Full-service partnerships.

Assembly Member Krell, with coauthor Gipson, advances a measure that would create presumptive eligibility for full-service partnerships for people with serious mental illness who are navigating high-risk transitions, tying timely access to a comprehensive, whole-person care framework that includes housing supports and evidence-based services. The core change would allow individuals meeting specific high-risk criteria—such as unsheltered homelessness, a transition after six months or more in a secured setting or incarceration, or a history of multiple crisis detentions—to be enrolled in full-service partnerships more rapidly, provided a licensed clinician recommends enrollment and the individual meets the program’s care standards. The proposal also specifies that a primary diagnosis of substance use disorder would not by itself render someone ineligible. Implementing this framework would depend on funds from the Behavioral Health Services Fund and would not obligate counties to use funds from other sources; a sunset on the amended framework and a separate operative framework are slated for January 1, 2027.

The measure enumerates the service components that full-service partnerships would offer, including mental health services, supportive services, and substance use disorder treatment, along with access to assertive community treatment and related evidence-based models (subject to exemptions for smaller counties), as well as field-based initiation for substance use treatment, outpatient services, ongoing engagement, housing interventions, and other DHCS-approved services. Service delivery would follow a trauma-informed, whole-person approach, coordinated to minimize barriers and aligned with a defined service-planning process. The program would require a standard of care with levels based on acuity and include community-defined practices, with a financing structure that pays for all behavioral health and supportive services from funds allocated for that purpose, subject to existing statutory constraints. Documentation of the service-planning process and the rendered services would be required, with DHCS empowered to establish and revise standards that may align with Medi-Cal documentation requirements.

Implementation involves multiple state and local actors and constraints. Counties would operate full-service partnership programs under guidance from the Department of Health Care Services, with input from the Behavioral Health Oversight and Accountability Commission and collaboration with the California State Association of Counties and the County Behavioral Health Directors Association on exemption criteria for counties with smaller populations. Enrollment decisions would require not only meeting defined eligibility criteria but also a clinician’s documented recommendation, and counties could defer enrollment if it would conflict with Medi-Cal contracts, court orders, or exceed capacity or funding. The bill’s findings frame the policy underpinnings, noting barriers faced by high-risk individuals with serious mental illness and describing presumptive eligibility as a mechanism to reduce care delays and align behavioral health services with housing and social supports.

Viewed in policy context, the measure sits within California’s Behavioral Health Services Act framework and the broader effort to align funding streams, service models, and outcomes for people with complex needs. It foregrounds a transition strategy that culminates in a new operative framework on January 1, 2027, while maintaining an interim sunset for the existing amended provisions. The proposal emphasizes not only access to a broad suite of services but also coordination with Medi-Cal obligations and data- or documentation-standard alignment across programs. The bill’s findings highlight perceived barriers and the rationale for presumptive eligibility, signaling a shift toward more timely, integrated care for high-risk populations, while preserving county discretion in light of funding and capacity constraints.