AMENDED IN SENATE AUGUST 13, 2026

AMENDED IN SENATE JUNE 11, 2026

AMENDED IN ASSEMBLY MARCH 26, 2026

AMENDED IN ASSEMBLY MARCH 16, 2026

CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION

95

Introduced by Assembly Member Bauer-Kahan

February 18, 2026

An act to amend Sections 53123.2, 53123.3, and 53123.4 of the Government Code, and to amend Sections 41135 and 41136 of the Revenue and Taxation Code, relating to mental health.

Vote: majority   Appropriation: no   Fiscal committee: yes   Local program: no

LEGISLATIVE COUNSEL’S DIGEST

Existing federal law, the National Suicide Hotline Designation Act of 2020, designates the 3-digit telephone number “988” as the universal number within the United States for the purpose of the national suicide prevention and mental health crisis hotline system operating through the 988 Suicide & Crisis Lifeline.

Existing law, the Miles Hall Lifeline and Suicide Prevention Act, requires, among other things, the California Health and Human Services Agency (agency) to create, no later than December 31, 2024, a set of recommendations to support a 5-year implementation plan for a comprehensive 988 system. Existing law requires the agency to convene a state 988 advisory group for purposes of advising the agency on the set of recommendations and requires the recommendations to include specified information. Existing law requires the advisory group to meet at least once per quarter until December 31, 2024. Existing law authorizes the agency to disband the advisory group on or after January 1, 2025. Existing law requires the agency, until December 31, 2029, to post regular updates, no less than annually, regarding the implementation of 988 on its public internet website.

This bill would require the advisory group to meet at least once per quarter until December 31, 2029. The bill would authorize the agency to disband or reconvene the advisory group on or after January 1, 2030. The bill would require the above-described regular updates to include, among other things, the progress toward statewide interoperability between 988 and 911. The bill would require the agency to have the primary responsibility for statewide governance and implementation of the 988 system. The bill would require the agency to maintain a 988 System Governance Board to provide cross-agency coordination and oversight related to implementation of the 988 system, as specified. The bill would require the State Department of Health Care Services to be responsible for oversight of 988 center operations, among other things.

Existing law requires the Office of Emergency Services (office) to establish and convene the State 988 Technical Advisory Board for purposes of advising the office on, among other things, recommendations on the feasibility and plan for sustainable interoperability between 988, 911, and behavioral health crisis services. Existing law requires the advisory board to meet no less than quarterly until December 31, 2028. Existing law, after December 31, 2028, authorizes the office to disband the advisory board. Existing law requires the office to appoint a 988 system director to implement and oversee the policy and regulatory framework for the technology infrastructure, coordination, and transfer of calls between 988, 911, and behavioral health crisis services.

This bill would require the advisory board to meet no less than quarterly until December 31, 2029, and thereafter, would authorize the office to disband or reconvene the advisory board. The bill would delete the requirement for the office to appoint a 988 system director. The bill, on or before December 31, 2029, would require the office, in consultation with the State Department of Health Care Services, to procure, implement, and designate a single statewide interoperability platform capable of facilitating real-time communication and warm handoffs between 988 centers and 911 public safety answering points. The No later than June 1, 2027, the bill would require the Emergency Medical Services Authority, in consultation with the office and the State Department of Health Care Services, to develop and adopt mandatory statewide protocols governing the transfer of calls and communications from 911 public safety answering points to 988 centers, as specified. The bill would require the authority to consult with, among others, county behavioral health agencies to develop these protocols.

Existing law establishes the 988 State Suicide and Behavioral Health Crisis Services Fund for the deposit of 988 surcharge revenue. Existing law requires 988 surcharge revenue to be prioritized to fund, among other things, the 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. Existing law requires 988 surcharge revenue in the 988 State Suicide and Behavioral Health Crisis Services Fund to be available upon appropriation by the Legislature for these purposes. Existing law requires an entity seeking funds available through the 988 Suicide and Behavioral Health Crisis Services Fund to annually file an expenditure and outcomes report, as specified.

This bill would require the State Department of Health Care Services to develop and maintain a statewide 3-year expenditure methodology for the 988 State Suicide and Behavioral Health Crisis Services Fund, as specified. The bill would require the methodology to be completed on or before June 30, 2027, and to first be used for, or before, the 2028–29 budget year. The bill would require the entity seeking funds to include in the report the net revenues, expenditures, and sources of revenues for 988 and receiving or seeking funds, as specified. The bill would also make conforming changes to the provisions relating to the disbursement of moneys in the 988 State Suicide and Behavioral Health Crisis Services Fund.

The people of the State of California do enact as follows:

SECTION 1.

Section 53123.2 of the Government Code is amended to read:

53123.2.

(a) No later than July 16, 2022, the Office of Emergency Services shall verify that technology that allows for transfers between 988 centers, as well as between 988 centers and 911 public safety answering points, is available to 988 centers and 911 public safety answering points throughout California.

