California's Behavioral Health Investments Require Expanded Services and Collaboration

Hospitals play a key role in California’s behavioral health system, but they are not the sole component. The state’s funding through the Behavioral Health Services Act and Proposition 1 will be most beneficial if it is paired with urgent investments in outpatient care, workforce development, housing, and improved coordination among the systems serving individuals in crisis.

The need for these changes is underscored as California broadens access to services through the CARE Act. Senate Bill 27 extends eligibility to include individuals with bipolar I with psychotic features and certain justice-involved individuals, which will have significant implications for the health care system and local hospitals.

As eligibility for CARE Act services expands, hospitals and outpatient providers must be prepared to accommodate the increased numbers. Hospitals can help establish a continuum of care that supports individuals before, during, and after a crisis, rather than only at the time of emergencies.

Northbay Health is set to open a Behavioral Health and Addiction Medicine Center in Fairfield in June 2028, funded by a $14.9 million award from the Behavioral Health Continuum Infrastructure Program and Proposition 1. This center will feature a 24/7 Behavioral Health Urgent Care model, a mental health clinic, and outpatient substance use treatment, addressing the needs of vulnerable populations like the homeless, justice-involved individuals, and foster youth aging out of care.

California currently faces a critical gap between emergency service availability and ongoing community care, leading many to cycle through emergency departments without receiving comprehensive treatment. Hospitals can help bridge this gap and stabilize individuals in crisis through constant operations and partnerships with counties.

Older adults on Medicare, particularly those with co-occurring conditions, face substantial barriers in accessing the appropriate services. It is essential that Medicare access and reimbursement are integrated into the planning of medical systems. The same applies to Medi-Cal, which serves a significant portion of Californians. Long-term sustainability of funding like BHSA and Medi-Cal will be essential to maintaining progress.

Partnerships between hospitals, counties, and community health departments have proven effective in improving post-discharge access and preventing individuals from falling through the cracks. The Fairfield center is an example of a collaborative approach that is necessary for California's future, focusing on interlinked systems.

Nevertheless, a hospital-based behavioral health center cannot single-handedly fulfill California’s behavioral health strategy. There remains a pressing need for accessible outpatient care, a sufficiently trained workforce, housing, and supportive services for those with serious mental illness. Moreover, better coordination is needed to ensure continuity of care as individuals transition between different providers and systems.

The success of these efforts will ultimately be measured by whether vulnerable populations, such as those experiencing homelessness or aging out of foster care, have reliable access to services at any hour. California's broader behavioral health investments should aim for this benchmark—creating more pathways to care and maintaining connections once individuals arrive.

Lois Cross is the vice president of government relations for Northbay Health.