■Proposition 1 would issue $6.4 billion in bonds and direct county behavioral health funds to provide care for the homeless, including veterans.
■Opponents say Proposition 1 forces counties to do more with less.
■Many behavioral health professionals are afraid to speak out against this proposition.
Proposition 1 is the only statewide initiative to go before California voters on the March primary ballot.
Gov. Gavin Newsom supports major reforms to California’s 20-year mental health fund, which has $14 million in campaign funds.
But opposition to Prop. 1 emerged as soon as it was proposed, around the time of two bills introduced by California state legislators.
An association of mental health nonprofits, agencies and county officials are trying to minimize the “disaster” that changes in how counties spend on mental health will bring about, according to a mental health expert who requested anonymity. He said he was working behind the scenes with the authors of Proposition 1 to achieve this goal. .
Additionally, Mr. Newsom’s control over California politics and public finances is so strong that many nonprofit representatives fear retaliation if they oppose the governor’s projects to address homelessness. I am concerned that this may not be the case.
Amendments to the Mental Health Services Act would move funding from counties to state agencies.
With just $1,600 in campaign contributions, anti-Prop. 1 supporters argued that forced housing, less funding for community mental health programs, and less local control are negatively impacting California’s mental health challenges. He hopes to somehow convince voters.
Proposition 1 promises to solve homelessness by repurposing mental health funds
The authors of Proposition 1 combined two efforts to provide support to people with behavioral disorders.
The first asks voters to approve a $6.4 billion bond to fund the creation of mental health treatment facilities and housing programs. The second amendment amends his 2004 MHSA, which was approved by voters.
The MHSA’s 1% state income tax on those earning more than $1 million a year has generated $29 billion from its creation to 2022, according to the LA Times.
This funding was designed to supplement county budgets. Ninety-five percent of MHSA funds go to counties to fund mental health programs.
Proposition 1 narrows the ways counties can spend behavioral health dollars. It also mandates that 30% of MHSA funds be spent on “housing interventions.”
MHSA reform strengthens California’s recent mandated care efforts.
Senate Bill 1338 allows family members or first responders to petition a court to mandate involuntary treatment for a mentally ill person. Senate Bill 43 increases powers and access to conservatorships.
Governor Gavin Newsom signed AB 1338 into law on September 14, 2022. AB 1338 created the CARE Court, allowing family members and first responders to petition the court for the involuntary incarceration of individuals suffering from mental illness. (Governor Gavin Newsom’s Office)
Mayor Dyer supports Proposal 1
Fresno Mayor Jerry Dyer said Proposition 1 will help address chronic homelessness.
“There is a mental health crisis in our state and country, and what we are doing right now is simply not working.” — Fresno Mayor Jerry Dyer
“Many of the people on the streets today are chronically homeless, and may be suffering from more severe levels of mental illness, or may not be mentally fit to accept housing services,” Dyer said. Ta. He said.
According to a study by the University of California, San Francisco, 82% of homeless people reported suffering from some form of mental illness at some point in their lives. The number of inpatient mental health facilities has continued to decline in recent decades.
Proposition 1 proposes creating 11,000 mental health beds across the state.
“There is a mental health crisis in our state and country, and what we are doing right now is simply not working,” Dyer said.
Proposition 1 shifts funding from youth to housing interventions
Proponents of Prop. 1 hope the funding will solve chronic homelessness, but opponents argue the change would take money away from county programs, especially those for children. There is.
“Outpatients with great services have better outcomes than inpatients without great services. So we need their services first. That’s exactly what will be lost in Proposition 1. That’s what happens.” — Paul Simmons, co-founder of California’s Depression and Bipolar Support Alliance
Proposition 1 instead focuses on helping veterans with substance abuse or behavioral health issues.
“A vote yes on Proposition 1 will ensure that we honor our veterans not only on this important occasion, but every day,” Newsom said in a news release. “Proposition 1 prioritizes getting people off the streets and tents, including those who have served our country, and getting them the care they deserve.”
Proposition 1 allocates $1 billion in “critical funding for veterans.” But his $1 billion isn’t new money. Proposition 1 would instead redirect funds that counties currently use toward early intervention programs for children to prevent behavioral health problems from worsening.
It is difficult for mental health professionals to quantify the effectiveness of early intervention programs. But one mental health expert says early intervention programs include children on the verge of homelessness. Many of these children are living in evacuation centers or unstable housing.
The expert said using mental health funds to clean homeless camps would create problems down the road.
