Behavioral Health Transformation – Proposition 1

What is Behavioral Health Transformation?

Behavioral Health Transformation (BHT) is the effort that will implement the ballot initiative known as Proposition 1. BHT complements and builds on California’s other major behavioral health initiatives. Californians voted to pass Proposition 1 to modernize the behavioral health delivery system, improve accountability and increase transparency, and expand the capacity of behavioral health care facilities for Californians. Proposition 1 includes up to $6.4 billion in bonds to build new supportive housing and community-based treatment settings. The Department of Health Care Services (DHCS) is enacting changes resulting from Proposition 1 through the BHT project. HCAI will administer at minimum 3 percent (estimated at $100 million annually) for the first-ever sustained and coordinated statewide workforce initiatives to expand a culturally competent and well-trained behavioral health workforce.

Learn more about Behavioral Health Transformation.

What is Proposition 1?

Proposition 1 (Prop 1) was passed by California voters in March 2024. The two-bill package, Senate Bill (SB) 326 (Eggman, Chapter 790, Statutes of 2023) and Assembly Bill (AB) 531 (Irwin, Chapter 789, Statutes of 2023), proposed statewide efforts to reform and expand California’s behavioral health system, and was put on the ballot by the California State Legislature and the Governor. DHCS refers to the implementation of these changes as Behavioral Health Transformation. Prop 1 consists of two parts: The Behavioral Health Services Act and the Behavioral Health Infrastructure Bond.

What is HCAI’s Role in Behavioral Health Transformation?

The Behavioral Health Services Act (SB 326) directs HCAI to implement a comprehensive behavioral health workforce initiative to build and support a robust and diverse behavioral health workforce capable of providing high-quality, holistic services to all Californians. This initiative will be developed in consultation with various stakeholders, including DHCS, behavioral health professionals, counties, education and training programs, and consumer advocates. Key strategies include training, supporting, and retaining both county and non-county contracted behavioral health workers, with a particular focus on increasing the racial, ethnic, and linguistic diversity of providers and enhancing access to services in underserved communities and areas. Additionally, the initiative will offer technical assistance to county contracted providers to strengthen their infrastructure to recruit and retain the workforce and support the utilization of peer support specialists within the behavioral health system.