Bottom Up or Top Down – How to Make America Great Again

Yesterday, the Sonoma County Board of Supervisors adopted their FY 25-26 Budget. The morning’s action was swift and brutal. Acknowledging that they knew less than ever about their traditional sources of revenue, the message of the document was “hold off” until more is known.

That doesn’t mean that the 262-page governmental instructional manual doesn’t contain valuable direction, just not the final set of decisions. Because HEAPA’s mission focuses on what are often called the safety net services, I’m going to use this post to highlight what I think are clues to moving those services forward. And in the process, I’m going to advocate for strengthening our bottom up democracy.

This post is going to highlight the budgets of the Department of Health Services and the Human Services Department. Home of most of the County’s programs, and the sources of an enormous amount of contracts for community-based services, they will probably bear the brunt of the impact of anticipated federal and state cutbacks. Hearing from the County Executive that the proposed $2.71 billion budget contains $335.9 million in federal funds, and $561.8 million in state funds (much of it dependent on federal funding), the Board was told that almost $300 million from those sources could be in jeopardy. At this moment, however, it could only report that $41 million in federal grants from the Department of Agriculture and FEMA have been cancelled.


“For the most part, the County is in wait-and-prepare mode with the federal budget. Many reductions have been discussed either by the administration or by Congress, but until a budget is passed, we will not know impacts. This is particularly true for potential reductions to large programs such as Medicaid. Even if the amount of a federal cut were known, how the state would react and what level of impact would ultimately come to the County are impossible to say. As such, it does not make sense to develop specific plans. Rather, it is imperative that the County not over-commit resources and remain nimble to address changes as they come.” 

The clues to moving forward in this budget can be found in the budgets of the two safety net departments. Pages 141 to 149 contain this information, and the full budget can be found through this link. The document is held on a private HEAPA drive, hopefully responsive to a link from this website. If not accessible to your pursuit, It should be downloadable to your computer from the press release issued by the County today: Sonoma County FY 25-26 Proposed Budget.

The top chart on page 145 shows the change in revenue for the four divisions of the Department of Health. It won’t surprise anyone whose programs operate in support of homeless that the Department’s expenditures for those services are are proposed to be reduced by $2,164,197 this year. It may surprise community contractors to learn that the County believes it will spend $24,320,657 on homeless programs. Recently, the Board adopted contracts for community services for next year for a little over $6 million. These contracts will soon be available on HEAPA’s drive. It has also become clear that state and federal funding for homeless programs is on the Trump chopping block, and County Homeless Continuums of Care may not exist much longer.

In contrast, the Department’s service area for behavioral health will experience a $29,835,331 increase in expenses this year, a 10.6% increase to a total of $306,809,778. Fueling this increase is the implementation of the Drug Medi-Cal Organized Delivery System (DMC-ODS), two large state grants for the Arrowood Bridge Housing Project and the Mental Health Diversion Project, a variety of Measure O expenditures for the County and City Mobile Support Teams, reestablishment of the school-based Crisis Assessment Prevention Education (CAPE), and a. wide range of contracts with providers of substance use and mental disorder outreach and counseling services for youth.

Behavioral Health: 

The biggest challenge to the Division is maintaining service capacity and delivery in our system of care-network, while at the same time working to implement considerable mandates and program changes from the state. In FY 2025-26, key areas of opportunity, as well as implementation challenges, include: 

Opioid Settlement Funds (OSF) – Sonoma County has received $12.7 million in OSF and expects to receiveanother $31 million by 2038 for a total of $43 million. This funding, and the release of a Notice of FundingAvailability (NOFA) in 2025, provides the Division with the opportunity to increase much needed localservices for: harm reduction, prevention and education programs, and the expansion of substance usedisorder services and treatment facilities targeted to the needs of our local population and to addressregional service gaps.

SB 43 Implementation – SB 43 will go into effect January 1, 2026, and amends the definitions of gravelydisabled under conservatorship law. This law has the potential to greatly impact the number of individuals under conservatorship, further taxing the availability of services, staff, and treatment programs and facilities serving this population. 

