December 15th, 2025
Department of Health Care Services
1501 Capitol Ave #6001
Sacramento, CA 95814
RE: County Policy Manual Module #4 Feedback
To Whom It May Concern,
Mental Health America of California (MHAC) is pleased to provide the following recommendation and concern regarding the County Policy Manual:
- Early Intervention Program
Background
The CA Legislature incorporated a guarantee in the Behavioral Health Services Act (BHSA) so that 51% of Early Intervention funds would serve children and youth. This guarantee was made in anticipation of the changing revenue allocations from the BHSA, to protect the vital support and services for our most vulnerable population. The proposed language in Section A.7 would allow Early Intervention Evidence Based Practices (EBPs) and Community Defined Evidence based practices (CDEPs) for parents and caregivers to count towards the 51% requirement if the service is, “for the benefit of that child/youth.”
Recommendation
DHCS must revert to the original language in Section 7A of the County Policy Manual to ensure funding for children and youth remains protected.
Justification
The proposed language serves as a loophole for counties to spend less on children and youth, reducing available services and conflicting with legislative intent. Any EBP or CDEP for parents and caregivers could be justified as a benefit. However, “for the benefit of” and “to serve” are two different things. As written in statute, “A county shall utilize at least 51 percent of the county’s funding allocated for early intervention programs to serve individuals who are 25 years of age and younger.”
- Regulatory Authority
Background
California Government Code requires DHCS to adopt regulations to implement the BHSA by July 1st, 2033. Until then, DHCS is allowed to bypass the regulatory process by means of plan or county letters, information notices, plan or provider bulletins, or other similar instructions without taking further regulatory action. This would include the County Policy Manual, which covers a broad range of topics for implementation and enforcement. The Policy Manual Introduction of the County Policy Manual also states that, “the guidance in this manual will serve as regulations.”
Concern
The County Policy Manual prescribes significant rules for counties to follow. Rules such as these should follow the normal regulatory process to ensure appropriate public notice and input. Can a policy manual serve as regulations? Does DHCS intend to submit these regulations to follow the normal regulatory process by 2033? If not, the public perception of this manual may be perceived as “underground regulations” as defined by the Office of Administrative Law. Clarification on the regulatory timeline and authority regarding the implementation of the Behavioral Health Services Act would help enhance public transparency.
MHAC appreciates the opportunity to provide input and is committed to working with DHCS on the successful implementation of the BHSA. If you have any questions, or if MHAC can provide any assistance please do not hesitate to contact me at kvicari@mhac.org or our Public Policy Coordinator, Danny Thirakul, at dthirakul@mhac.org.
In Community,
Karen Vicari
Director of Public Policy
Mental Health America of California
