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What is Prop 1, California’s mental health and homelessness ballot measure?

Orange County Register - 1/30/2024

There is only one statewide ballot measure before California’s primary voters this year — and it’s an effort meant to increase mental and behavioral health services, particularly for the state’s homeless population.

For Proposition 1, voters are asked whether to authorize a nearly $6.4 billion bond for facilities for mental health or substance abuse treatment.

It is not a new tax; instead, the measure shifts about $140 million in existing tax revenue from counties to the state for mental health, drug and alcohol treatment, according to the Legislative Analyst’s Office summary.

Since 2005, California has collected a tax from people with incomes over $1 million and used that money — between $2 billion and $3.5 billion every year — on mental health services. Under this, called the Mental Health Services Act, 95% of that money goes directly to counties to spend on certain types of services.

If Prop 1 is successful in the primary election, the state would get more of that funding (about 5% more) and would have to spend some on increasing the amount of mental health care workers in the state as well as drug and alcohol prevention measures, according to the LAO. Counties would be required to spend more on housing and personalized support services.

An estimated 4,350 housing units (with half earmarked for veterans) and 6,800 spaces for people to receive mental health services would be created if the measure is approved — as well as about 26,700 outpatient treatment slots, according to the California Budget & Policy Center.

The state would have to repay the bonds by $310 million each year for 30 years — a potentially unpalatable figure when the state is already grappling with a nearly $38 billion budget deficit.

The Governor’s Office calls it a “re-focus of billions of dollars in existing funds to prioritize Californians with the deepest mental health needs, living in encampments or suffering the worst substance use issues.”

The goal, supporters say, is to emphasize housing in tandem with mental health care.

“These reforms, and this new investment in behavioral health housing, will help California make good on promises made decades ago,” said Gov. Gavin Newsom. “We see the signs of our broken system every day — too many Californians suffering from mental health needs or substance use disorders and unable to get (the) support or care they need.”

Proponents say the measure will expand community-based services that will help an estimated tens of thousands of residents a year and prioritize treatments for those who are struggling rather than incarceration.

Proponents also say the measure will earmark $1 billion for veterans experiencing homelessness, substance abuse issues or mental health challenges.

“When you see people in the street, they’re covered in urine or covered in feces and they’re dirty and they’re pacing and they’re talking or screaming at each other … what you are witnessing is human pain and suffering,” Brian Rice with the California Professional Firefighters Association said at a recent rally in support of Prop 1 in Los Angeles.

“We can’t keep doing this,” Rice said.

Other supporters of the measure include the National Alliance on Mental IllnessCalifornia, the California Chamber of Commerce and the Orange County Coalition of Police and Sheriffs.

A December survey found 68% of likely voters said they would support Prop 1, compared to 30% who said they were a no and 2% who were undecided. That Public Policy Institute of California poll found the measure was more popular among registered Democrats: 85% of Democrats said they’d vote yes along with 40% of Republicans and 66% of independents.

Those opposed to the ballot measure argue that it reallocates funds used for other mental health services offered by counties, like crisis response and outreach efforts. The measure could, according to the League of Women Voters, ultimately hamper “counties’ ability to set priorities based on local needs for mental health services.”

There are concerns, too, that the measure could amplify forced treatment — something else — and curtail crucial services the MHSA has provided for historically underserved communities, like LGBTQ+ or communities of color, according to the Budget & Policy Center.

“Any variances that may allow counties to spend more or less on specific categories would increase their administrative costs and do not erase the lack of flexibility they would have to meet specific needs,” the League of Women Voters said.

In its argument against the measure, a group of mental health organizations argued that the provisions wouldn’t provide long-term housing or solutions for unhoused Californians.

“Two-thirds of the money is for time-limited and potentially ‘locked’ treatment beds, not permanent housing. When people leave treatment, they’ll be back on the streets, still disabled, unable to work, again without housing,” said Mental Health America of California CEO Heidi Strunk and California Association of Mental Health Peer-Run Executive Director Andrea Wagner.

The League of Women Voters also contends that the measure was rushed through the legislative process last year — meaning debate from community-based organizations and civil rights advocates was stifled. Budgetary decisions, the group argues, should be made by the legislature and not a ballot initiative.

Assemblymember Diane Dixon, R-Newport Beach, and Sen. Brian Jones, R-San Diego, are also opposed to the measure.

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