Mental Health Services Act (MHSA) transition to Behavioral Health Services Act (BHSA) – Preparation for the 2026 implementation of BHSA will have broad impacts on the Division, including substantial changesin funding allocations for behavioral health funds. The Division will be implementing new and robust processes for developing local spending plans.(underline mine)

Human Services Department

HSD is experiencing key budgetary changes driven by shifts in federal and state funding, increased program costs, and strategic use of fund balance to support critical services. 

Adult and Aging Services: A $1.3 million reduction in grant revenue, with equivalent reductions in expenditures, resulting from the conclusion of one-time emergency funding from the American Rescue Plan Act (ARPA) and the Older Adults Recovery and Resilience (OARR) program accounts for the bulk of the $1.9 million reduction in Adult and Aging. The ARPA and OARR fund supported unique programs and supplemented existing programs such as Direct Transportation, Telephone Reassurance, Mobility Management (Transportation Navigation), Caregiver Respite, Legal Aid services, Home-Delivered Meals and Nutrition Infrastructure. 

Economic Assistance: The $2.1 million increase is due to a significant reduction in vacancy rates. By updating salary and benefits, the Human Services Department was able to draw down additional Supplemental Nutrition Assistance Program (SNAP) funding for CalFresh. 

Administrative Services: The $5.9 million increase is due to a $2.4 million increase in Country general fund and $3.6 million increase in 2011 and 1991 realignment revenue projections. The increase in General Fund is due to the increase in the cost of IHSS Maintenance of Effort (MOE). (see below). 

In-Home Supportive Services (IHSS): Wages and benefits for IHSS care providers increased by $5.8 million due to the annual 4% increase to the MOE, rising provider benefit costs driven by an increase in paid IHSS hours, and the recently negotiated labor agreement with SEIU 2015. As part of the labor agreement, provider wages will increase by $2.00 per hour, bringing the total wage to $19.85 per hour as of March 1, 2026. Including benefits, the total hourly compensation will be $20.70. The costs associated with the County’s share of the IHSS wages are split between the General Fund and Realignment funding, and the increase in General Fund Contribution is thus largely tied to the increase in IHSS costs. 

State, Federal, and Other Governmental Revenues: Overall revenues are projected to increase by $6.5 million, or 2.0%. Key revenue changes include but are not limited to: 

•A $4.0 million increase in CalFresh funding.

•The reinstatement of the CalWORKs single allocation, restoring $2.1 million in funding.

•A projected $1.7 million increase in the IHSS Administration allocation to offset rising provider benefitcosts.

•A $3.6 million year-over-year increase in Realignment revenue forecast for both 1991 and 2011Realignment. Revenue forecasts are aligned with state projections based on the latest available resources.

Estimated revenue for next year reflect the aforementioned $1.3 million reduction in Adult and Aging emergency funding, the $2.9 million reduction in Housing and Disability Advocacy Program (HDAP) and Housing Support Program (HSP) rollover allocation funding, and the end of some grant funding in FY 2024-25. 

Use of Fund Balance: Staff recommends utilizing $3.9 million in fund balance for one-time expenditures to address specific funding gaps and programmatic needs. 

•$1.5 million to cover increases in insurance liability costs.

•$500,000 to support the transition plan to reduce HDAP and HSP funding in Employment and Training.

•$1.1 million in Title IV-E Waiver certainty grant funds, which must be spent by September 30, 2026, tosustain child abuse prevention services initiated under the waiver.

•$650,000 from the wraparound reinvestment fund for unanticipated startup costs related to Short-TermResidential Therapeutic Programs (STRTP) – the funds are restricted to child welfare services and noadditional revenue is expected.

•$250,000 in No Wrong Door project funding in alignment with the County Strategic Plan.  

The use of fund balance is $1.7 million lower compared to the prior year. The utilization of Wraparound Reinvestment Funds and No Wrong Door project funding remains consistent with prior year levels. The use of Title IV-E waiver funds is decreasing, as the remaining available funds must be fully expended by September 30, 2026. Inthe prior year, $1.6 million from fund balance was budgeted due to uncertainty surrounding the CalWORKsAdministration Single Allocation budget. However, the Governor’s revised budget restored the proposedreductions, making the use of fund balance unnecessary. Historically, the Human Services Department has notbudgeted for the use of fund balance due to strong and reliable revenue sources.

HSD remains committed to managing these budgetary changes strategically to ensure the continued delivery of essential services while adapting to the evolving funding landscape. 

