Mental Health Services Act (Prop 63)

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The passage of Proposition 63, known since November 2004 as the Mental Health Services Act (MHSA), provides the first opportunity in many years for increased funding, personnel and other resources to support County mental health programs and monitor progress toward statewide goals for children, transition-age youth, adults, older adults and families.

The Act addresses a broad continuum of prevention, early intervention and service needs and the necessary infrastructure, technology and training elements that will effectively support this system. We are thrilled to have you as a visitor, and hope you will want to become involved in MHSA planning processes as they occur. For information regarding the contents of the site or to learn more about how to become involved in planning processes, email





Public Hearing and Closing of Public Comment Period for MHSA Annual Update and Innovation Project Plans

The MHSA Annual Update FY 2015-2016 was updated to include three new Innovation Project plans for approval.  The Mental Health, Substance Abuse and Recovery Commission (MHSARC) opened a 30 day public comment period on Wednesday, March 2, 2016 for review of the MHSA Annual Update, now including three new Innovation Project plans.  A public hearing is scheduled to close the 30 day public comment period on Wednesday, April 6, 2016.  MHSARC meeting time and location below:

MHSARC Meeting
225 37th Ave., Room 100
San Mateo, CA 94403

We received Innovation Project ideas through the MHSA Three-Year Plan process, the MHSA Steering Committee prioritized 5 Innovation Projects for possible funding, a Letter of Interest process further identified capacity and interest and a Request for Proposal (RFP) process is currently in selection phase for the Health Ambassador Program for Youth (HAP-Y), released December 15, 2015 and the LGBTQ Coordinated Services, released January 15, 2016.  These two and the Neurosequential Model of Therapeutics (NMT) expansion to adults project are included for approval with the Annual Update.  The remaining two technology-based projects are still in development. 

Please review the Plan and provide your comment by utilizing the comment form below. You can submit your comments by email to or mail to:

Doris Estremera, MHSA Manager
Behavioral Health and Recovery Services
225 37th Avenue, 3rd Floor
San Mateo, CA 94403


If you have any comments/questions please send them to, or by mail to:

Doris Estremera, MHSA Manager
Behavioral Health and Recovery Services
225 37th Avenue, 3rd Floor
San Mateo, CA 94403

For the most current program-specific updates, which include MHSA funded programs, sign up to receive the BHRS e-journal, Wellness Matters and visit the BHRS Blog. To receive updates on the BHRS  Community Service Areas, which inform MHSA planning, visit the BHRS Good and Modern page.

MHSA Steering Committee

The MHSA Steering Committee makes recommendations about the planning and services development process of MHSA. As a group, the MHSA Steering Committee assure that MHSA planning reflects local diverse needs and priorities, contains the appropriate balance of services within available resources and meets the criteria and goals established. View the current list of MHSA Steering Committee members and the Roles and Responsibilities document.


MHSA Planning Timeline

MHSA planning, implementation and updates are on a Fiscal Year (FY) calendar July 1 – June 30.  Counties are required to plan for and submit a Three-Year MHSA Plan and Annual Updates each year.   

Current Three-Year Implementation Phase:  July 1, 2014 through June 30, 2017
Annual Updates Due:  December 2015, December 2016, December 2017
Next Three-Year Planning Phase: January 2017 – April 2017
Next Three-Year MHSA Plan Due:  December 2017


MHSA Evaluation

Prevention & Early Intervention Program Evaluation

In July 2013, we set out to evaluate our Prevention & Early Intervention (PEI) programs to understand the impact these programs are having in terms of promoting mental health, reducing the risk of mental illness, and decreasing the severity and negative consequences associated with onset of mental illness. The first year report, for services implemented in fiscal years 2013-14, is now available.

Full Service Partnership Qualitative Evaluation

In 2015, the American Institutes for Research (AIR) conducted a number of analyses of the San Mateo County FSP Programs outcomes and a full report will be released soon.  In the meantime, check out the FSP hospitalization and psychiatric emergency outcome report. Clients of San Mateo County's FSP Program had statistically significant decreases in psychiatric hospitalizations and emergency services according to this recent study.  Reductions in use of psychiatric hospitalizations and emergency services may indicate that individuals’ mental health status has improved and that they no longer require intensive care

In 2014 our Full Service Partnership (FSP) programs were evaluated to understand how well FSPs are working from the perspective of administrators, providers and consumers/clients.

