Every three years, Plumas County Behavioral Health produces a three-year integrated plan and asks for public feedback before approval by county and state officials. This year, that plan looks different following an amendment to California’s 2004 Mental Health Services Act. The 2024 amendment, approved by voters statewide as Proposition 1, created stricter guidelines and shifted much of the focus to housing support.
The MHSA — now BHSA — helps fund Plumas County programs, some of which include transportation to clinics, school counselors, therapy groups, housing support and outreach initiatives. The behavioral health department is asking for public comment on its three-year integrated plan by March 6.
Sharon Sousa, director of Plumas County’s behavioral health department, said the MHSA filled in the gaps in care left in Medi-Cal coverage, including transportation to medical appointments. The county couldn’t bill Medi-Cal for those costs. That’s where MHSA funding came in.
Funding for the act comes from a 1% tax on people who make over $1 million. The funds are dispersed to counties based on population size, said Jessica McGill, quality improvement and compliance manager for the county behavioral health department.
The act:
Renamed the MHSA to Behavioral Health Services Act.
Amended the MHSA to offer treatment for substance use disorders and created stricter guidelines on how MHSA dollars are spent.
Established a $6.38 billion bond for mental health facilities and supportive housing for veterans and those at risk of homelessness with mental illness.
Increased the county allocation to the state from 5% to 10%. Some of that money is from the shift of local population-based prevention programs to the California Department of Public Health.
The major programming and spending changes will take effect in July. The estimated yearly allocation of $2.5 million will be divided into three categories: housing support (30%), full service partnerships (35%) and behavioral health services and supports (35%).
According to the budget for the integrated plan, $175,000 of full service partnerships funds would be transferred to housing intervention to help the county contract with an entity to provide permanent-supportive housing. Full service partnerships are curated programs to individuals struggling with mental illness who are at risk of being unhoused, in the justice system or with a history of repeated hospitalizations.
Three new programs required
Proposition 1, which created the changes to mental health programs, “put restrictions on large parts of how we could use that money,” Sousa said. “They didn’t ask each county ‘what needs do you have? What do you want to use that money for?’”
The 2024 law requires narrow programs that focus on a certain demographic. Because of Plumas County’s size, these programs sometimes serve only a handful of people, McGill said.
This has posed a challenge. The county is struggling with severe workforce limitations — about 50% for PCBH — that sometimes conflict with regulations and laws when implementing those programs, McGill said. The department also lost its MHSA coordinator before the county began creating the three-year plan.
Three programs from the BHSA will be implemented in this three-year plan: psychosis screening and care, personalized programs for youth experiencing severe mental illness and in-the-field services for people experiencing substance-use disorders.
Before the amendment, most of the funding was directed toward behavioral health support. This included programs such as outreach, intervention, education, capital facilities and innovative pilot projects, McGill said.
Now, with only 35% of the funding being allocated for those services, the Plumas department is looking at what the county needs and what services it will still be able to provide with the more limited funding, Sousa said.
Housing becomes top priority
With so much more money designated for housing options, Sousa said the Plumas County Board of Supervisors has asked her department to gather community feedback on how residents want to see it spent.
The housing options category is expected to hold $925,000, according to the department’s budget. It allocates $500,000 of that funding for long-term supported housing, such as apartments, and $300,000 for short-term supported housing, such as hotels.
Currently, PCBH can place someone in a hotel for emergency housing. It contracts with Environmental Alternatives, a nonprofit corporation offering services to children and young adults, to provide temporary housing. Previously rent subsidies were dedicated to people at risk of hospitalization or incarceration, McGill said. Under the new amendment, those subsidies can also be used for low-income families and youth.
Rent subsidies are restricted to one year. During that time, the department would help individuals apply for other housing support programs and find housing options in or out of the community, she added.
“We look at the big picture: what’s plan a, b and c, and let’s see how we can get you there within that 12 months of housing subsidies,” McGill said.
“It’s simply going to take us longer to figure out the long-term, permanent-supportive housing.”
Sharon Sousa, Plumas County’s behavioral health department director
While there is some temporary housing offered through PCBH and the Plumas Crisis and Intervention Center, the state now requires permanent-supportive housing — long-term housing for people who struggle with severe mental illness.
Sousa acknowledged that is lacking in Plumas County. It is something PCBH has been working on. But the Dixie Fire has limited the amount of housing the department can acquire and there’s been some community pushback, she said. There’s a misconception that severely-mentally ill clients will come into the county if they build permanent-supportive housing, Sousa said. There’s already a countywide need for people who are already here. “They’re somebody’s relative, friend and neighbor,” she said.
If the county doesn’t provide permanent-supportive housing, it will receive a corrective action plan from the state. That could later lead to fines.
“It’s simply going to take us longer to figure out the long-term, permanent-supportive housing,” Sousa said.
Addressing depression from youth to the elderly
When the county requested data from the state, Sousa was surprised to see Plumas County’s suicide rate from 2021 to 2023 more than double the state average. The county had 24.8 suicides per 100,000 residents; the statewide rate was 10.8.
There were signs of this in the 2025 stakeholder survey. It showed depression as the number one reported concern. The department has been working to address depression in youth, but what they saw from the data was that the elderly were also struggling. This is something the department intends to work on.
Sousa said she was unaware of the rate being so high, and speculated that many of the victims might not be Medi-Cal recipients served through her department. Based on the data, she said the department aims to forge closer relationships with emergency departments in an effort to receive more referrals and provide follow-up care.
“One of the things we are going to do with behavioral health services and support money is put a lot more emphasis on suicide prevention,” Sousa said.
“A lot of education reducing the stigma and being more proactive with intervention is going to be the biggest focus,” McGill said.
If someone is experiencing a mental health need, a call to PCBH would dispatch a mobile team with resources and support. The team would then work on getting ongoing care.
The three-year integrated plan is open for public comment until March 6. Feedback and questions can be emailed to Shelley Evans at [email protected].