Opportunities and Challenges 

Staff continues to adapt to the evolving fiscal and programmatic landscape, addressing critical funding reductions while identifying opportunities to enhance service delivery and operational efficiency. As demand for services grows, HSD will remain committed to maintaining essential programs and ensuring the well-being of Sonoma County’s most vulnerable residents. 

Adult & Aging 

Public Conservator: Legislative changes at the state level will likely lead to an increase in conservatorships within Sonoma County. Two key unfunded legislative initiatives are expected to drive this growth: 

Community Assistance, Recovery, and Empowerment (CARE) Court went into effect in December 2024,introducing court-ordered treatment and supportive services for individuals with severe mental illness,such as schizophrenia. If individuals fail to comply with court-ordered treatment, they may be placedunder conservatorship, increasing caseloads for the Public Conservator’s office.

Senate Bill 43, which takes effect in January 2026, expands the definition of “gravely disabled” to includeindividuals with severe substance use disorders, such as chronic alcoholism, even in the absence of a co-occurring mental health disorder. This broadened eligibility has the potential to significantly increase thenumber of individuals requiring conservatorship, further straining an already overburdened system.

Adult & Aging Information & Assistance (I&A) Program: The Program has experienced a significant surge in demand, reflecting both the ongoing demographic shift toward an aging population and the growing complexity of needs among older adults. Originally introduced in 2019, the Program has proven to be a vital resource for our community, connecting thousands of individuals to critical services. However, as demand continues to rise, our ability to sustain and scale this essential program is becoming increasingly challenging. 

Key Trends & Growing Needs 

•Phone calls: Over the past 12 months, I&A has handled 10,186 incoming calls, marking a 26.21% increasein the last six months alone.

•In-Home Supportive Services (IHSS) referrals: The Program facilitated 1,656 new IHSS referrals, reflectinga 29.68% increase in six months. 

•Medi-Cal assistance: There were 1,535 Medi-Cal-related discussions with senior clients, which is a 37.25%rise in requests for assistance in the last six months.

The rising demand for I&A services signals an opportunity for proactive leadership and investment in aging services. By expanding funding, strengthening partnerships, and leveraging innovative solutions, the County can build a system that meets today’s needs while preparing for the demands of tomorrow. Investing in this program will not only support the County’s growing senior population but also reduce long-term costs by enabling earlier interventions and preventing costlier crisis and out-of-home care. The Department is focused on ensuring that aging residents receive the timely support they need while maintaining a system that is efficient, equitable, and scalable. 

Family, Youth & Children 

Family First Preventions Services Act (FFPSA): This federal legislation created a funding stream for child abuse prevention services that will become accessible to California counties in the fall of 2026. The Division continues to plan and work with the community to prepare for full implementation. To draw down federal dollars, the services provided to families must be evidenced based, approved by the federal government, and included in the California state plan. To support the community to be ready to provide these services, the division has used specifically allocated block grant dollars to support several pilot programs using evidenced based practices in the community and support training for community providers on these evidence-based practices. 

Valley of the Moon Short Term Residential Therapeutic Program (STRTP): The STRTP’s doors opened for service on July 9, 2024, to start the 3-year pilot. To date, the STRTP has served 10 Sonoma County youth and enabled them to remain in their community, stay near their families and networks of support, and continue attending their schools of origin. The program population will expand to 16 youth with the hiring of a second behavioral health clinician in the near future. Thus far the Valley of the Moon STRTP has only served Sonoma County youth. However, we are working closely with our partners at Sonoma County Behavioral Health in order to establish contracts to serve youth from neighboring counties. 

Employment & Training 

Employment and Training General Assistance (GA) program: The Program has seen a 47% increase in caseload, reflecting both the success of efficiency-driven strategies and the growing need for economic support among the County’s most vulnerable residents. By streamlining application processing without adding staff, we have significantly improved access to assistance, ensuring that those in need receive timely support. However, this progress has come at a cost—placing substantial strain on our workforce and limiting our ability to provide high-quality, comprehensive services. 

Employment and Training (E&T) is working on strengthening the GA program by ensuring sustainable case management capacity to provide individualized support, expand job training and placement efforts to help GA recipients transition to stable employment and leverage technology and partnerships to enhance service delivery within staff capacity. In addition, E&T is working on reducing GA appointment wait times, which are currently 4-5 weeks. 