(b) (1) No later than 90 days after the passage of this act, the office shall establish and convene the State 988 Technical Advisory Board for purposes of advising the office on all of the following:

(A) Recommendations on the feasibility and plan for sustainable interoperability between 988, 911, and behavioral health crisis services, including the identification of any legal or regulatory barriers to the transfer of 911 calls.

(B) The development of technical and operational standards for the 988 system that allow for coordination with California’s 911 system.

(C) The creation of standards and protocols for when 988 centers will transfer 988 calls into the “911” public safety answering points or points (PSAP), or mobile crisis dispatch, including county behavioral health mobile crisis dispatch, and vice versa.

(2) The board shall meet no less than quarterly until December 31, 2029. Following that date, the board may be disbanded or reconvened at the discretion of the office.

(3) The board shall consist of a representative from the California Health and Human Services Agency and expert representatives, including, but not limited to, those from 988 centers, 911, and county behavioral health agencies, and behavioral health crisis service providers.

(c) On or before December 31, 2029, the office, in consultation with the State Department of Health Care Services, shall procure, implement, and designate a single statewide interoperability platform capable of facilitating real-time communication and warm handoffs between 988 centers centers, mobile crisis team dispatch, including county behavioral health mobile crisis teams, and 911 public safety answering points.

(d) The office shall consult with the National Suicide Prevention Lifeline and the Substance Abuse and Mental Health Services Administration on any technology requirements for 988 centers.

(e) The office shall retain responsibility for technical interoperability between 988 mobile crisis dispatch, including county behavioral health dispatch, and 911 systems, including telecommunications coordination and related technology functions.

(f) The (1) No later than June 1, 2027, the Emergency Medical Services Authority, in consultation with the office and the State Department of Health Care Services, shall develop and adopt mandatory statewide protocols governing the transfer of calls and communications from 911 public safety answering points to 988 centers. centers and mobile crisis team dispatch points, including county behavioral health mobile crisis dispatch points. The protocols shall include all of the following:

(A) Criteria for transfers between 911 mobile crisis team dispatch, including county behavioral health mobile crisis dispatch, and 988.

(C) Standards to support the least restrictive and clinically appropriate responses to behavioral health crises.

(D) Coordination standards between 988 centers, emergency medical services providers, mobile crisis teams, and public safety agencies. including county behavioral health mobile crisis teams, public safety agencies, and other first responders.

SEC. 2.

Section 53123.3 of the Government Code is amended to read:

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, 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, 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 call 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 proposed 988 operational budget for the purposes of establishing the rate of the 988 surcharge and how revenue will be dispersed 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 and mobile crisis teams, including county behavioral health mobile crisis teams, 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 statewide interoperability between 988 mobile crisis teams, including county behavioral health mobile crisis teams, and and 911.

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

(3) Implementation status of the statewide interoperability platform established pursuant to Section 53123.2.

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

(d) (1) The California Health and Human Services Agency shall have the primary responsibility for statewide governance and implementation of the 988 system.

(2) (A) The California Health and Human Services Agency shall maintain a 988 System Governance Board to provide cross-agency coordination and oversight related to implementation of the 988 system.

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

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

(1) Oversight of 988 center operations.

(2) Oversight of mobile crisis integration into the 988 system. response to the 988 centers.

(3) Administration of the 988 State Suicide and Behavioral Health Crisis Services Fund, except for technical interoperability functions retained by the Office of Emergency Services, pursuant to Section 53123.2.

(4) Development of statewide operational, workforce, training, technology, and technology standards, and funding methodologies necessary to implement the 988 system.

(5) Establishment of statewide requirements, implementation standards, and protocols necessary to support integration between 988 centers and mobile crisis teams, and mobile crisis response, including county behavioral health mobile response, including real-time coordination, warm handoff capability, and response protocols.

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

(f) No later than December 31, 2029, and to the extent not prohibited by federal law, Medi-Cal mobile crisis service providers shall maintain the capability the department shall establish the capability and issue a requirement for county behavioral health mobile crisis response teams to receive and respond to referrals, dispatch requests, or warm handoffs from 988 centers in real time.

(h) Nothing in this section shall prohibit 988 centers from coordinating with other behavioral health crisis response entities, including city-operated or locally operated mobile crisis teams.

SEC. 3.

Section 53123.4 of the Government Code is amended to read:

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 solely for the operations of the 988 center and mobile crisis teams as defined in the American Rescue Plan Act of 2021 (Section 9813(b)(2) of Public Law 117-2). 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, 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 county behavioral health directly operated or contracted 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 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 maintain a statewide three-year expenditure methodology for the 988 State Suicide and Behavioral Health Crisis Services Fund.

(2) The methodology shall be developed through a public process. process with input from representatives of 988 call centers and mobile crisis response teams, including county behavioral health teams.

