As of July 1, 2026, the Behavioral Health Services Act (BHSA) is officially in effect statewide—with all 58 California counties now operating under their new County Integrated Plans. Here’s your guide to what they are, what’s inside them, how they differ from prior plans, and how to read one yourself.
Every California county has now submitted its first three-year Integrated Plan (IP) under the Behavioral Health Services Act (BHSA), the funding and reform framework created by Proposition 1. These plans run 150-200+ pages, follow a rigid state template, and are dense reading. But they’re also the single best public window into how each county intends to spend its behavioral health dollars over the next three years, including on the outcomes we care most about: reducing hospitalization, reducing homelessness, reducing incarceration, and strengthening the workforce.
Below is your guide to what an Integrated Plan is, why it exists, and exactly where to look if you only have twenty minutes and a specific question in mind.
What the County Integrated Plan is and why it matters
A County Integrated Plan (IP) is a new, mandatory three-year filing that every county behavioral health department must submit to the Department of Health Care Services (DHCS). Its stated purpose is to function as a spending plan reflecting total behavioral health investment across every funding source—not just BHSA dollars. This includes Medi-Cal funding, federal block grants, opioid settlement funds, county general fund, and more.
In practice, that “global” view mostly shows up as aggregate totals — the county reports one combined dollar figure per service category across all funding streams — while the detailed, program-by-program reporting that makes up most of the document is specifically about how BHSA dollars are being spent, with non-BHSA sources disclosed mainly as participation checklists or as “additional funding leveraged” alongside a given BHSA-funded program, not as their own fully itemized sections.
This is a meaningful change from what came before. Under the previous Mental Health Services Act (MHSA), counties submitted a Three-Year Program and Expenditure Plan, but it covered only MHSA dollars and followed no common template. As a result, it produced inconsistent, hard-to-compare data across counties. The BHSA County Integrated Plan is designed to fix that: a single standardized template, a single filing that spans a county’s entire behavioral health funding picture, and a direct tie to state-defined outcome measures. You can learn more about the evolution from the MHSA to the BHSA here.
What’s actually in the Integrated Plan
Every county’s Integrated Plan follows the same DHCS template, in the same order.
1. General Information
This section provides necessary administrative information, including who to contact if you have questions about the plan:
- Behavioral health agency name and mailing address
- Required roster of role-specific contacts: BHSA Coordinator, primary/secondary Mental Health and SUD contacts, Housing Interventions contact, SMHS and DMC-ODS Compliance Officers, QA/QI lead, Medical Director, etc.
2. County Behavioral Health System Overview
This section provides a high level picture of the county’s entire behavioral health system, including who the county is currently serving and what infrastructure it has to serve them. It specifically includes:
- Data tables reporting counts of children/youth and adults served, broken out by Medi-Cal enrollment, homelessness status, justice involvement, foster care/child welfare overlap, acute psychiatric care, and conservatorships
- Technical infrastructure: EHR vendor, health information exchange participation, API and data-sharing compliance
- A full checklist of every funding stream and mandated service the county participates in (block grants, realignment, Medi-Cal SMHS/DMC-ODS)
3. Statewide Behavioral Health Goals
DHCS developed 14 statewide population health goals to guide the development of this plan. Counties are required to address six of these goals, and can select at least one from the eight others to include in their plan. This section highlights how counties will achieve these goals, providing information on:
- County status and disparities analysis for each of the six mandatory goals: Access to Care, Homelessness, Institutionalization, Justice-Involvement, Removal of Children from Home, and Untreated Behavioral Health Conditions
- Planned programs and funding sources tied to each goal
- At least one additional self-selected goal, chosen because the county is underperforming the state average
4. Community Planning Process
The BHSA requires counties to develop their integrated plan alongside local stakeholders, including: families with loved ones who have lived experience, adults with lived experience, CBOs, local education/social services/etc. agencies/partners/orgs, veterans, MH/SUD providers, etc. This section documents how the county engaged the community to develop their plan, providing the following information:
- A dated log of every stakeholder engagement activity (surveys, focus groups, workgroups, etc.)
- List of specific organizations engaged, and confirmation that all required stakeholder groups were reached
- Coordination with local health jurisdictions and Medi-Cal managed care plans
- Public comment period and hearing record log
5. Behavioral Health Care Continuum
DHCS developed two standardized frameworks, one for mental health and one for substance use disorder, for counties to show what services they plan to use across each continuum and how they plan to fund it. This new framework is useful because it allows: planned expenditures across key service categories in their service continuum. They specifically enable:
- counties to identify gaps in their service continuum and plan their investments to expand access and achieve the statewide population health goals.
- state-level analysis and comparison over time and across counties
This section provides the county’s full financial picture across each continuum of care framework:
- Planned spending across the entire continuum of care for mental health and SUD systems: prevention, early intervention, outpatient, crisis, residential, and inpatient/acute
- Dollar figures are aggregated across all funding sources per category, not just BHSA
6. Behavioral Health Services Act/Fund Programs
The BHSA requires counties to spend their BHSA funds across three categories. This section—arguably the heart of the plan—outlines the programs and services counties are using BHSA dollars to fund across each category.
It specifically provides information on: what the program is, the projected number of eligible individuals for each program, the intended outcomes for programs, and estimates for the number of practitioners needed to serve all eligible individuals.
7. Workforce Strategy
As part of the BHSA’s goals to strengthen California’s behavioral health workforce, this section is a self-assessment of whether the county has enough qualified people to deliver on their programs outlined above.
