§ 53123.3

(a) (1) No later than December 31, 2024, the California Health and Human Services Agency shall create a set of recommendations to support a five-year implementation plan for a comprehensive 988 system.

(2) The California Health and Human Services Agency shall convene a state 988 advisory group for purposes of advising the California Health and Human Services Agency on the set of recommendations to support the five-year implementation plan. The recommendations shall specify what can be accomplished pursuant to existing administrative authority and what will require additional legislation for implementation.

(3) The advisory group shall include, but is not limited to, the State Department of Health Care Services, the office, the State Department of Public Health, the Emergency Medical Services Authority, representatives of counties, representatives of employees working for county behavioral health agencies and agencies who subcontract with county behavioral health agencies who provide these services, health plans, emergency medical services, law enforcement, consumers, families, peers, 988 centers, designated 988 centers, and other local and statewide public agencies.

(4) The advisory group shall meet at least once per quarter until December 31, 2029.

(5) The advisory group may be disbanded or reconvened at the discretion of the California Health and Human Services Agency, but shall not be disbanded before January 1, 2030.

(b) The California Health and Human Services Agency and the advisory group shall make recommendations on all of the following:

(1) Federal Substance Abuse and Mental Health Services Administration requirements and national best practices guidelines for operational and clinical standards, including training requirements and policies for transferring callers to an appropriate specialized center, or subnetworks, within or external to, the National Suicide Prevention Lifeline network.

(2) Maintenance of an active agreement with the administrator of the National Suicide Prevention Lifeline for participation within the network.

(3) Compliance with state technology requirements or guidelines for the operation of 988.

(4) A state governance structure to support the implementation and administration of behavioral health crisis services accessed through 988.

(5) 988 infrastructure, staffing, and training standards that will support statewide access to crisis counselors through telephone call, text, and chat, 24 hours per day, seven days per week.

(6) Access to crisis stabilization services and triage and response to warm handoffs from 911 and 988 centers and designated 988 centers.

(7) Resources and policy changes to address statewide and regional needs in order to meet population needs for behavioral health crisis services.

(8) Statewide and regional public communications strategies informed by the National Suicide Prevention Lifeline and the Substance Abuse and Mental Health Services Administration to support public awareness and consistent messaging regarding 988 and behavioral health crisis services.

(9) Recommendations to achieve coordination between 988 and the continuum of behavioral health crisis services. Recommendations shall address strategies for verifying that behavioral health crisis services are coordinated for a timely response to clearly articulated suicidal or behavioral health contacts made or routed to 988 services as an alternative to a response from law enforcement, except in high-risk situations that cannot be safely managed without law enforcement response and achieving statewide provision of connection to mobile crisis services, when appropriate, to respond to individuals in crisis in a timely manner.

(10) Quantifiable goals for the provision of statewide and regional behavioral health crisis services, which consider factors such as reported rates of suicide attempts and deaths.

(11) A process for establishing outcome measures, benchmarks, and improvement targets for 988 centers and the behavioral health crisis services system. This may include recommendations regarding how to measure, the feasibility of measuring 988 system performance, including capacity, wait time, and the ability to meet demand for services for 988 State Suicide and Behavioral Health Crisis Services Fund fund recipients. This may also include recommendations for how to determine and report the amount billed to and reimbursed by Medi-Cal or other public and private health care service plans or insurers related to 988 services.

(12) Findings from a comprehensive assessment of the behavioral health crisis services system that takes into account infrastructure projects that are planned and funded. These findings shall include an inventory of the infrastructure, capacity, and needs for all of the following:

(A) Statewide and regional 988 centers.

(B) Mobile crisis team services, including mobile crisis access and dispatch call centers.

(C) Other existing behavioral health crisis services and warm lines.

(D) Crisis stabilization services.

(13) Procedures for determining the annual operating revenues, expenditures, and 988 operational budget for the purposes of establishing the rate of the 988 surcharge and how revenue will be disbursed to fund the 988 system consistent with Section 53123.4 and Section 251a of Title 47 of the United States Code.

(14) Strategies to support the behavioral health crisis service system is adequately funded, including mechanisms for reimbursement of behavioral health crisis response pursuant to Sections 1374.72 and 1374.721 of the Health and Safety Code, including, but not limited to:

(A) To the extent that any necessary federal approvals are obtained and federal financial participation is available and is not otherwise jeopardized, seeking to maximize all available federal funding sources for the purposes of behavioral health crisis services and administrative activities related to 988 implementation, including federal Medicaid reimbursement for services; federal Medicaid reimbursement for administrative expenses, including the development and maintenance of information technology; and federal grants.

(B) Coordinating with the Department of Insurance and Department of Managed Health Care to verify reimbursement to 988 centers or designated 988 centers for behavioral health crisis services by health care service plans and disability insurers, pursuant to Section 1374.72 of the Health and Safety Code and Section 10144.5 of the Insurance Code and consistent with the requirements of the federal Mental Health Parity and Addiction Equity Act of 2008 (29 U.S.C. Sec. 1185a).

(c) Until December 31, 2029, the California Health and Human Services Agency shall post regular updates, no less than annually, regarding the implementation of 988 on its public internet website. The updates shall additionally include all of the following:

(1) Progress toward implementing an interoperable solution between 988 and 911.

(2) Progress toward statewide integration between 988 centers and mobile crisis teams, including behavioral health mobile crisis teams.

(3) Statewide answer rates for call, text messages, and chats.

(d) (1) The California Health and Human Services Agency shall, subject to an appropriation, maintain a 988 System Governance Board to provide cross-agency coordination and oversight related to implementation of the 988 system until January 1, 2030.

(2) The board shall include representatives from, at minimum, the California Health and Human Services Agency, the State Department of Health Care Services, the Emergency Medical Services Authority, the State Department of Public Health, the Department of Managed Health Care, the Department of Insurance, and the office.

(e) The State Department of Health Care Services shall be responsible for all of the following:

(1) Oversight of 988 center and designated 988 center operations.

(2) Beginning July 1, 2027, administration of the 988 State Suicide and Behavioral Health Crisis Services Fund established pursuant to Section 53123.4, except for technical interoperability functions retained by the office pursuant to Section 53123.2.

(3) Establishment of statewide standards and protocols to support least restrictive responses to behavioral health crises, including behavioral health or medical responses in lieu of law enforcement response whenever safe and appropriate.

(f) (1) The Emergency Medical Services Authority shall establish, in accordance with subdivision (f) of Section 53123.2, statewide training and protocol standards, in alignment with national best practices and California’s specific needs, for personnel involved in the following:

(A) Transfer of calls between 911 public safety answering points and 988 behavioral health crisis services.

(B) Medical triage.

(C) Response to warm handoff.

(2) The Emergency Medical Services Authority may implement a quality monitoring program to oversee the effectiveness of the activities under paragraph (1) for medical and behavioral health calls. The authority may assess the quality of care and report on the system’s effectiveness to the California Health and Human Services Agency and the State Department of Health Care Services annually. System participants, including, but not limited to, state and local agencies, public safety answering points, 988 centers, and designated 988 centers, may provide the authority with the data necessary to perform the assessments as specified by the authority in regulations.

(3) The Emergency Medical Services Authority may adopt regulations, in accordance with Section 1797.107 of the Health and Safety Code, to implement this subdivision.

(g) This section does not prohibit 988 centers and designated 988 centers from coordinating with other behavioral health crisis response entities, including city-operated or locally operated mobile crisis teams.

(Amended by Stats. 2026, Ch. 252, Sec. 3. (AB 173) Effective September 18, 2026.)