County Behavioral Health Directors Association of California

What it reported doing in 2024

Advocacy: Legislative Advocacy: CBHDA co-sponsored one bill, AB 618 (Krell) with the Local Health Plans Association of California (LHPC), to improve data sharing between Medi-Cal managed care plans and county behavioral health agencies.In addition, CBHDA was a strong supporter of AB 1037 (Elhawary) to modernize statutes related to substance use disorder services.In addition, CBHDA analyzed over 100 pieces of legislation and weighed in on dozens of bills related to: mental health, substance use disorders, housing and homelessness, and criminal justice to shape policy proposals that might impact our members.CBHDA prioritized funding in the state budget process and hired two new fiscal staff to assist with legislative and budget policy advocacy. With these new hires, CBHDA was successful in securing $50 million for county behavioral health to support the implementation of Proposition 36. CBHDA staff and members also participated by providing testimony at numerous budget and legislative hearings.CBHDA hosted its fifth annual lobby day at the state Capitol, bringing county behavioral health members to Sacramento to lobby on CBHDA priorities.Administrative Advocacy: CBHDA prepared and submitted comments on more than 100 state policy proposals, on a range of topics from Proposition 1, to the BH-CONNECT Waiver, to CARE Court and the implementation of a variety of new laws. Behavioral Health Services Act (BHSA): CBHDA worked diligently with our membership through our various committees and work groups to gather critical information on the impacts of the Behavioral Health Transformation (BHT) and inform draft secondary guidance to implement the BHSA. In addition to the Housing and Houselessness Work group established in January 2024, CBHDA also launched a new Behavioral Health Workforce Work group in October 2024, as well as numerous ad hoc work group series in the Spring of 2025 on the following topics: Full Service Partnerships, Exemption and Transfers, Prevention and Early Intervention, BHSA IT Solution for the County Portal, Financial Services, Behavioral Health Outcomes, Accountability and Transparency Report (BHOATR), and evidence-based practices (EBPs)/community-defined evidence practices (CDEPs). Over the course of the last year, CBHDA has submitted written feedback on the first three Modules of DHCS BHSA Policy Manual and another 22 different policy advocacy letters, which led to favorable changes in overall DHCS BHSA policies for county BH departments. The list below reflects some of the policies achieved through CBHDAs advocacy on behalf of county behavioral health agencies: Ensured that all counties will receive automatic exemptions from EBP fidelity requirements for the first three-year Integrated Plan. Instead, the state will offer counties state-funded technical assistance on the required EBPs through their contracted Centers of Excellence to scale up these EBPs. An increase in the maximum cost-per-unit threshold for BHSA housing units from $115,000 to $450,000, representing a fourfold increase that more accurately reflects the current cost of developing housing. DHCS will allow counties to use up to seven percent (7%) of their BHSA Housing Intervention funding for Outreach and Engagement activities. Without this change, counties would have had to use funding from the BHSA Behavioral Health Services and Supports bucket, which was already significantly reduced, for housing related outreach and engagement activities. Ensured that county behavioral health clients already receiving housing through the FSP component funding under MHSA can be automatically transitioned to the BHSA Housing Intervention funding. Broadened the state's definition of Early Intervention programming to allow counties greater flexibility in sustaining services currently funded under the MHSA Prevention and Early Intervention component. Ensured there will be no funding restrictions when moving unexpended MHSA over to the BHSA. Reduced administrative bur

Financial Efficiency

• Mission deployment rate: 58.6%; rating input score 59
• Program expense ratio: 70.7%; rating input score 71
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 63rd percentile among comparable filings
• Pay-setting controls: 3 of 6 controls in place; rating input score 50
  • Compensation committee: Pass
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Pass
  • Board or committee approval: Pass
• Foreign activity oversight: Limited
• Grant itemization coverage: Limited
• Major donor itemization: Limited
• Related-party transparency: Limited

Accountability

• Independent voting board: 100%; rating input score 100; 63rd percentile among comparable filings
• Governance controls: 5 of 8 controls in place; rating input score 62
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Fail
  • Document-retention policy: Fail
  • CEO compensation review process: NotApplicable
  • Other executive compensation review process: Pass
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Fail
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: 16.7%; rating input score 73; 73rd percentile among comparable filings
• Total-asset coverage ratio: 2.03; rating input score 62; 62nd percentile among comparable filings
• Liabilities to assets ratio: 0.21; rating input score 43; 43rd percentile among comparable filings
• Officer compensation ratio: 24.4%; rating input score 9; 9th percentile among comparable filings

Growth

• Program expense growth: 9.3% per year; rating input score 100; 61st percentile among comparable filings
• Revenue growth: 12.5% per year; rating input score 100; 76th percentile among comparable filings
• Asset growth: 14.9% per year; rating input score 100; 74th percentile among comparable filings