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40 Alameda Countywide Homeless and Special Needs Housing Plan Context for Behavioral Health Care and Housing Alameda County's Behavioral Health Care System Today California state law delegates responsibility for mental health service provision to counties. Alameda County is one of two exceptions in the state in which city-based public mental health programs are also statutorily authorized and funded. In Alameda County, the primary agency responsible for mental health services is Alameda County Behavioral Health Care Services, (BHCS), a department of the Alameda County Health Care Services Agency. In Berkeley, the Mental Health Division of the Health and Human Services Department provides public mental health services to residents of the cities of Berkeley and Albany and coordinates these services with the larger county system. BHCS is mandated to provide psychiatric crisis or emergency care, inpatient care, outpatient/day care, case management, conservatorship, administration, and evaluation, Some services are provided directly by the BHCS, while others are provided by community~based organizations under contract with BHCS. State legislation also establishes standards for staffing, quality assurance, reporting and other general practices. Alameda County has used discretionary funding to develop additional programs, such as housing support services and community-based organization stabilization.3 The City of Berkeley is one of two city-based public mental health jurisdictions in California. Berkeley Mental Health (BMH) provides a broad range of mental health and support services and consumers receive acute inpatient, conservatorship, long-term care and some additional services from Alameda County. Consumers enter the BHCS system through a single screening point, a toll-free telephone referral point called Acute Crisis Care and Evaluation for System-wide Services (ACCESS). When consumers call ACCESS, they are screened for eligibility and may be referred to a community- based organization. Berkeley and Albany residents may also access services directly through Berkeley Mental Health, where they are screened for service eligibility and admitted or appropriately referred in coordination with the Alameda County ACCESS program. BHCS is also responsible for substance use treatment services in the county, although the two branches of the agency that address mental health and substance use are distinct. Most substance use treatment services are provided by community-based organizations under contract with BHCS. In FY 2003-2004, BHCS had contracts with 39 community-based organizations for a total of nearly $28 million for alcohol and other drug programs.4 In FY 2004-2005, BHCS was responsible for a budget of more than $220 million and for more than 450 FTE employees combined for both mental health and substance use programs.5 In 2004, BHCS allocated about $11 million to housing programs, including approximately $5 million in various 3 Alameda County Behavioral Health Care Services website. Available online: www.co.alameda.ca.us/health/behavior/behav.htm (Accessed: April 29, 2005). 4 Alameda County, FY 2004-2005 Final Amended Budget, pp. 533-535. Available online; www.co.alameda.ca.us/budget/budget_ 2005 jinal_amended.pdf (Accessed: May 12, 2005). 5 Alameda County, FY 2004-2005 Final Amended Budget. Available online: www.eo.alameda.ca.us/budget/budget_2005 _final_amended.pdf (Accessed; May 12, 2005).