State and Federal Budget Impacts 

Housing and Disability Advocacy Program (HDAP) & Housing Support Program (HSP): The discontinuance of HDAP and HSP rollover allocations presents a significant challenge for housing services. This funding loss will reduce the availability of housing assistance for individuals experiencing or at risk of homelessness, particularly those with disabilities. As a result, staff is implementing cost-saving measures, including the planned closure of transitional housing programs and reductions in case management, financial assistance, and community resource connections. Staffing adjustments are also underway to realign personnel with available funding. The remaining allocation will be fully dedicated to maintaining housing for existing clients as the County develops a long-term sustainability plan. HSD anticipates minimal impact on most families. However, the primary effect will be a reduced capacity to accept new cases starting in 2026. 

Federal Funding: HSD receives a significant portion of its funding from federal sources. With the future direction of the federal administration uncertain, proposed reductions could potentially impact these funds. In Fiscal Year 2023-24, the County secured $101 million in federal funding. The programs most reliant on federal funding include CalWORKs, Adoptions, CalFresh, Foster Care, and Medi-Cal. “

HEAPA will be supporting regular monthly meetings of representatives of the County Advisory Commissions and Boards within the safety net departments. Collaborations and alignment of these advisors is essential in a year so full of change and critical decision-making. If the country is to continue to build a responsive system of government-funded facilities and services, it must be designed and monitored by those closest to the need.

California lawmakers reject hundreds of bills in rapid-fire hearings

By Jeanne Kuang and Yue Stella Yu, CalMatters

        
           

Tax credits for the parents of young children. A state-funded scientific research institute. Exempting service workers’ tips from state income tax.

Those are among the hundreds of proposals California lawmakers swiftly rejected Friday under the banner of cost savings, as they cited the state’s $12 billion budget deficit — a worsening figure due to the threat of unprecedented federal funding cuts and California’s ballooning spending on health care for low-income residents. 

“We are in (a) very difficult budget environment this year, so consequently many good bills are going to fall by the wayside today,” said Assembly Appropriations Committee Chair Buffy Wicks, an Oakland Democrat, before beginning that chamber’s hearing. 

“We are not in a year where we can be expanding programs, developing new offices, new agencies, new departments, and expanding our footprints.”

The Friday procedure is known as the “suspense file” — the state Legislature’s most secretive and fast-paced biannual hearing, where the chairs of the Assembly and Senate Appropriations committees quickly shoot down pricey proposals with little explanation, often acting more aggressively during years of budget woes. 

The suspense files are where the appropriations committees send bills that would cost the state at least $50,000 in the Senate and $150,000 in the Assembly. The process was originally a way for lawmakers to consider policy proposals that cost the state money together by balancing them against each other. 

But the well-accepted open secret in Sacramento is that it’s also an opportunity for lawmakers to quietly kill controversial bills, appease powerful special interests or just winnow down the number of bills they’ll have to debate on the floor. Lawmakers decide ahead of time, in secret, whether to pass the bills to the full Senate or Assembly, or to withhold them. The public hearings are a rapid-fire announcement of the decisions.

On Friday, the Senate Appropriations Committee axed 29% of the 432 bills on its list, although it kept a handful of those alive to work on next year. That’s more aggressive trimming than the committee did last May. 

“The state is facing a significant budget deficit and with that in mind, the committee had to make difficult choices on a number of bills to reduce costs,” said Senate Appropriations Chairperson Anna Caballero, a Merced Democrat, before the hearing. She opened the hearing with a defense of the arcane proceedings, explaining that the results would be posted online, but rushed out to catch a flight after the meeting without discussing her approach with reporters. 

The Assembly Appropriations Committee killed 35% of the 666 measures on its suspense file, similar to last year. Lawmakers had been warned to keep the cost of their proposals down, Wicks said. 

“We stressed heavily to members as they were putting together their legislative package this year to be very mindful of cost,” she told reporters.

The state’s fiscal future is anything but certain: As federal threats loom, Gov. Gavin Newsom earlier this month rolled out a $322 billion spending plan that included significant cuts to Medi-Cal, the state’s health care system for low-income Californians, and a 3% cut to public universities. 

