On March 5, 2024, in addition to the Presidential* (see note below about the Global Presidential Primary), Congressional and Senate Primaries plus several statewide and local primary votes, voters from California will be asked to weigh in on Proposition 1, Behavioral Health Services Program and Bond Measure. With the catchy slogan “Yes on 1 – Treatment not Tents,” the measure is positioned as a milestone in the fight against homelessness in California. However, calls from on the other side, “Hospital Beds are not Homes!” and “#HelpNotHide”, suggest that the issue may be more complex.

What is Proposition 1?

Proposition 1 has two key aspects. First, it proposes to amend the Mental Health Services Act (passed as Proposition 63 in 2004), which levied a 1% tax on income over $1 million to fund mental health services and programs. (In 2022-2023, this amounted to $3.3 billion according to the Legislative Analyst’s Office.) Proposition 1 specifically proposes to:

• rename the original 2004 act to the Behavioral Health Service Acts and expand its scope to include substance use disorders;
• change how counties can spend the funds, in particular requiring that 30% be allocated to housing intervention programs; and
• increase the size of the oversight commission from 16 to 27 voting members and to require a state-level audit no later than 2029, and every three years thereafter until 2035.

Second, Proposition 1 proposes to issue a bond worth $6.38 billion to fund housing for homeless people and for veterans with mental health or substance abuse disorders. Proceeds would be allocated as follows:

• $1.05 billion on housing for homeless veterans with mental health or substance use disorders;
• $922 million on housing for people with behavioral health needs who are homeless or at risk of homelessness; and
• $4.39 billion for grants toward treatment and housing eligible under the Behavioral Health Continuum Infrastructure Program

This bond is the fifth since 2000 to tackle the problem of veteran housing and homelessness. However, the current bond is broader in scope, addressing homelessness in populations with mental health problems as well as veterans.

How Did We Get Here?

Since the adoption of the Mental Health Services Act in 2004, California counties have been tasked with spending the funds raised annually through the 1% tax on income over $1 million. Each county’s board of supervisors is required to submit a three-year program and expenditure plan to the Mental Health Services Oversight and Accountability Commission and to the State Department of Health Care Services. Plans should cover all stages of mental health services from prevention and early intervention to sustained support for particular populations (children, adults, seniors) to service innovation.

Proposition 1 is classified as a legislatively referred state statute, meaning that it was placed on the March ballot through a vote of the state legislature. In this case, two laws passed by the legislature in 2023, Senate Bill 326 and Assembly Bill 531 (which introduced the bond measure) included provisions for a joint measure to be included on the March 2024 ballot. Both bills were sponsored by Democrats, and both passed through the California state legislature with strong majorities including some bipartisan support. 

The new measures are touted as a change in how California administers mental health services. Proponents argue that they are necessary to confront endemic homelessness among those affected by mental health and substance use problems. The text of the bill suggests that both the effectiveness and oversight of current mental health services are also in question. In the view of Governor Gavin Newsom, a proponent, Proposition 1 “marks a powerful and important milestone that we are moving beyond identifying issues, to a paradigm shift to begin the process of being accountable to solve them.” (Los Angeles Daily News, October 12, 2023) And “This reform will bring much needed accountability currently lacking at the local and state level, increased transparency and visibility into the whole mental health and addiction treatment system, and a modernized focus to address today’s crises.” (The Observer, September 27, 2023) It is “about holding ourselves to a high level of accountability, a higher level of expectation.” (The Sacramento Bee, October 12, 2023) He believes the approach could eventually serve as a model for other states. The measure is seen as a complement to Newsom’s Community Assistance, Recovery and Empowerment (CARE) Court and several other measures to confront homelessness and a perceived mental health crisis. 

Opponents point to the fact that earmarking funds for housing will inevitably require a cut to current services and programs. They note that these programs can be a lifeline to underserved communities, including the uninsured. They also point to a last minute change in the language of the proposition which now allows funds to be used for “forced treatment” of patients committed against their will. In the words of the opponents, 

"Financial support for a wide array of effective, voluntary, evidence-based, community-based, accessible, service options will be dramatically cut. Also on the chopping block is one of the only funding sources for peer support and culturally responsive mental health services for racial and ethnic minority communities. In their place, Proposition 1 would massively expand involuntary treatment options. There is no evidence base of effectiveness for these forced treatment proposals, and a multitude of reports show how these attempts at care primarily result in further distress and harm to the service user." (The Davis Vanguard)

Finally, they argue that the bond measure is costly and fiscally problematic. (Californians Against California Proposition 1)

The early text was amended to address several concerns, including by introducing the possibility to transfer money between spending categories in certain situations and by offering some exemptions to rural communities. In response to the concerns about “forced treatment,” Newsom’s spokesperson has stated the language was changed to add flexibility, making it possible to fund the “full spectrum of behavioral health treatment sites.” (The Sacramento Bee, October 12, 2023)

 

Don’t forget to vote in the March 5, 2024 Primary* Election! 

To register to vote and to request your ballot, go to www.VoteFromAbroad.org TODAY!

* Vote in DA’S GLOBAL PRESIDENTIAL PRIMARY as well as the CA PRIMARY - just remember, you can only vote for PRESIDENT ONCE!

The Democrats Abroad Global Presidential Primary (GPP) starts on Super Tuesday March 5 through March 12, 2024, to help select the next Democratic presidential candidate and our delegates to the DNC Convention in August. Simply leave the Presidential race blank on the CA Primary Ballot if you wish to vote in the GPP. More information here.

Who Supports?

Yes On 1 - Treatment Not Tents, California Democratic Party, Gov. Gavin Newsom (D), State Sen. Susan Talamantes Eggman (D), Lt. Gov. Eleni Kounalakis (D), Blue Shield of California, Sutter Health, National Alliance on Mental Illness California, Mental Health Services Oversight and Accountability Commission, California Medical Association, California Hospital Association, Alice B Toklas LGBTQ Democratic Club, California Professional Firefighters, League of California Cities, Santa Monica City Council, California Business Roundtable, California Chamber of Commerce, California Business Properties Association

Who Opposes? 

Californians Against California Proposition 1, League of Women Voters of California, State Sen. Minority Leader Brian W. Jones (R), State Assemblywoman Diane B. Dixon (R), Mental Health America of California, California Association of Mental Health Peer-Run Organizations, Depression and Bipolar Support Alliance of California, California Pan-Ethnic Health Network, Cal Voices, Life Aid Research Institute, Disability Rights California, California Health Care Foundation, Davis Vanguard, 

 

Source: Ballotpedia ; Blue Voter Guide

Read More…

• Cal Voices. Mental Health Services Act (MHSA)
• League of Women Voters Education Fund
• The Observer, September 27, 2023
• Cal Matters, October 10, 2023
• LAist, October 12, 2023
• Los Angeles Daily News, October 12, 2023
• The Los Angeles Times, October 12, 2023 
• The Sacramento Bee, October 12, 2023
• The Davis Vanguard, October 13, 2023

Note: For those voting in Los Angeles County, Nevada County (Grass Valley/Nevada City), San Francisco County or Orange County (Huntington Beach), there are also several local measures on the Primary ballot. For more information, go to: Ballotpedia - California 2024 local ballot measures

 

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