Mental Health and Homelessness Services Expand in Sonoma County Under Measure O

Approved by 68 percent of voters in November 2020, Measure O established a quarter-cent sales tax to strengthen behavioral health and homelessness services. Now entering its fifth year, the measure is supporting a coordinated system of care that reaches residents earlier, responds more effectively in crisis, and connects more people to treatment and housing.

“Measure O reflects this community’s decision to invest in care, stability and dignity for our most vulnerable residents,” said Supervisor Rebecca Hermosillo, chair of the Board of Supervisors. “Five years into this effort, we are seeing tangible results: more people are getting help when and where they need it, and we are building a stronger, more responsive system of care.”

Measure O generated $33.1 million in fiscal year 2024–2025, exceeding initial projections and allowing Sonoma County to expand mental health, substance use treatment and homelessness services across all five voter-approved categories. Spending totaled $54.7 million. The County recovered $22.1 million of those costs through state and federal reimbursements, helping stretch local Measure O dollars.

The annual report, produced by the Measure O Citizens’ Oversight Committee, is required under the ordinance to ensure transparency and fiscal accountability. It highlights continued growth in programs that did not exist before Measure O, including mobile crisis response, school-based mental health services and expanded housing coordination.

During the last fiscal year, Measure O funding supported:

• $29.9 million for emergency psychiatric and crisis services
• $15.4 million for behavioral health facilities
• $5.2 million for behavioral health homeless and care coordination
• $3.7 million for mental health and substance use disorder outpatient services
• $625,740 for transitional and permanent supportive housing

Programs funded through Measure O are delivering measurable results across Sonoma County. Among the examples:

• Mobile crisis teams responded to more than 22,000 calls across Sonoma County. Most were resolved without law enforcement involvement, shifting behavioral health response away from emergency rooms and police.
• The Sonoma County Healing Center, a short-term inpatient facility for people experiencing psychiatric emergencies, provided care to more than 200 residents, helping individuals stabilize locally and stay connected to family, support systems and follow-up care.
• The County’s Crisis Stabilization Unit served more than 650 people experiencing mental health emergencies, providing rapid assessment and short-term care to help stabilize individuals and connect them to appropriate treatment.
• School-based mental health services returned to 16 high school campuses, ending a six-year pause. The program connected 109 students to care and responded to 33 on-campus crises.
• Expanded outreach and care coordination programs helped people move from encampments into shelter and permanent housing while providing ongoing support to help them stay housed.

“Voters asked for a system that is accountable, compassionate and effective,” said Nolan Sullivan, director of the Department of Health Services. “This report shows that Measure O is making our community stronger, healthier and more dignified.”

The Measure O Annual Report is available online in English and Spanish. Printed copies are available by request at [email protected]. Reports for previous years are available on the County’s Measure O webpage.