(3) The methodology shall be completed on or before June 30, 2027, and shall first be used for, or before, the 2028–29 budget year. The department may update the methodology after June 30, 2027.

(4) The methodology shall establish projected statewide funding needs for a three-year period period consistent with this section and shall serve as the basis for the Legislature’s appropriation of 988 surcharge revenues.

(5) The methodology shall account for all of the following:

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

(B) Anticipated mobile crisis dispatch and response volume.

(C) Staffing levels necessary to meet projected demand.

(D) Workforce vacancy rates and workforce sustainability needs.

(E) Funding necessary to support training time for 988 center staff and mobile crisis personnel.

(F) Technology, telecommunications, infrastructure, and modernization needs.

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

(H) Surge capacity and disaster readiness.

(I) Federal performance standards and national best practices.

(J) Existing and anticipated federal, state, local, and private reimbursement sources.

(d) The State Department of Health Care Services may adopt regulations regarding how funds received shall be disseminated to support the operations of the 988 system and related behavioral health crisis services.

(e) The State Department of Health Care Services shall require an entity seeking funds available through the 988 Suicide and Behavioral Health Crisis Services Fund to annually file an expenditure expenditure, revenues, and outcomes report in a form and manner as determined by the State Department of Health Care Services. The expenditure 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 health coverage status of individuals served, if known. The net revenues, expenditures, and sources of revenues for 988 and receiving or seeking 988 State Suicide and Behavioral Health Crisis Services funds, 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. services, and warm handoffs with mobile crisis response dispatch.

(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.

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

SEC. 4.

Section 41135 of the Revenue and Taxation Code is amended to read:

41135.

(a) All amounts required to be paid to the state under this part shall be paid to the department in the form of remittances payable to the California Department of Tax and Fee Administration. The department shall transmit the revenues to the State Treasurer to be deposited in the State Treasury to either the credit of the State Emergency Telephone Number Account in the General Fund, or the 988 State Suicide and Behavioral Health Crisis Services Fund, depending on the apportionment of the revenues arising from each surcharge.

(b) The department, in consultation with the State Department of Health Care Services and the Office of Emergency Services, may adopt regulations to implement the apportionment of the revenues from each surcharge.

(c) The department shall submit an annual report to the State Department of Health Care Services on revenue generated by the 988 surcharge.

SEC. 5.

Section 41136 of the Revenue and Taxation Code is amended to read:

41136.

(a) From the funds in the State Emergency Telephone Number Account, all amounts of the 911 surcharge collected shall, when appropriated by the Legislature, be spent solely for the following purposes:

(1) To pay refunds authorized by this part.

(2) To pay the department for the cost of the administration of the 911 surcharge under this part.

(3) To pay the Office of Emergency Services for its costs in administration of the “911” emergency telephone number system.

(4) To pay bills submitted to the Office of Emergency Services by service suppliers or communications equipment companies for the installation of, and ongoing expenses for, the following communications services supplied to local agencies in connection with the “911” emergency phone number system:

(A) A basic system, defined as 911 systems, including, but not limited to, Next Generation 911, and the subsequent technologies, and interfaces needed to deliver 911 voice and data information from the 911 caller to the emergency responder and the subsequent technologies, and interfaces needed to send information, including, but not limited to, alerts and warnings, to potential 911 callers.

(B) A basic system with telephone central office identification.

(C) A system employing automatic call routing.

(D) Approved incremental costs.

(5) To pay claims of local agencies for approved incremental costs, not previously compensated for by another governmental agency.

(6) To pay claims of local agencies for incremental costs and amounts, not previously compensated for by another governmental agency, incurred prior to the effective date of this part, for the installation and ongoing expenses for the following communication services supplied in connection with the “911” emergency telephone number system:

(A) A basic system, defined as 911 systems, including, but not limited to, Next Generation 911, and the subsequent technologies, and interfaces needed to deliver 911 voice and data information from the 911 caller to the emergency responder and the subsequent technologies, and interfaces needed to send information, including, but not limited to, alerts and warnings, to potential 911 callers.

(B) A basic system with telephone central office identification.

(C) A system employing automatic call routing.

(D) Approved incremental costs. Incremental costs shall not be allowed unless the costs are concurred in by the Office of Emergency Services.

(b) (1) From the funds in the 988 State Suicide and Behavioral Health Crisis Services Fund, all amounts of the 988 surcharge collected shall be spent for purposes identified in Section 53123.4 of the Government Code. However, before funds are disbursed as provided in Section 53123.4 of the Government Code, funds shall be used for all of the following:

(A) To pay refunds authorized by this part.

(B) To pay the department for the cost of the administration of the 988 surcharge under this part.

(C) To pay other state departments for their costs in administration of the 988 Suicide & Crisis Lifeline.

(2) The remainder of the revenue shall be disbursed to the State Department of Health Care Services for the purposes identified in Section 53123.4 of the Government Code.