Homeless people walk through a homeless camp along Coyote Creek near Old Oakland Road, San Jose, Calif., May 11, 2023 (Daily Kanno/Bay Area News Group)
For decades, thousands of Californians struggling with mental health and addiction have languished on the streets. Voters will now decide whether the March 5 ballot measure is the answer to getting desperately needed care.
Proposition 1 is the only statewide measure on the ballot and would raise about $6.4 billion in bonds for more than 11,000 new treatment beds and homeless housing. The two-part measure would also use funding already in the mental health system to expand intensive treatment programs and build supportive housing, potentially leaving less money available for early intervention and other services. be. We could accomplish both without raising taxes.
Supporters of Proposition 1 acknowledge that it would only help a fraction of California's estimated 181,000 unhoused residents. But they say the measure primarily targets homeless people with the highest needs, the ones voters are most likely to see wandering into driveways or yelling at anyone. claims.
Disability rights activists and some local officials have expressed concerns about an increase in involuntary detention and possible changes to mental health funding, but Proposition 1 has received a lot of attention from Republican and Democratic state legislators. The measure received widespread support and was brought to voters amid mounting public pressure. To solve the homeless problem. They describe Proposition 1 as the linchpin of an ongoing mental health overhaul aimed at forcing treatment on more people with severe mental disorders.
“We've created more flexibility, more tools, more accountability, more resources,” Gov. Gavin Newsom said. “We need more beds now.”
What exactly does proposal 1 do?
The measure would allow the state to issue $6.38 billion in bonds to add an estimated 6,800 beds for people in need of mental health care and addiction treatment to help fill a nationwide bed shortage. becomes possible. Including state hospitals, California currently has an estimated 21,000 psychiatric beds. Proposition 1 would fund approximately 4,350 units of homeless housing, with approximately 2,350 units set aside for homeless veterans.
The county will use the funds to build or build a variety of treatment centers, from long-term residential care facilities for those in more stable conditions to closed-door clinics for those in crisis. Can be expanded. New housing projects will have on-site services that connect residents with mental health care and drug counseling.
While the additional mental health beds are not specifically for homeless people, the overarching goal is to help those with the most severe disabilities and disabilities who often end up on the streets. .
A University of California, San Francisco survey of homeless people in the state last year found that more than two-thirds reported experiencing mental health symptoms.
Still, experts say those in critical condition make up a minority of the unhoused population, and it's clear that states must continue to invest in housing if they want to end homelessness. It has said.
“This conversation is focused on a small group of people because they are… “It's most noticeable when you're outdoors.”
The bond money will be distributed through project grants that counties apply for. The bond issue would cost the state an estimated $310 million a year over 30 years, less than 0.5 percent of projected general fund revenue, according to a report from the Legislative Analyst's Office.
Proposition 1 would also require counties to spend 30% of the cash they receive from the voter-approved Mental Health Services Act (a state tax on millionaires) on rental assistance and supportive housing construction, including for the homeless. is. Mental health taxes collect about $1 billion each year.
Additionally, counties would be required to spend 35% of these funds on those with the most severe needs. For some counties, that could mean shifting funding away from programs that help people with mild symptoms. The measure would direct approximately $140 million annually from counties to strengthen the state's mental health programs.
What else is the nation doing to overhaul its strained mental health system?
Proponents of Proposition 1 blame today's overburdened mental health system on the closure of many of California's large psychiatric hospitals that began in the 1960s.
The closure was part of a statewide movement to “deinstitutionalize” people with mental health issues and other disabilities. The effort culminated in then-Gov. President Ronald Reagan signs the Lanterman-Petris-Short Act.
The state currently has a shortfall of about 7,730 therapeutic and residential care beds, according to a 2021 study by public policy think tank RAND. This is about 1,000 more creations than Proposition 1 promised.
Still, Auckland Mayor Shen Tao said that by adding more beds, local authorities could “successfully bring in people who are unable to make decisions for themselves, no matter what their circumstances, and give them a chance to live their lives.” I will,” he said. In a dignified way. ”
To force more homeless people into treatment, proponents of Proposition 1 point to two recent reforms being phased in across the state.
The first is CARE Court, a new program that allows medical professionals, families and others to petition a judge to order some homeless people into mental health programs. The second is a state law enacted this year that changes the conservatorship system to force more homeless people into involuntary care who cannot meet their basic needs.
What are the arguments against Proposition 1?
Disability rights groups argue that the measure and accompanying mental health reforms represent a potentially dangerous retreat to the inhumane and forced treatment of the past.
Some taxpayer groups have argued that issuing new bonds will inevitably lead to wasteful spending and burden states already struggling to balance their budgets with even more unsustainable debt. There is.
At the same time, local officials are concerned that budget changes to the Mental Health Services Act could result in cuts to some of the county's existing mental health programs and staff.
Susan Ellenberg, chairwoman of the Santa Clara County Board of Supervisors, said she believes reducing funding for programs that treat residents' mental health problems before they become serious could hamper the county's efforts to prevent homelessness. Are concerned. He also said the change would require the county to give up $9 million to support state-run programs.
Who supports the measure?
Proposition 1 has gained support from a variety of business, labor, construction, and health care groups, including the Service Employees International Union and Kaiser Permanente. As of January 24, supporters reported raising more than $16 million in campaign contributions, while opponents had raised just $1,000.
The bill appears to be gaining early support among voters, with 68% in favor, according to a December poll from the Public Policy Institute of California. Proposition 1 requires a simple majority to pass.
Alison Monroe of the Alameda County Family Association, which advocates for the severely mentally ill, said the measure would help 28-year-old Diana Staros, who was a teenager in her care at an East Oakland laundromat, overdose last year. He said that he could have been saved from.
Staros was living in a nursing home in Oakland at the time of his death. Monroe believes Staros needs more intensive treatment for schizophrenia in a locked facility, but she said there are few such options in Alameda County.
“She probably didn't like it at all and said she was locked up, but at least she would be alive,” Monroe said.