Paul Simmons, co-director of the No on Prop. 1 campaign and co-founder of the California Depression and Bipolar Support Alliance, likens early intervention to treating cancer.
“If you catch and treat cancer at stage 1, so to speak, the prognosis is very good, although the cost of treatment may be high,” Simmons said. “If you wait until stage four, it’s incredibly expensive and you’re out of luck anyway.”
Related article: Mental health by mandate? Newsom’s court-ordered care begins Monday
Loss of local control could mean loss of county programs
Although many county officials have not taken a public position on Proposition 1, they have been vocal about the changes the initiative will bring.
To be eligible for the prevention and early intervention program, a person must have been diagnosed with a severe mental illness or severe emotional disorder, said Ahmadreza Bahrami, Fresno County’s manager of behavioral health and equity services.
Given that a significant portion of MHSA funding goes to early intervention programs for children and youth, Proposition 1 would reduce funding for these programs by outlining how counties must use the funds. Reduce the amount offered.
Proposition 1 requires counties to spend 30% of MHSA funds on “housing interventions.” That means rent and security deposits, Bahrami said.
“But the cost of supportive services in our permanent supportive housing efforts is not,” Bahrami said.
Under Proposition 1, funding for early intervention for children and youth would decrease to 8% of MHSA funding.
Related article: As California counties rein in funding, mental health providers say…
“If passed, Proposition 1 would eliminate local control of funding for national mental health prevention and related activities,” Bahrami said.
Bahrami said programs such as suicide prevention, stigma reduction and navigation aids could be phased out in the coming years.
Proposition 1 also puts many substance abuse disorders under the behavioral health category, but it doesn’t add any funding.
“It’s going to take less money to do the same thing,” Simmons said. “They know they’re going to have to cut programs, but they don’t know yet what they’re going to cut. But typically it’s going to be smaller, community-based organizations. Sho.”
Proposition 1 redirects money and control to the state
Proposition 1 would double the amount sent to states from the MHSA from 5% to 10% of millionaire taxes. The nonpartisan Legislative Analysis Service estimates that $140 million a year would be transferred from counties to the state. Due to the variable nature of taxes collected each year, the amount may change.
The state will use 3% of MHSA funding to create a workforce initiative through the California Office of Health Care Access and Information, according to a study by the California Association of Counties. CSAC did not take a formal position on Proposition 1.
The state will contribute 4% of MHSA funding, administered by the California Department of Public Health, to support suicide hotlines and other prevention programs. Three percent of MHSA funds will go to state governments.
Much of the work, especially prevention programs, falls to counties, so the state needs to build the infrastructure.
Proposition 1 also makes the MHSA Oversight Committee accountable for DHCS.
“The way I see it, they’re going to be managing it in spreadsheets. It’s all just numbers,” Simmons said. “And that’s what I’m talking about. When it comes to mental health, you can’t just count numbers.”
$6.4 billion in bonds creates various grant programs
The $6.38 billion bond will address a variety of housing needs. This breakdown comes from the California Association of Counties.
- $1.065 billion for loans or grants to veterans or their households who are homeless, chronically homeless, or at risk of homelessness.
- $922 million in loans or grants for people who are homeless (not necessarily veterans) and people with behavioral health issues.
- $4.39 billion to continue behavioral health treatment
- $1.5 billion in grants to cities, counties, and tribal organizations under the Behavioral Health Continuum Infrastructure Program
- $2.89 billion in additional grants under the BHCIP
- Additional grants administered by the California Department of Health Services for the construction, acquisition, or rehabilitation of real estate assets or investments in necessary infrastructure.
The bond will cost $310 million annually over 30 years, LAO said.
The bonds will be issued after voters pass four other veterans housing programs.
Proposition 1, approved by voters in 2018, provided $4 billion for veterans housing programs. Voters also approved Proposition 41, which provides $600 million for veterans housing and homelessness prevention. In 2008, voters approved Proposition 12, his $900 million for the CalVet mortgage program. Proposition 16 of 2000 provided his $500 million for veterans housing programs.
Who paid for the Prop 1 campaign?
Governor Newsom is the biggest contributor to Proposition 1. Newsom Vote Task Force. In favor of Proposition 1, he contributed $13.6 million.
Conversely, the campaign against Proposition 1 raised $1,600, Simmons said. They are running the campaign with volunteers, primarily from the mental health services industry.
Many feel that the state expects too much from counties without providing them with the resources they need.
“Outpatients with great services outperform inpatients without great services, so we need their services first, and that’s exactly what will be lost in Proposition 1. ,” Simmons said.