Health care expansions on the chopping block

On Friday, some Assembly measures that would have expanded health care services for Californians met their fate. That includes Wicks’ own proposal seeking federal approval to qualify some housing services as Medi-Cal benefits, a $40 million endeavor that Newsom previously vetoed. The committee also killed a proposal to allow more Medi-Cal enrollees to receive home-based care and another that would have allowed higher-earning immigrants in the country illegally to purchase insurance plans on Covered California, the state-run health care marketplace.

Several lawmakers and state Capitol staff sit behind a two-row dais during a legislative hearing. A large oval image of the California State Assembly seal can be seen hung up on the wall behind them.
Assemblymembers meet during a suspense file hearing at the Capitol Annex Swing Space in Sacramento on May 23, 2025. Photo by Fred Greaves for CalMatters

In the Senate, lawmakers shelved a proposal by Sen. Catherine Blakespear to impose campaign contribution limits on candidates for judicial office and school board races, which the influential California Teachers Association opposed. They axed Sen. Henry Stern’s proposal to expand the state’s contentious new mental health program CARE Courts to include defendants with bipolar disorder I, and Sen. Marie Alvarado-Gil’s bill to address mountain lion interactions that has pitted rural communities against animal rights and wildlife conservation advocates. 

The Senate Appropriations Committee also killed two Republican tough-on-crime proposals, showing the limits of Democrats’ recent shift slightly rightward on crime. Until Friday, it had been surprisingly smooth sailing this year for Senate Minority Leader Brian Jonesbill to block sex offenders from being released from prison through the state’s elderly parole program, and Sen. Kelly Seyarto’s bill to increase penalties for selling or giving fentanyl to minors.

The law enforcement-backed bills were opposed by criminal justice reform advocates, who still hold sway with the majority party and often argue it would be too costly for the state to imprison more people. 

In a statement, Jones, a San Diego Republican, called the suspense file process “anti-democratic” and accused Democrats of “silencing the voices of victims and the public.”

Some measures are now postponed until next year. That includes two Assembly measures seeking tighter regulations on ticket sales for sports and musical events, amid fierce opposition from ticketing platforms such as Stubhub and from local chambers of commerce. The measures would restrict when those platforms can resell tickets, strengthen the disclosure of ticket information and require venues to accept proof of purchase as tickets. 

Assm. Isaac Bryan, a Culver City Democrat who authored one of the measures, said Wicks never articulated her concerns with his proposal, even though Wicks told reporters Friday her staff had been in touch with Bryan’s office. “There was never an attempt to discuss the bill,” which led him to believe her concerns had been alleviated, Bryan said in a statement.

Lawmakers also pushed off some issues to be debated further during budget negotiations between the Legislature and Newsom. That process will accelerate in the coming weeks before a mid-June deadline to pass a balanced budget. 

Newsom’s film tax credit pushed to budget talk

They stripped out language in both Assembly and Senate bills to more than double the state’s film tax credit to $750 million. Newsom has pushed hard for the tax credit expansion to help the ailing Los Angeles industry and keep production in state, and he’s included the money in his budget proposals which lawmakers will debate separately. 

Assemblymember Rick Zbur, a Los Angeles Democrat who authored the Assembly version of the measure, said the committee move was merely a technical one to separate budget allocations from policy changes. 

“The increase in the size of the program will happen in the budget,” Zbur said. “I’m not that nervous about it.”

But to others, the move indicated that some lawmakers remain skeptical of spending so much on the program. Sen. Ben Allen, an El Segundo Democrat who sponsored the Senate bill to boost the tax credits, said he was “certainly disappointed.”

“It’s something we are going to push back against as budget negotiations begin to heat up,” he said in a statement.

An ambitious and highly technical proposal by Sen. Scott Wiener reining in the landmark California Environmental Quality Act to make it harder for opponents of development to sue to block housing projects also will be debated in the budget process.

In the Senate Appropriations Committee, lawmakers passed the bill but Caballero said they would continue negotiating it to help the state meet its housing needs “without compromising environmental protections.”

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

Behavioral Health Planning Grants

HEAPA has agreed that full participation from the Sonoma County Lived Experience Advisory Planning Board (LEAP/B) is essential to the successful implementation of Sonoma County’s implementation of Proposition One, Behavioral Health Transformation. Two grants were authorized to it which seek to strengthen their participation in County planning efforts.

