{"id":44524,"date":"2026-05-18T12:01:00","date_gmt":"2026-05-18T12:01:00","guid":{"rendered":"https:\/\/healthwatchminute.com\/?p=44524"},"modified":"2026-05-18T12:01:00","modified_gmt":"2026-05-18T12:01:00","slug":"state-budget-cuts-target-crown-jewel-of-mental-health-care","status":"publish","type":"post","link":"https:\/\/healthwatchminute.com\/?p=44524","title":{"rendered":"State budget cuts target \u2018crown jewel\u2019 of mental health care"},"content":{"rendered":"\n

On a recent morning, two people wearing purple shirts and carrying clipboards entered the courtyard of a nondescript building in San Diego\u2019s Midway District, speaking gently to a woman in distress.<\/span><\/p>\n

Asking a series of standard questions, the Mobile Crisis Response Team members learn<\/span>ed that this person was struggling to cope with several challenges: her daughter\u2019s unmet mental health needs, the cancellation of her Medi-Cal health insurance and an inability to find a therapist willing to schedule an appointment.<\/p>\n

After four years of such calls, these front-line mental health care workers have learned how to diffuse such situations, in this case, providing contacts for local therapists likely to be able to meet quickly and assigning a case manager to start the process of restoring Medi-Cal coverage. The team would check back in for 72 hours to make sure that progress was being made.<\/p>\n

But this level of care is under threat due to state-level budget changes that executives warn could significantly erode mobile crisis capacity in San Diego County and statewide.<\/p>\n

The situation that unfolded in the Midway District this week is an example of what\u2019s at stake.<\/p>\n

While this client was not judged to be an immediate danger to herself or others, it was not difficult to see that she was headed for some sort of psychiatric emergency if the right resources remained out of reach, said program administrator and licensed therapist Bre Lane.<\/p>\n

\"Case
Case manager Luis Bernal and program administrator Bre Lane, a licensed clinician, prepare to head out to a call on Wednesday, May 13, 2026. (Kristian Carreon \/ The San Diego Union-Tribune)<\/figcaption><\/figure>\n

Her most recent call, Lane says as she and case manager Luis Bernal drive back to MCRT headquarters in Mission Valley, illustrates the whole point of the early intervention model.<\/p>\n

\u201cHad we not intervened, she probably would have had to go to an emergency department,\u201d Lane said. \u201cJust by us going and talking to her and giving her resources, and then staying connected for 72 hours, we can prevent law enforcement from having to go out, and we can prevent unnecessary hospitalization.\u201d<\/p>\n

According to the program\u2019s most recent annual report, about 60% of calls stabilize clients in the field and just 2% result in hospital treatment.<\/p>\n

San Diego County has been among the state\u2019s most ardent MCRT supporters. Starting the service in 2021 with just three vehicles, the operation now fields 21 vans and sport utility vehicles offering round-the-clock response throughout the region.<\/p>\n

\"Telecare
Telecare MCRT vehicles are parked in the parking lot at the Mobile Crisis Response Team headquarters on Wednesday, May 13, 2026. (Kristian Carreon \/ The San Diego Union-Tribune)<\/figcaption><\/figure>\n

The service has grown rapidly, from 1,489 calls for service in the first year to 9,200 last year and a further 20% increase logged in the current year.<\/p>\n

While countywide impact on emergency departments is not perfectly clear from publicly reported data, local ERs have shown a decrease in the number of emergency patients transferred for inpatient care.<\/p>\n

The San Diego County Psychiatric Hospital has also seen significant changes since MCRT teams began working upstream to prevent crises. By the county\u2019s accounting, the number of admissions to the hospital\u2019s emergency psychiatric unit have fallen by 43% since the advent of MCRT. There were 606 monthly admissions, on average, in 2020, falling to 344 on average per month in 2025.<\/p>\n

