§ 53123.4

(a) The 988 State Suicide and Behavioral Health Crisis Services Fund is hereby established in the State Treasury.

(b) (1) The fund shall consist of the revenue generated by the 988 surcharge assessed on users under Section 41020 of the Revenue and Taxation Code, which revenue shall be used in compliance with subdivision (c) of Section 53123.7, solely for the operations of the 988 centers until December 31, 2029, or designated 988 centers and mobile crisis teams, which may include any expenditures authorized pursuant to Section 251a of Title 47 of the United States Code and any applicable rules or regulations adopted by the Federal Communications Commission, including, but not limited to, state administration expenditures, including personnel and other related costs. The fund shall also consist of any other appropriations made to it by the Legislature. The Legislature may consider additional uses for the revenue generated by the 988 surcharge based on recommendations made by the California Health and Human Services Agency and the advisory group pursuant to subdivision (b) of Section 53123.3.

(2) The revenue generated by the 988 surcharge shall, to the extent not prohibited by Section 251a of Title 47 of the United States Code and any applicable rules or regulations adopted by the Federal Communications Commission and in compliance with subdivision (b) of Section 41136 of the Revenue and Taxation Code, be prioritized to fund the following:

(A) First, the 988 centers, until December 31, 2029, and designated 988 centers, including the efficient and effective routing of telephone calls, personnel, and the provision of acute behavioral health services through telephone call, text, and chat to the 988 number.

(B) Second, the operation of mobile crisis teams accessed via telephone calls, texts, or chats made to or routed through 988 as specified under Section 4(a)(2)(B) of Public Law 116-172.

(3) Money in the fund shall not be subject to transfer to another fund or to transfer, assignment, or reassignment for another use or purpose outside of those specified in this article.

(4) 988 surcharge revenue in the fund shall be available, upon appropriation by the Legislature, for the purposes specified in this article.

(5) The revenue generated by the 988 surcharge shall be used to supplement, not supplant, federal, state, and local funding for 988 centers, designated 988 centers, and behavioral health crisis services.

(6) The revenue generated by the 988 surcharge may only be used to fund service and operation expenses that are not reimbursable through Medicaid federal financial participation, Medicare, health care service plans, or disability insurers.

(c) (1) The State Department of Health Care Services shall develop and update, as necessary, a two-year statewide funding estimate for 988 centers, until December 31, 2029, designated 988 centers, and state administrative costs. The annual statewide funding estimate may be used to inform the Legislature’s appropriation from the 988 State Suicide and Behavioral Health Crisis Services Fund for the operations of 988 centers, until December 31, 2029, designated 988 centers, and state administrative costs.

(2) The statewide funding estimate shall be developed through a public process with input from stakeholders, including, but not limited to, representatives of 988 centers, until December 31, 2029, designated 988 centers, and mobile crisis response teams, including county behavioral health agencies.

(3) Commencing with the 2027–28 fiscal year, and each fiscal year thereafter, the State Department of Health Care Services shall project an annual statewide funding estimate for the next fiscal year prior to the enactment of the annual Budget Act for the next fiscal year.

(4) The statewide funding estimate shall consider factors, including, but not limited to, all of the following:

(A) Anticipated statewide call, text, and chat volume.

(B) Staffing and workforce levels necessary to meet projected demand.

(C) Training support for 988 center staff until December 31, 2029, and designated 988 center staff.

(D) Geographic equity and statewide access needs, including rural access.

(E) Surge capacity and disaster readiness.

(F) Federal performance standards and national best practices.

(G) Preliminary assessment of the impact to the surcharge associated with the estimate.

(H) Compliance with the voluntary protocols established pursuant to subdivision (f) of Section 53123.2.

(d) The State Department of Health Care Services shall require an entity seeking funds available through the 988 State Suicide and Behavioral Health Crisis Services Fund to annually file an expenditure, revenues, and outcomes report in a form and manner as determined by the State Department of Health Care Services. The expenditure, revenues, and outcomes report shall include, but is not limited to, the following:

(1) The total budget.

(2) Number and job classification of personnel.

(3) The number of individuals served.

(4) The outcomes for individuals served, if known.

(5) The net revenues, expenditures, and sources of revenues for 988, including county behavioral health or other noncounty contracted or directly provided mobile crisis response, by the entity seeking funds.

(6) Beginning July 1, 2025, to the extent feasible and consistent with paragraph (11) of subdivision (b) of Section 53123.3, measures of system performance, including capacity, wait times, and the ability to meet demand for services and warm handoffs.

(7) Beginning January 1, 2030, to the extent feasible and consistent with paragraph (11) of subdivision (b) of Section 53123.3 the amount billed to and reimbursed by Medi-Cal or other public and private health care service plans or insurers.

(8) The number of individuals who used the service and self-identified as veterans or active military personnel, if known.

(9) Beginning on January 1, 2029, compliance with voluntary protocols pursuant to subdivision (f) of Section 53123.2.

(e) (1) The State Department of Health Care Services shall review and either approve or deny the annual expenditure, revenues, and outcomes report.

(2) If an entity’s annual expenditure, revenues, and outcomes report is not approved, the State Department of Health Care Services shall provide technical assistance to the entity to correct and resubmit the report for approval.

(f) The State Treasurer shall report annually to the office and the State Department of Health Care Services on fund deposits and expenditures.

(g) The California Health and Human Services Agency, in consultation with the office, the Department of Managed Health Care, the State Department of Health Care Services, the Department of Insurance, the Emergency Medical Services Authority, and relevant stakeholders, shall, subject to an appropriation, develop recommendations for a system of funding, which includes funding sources outside of the state General Fund, for the operation of mobile crisis teams in accordance with this article.

(Amended by Stats. 2026, Ch. 252, Sec. 4. (AB 173) Effective September 18, 2026.)