Q: In the Steinberg Institute's budget memo, you applauded both the Senate and Assembly for prioritizing funding for mobile crisis services. What will this continued funding make possible? What impact do you hope to see? 

For many Californians, their first interaction with the behavioral health system happens during a crisis. For too long, that has meant an unnecessary encounter with law enforcement or an emergency department leading to incarceration or hospitalization.

The Assembly proposal specifically directs 988 funding toward mobile crisis teams. These teams bring trained behavioral health professionals directly to people in crisis, allowing many crises to be resolved over the phone with 988 or safely stabilized in their homes or communities.

Mobile crisis teams also can connect people with ongoing treatment and support, setting them on a path toward long-term recovery. 

Q: As a contrast, if funding for mobile crisis benefits expire in 2027, what do you see happening? What is at stake for Californians, patients, and emergency responders? 

If California makes the Medi-Cal mobile crisis benefit optional, access to appropriate and life-saving care will become increasingly dependent on where someone lives. 

Larger or better-resourced counties may be able to sustain mobile crisis teams, but many smaller and rural counties are already struggling to make these programs financially viable even with state support.

Without continued funding, many communities will likely reduce or eliminate services altogether, resulting in greater reliance on law enforcement, emergency departments, and hospitals to respond to behavioral health crises.

That means higher costs, worse outcomes for patients, and increased strain on first responders.

Q: Could you share an example of how mobile crisis teams, community paramedicine, EMS systems, and behavioral health providers work together to create a more effective response for people experiencing a mental health or substance use crisis? 

California already has promising examples of what an integrated approach can look like.

One is the San Ramon Valley Fire Protection District, which has incorporated behavioral health screening questions into its emergency dispatch process. When appropriate, emergency dispatchers can redirect calls to 988 or prioritize an EMS-led response rather than a law enforcement response. 

Ultimately, 988, 911, and mobile crisis teams should function as one coordinated system. Regardless of how someone enters the system, there should be no wrong door into the care that best meets their needs. 

Q: Looking ahead, what are the most important opportunities or priorities you see for strengthening California's behavioral health crisis system over the coming years? 

California has enacted some of the most significant behavioral health reforms in the country over the past several years. Now, we must ensure those reforms achieve their intended impact through strong implementation.

By identifying and addressing operational barriers, improving coordination among 988, 911, and emergency responders, and continuing to invest in Medi-Cal mobile crisis services, California can fulfill the promise of a system where every community has access to high-quality crisis services, regardless of zip code.