Gov. Gavin Newsom’s revised budget proposal may sharply limit the reach of a statewide behavioral health program credited with improving access to emergency care. Locally, Mobile Crisis Response Teams (MCRTs) provide support to individuals facing mental health crises, regardless of insurance or housing status. The teams include trained civilians who connect individuals to long-term mental health services while diverting law enforcement personnel who may not have the training to handle mental health emergencies.“There have been over 32,000 calls to the Mobile Crisis Response Teams in San Diego County, and only 2% required that law enforcement also respond,” said San Diego County Sheriff Kelly Martinez. Martinez and other experts, including members of the County Behavioral Health Directors’ Association of California (CBHDA) gathered online and before the media last week to push for restoration of the state funding for the teams. Losing it, they warned, would mean losing ground when it comes to crisis care. “Making mobile crisis optional would move us backwards,” said Jessica Wilson, CEO of the National Alliance on Mental Illness California. “It would shift the burden to counties and create this patchwork system where one family may get a trained crisis team while another family in another county may be left with no reliable response at all.”In 2021, the federal government passed the American Rescue Plan Act to help communities recover from the COVID-19 pandemic. Part of the act allowed mobile crisis services to fall under Medicaid, the federal program that covers healthcare for patients with low incomes.A federal match of 85% was included in the federal bill for the benefit, but the match drops to 50% in 2027, according to CBHDA Executive Director Michelle Cabrera. This cut will require counties to find $169 million annually to cover the service with the reduced federal support.California piloted the service as a Medi-Cal benefit – the state’s name for its Medicaid program – with 24/7 operation. But under Newsom’s proposed budget, mobile mental health crisis services would be transformed into an optional, county-funded benefit starting in April 2027. For San Diego County, that could mean a $24 million hit to the budget. Since 2021, the number of MCRTs in San Diego has increased to 44, and 98% of calls receive a response in under an hour. The teams also take pressure off law enforcement, which once had to cover the majority of mental health calls.“This partnership allows us to keep deputies focused on high priority calls and community safety while ensuring people in crisis receive care, coordination, stabilization support and connection to ongoing treatment,” Martinez said.The county has been aggressive on the behavioral health front in the past five years, increasing annual investments and opening new crisis stabilization centers, which provide short-term services to those in crisis.The efforts are part of a “Care Before Crisis” mental-health strategy, aimed at reducing homelessness, incarceration and hospitalization. But the county is concerned that the proposed state cutbacks will limit care to the 112,000 San Diegans they serve.After Newsom’s May Revise, the 2027 fiscal year budget, as proposed, will be the largest spending plan in California’s history, at $349 billion, despite a $400 million drop in Medi-Cal funding.Medi-Cal, one of the largest programs in the state’s budget, faces additional pressure due to House Resolution 1, the federal Republican megabill also known as the “One Big Beautiful Bill Act.” Under the bill, cost of care rises for adults ages 19 to 59 who have “unsatisfactory” immigration statuses. By January 2027, Medi-Cal is expected to serve 500,000 fewer people.Nadia Privara Brahms, director of San Diego County Behavioral Health Services, said, “As we see the impacts of H.R. 1, it’s likely that more people will need mobile crisis services as they lose their health care benefits.”She called the mandatory mobile crisis “essential to support our children, neighbors, our loved ones in crisis,” and urged the governor and Legislature to “prioritize long-term funding for this program.”
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