainties regarding participant numbers and eligibility criteria pose challenges for future budgeting.

Lastly, the meeting addressed the CalAIM initiative, a series of reforms to the Medi-Cal program, which includes a proposed behavioral health community-based continuum demonstration. This waiver aims to secure federal reimbursement for behavioral health services in short-term institutional settings, thereby expanding community-based care and reducing reliance on institutional stays.

The meeting concluded with a commitment to continue exploring these initiatives and their implications for improving behavioral health services across California. The committee expressed readiness to address any questions regarding the effectiveness and implementation of these programs.