\"Kibrom
Kibrom Gebregziabher, a clinician, works in the triage room where he receives crisis calls at Telecare\u2019s Mobile Crisis Response Team headquarters on Wednesday, May 13, 2026. The center takes calls from 911 and the access and crisis line.(Kristian Carreon \/ The San Diego Union-Tribune)<\/figcaption><\/figure>\n

These results, though, have not spared MCRT from potential funding cuts.<\/span><\/p>\n

The California Department of Health Care Services indicated<\/a> in January that it plans to make MCRT teams a voluntary, rather than mandatory, service statewide. That change, and the expiration of a federal program that matched state spending on crisis response teams at an 85% rate, would leave counties responsible for making up lost revenue \u201cwith local fund sources.\u201d<\/p>\n

Despite a strong lobbying effort against the changes, this cost-cutting solution is still in play. A spokesperson with the state finance department confirmed in an email this week that nothing has changed about the plan with the release of the state\u2019s May budget revision on Thursday.<\/p>\n

Nadia Privara Brahms, the county\u2019s behavioral health director, testified<\/a> on the potential effects of the change during a state Senate budget subcommittee meeting on April 30.<\/p>\n

The director said that San Diego County\u2019s program, which costs about $24 million per year to operate, would see a $15 million loss if the proposed changes survive the fiscal planning process.<\/p>\n

Losing funding, she said, will \u201cforce us to significantly scale back our crisis teams, impacting our entire system.\u201d<\/p>\n

It was a dire assessment, especially for a county spending $1.26 billion<\/a> on behavioral health services this fiscal year.<\/p>\n

Given that a loss of $15 million would represent about 1.2% of the county\u2019s behavioral health care budget, wouldn\u2019t it be possible to shift other priorities to keep MCRT, a program that county officials champion as among the most effective, whole?<\/p>\n

Privara Brahms did not respond Friday to a request for comment. But she did say during her speech in Sacramento that the proposed cuts would not be easily accommodated.<\/span><\/p>\n

\u201cOur county cannot absorb these costs and maintain the existing capacity \u2026 it will undo the progress we have made to improve access to care and reduce barriers,\u201d Privara Brahms said, adding that work in local schools is also at risk.<\/p>\n

The County Behavioral Health Directors Association of California has pushed back hard against this cost-cutting proposal, issuing a statement Thursday that called on Gov. Gavin Newsom to work with the Legislature after it became clear that the proposed MCRT funding changes were still in force after the May budget revision.<\/p>\n

Mobile crisis response teams, said Michelle Cabrera, the association\u2019s executive director, have shown enough positive real-world results to make them worth fighting for.<\/p>\n

\u201cFrom our perspective, of the more than 85 new initiatives that the Newsom administration has rolled out in behavioral health, the crown jewel has been mobile crisis response teams,\u201d Cabrera said. \u201cThey have really brought a tremendous amount of value in avoided confrontations with law enforcement, avoiding unnecessarily sending people to the emergency department.\u201d<\/p>\n

\"Case
Case manager Luis Bernal and program administrator Bre Lane walk back to their van after speaking with an individual at another Telecare location on Wednesday. (Kristian Carreon \/ The San Diego Union-Tribune)<\/figcaption><\/figure>\n

Making these programs optional, rather than mandatory, and thus shifting a greater funding burden to county behavioral health departments, is likely to fall hardest on rural counties with significantly lower population densities than are found in urban centers such as Los Angeles, San Francisco and San Diego.<\/p>\n

\u201cWithout the state funding, without the state mandate, you absolutely will see pockets where it either doesn\u2019t exist at all, or it\u2019s only in the nine-to-five hours,\u201d Cabrera said.<\/p>\n

Bre Lane, the San Diego MCRT program administrator, was instrumental in building the local program into what it is today. It is hard, she said, to imagine shrinking a program that has grown so much in just five years.<\/p>\n

\u201cWhen we first opened, we were doing like 50 calls a month, and I remember feeling like, \u2018oh my god, we\u2019re doing something, you know,\u2019\u201d she said. \u201cAnd now we have some times where we\u2019re doing 50 calls a day.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

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