Local health officials are again raising alarm over Gov. Gavin Newsom’s proposal to reduce state funding for specialized mobile crisis teams that respond to people experiencing psychiatric emergencies.
The governor has proposed shifting to counties the state’s financial obligation for funding those services under Medi-Cal, California’s version of the federal Medicaid program. County health officials had hoped the proposal would be eliminated in the governor’s May budget revision. It’s still there.
Currently, the state pays only 15% of the cost while the federal government pays 85% under a pandemic-era “enhanced federal match” that’s slated to end next spring. Thereafter, the cost share is expected to become the more common 50-50 under Medi-Cal, which state officials have said would cost the state’s general fund an estimated $170 million a year.
Under the governor’s proposal, the state would redesignate mobile crisis services as an optional benefit under Medi-Cal, thereby shifting the “non-federal match” to counties.
Local county officials argue that communities with fewer financial resources would be unable to cover the cost of those services.
“Mobile crisis is not an optional add-on in a rural county like ours,” Elise Jones, director of Lake County Behavioral Health Services, said in an email.
“It is one of the most effective tools we have to respond to people in crisis in the community, reduce unnecessary law enforcement involvement, divert people from emergency departments and jail when appropriate, and connect individuals and families to ongoing care,” she said.
Jones said Lake County was among the first counties in the state to launch mobile crisis services after the federal government’s enhanced funding became available during the pandemic. At the same time, she said, financially-strapped counties have had to implement a host of sweeping, state-driven initiatives that are transforming mental health services and the Medi-Cal program.
“For small, rural, and financially constrained counties, these changes are not easy to absorb,” Jones said. “When state funding is reduced or shifted during this level of transformation, the practical effect is that counties are asked to do more with fewer tools.”
One of the requirements for receiving the enhanced federal funding was for states to make mobile crisis services available 24-7. State funding helped make that possible, said Nolan Sullivan, director of the Sonoma County Department of Health Services. In Sonoma County, mobile crisis services have been provided since before the pandemic, but state funding allowed the county to expand the program.
Sullivan called the governor’s proposal “deeply disappointing.” Sonoma County helps fund mobile crisis services with about $5 million from Measure O, a countywide quarter-cent sales tax approved by voters in 2020 for mental health, drug addiction and homeless programs.
The funds support two mobile crisis programs, inRESPONSE and SAFE, operated by nonprofits, as well as the county’s own Mobile Support Team. Currently, only the county’s program receives Medi-Cal dollars. The Measure O tax is set to expire in 2031.
“This proposed state reduction will have significant long-term impacts on our community’s ability to provide these lifesaving services,” Sullivan said in an email.
Sullivan said the funding shift “would result in millions of dollars in new local costs and could ultimately place lives at risk.”
The funding reduction comes at a time when counties are bracing for significant federal reductions under President Donald Trump’s One Big Beautiful Bill, he said. Along with substantial state reductions in health coverage for undocumented immigrants in Sonoma County “the timing of this proposal could not be more challenging for local behavioral health and public safety systems,” he added.
Newsom’s proposal was unveiled back in January with the first iteration of his nearly $350 billion 2026-27 budget. Newsom kept the cut in tact in his revision released May 14.
The cut was part of the governor’s effort to close a nearly $3 billion shortfall, though he said Thursday higher tax collection has helped erase that deficit.
The loss of state funding for mobile crisis services could force struggling jurisdictions like Lake County to end their programs, said Michelle Doty Cabrera, executive director of the California Behavioral Health Directors Association, which represents the state’s public mental health administrators.
Doty Cabrera said the Medi-Cal funding for mobile crisis response has allowed counties to build out their community-based crisis response teams trained in de-escalation, reducing the need for law enforcement involvement and sparing hospital and justice system resources.
“In the absence of state funding, most counties won’t be able to sustain these programs that save lives and offer relief to families who need somewhere to turn,” Doty Cabrera said in a statement following the release of the governor’s budget revision.
Doty Cabrera and local health officials called on state legislators to work with the Newsom administration to reverse state cuts to mobile crisis services.
You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com.