Bryce Moss fidgeted as he sat on the porch of his Clearlake mobile home, recounting how mental health workers with Lake County’s mobile crisis team saved his life, several times.

Moss, 40, a recovering alcoholic diagnosed with schizophrenia, PTSD, depression and ADHD, choked up as he described the help he received from those county workers.

Like other county mobile crisis teams throughout the state, Lake County’s team works closely with law enforcement to respond 24 hours a day, seven days a week to people in the community who are experiencing a mental health crisis. In many cases, the team relieves police and sheriff’s deputies from the burden of responding to crisis calls.

When Moss got out of a Clearlake Oaks addiction recovery center more than a year ago, a substance abuse counselor “took me under her wing” and immediately helped him find housing.

“They saved my life,” Moss said. “They helped me get sober. … They’re a godsend for people like me.”

Now, those services — launched over the past decade by local governments across the greater North Bay, with funding from the state and federal governments — are in jeopardy.

Buried in Gov. Gavin Newsom’s proposed $348.9 billion 2026-27 budget is a plan that would shift the state’s financial obligation for those services over to counties.

That move would be a big blow to the state’s most economically distressed counties, potentially forcing them to shutter their mobile crisis programs. The fallout would create a patchwork of county “haves and have-nots” across the state, said Michelle Doty Cabrera, executive director of the California Behavioral Health Directors Association, which represents the state’s public mental health administrators.

“They’re going to have to shut down all or part of their mobile crisis response,” Doty Cabrera said. “People are really devastated by that possibility because they’ve seen the real benefit … diverting people away from law enforcement involvement, away from hospital emergency departments, and away from more expensive and traumatic, frankly, interventions.”

For their part, Newsom administration officials argue that state support for mobile crisis services was only temporary, and that state funding is no longer sustainable given budget shortfalls in the tens of billions of dollars in the coming years.

The proposed shift would shoulder counties with as much as $130 million annually to sustain the programs, according to the state behavioral health directors association.

For many, it would open a gap they can’t fill.

Critical hub for help

Shortly after Newsom released his budget in January, Elise Jones, director of Lake County Behavioral Health Services, issued a news release raising concerns about the funding shift. The county’s nine-member team has been operating since 2023, shortly after the state made its share of funding available.

The mobile crisis team’s dispatch and administrative office is located in Clearlake Oaks, where it can respond quickly to calls from communities on the east side of Clear Lake. The team also has a crisis worker who is embedded with officers at the Lakeport Police Station.

The main room at the dispatch center has the feel of a living room, with couches, chairs, a TV and a nearby coffee dispenser. Dispatcher Katherine Freeman sits at a computer in the corner of the room, keeping track of calls for service as they come in.

The majority of calls that go to the dispatch center originate from 911 and the national 988 crisis hotline systems, said Christine Andrus, deputy director of administration for Lake County Behavioral Health Services. In many cases, she said, that greatly reduces the need for law enforcement involvement.

“I think it’s important to know the amount of calls we take off of law enforcement’s hands,” Andrus said.

Aside from responding to mental health crisis calls, the team also does extensive outreach to homeless residents, many struggling with mental illness and substance use disorders.

In most cases, the team can successfully de-escalate and resolve crises, avoiding the need to use more expensive public services, said April Giambra, Lake County’s clinical deputy director for mental health and substance use services.

“For the most part, 90% of the time, we are able to prevent it from rising to the next level — of hospitalization or incarceration,” Giambra said.

The funding shift would represent a loss of nearly $1 million for Lake County, likely decimating a program that’s taken several years to build, she said.

Currently, counties across the state do not have to contribute any local dollars to draw down the federal match for mobile crisis response.

Under the current structure, the state covers the non‑federal share. But that could change next year.

Federal surge, state pullback

Recent state and federal funding for mobile crisis services traces back to the COVID-19 era, when the nation was throwing vast amounts of money at medical and mental health-related programs.

During the pandemic, the federal government, under the American Rescue Plan Act, boosted its reimbursement for certain Medicaid programs, including mobile crisis services. The federal government’s Medicaid match for these services was increased to 85%. (In many cases, the federal government’s contribution for Medicaid-funded programs is 50%.)

To qualify, mobile crisis teams had to operate 24/7, every day of the year; be trained in de-escalation, trauma-informed care and harm reduction; and have established links to various community service providers.

However, that 85% federal match was available only through March 31, 2027.

Taking advantage of that enhanced federal match, in 2022 the state offered five years of funding for mobile crisis services as a mandatory benefit under Medi-Cal, the state’s version of the Medicaid program. Designating the service a mandatory benefit meant the state was obliged to put up the other 15%.

But with the enhanced federal match ending next spring, the state’s share will increase significantly. In January, Newsom proposed redesignating mobile crisis services as an optional benefit, meaning counties would have to take on the burden of the non-federal match.

H.D. Palmer, spokesman for the California Department of Finance, said state funding is no longer sustainable given current and future budget shortfalls.

Palmer said in an email that extending funding beyond next March — after the federal share of Medi-Cal drops to 50% — would cost the state’s general fund an estimated $170 million a year.

