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Taking the Lead: Implementing Investments and Initiatives

The state continues to rely on counties to partner or lead on solutions to persistent and complex state challenges. For both ongoing and future implementation efforts, UCC will work to ensure that urban counties have appropriate flexibility and sufficient resources to carry out the following initiatives, each of which impose urban county workload in 2024 and beyond.

UCC will engage in the following advocacy actions:

  • CARE Act—UCC will continue to support five urban counties – Los Angeles, Orange, Riverside, San Diego, San Francisco – that began early implementation in 2023 of the CARE Act (SB 1338, 2022), a new civil court framework for individuals with severe mental health issues to receive individualized care plans. Additionally, UCC will provide support and assistance to all urban counties in planning for CARE Act implementation in advance of the December 1, 2024 effective date for Cohort 2 counties.
  • Behavioral Health Services Act (BHSA)—Contingent on the voters’ passage of Proposition 1 on the March 2024 ballot, UCC will support urban counties in transitioning to the new funding requirements in 2026, new reporting requirements, BHSA revenue volatility, as well as accessing the behavioral health infrastructure bond resources.
  • Homelessness Solutions— The Governor’s 2024-25 budget proposal does not reduce the previously planned 2023-24 investments in the Encampment Resolution Grant Program ($400 million) or Homeless Housing, Assistance, and Prevention (HHAP) program ($1 billion). However, the proposal does not include new funding to extend either program into 2024-25.
  • Managed Care Organization (MCO) Tax—AB 119 (Chapter 13, Statutes of 2023) authorized an MCO Tax, effective April 1, 2023, through December 31, 2026. MCO Tax revenues will be used to support the Medi-Cal program, including, but not limited to, new targeted provider rate increases and other investments that advance access, quality, and equity for Medi-Cal members and promote provider participation in the Medi-Cal program. The Department of Health Care Services submitted to the Legislature, as part of the 2024-25 Governor’s Budget, a plan for additional targeted increases to Medi-Cal payments or other investments using MCO Tax funds deposited in the Medi-Cal Provider Payment Reserve Fund (MPPRF). The investments have the potential to benefit county health care systems, including county hospitals and clinics. UCC will work to ensure that MCO Tax revenues maximally benefit urban counties.
  • Division of Juvenile Justice (DJJ) Realignment—With the passage of SB 823 (2020) and SB 92 (2021), counties are now responsible for the care, treatment, and – where required – custody of all youth in the juvenile justice system. As of June 30, 2023, all remaining DJJ facilities have closed and those youth who were unable to discharge or otherwise transition from DJJ prior to the closure date have been accommodated. To create positive youth outcomes, UCC will partner with the Office of Youth and Community Restoration, support cross-county collaboration, and advocate for state legislation and resources to promote successful program delivery.