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Marin supervisors back state measure on mental health spending

Marin Independent Journal - 2/11/2024

Feb. 11—Marin County supervisors are backing a statewide proposition on the March 5 ballot that would authorize $6.4 billion in bonds to build mental health treatment facilities and revamp other key mental health spending.

In doing so, they became the first county supervisorial board in the state to throw its support behind the only state proposition on the March ballot, according to Talia Smith, a county administrative analyst.

"The governor has been very vocal and clear that this is his highest policy priority," Smith told supervisors prior to their decision.

The proposition, which was placed on the ballot by the Legislature, is opposed by Disability Rights California, the League of Women Voters and the California Association of Mental Health Peer-Run Organizations.

Several statewide groups, including the California State Association of Counties, the California Behavioral Health Directors Association and the California Welfare Directors Association have elected to remain neutral on the proposition.

Supporters include the League of California Cities, the California chapter of the National Alliance on Mental Illness and labor organizations such as the Service Employees International Union.

Supporters say the bond will create much-needed funding for new mental health beds.

"California has a known shortage of treatment beds for individuals who have behavioral health needs," Smith told supervisors. "There's an estimate that the current gap of need in the state is around 10,000 treatment beds."

Opponents of the proposition note that the measure would also rejigger the way in which Mental Health Services Act funding is required to be spent. Approved by California voters in 2004, the act raises $2 billion to $3.5 billion annually.

Eighty percent of that revenue must be used for crisis services and supports, and 51% of those funds must be used for "full-service partnerships," which are recovery-oriented, comprehensive services for people with serious mental illnesses. The remaining 20% must be spent on prevention and early intervention.

Proposition 1 would require that counties spend between 23% and 30% of their Mental Health Services Act funding on housing for people with serious mental illness and/or substance use disorders. Currently, the money can only be used to benefit people with a substance use disorder if they have a mental illness.

Under Proposition 1, another 35% of the funds would have to be used for full-service partnerships and the remaining 35% used for behavioral health services and supports.

Proposition 1 would also reduce the share of the law's funds that counties receive from 95% to 90%, with the other 5% going to the state. Marin receives $16 million to $23 million in Mental Health Services Act funding annually, so the proposition would cut its funding by about $1 million a year.

Smith said opponents of the proposition assert that the cut in funding to counties, combined with the expanded mandate of whom the funds serve, would result in a reduction in mental health services.

Todd Schirmer, director of Marin County Behavioral Health and Recovery Services, said, "The bottom line is that if Proposition 1 passes we're anticipating a budget gap in our behavioral health services" of between $7 million and $9 million.

Schirmer said the new requirement to spend up to 30% of the revenue on housing would cause the shortfall. He said he could shift some county general fund money already being spent on housing to backfill.

Schirmer said it wouldn't cover everything, "but it can cover some of that."

Mental Health Services Act revenue accounts for about a quarter of his division's budget.

At the same time, Schirmer said, "One of the key gaps in our system right now is long-term treatment beds for people with behavioral health disorders."

He said that gap is likely to grow larger because of a new law, Senate Bill 43, that makes it easier to detain and place into conservatorship people deemed "gravely disabled."

"Proposition 1 would create an opportunity for us to build treatment capacity for that population," Schirmer said.

County supervisors have exercised an option to delay implementation of SB 43 until as late as January 2026, and if passed by voters, Proposition 1 also would not take effect until January 2026.

"The good news is that we have a lot of time," Schirmer said.

Smith said polling indicates that Proposition 1 has the support of about 68% of voters. The proposition requires a simple majority to pass.

While all of the supervisors agreed the board should endorse the proposition, some were more enthusiastic than others.

Supervisor Mary Sackett, the first to voice her support, said, "One of the root causes of a lot of the issues we're trying to address is a lack of housing, and that's where I find this measure compelling."

"We continue to see so many folks on the street," Sackett said, "and providing them with the services and stability and treatment they need when they're on the street continues to be a challenge."

Supervisor Katie Rice expressed concern that Proposition 1 would result in less funding for prevention and early intervention programs.

"It makes sense to embrace at some level what feels like is coming regardless," Rice said, "but if we do move forward with a letter of support we should also call out our concerns."

Supervisor Eric Lucan said, "I do think that this is going to pass, but that's not why we should support it."

Lucan said that any legislation proposing such a "monumental shift" in state policy is bound to have some things in it that "we don't like or don't work."

"But I think there is more in it that works," Lucan said. "This is something we should get behind."


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