The first grant, coupled with a known request from the Executive Committee of the Behavioral Health Board, would reimburse the meals, lodging, and transportation for any LEAP/B member to all state and county trainings in the next year concerning Prop One Implementation. The second grant, authorizes the reimbursement of any LEAP/B member for all unreimbursed costs incurred to participate in Sonoma County LEAP/B, Sonoma County Homeless Coalition, and Behavioral Health Board meetings for the next year. For more information on access to these grant funds, email us at heapa.org/contact/

Zoom to the Streets

Greetings!

I’m experimenting with how AI technology can become useful to mass demonstration organizers. On Thursday, a group of homeless organizers had a meeting on Zoom. Great meeting, complex conversations, even if they weren’t also preparing for a major gathering on Saturday afternoon in the town square. Zoom’s AI companion was turned on, and resulted in it providing a concise digital summary of what was said. That summary was then provided to ChatGPI, which was asked to create: 1) an article for the groups’ website, complete with researched internet linked articles on the topics discussed; 2) a song/speech playlist from YouTube related to the topics discussed to broadcast at Saturday’s public gathering; and 3) a digital file to provide to a banner-making company, including QR-codes to carry in the square on Saturday. The result is a very well-equipped group of activists on Saturday – all provided by an AI-enhanced meeting occurring on Thursday.

Proposition One Update Presentations

Recent WEBSITE or BOS Presentations

Shasta Website: https://www.shastacounty.gov/health-human-services/page/updates-prop-1-californias-behavioral-health-transformation

Marin BOS Presentation: Proposition 1 Transition Planning

Marin Slide Show: 4 – PRESENTATION

County Behavioral Health Board Websites

Marin: https://www.marinhhs.org/boards/marin-county-behavioral-health-board

Mendocino: https://www.mendocinocounty.gov/departments/behavioral-health-and-recovery-services/mental-health-services/behavioral-health-board

Napa: https://www.countyofnapa.org/1018/Behavioral-Health-Advisory-Board

Sacramento: https://dhs.saccounty.gov/BHS/Pages/BHS-Home.aspx

San Francisco: https://www.sf.gov/departments–department-public-health–behavioral-health

Shasta: https://www.shastacounty.gov/health-human-services/page/behavioral-health-social-services-adult-services-childrens-services-and

Solano: https://www.solanocounty.com/depts/mhs/default.asp

Yolo: https://www.yolocounty.gov/government/general-government-departments/health-human-services/boards-committees/local-mental-health-board

BHBoard Meeting Agenda/BHSA Materials

Mendocino, Feb 26th Meeting: https://www.mendocinocounty.gov/departments/behavioral-health-and-recovery-services/mental-health-services/behavioral-health-board

Sacramento: https://dhs.saccounty.gov/BHS/Pages/MHSA/Plans-and-Updates/GI-MHSA-FY2024-25-and-2025-26-Two-Year-Plan.aspx

Government Transformation

The traditional government financing design is being turned upside down.  No longer can we expect the federal or state governments to advance or reimburse local governments.  And if the uses of federal and state funds are now to give tax breaks to the rich, and to end and reduce deficit spending, then federalism and state solvency are going to be severely tested.

Which brings us to the question addressed at Santa Rosa’s goal-setting workshop yesterday – What are the basic services which should consume the City’s budget?  What do our residents want, and what should our elected representatives provide, from the City?  The Council chose to recognize that its own workforce was exhausted and could not perform well on most of its assigned goals and duties.  Their answers were fewer goals, clearly understood by the public, with longer acknowledged timeframes.  Their very top priority was to “Achieve and Maintain Fiscal Sustainability”.   Though you might have heard that before in tough economic times, I’ve never seen a more worried group of leaders and staff.  The word “transformation” was used many times, and I don’t think many had clear visions of positive outcomes.

In the general questioning of the purposes of all government, this local examination is crucial.  To many, it may be the only chance for citizen impact.  Lately, Sonoma County voters have agreed to tax themselves to provide some vital resources under local control.  A unified and cooperative group of leaders could work together to develop a better funding system.  The County and its cities need to protect each other from simplistic departmental budget slashing, or none of us will be happy with how local governments will be transformed.