Behavioral Health Services Act Racial Equity County Integrated Plan Scorecards

About the BHSA Scorecard Project

The Behavioral Health Services Act (BHSA), approved by California voters in 2024 through Proposition 1, reforms the Mental Health Services Act (MHSA) and is intended to strengthen mental health and substance use disorder services across California. Most BHSA funding is allocated to counties, which are responsible for planning and delivering services. Each county develops a County BHSA Integrated Plan outlining how it intends to use all available behavioral health funding, including BHSA funds, over a three-year period. The California Department of Health Care Services (DHCS) sets the requirements for Integrated Plans and reviews counties’ plans and Annual Updates.

Because California’s current behavioral health systems continue to underserve people of color, it is essential that state and county implementation of the BHSA identify, address, and reduce racial disparities in access, quality, and outcomes. We developed our BHSA Scorecard Project with input from community partners to assess how counties’ Integrated Plans address racial equity. The scorecards highlight strengths, elevate best practices, and identify specific opportunities for improvement for each county.

We reviewed the final Integrated Plans of 10 counties and developed scorecards with letter grades assessing their plans across seven equity domains:

  • Community engagement
  • Culturally and linguistically responsive workforce
  • Language access
  • Racially equitable Behavioral Health Services and Supports (BHSS) strategy
  • Funding equity and sustainability
  • Community-based approaches to care
  • Promoting racial equity and addressing racial disparities
Read our methodology and scoring rubric here

View the Scorecards

Note: These scorecards assess the content of counties’ BHSA Integrated Plans, rather than implementation or outcomes. They do not capture all local context or community experiences. The findings should be considered alongside community knowledge and ongoing monitoring of implementation.

How We Developed the Scorecards:

Our process began before draft Integrated Plans were released and continued through review of the final Integrated plans, with community priorities guiding the development of our recommendations and criteria.

  1. Listening to community priorities. We held focus groups with community partners to understand their priorities, concerns, and what they wanted to see in their counties’ Integrated Plans. In some counties, we also co-hosted listening sessions with county behavioral health departments in partnership with local community organizations.
  2. Developing early recommendations. Drawing on these conversations, we developed county-specific letters with recommendations that counties could incorporate into their draft Integrated Plans. This supported advocacy while plans were still being developed.
  3. Building and refining the criteria. We developed and refined the scorecard criteria through multiple rounds of partner feedback to ensure they reflected community priorities. We worked to make the criteria clear and accessible, giving partners and community members a practical framework for navigating lengthy, complex plans and assessing how counties addressed their needs.
  4. Reviewing draft plans and informing partners. Once draft Integrated Plans were released, we reviewed them against the scorecard criteria to identify strengths and opportunities for improvement. We shared our findings with partners in each county so they could better understand their county’s plan and use the information in their local advocacy and participation in the community planning process.
  5. Engaging counties in constructive dialogue. We approached county engagement from a strengths-based perspective, contacting behavioral health departments with follow up questions and requests to meet, and inviting local partners to participate. We highlighted strengths, shared specific recommendations, and gave counties an opportunity to clarify their plans and provide additional information that might not have appeared in the draft plans. These conversations also helped identify commitments and information that could be included in the final plans.
  6. Scoring the final plans. When final Integrated Plans were released, we reviewed and scored them using the same scorecard criteria applied to the draft Integrated Plans. We assessed where counties addressed community priorities and where opportunities for improvement remained. Final scores/grades reflect the information and commitments documented in the final plans.
  7. Supporting continued advocacy. Partners and community members can continue using the scorecards as a tool to identify priorities, ask questions, and advocate for improvements during each Annual Update process and the development of the next Integrated Plan. The scorecards provide a shared foundation for ongoing dialogue, community participation, and accountability.