The public sector behavioral health system has been experiencing unprecedented changes related to the COVID-19 pandemic. Face-to-face care delivery is being replaced by telehealth services across a range of inpatient, residential, and outpatient settings and practices. Psychotropic medication prescribing is shifting away from use of modalities requiring in-person visits, and federal agencies have relaxed requirements around prescription of medications, including Clozapine and Medication Assisted Treatment. Many community mental health providers are facing financial shortfalls due to reduced visit volume and state budget cuts. While this landscape is evolving rapidly, it appears increasingly evident that many of these changes will be long-lasting, that we are moving toward a “new normal” in community mental health service delivery. These changes will have major implications both for mental health clinicians and for service users.