The California budget proposal advanced by Governor Gavin Newsom would change the financing model for the state’s mobile crisis response teams, a network credited with improving access to emergency mental health care. Local programs such as San Diego’s teams operate regardless of a person’s insurance or housing status, pairing trained civilian responders with pathways to ongoing treatment. Supporters warn that shifting the program to an optional, county-funded benefit will force local jurisdictions to decide whether to preserve this 24/7 crisis capacity or scale services back.
San Diego officials emphasize the operational impact of the policy shift. County leaders report that MCRTs answered more than 32,000 calls and that only 2% of those situations required law enforcement to join the response. The county has expanded to 44 teams, achieving a response time under an hour in 98% of cases. Officials argue that the teams not only provide clinical stabilization and coordination but also free deputies to focus on higher-priority public safety tasks.
Why funding is changing
The financing challenge stems from how the benefit was incorporated into Medi-Cal following federal pandemic relief. Under the American Rescue Plan Act, states could claim an enhanced federal match to bring mobile crisis services into Medicaid. That temporary boost included an 85% federal match that supports much of the program today. However, that match is set to fall to 50% in 2027, creating a fiscal gap that counties would have to fill. The County Behavioral Health Directors’ Association of California estimates that the lower match will require counties to identify roughly $169 million annually to maintain the current level of service.
Local consequences and county concerns
For San Diego, the proposed budget would represent approximately a $24 million reduction in state-supported funding if counties are forced to assume more of the cost. Local behavioral health leaders say such a cut threatens the county’s recent investments, which include new crisis stabilization centers and an overall “Care Before Crisis” strategy designed to reduce homelessness, incarceration, and hospitalization. County officials caution that the change could produce a patchwork of access across California, where one community retains robust MCRT coverage while another significantly trims services.
Voices from the field
San Diego County officials and advocates have publicly urged the governor and Legislature to preserve the state’s commitment. Sheriff Kelly Martinez highlighted the teams’ role in reducing law enforcement involvement, noting that MCRTs helped handle tens of thousands of calls with minimal deputy involvement. Mental health advocates, including the National Alliance on Mental Illness California, warn that making the program optional would shift responsibility to already stretched county budgets and could create unequal access to trained crisis responses across jurisdictions.
Operational impacts and service demand
Behavioral health leaders point to the likely increase in demand if federal policy reduces Medi-Cal coverage. Provisions in federal legislative proposals, referenced as House Resolution 1 by state officials, could limit eligibility for some adults based on immigration status and are projected to reduce enrollment by roughly 500,000 people by January 2027. San Diego County Behavioral Health Services director Nadia Privara Brahms observed that as people lose coverage, more residents may require mobile crisis interventions, not fewer. That dynamic could intensify the fiscal squeeze at the exact moment the federal match drops.
What advocates want
Stakeholders across the state are seeking clarity and long-term commitments. The County Behavioral Health Directors’ Association and local leaders are asking the governor and Legislature to identify a durable funding solution that keeps the mandatory mobile crisis benefit intact. They argue that sustained state support is essential to preserve 24/7 response capacity, maintain rapid response times, and continue diverting people from emergency departments and jail into treatment and stabilization services.
Policy choices ahead
The May Revise outlines a record-high state budget, but it also reflects a smaller Medi-Cal allocation and competing fiscal pressures. Counties must weigh whether to absorb higher costs, reduce services, or seek alternative revenue. Local officials warn that the choice will shape crisis response availability for the roughly 112,000 residents the county currently serves through these programs. As negotiations continue, advocates urge policymakers to prioritize long-term funding that secures the gains made in crisis care.
Ultimately, the debate centers on whether California will preserve a unified, statewide approach to mobile crisis response or allow counties to create variable systems based on local budgets. For communities that rely on trained civilian teams to handle mental health emergencies, the outcome will determine whether the emphasis remains on coordinated treatment and diversion from law enforcement or on reactive, inconsistent care models tailored to each county’s fiscal capacity.