Statewide MHSA Evaluation Reports Released


MHSA Plan and Components

MHSA Three-Year Plan & Annual Update

On January 27, 2015, the San Mateo County Board of Supervisors reviewed and approved the MHSA Three-Year Program and Expenditure Plan FY 2014-2015 through FY 2016-2017 & Annual Update FY 2014-2015:

The development of the MHSA Three-Year Plan involved a thorough Community Program Planning (CPP) process. Instructions and guidelines for the development of the plan can be found at the Mental Health Services Oversight and Accountability Commission(MHSOAC) website.  See the following presentation and documents for more information on our local CPP process:

Annual Updates

MHSA fundable activities are grouped into “components” each one with its own set of guidelines and rules:

Community Services & Supports (CSS)

CSS activities focus on providing direct services and treatment to people of all ages living with serious mental illness. At least 51% of CSS dollars have to be spent on full service partnerships, which provide 24/7 wraparound services.

Previous Years:

Prevention & Early Intervention (PEI)

PEI activities target individuals of all ages prior to the onset of mental illness, with the one exception of programs focusing on early onset of psychotic disorders. Learn more about the Office of Diversity and Equity, the Stigma Free San Mateo County and Prevention & Recovery in Early Psychosis (PREP); three PEI funded programs. MHSA PEI funds the following Community Interventions for School Age and TAY programs:

  • Early Childhood Community Team - supporting social emotional development in child care settings by providing consultation to child care providers;
  • Seeking Safety - helping people attain safety from trauma/PTSD (Post Traumatic Stress Disorder) and substance abuse
  • Project SUCCESS - preventing and reducing substance use and abuse and associated behavioral issues among high risk, multi-problem adolescents
  • School-based Services – aligning mental health clinicians to four middle schools in San Mateo County to serve SED children

The following agency's were selected to receive awards to implement these programs:

  • StarVista - Early Childhood Community Teams 
  • Puente de la Costa Sur - Project SUCCESS and Seeking Safety
  • Asian American Recovery Services, Inc, Health Right 360 - School-based Services
  • El Centro de Libertad - Seeking Safety
  • Pyramid Alternatives - Seeking Safety

Previous Years:

Capital Facilities & Information Technology (CF & IT)

CF&IT component funded eClinical Care, an integrated business and clinical information system (electronic health record) as well as ongoing technical support.


The MHSA Housing Program funds permanent supportive housing for individuals with severe mental illness and that meet the MHSA eligibility criteria as homeless or at-risk of being homeless. The Mental Health Association (MHA) of San Mateo County submitted a proposal to develop Waverly Place Apartments in North Fair Oaks community, which was reviewed and accepted by committee in February, 2014. Visit our MHSA Housing Program page for updates on this project.

Innovation (INN)

The MHSA Innovation Component allows counties to apply for funds for innovative projects, defined as novel, creative, ingenious approaches developed within communities and lead to learning for the mental health system. This past year 2014, the Community Program Planning (CPP) process to develop the MHSA Three-Year Plan included generating ideas for innovative projects.   The MHSA Steering Committee made recommendations on which projects to move forward for further exploration, listed below in the order of votes received. We requested Letters of Interest from organizations for the following six project areas:

•    The Health Ambassador Program
•    Neurosequential Model of Therapeutics (NMT) for adults
•    Housing advocacy services
•    LGBTQ Behavioral Health Center
•    Technology Innovations to support youth treatment and crisis
•    Technology Innovations for engaging isolated and hard-to-reach adults

We are now assessing the proposed ideas and working with our partners at the State before moving to the next phase in the planning process. 

For the first San Mateo County Innovation Plan funded through June 2015, BHRS built on several emerging, innovative practices for the San Mateo County Total Wellness program.

Workforce Education & Training (WET)

WET programming includes training, education, programs and policies to assist in the engagement and selection of a diverse workforce that includes consumers, families, and community members and schools.  Visit the BHRS WET website to learn more about the programs and services.

Current Approved Plan

Previous Years

For any comments or questions, contact:

Doris Estremera, MHSA Manager
Behavioral Health and Recovery Services Division, San Mateo County Health System
225 37th Avenue, San Mateo, CA 94403
Phone: 650.573.2889