“In addition to addressing next year’s budget shortfall of nearly $3 billion, the state must also close a shortfall of roughly $22 billion the following year,” Palmer said.

“For these reasons, the administration has proposed redesigning this as an optional benefit, to be offered at counties’ discretion, as the most sustainable path for the program going forward,” he said.

Doty Cabrera said the funding change would jeopardize hundreds of millions of dollars the state and counties have made over the past several years to build out their 24/7 mobile crisis infrastructure.

The first round of the Behavioral Health Continuum Infrastructure Program, a statewide initiative funded by the 2024 voter-approved Proposition 1, made a $202 million investment to more than 78 jurisdictions operating mobile crisis teams across the state, according to state health officials.

Local impact

In Sonoma County, health officials are still trying to determine the impact of the proposed funding shift if enacted by the Legislature. Currently, only the county’s mobile crisis program, serving the unincorporated area, is receiving Medi-Cal reimbursements.

There are two other nonprofit-run mobile crisis teams that serve Santa Rosa and southern Sonoma County. They also are either fully or substantially funded through Measure O, a countywide quarter-cent sales tax approved by voters in 2020 for mental health, drug addiction and homeless programs.

One of those teams, InRESPONSE, serving Santa Rosa, has already faced significant funding challenges as the city navigates its own post-pandemic financial crisis, with potentially deep job cuts ahead for the police and fire departments that account for the largest share of its general fund spending.

“We know we’re going to take a hit, we just don’t know how big that financial hit’s going to be, but it’s going to be big,” said Nolan Sullivan, Sonoma County’s health services director.

Lake County officials were more surefooted and blunt. The loss of state funding would endanger the future of their program. (Lake County facilitated access to their team’s activities to report on that program for this story. Sonoma County would not provide that access unless The Press Democrat signed a type of confidentiality agreement governing medical record privacy and health care providers, which the newspaper declined to do.)

During fiscal year 2024-25, the Lake County’s mobile crisis team billed Medi-Cal for 418 crisis encounters. If the county had to pay the non-federal share of those encounters, it would have had to come up with roughly $900,000, said Andrus, the county’s deputy director of administration.

“That is why the governor’s proposed shift is significant,” Andrus said in an email. “If the change remains in the 2026‑27 budget, Lake County would need to plan for an additional $900,000 to $1.2 million annually just to maintain our current Mobile Crisis operations.”

Andrus said that range reflects normal year‑to‑year variation in call volume and complexity with various encounters.

Elise Jones, Lake County’s behavioral health director said that amount represents up to 5% of the county’s annual spending on mental health services. However, she said it’s difficult to quantify how much money the program saves by stabilizing people in crisis, keeping them out of hospital emergency departments or having to receive a higher level of care.

Lakeport Police Chief Dale Stoebe said the funding shift threatens a highly successful county program that impacts his staff on a daily basis. The county’s mobile crisis team’s staff member, Bonnie O’Donnell, is embedded at the police station.

Stoebe said O’Donnell is a valuable resource in a county where many residents face poverty, drug and alcohol addiction and homelessness.

Stoebe said his police force struggles with retaining police officers and often loses them to other jurisdictions after only a few years. He worries the loss of the county’s mobile crisis team will mean newly minted police officers will once again be the only ones responding to mental health crises.

“Fifteen, 20 years ago, we could navigate that because we had officers that had 10, 15, 20 years of experience,” Stoebe said. “It’s a recipe for disaster when you now are forcing cops to be the only ones responding to people in crisis, and they have two, three, four years of experience.”

In contrast, the people who staff Lake County’s mobile crisis team, like many others throughout the state, have years or decades of experience working with people who live with mental illness and drug addiction.

Boots on the ground

O’Donnell said that with 14 years of substance use counseling behind her she jumped at the opportunity to work with the mobile crisis team.

She wanted to be part of the “boots on the ground. Being out there in the community and being the hand up for that individual.”

Stoebe said having O’Donnell as an embedded resource for police officers allows for earlier intervention. They said people in crisis are often more willing to speak with someone who is not in a police uniform.

“I’ve been called out onto a scene where a gentleman had a knife and guns were drawn by the sheriff,” O’Donnell said. “Me and my partner were able to talk the guy into dropping the knife, tossing the knife, and he willingly got in our vehicle, and we were able to take them to the hospital.”

Stoebe said such scenarios are not possible without effective and established partnerships between law enforcement and mental health staff.

Doty Cabrera of the California Behavioral Health Directors Association called Lake County’s mobile crisis program “transformational.” Many of the people working in the team were county clients of behavioral health services and now work as peers on the team.

Doty Cabrera said if the proposed funding shift remains in Newsom’s budget, many counties will be forced to scale back their programs. That means cutting back on hours and only having mobile crisis available during peak hours or eliminating the program entirely.

“That will mean a return to the pre-mobile crisis reality where people had to fail into services rather than be stabilized in their homes, in their communities, at school, wherever the crisis and the needs are,” she said.

You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com.