Behavioral Health Fiscal Academy - California Mental Health Services Authority

The Behavioral Health Fiscal Academy (BHFA) is a structured training program designed exclusively for county behavioral health finance professionals who are new or at an intermediate level. Its purpose is to equip participants with the essential knowledge and practical tools needed to navigate the complex world of Medicaid/Medi-Cal funding, fiscal planning, and compliance requirements.

Unlike advanced-level content, BHFA focuses on building a strong foundation. The academy provides a clear, step-by-step framework for understanding behavioral health funding streams, reimbursement methodologies, forecasting strategies, and key regulatory obligations—without assuming years of prior experience. See the academy syllabus.

What Makes BHFA Different?

Tailored for beginners and intermediates: This is not an advanced course. It’s designed for those who need practical, actionable guidance—not deep theory or advanced analytics.
Hands-on approach: While each session includes brief historical and conceptual context, the emphasis is on functional “how-to” skills that county finance professionals need right now to interpret, manage, and apply behavioral health funding structures.
BHFA includes nine fiscal training courses, each focused on giving participants the confidence and clarity to handle real-world fiscal challenges. Topics are presented in plain language, with examples and tools that can be applied immediately.

Critical Questions We’ll Answer

My county’s local Fee-for-Service Medi-Cal (FFS/MC) hospital wants to increase their negotiated rate—where can I learn the limitations and strategies to address this?
How can I ensure that a program aligns with Opioid Settlement Funds’ eligible uses?
What specific deductions are made from my county’s 1991 Realignment? What is the State Managed Care Offset, and how do I reconcile those costs?
How do I evaluate whether a new program is eligible to claim for Medicaid? What makes an activity eligible for administrative reimbursement?

Course Schedule & Registration

Course Overview

Behavioral Health Financing
This course provides a comprehensive overview of the core funding streams and fiscal principles shaping behavioral health financing, including the transition from MHSA to BHSA. Participants will learn strategic approaches to braiding funds, maximizing Medi-Cal payment reforms, and navigating compliance to optimize resources for community behavioral health services.
Developing Grant Budgets
Master the fundamentals of creating compliant, strategic grant budgets for behavioral health programs. This course covers diverse grant types, program income handling, capital budgeting, and sustainability planning, culminating in a pro forma development exercise tailored to large-scale infrastructure grants like BHCIP.
BHSA Budget Modeling
Gain hands-on skills for developing accurate three-year Behavioral Health Services Act budgets using the CalMHSA tools and guides. This training demystifies the budgeting process, offering practical insights on data sourcing, expense estimation, and aligning expenditures with BHSA components to enhance fiscal transparency and planning.
Forecasting SMH & SUD Medi-Cal Patient Revenue
Explore essential forecasting techniques for Specialty Mental Health and Substance Use Disorder Medi-Cal revenues. This course covers key reimbursement factors, policy impacts, and practical methods to predict county behavioral health revenue streams accurately, empowering fiscal teams to plan with confidence amid evolving payment models.
Prop 30 & Other Medicaid Reimbursement Pathways
Delve into Medicaid administrative claiming strategies and Proposition 30 reimbursement pathways vital for county behavioral health plans. The course emphasizes compliance, documentation best practices, and integration of administrative and quality assurance claims to maximize federal match and state funding.
BH-CONNECT EBP Claiming
Navigate the complexities of Evidence-Based Practice (EBP) fidelity, budgeting, and Medi-Cal bundled billing through BH-CONNECT. This course focuses on fiscal analysis for EBP teams such as ACT and CSC, helping counties evaluate the financial and operational impacts of opting into bundled payments while maintaining program quality and compliance.
Psychiatric Inpatient Fiscal Landscape
Understand the fiscal complexities of psychiatric inpatient services, including facility types, IMD exclusion, and reimbursement models. This course equips participants with knowledge of rate setting, contracting strategies, and county obligations to effectively manage inpatient behavioral health financial responsibilities.
CBO Rate Setting Strategies
Learn effective strategies for setting competitive yet sustainable contract provider rates within behavioral health systems. This training addresses market dynamics, productivity analysis, and county priorities to craft rate-setting approaches that balance fiscal responsibility with provider engagement and service quality.
1991R, 2011R, BHSF Forecasting
Build expertise in interpreting statewide and county-specific budget forecasts for major behavioral health funding streams including 1991 and 2011 Realignment and BHSA. This course guides participants through data sources, allocation methodologies, and offset considerations to enhance budget accuracy and fiscal decision-making.

Registration & Syllabus

Topic	Date	Learning Objectives	Registration
Behavioral Health Financing	Nov. 4 10 a.m. – Noon	Understand the core principles underlying the vast array of behavioral funding streams Understand the concept of braiding funding streams while avoiding supplantation	Zoom Link
Developing Grant Budgets	Nov. 6 10 a.m. – Noon	Learn grant budgeting fundamentals using a real-world example Apply budget strategies based on the type of project Develop grant budgets that align with fiscal planning needs	Zoom Link
BHSA Budget Modeling	Nov. 10 10 a.m. – Noon	Use the CalMHSA BHSA Budget Analyst’s Reference Guide to develop the competencies necessary for completing the BHSA Integrated Plan budget template Develop skills to create a three-year BHSA budget using the CalMHSA BHSA Budgeting Tool	Zoom Link
Forecasting SMH & SUD Medi-Cal Patient Care Revenue	Nov. 13 10 a.m. – Noon	Learn the principles and key considerations for forecasting Medi-Cal revenues for behavioral health services Identify factors affecting reimbursement trends	Zoom Link
Prop 30 & Other Medicaid Reimbursement Pathways	Nov. 18 10 a.m. – Noon	Understand Prop. 30 reimbursement methodologies Learn best practices for structuring Medicaid admin. claims Establish documentation strategies for compliance	Zoom Link
BH CONNECT EBP Claiming	Nov. 20 10 a.m. – Noon	Learn how to navigate EBP fidelity requirements and funding implications Build team composition-based budget estimates for bundled services Evaluate BH-CONNECT service delivery options	Zoom Link
Psychiatric Inpatient Fiscal Landscape	Dec. 1 10 a.m. – Noon	Differentiate psychiatric inpatient facility types and identify key fiscal considerations for each Understand the Institutions for Mental Diseases (IMD) exclusion and its implications Understand negotiation strategies for certain hospital facilities Explain county obligations for involuntary commitment costs. Describe professional inpatient psychiatric services and outline reimbursement and claiming pathways.	Zoom Link
CBO Rate Setting Strategies	Dec. 3 10 a.m. – Noon	Develop equitable rate setting methodologies Evaluate rate setting strategies based on service scope Implement contract structures that minimize fiscal risks	Zoom Link
1991R, 2011R, BHSF Forecasting	Dec. 9 10 a.m. – Noon	Retrieve and interpret budget forecasts from the Governor’s budget by applying county-specific distribution percentages to arrive at a county-level budget amount for 91R, 2011R ,and BHSA Understand 1991R offsets and how to reconcile the managed care inpatient service offsets	Zoom Link