- Overall vacancy rate for clinical/direct-service positions, and the five hardest-to-fill roles
- Narrative on expected workforce shifts over the next three years
- Whether the county is leveraging the state’s BH-CONNECT workforce programs (scholarships, loan repayment, recruitment/retention funding, training)
8. Budget and Prudent Reserve, and Certification
This section is the financial and legal sign-off that makes the plan official. It includes:
- The completed budget template and prudent reserve calculations
- Certification from the county Behavioral Health Director and County Administrator
- Final approval from the county Board of Supervisors
Sections 3 and 6 are where nearly all of the substantive, program-level detail lives — if you’re short on time, those are the two worth reading closely.
Where to look: a question-driven guide to the County Integrated Plan
Integrated Plans are long, but they’re consistently structured. If you know what you’re looking for, you can skip straight to the relevant section. Here’s a cheat sheet organized around the questions we get asked most.
| If you want to know… | Search the PDF for…
Ctrl+F for the bolded keywords to get to the relevant sections. |
| Where does the county’s money come from, and what does it fund? | Go to:“County Behavioral Health System Service Delivery Landscape” section
The heading “County Behavioral Health System Service Delivery Landscape” provides a full accounting of every funding stream and how each is used. |
| How is the county addressing the six mandatory statewide goals? | Go to: “Statewide Behavioral Health Goals” section
The “Statewide Behavioral Health Goals” section provides specific details on the county’s plan for each of its goals– outcome measures, data systems, disparities analysis, and more. For more information on each goal, search for the goal’s own heading: “Homelessness,” “Institutionalization,” “Justice-Involvement,” “Removal of Children from Home,” and “Untreated Behavioral Health Conditions”. |
| What metrics are they using to track success? | Go to: “Statewide Behavioral Health Goals” section
Under each goal heading, look for “Primary Measures” and “Supplemental Measures”. This is where you’ll find the actual data points (e.g., inpatient administrative days, PIT homelessness counts, arrest rates) the county is being held to. |
| Which programs is the county running to hit each goal? | Go to: “Statewide Behavioral Health Goals” section
The “Cross-Measure Questions” heading under each goal — narrative on what the county will strengthen or newly implement starting July 1, 2026, tied to the data |
| Which extra goal did the county pick to focus on? | Go to: “County-Selected Statewide Population Behavioral Health Goals” section
The section “County-Selected Statewide Population Behavioral Health Goals” is where every county must choose at least one additional goal where it’s underperforming the state average |
| What’s actually being funded under the three main BHSA buckets? | Go to: “Behavioral Health Services Act/Fund Programs” section
The Behavioral Health Services Act/Fund Programs section has a subsection per funding category: “Behavioral Health Services and Supports (BHSS),” “Full Service Partnership Program,” and “Housing Interventions” — usually appearing in that order, back to back |
| How does the county plan to reduce hospitalization and incarceration?* | Go to: “Behavioral Health Services Act/Fund Programs” section
The section “Full Service Partnership Program” — this is where ACT/FACT (including the forensic variant for justice-involved clients), Intensive Case Management, High Fidelity Wraparound, and Individual Placement and Support all live, along with eligible-population estimates and staffing plans |
| How does the county plan to reduce homelessness?* | Go to: “Behavioral Health Services Act/Fund Programs” section
The section “Housing Interventions,” and further down, “BHSA Housing Interventions Implementation” — the county’s own gap analysis across 20 housing types, plus a detailed accounting of rental subsidies, operating subsidies, landlord outreach funds, and capital development projects |
| How is the county strengthening its workforce?* | Go to: “Behavioral Health Services Act/Fund Programs” section AND “Workforce Strategy”section
Two sections provide information on workforce:
|
| Is the county actually piloting anything new? | Go to: “Behavioral Health Services Act/Fund Programs” section
The section “Behavioral Health Services Fund: Innovative Behavioral Health Pilots and Projects” provides information on new programs the county is planning. It is optional, but also a good signal of where a county sees gaps in its existing system. |
*These questions specifically address the Steinberg Institute’s Vision 2030 goals.
Next steps: What happens after a county submits its plan
Each county submitted its Integrated Plan by June 30th—but submission isn’t the finish line. It’s the start of a formal review cycle.
The Integrated Plan takes effect July 1st, even if it hasn’t yet been approved by DHCS.
DHCS is continuing to review and approve county plans after July 1st. No matter the status of their plan, counties started operating under the plan once BHSA went into full effect. Once approved, each county’s IP is published on the DHCS website.
Integrated Plans aren’t the only reporting requirement.
Each three-year Integrated Plan cycle requires an Annual Update in years two and three—a full review of every section, revised for the coming fiscal year. Counties can also file Intermittent Updates at any point to respond to urgent local changes. These updates are what DHCS will later measure counties against: the first BHOATR (due January 2029) will compare actual FY 2026-27 performance to the baseline set in this original final IP, so what a county commits to now has real downstream accountability attached to it.
Our Take
For the first time, every California county has put its behavioral health spending plan into a single, standardized, publicly available document—one that has to speak directly to reducing hospitalization, reducing homelessness, reducing incarceration, and strengthening the workforce. It is a meaningful first step to streamline our fragmented systems and work towards similar goals.
We’ll be tracking the next phase closely. Once all 58 plans are finalized and approved, we’ll share a cross-county analysis looking at where counties converged, where they diverged, and what that tells us about the real priorities behind California’s biggest behavioral health overhaul in two decades.