Governor Gavin Newsom is calling on lawmakers and voters to pass sweeping mental health reforms that would commit billions of dollars in state funding for housing and behavioral health-based treatment facilities across California.
The Democratic governor’s proposal, introduced Sunday in San Diego, would raise at least $3 billion through a bond measure to finance the construction of new mental health campuses, residential settings and permanent supportive housing. Newsom wants to redirect another $1 billion in funds annually from an existing income tax on top earners to operate the facility, his office said.
“It is unacceptable what we are dealing with, at scale right now, in the state of California,” Newsom said during an event at Alvarado Hospital Medical Center to announce his plan. “We have to address and confront the reality of mental health in this state and our nation.”
The governor’s call for a 2024 ballot measure to modernize the state’s behavioral health system is the cornerstone of his State of the State tour.
Instead of delivering a traditional address to lawmakers on Capitol Hill this year, Newsom traveled across California to launch his political agenda for his second term. The governor unveiled an ambitious goal in Sacramento to reduce homelessness statewide, traveled to San Quentin to announce the transformation of the maximum-security prison into a rehabilitation center and touted a new contract in Downey to produce insulin. low cost under a state label.
Assistant governors heralded their effort to redesign the state’s mental health system as an opportunity to turn the page on decades of failure to build an effective community-based system in California. Newsom often points to former Gov. Ronald Reagan’s effort to end involuntary commitment and close state mental hospitals in the late 1960s as the main factor why so many people are living on the streets or behind bars today.
A stronger mental health system is imperative to Newsom’s agenda to reduce homelessness and fix the criminal justice system. At a time when violent crime is on the rise and voters remain frustrated with the lack of progress on the homelessness crisis, it is also critical to the Democratic governor’s legacy.
“He’s committed to it,” said Sean Clegg, one of Newsom’s top political strategists. “He is going to lead and he is going to spend his political capital.”
A key component of Newsom’s plan is to reform the Mental Health Services Act of 2004, which was approved by the voters under proposition 63 establish a 1% income tax for millionaires in California as a way to shore up funding for county-run services.
Funding has fluctuated over the years, but roughly equalized $3.3 billion in fiscal year 2022-23, according to the nonpartisan Legislative Analyst’s Office. Funding from Proposition 63 now represents about 30% of the state’s public mental health system, the governor’s office said.
Newsom’s announcement would revise the funding structure to redirect 30% of Proposition 63 funds each year, or about $1 billion, toward operating community housing for people at risk of or currently experiencing homelessness. homeless and people who have serious mental illness and substance use disorders. Some of the housing created would be reserved for veterans in California.
The proposal also includes changes to Proposition 63 that would allow money to be spent solely on substance use treatment for qualifying people, which is currently not allowed, according to the governor’s office.
The governor’s office said the bond measure he proposed for the 2024 ballot would pay for enough new beds for mental health care to care for more than 10,000 additional people each year. The state faces a shortage of 6,000 behavioral health beds, his aides said. Newsom said the goal is to raise between $3 billion and $5 billion from the bond measure.
“This is a great idea. It is half a century behind in the state of California,” Newsom said.
Sacramento Mayor Darrell Steinberg, who helped write Proposition 63 when he was a state legislator, said he supported Newsom’s changes.
“We are reaching 20 years, and after nearly two decades, it is always time to update and modernize a good law and focus it more on the most serious consequences of untreated mental illness,” Steinberg said.
Steinberg said Proposition 63 has helped “hundreds of thousands of people,” but a greater focus is now needed on people living in homeless encampments with serious mental illness and those coming out of the criminal justice system.
“There is already focus. It just needs more attention,” she said.
Los Angeles Mayor Karen Bass said Newsom’s plan will free up more bed space for those in need.
“These reforms will help us address the crisis on our streets and bring more Angelenos inside with the support they need,” Bass said in a statement. “I support these efforts and look forward to working with the Governor and Legislature to ensure their success on the ballot.”
State Sen. Susan Eggman (D-Stockton) said she will introduce legislation to implement Newsom’s plan and put it on the ballot. Proposition 63 was a good start in addressing California’s mental health crisis, Eggman said, but she agrees it’s time for a “remake.”
The changes will speed construction and sustainable financing for the type of “housing that heals,” but it is in short supply, he added. That could include new cabin communities or adult residential housing that are less restrictive and more neighborhood-oriented, rather than gated facilities that keep people separate from the general population.
Sunday’s announcement would add to a series of recent changes lawmakers have made to restructure California’s mental and behavioral health system since its last major overhaul six decades ago.
That includes expanding Medi-Cal and allowing incarcerated people some benefits before they are released from prison. Eggman was one of two lawmakers last year who helped pass Newsom’s new program to treat people with serious mental illness, known as care court (for Community Assistance, Recovery and Empowerment).
The plan established a new court system that would mandate treatment for those with serious mental illness, a population the state estimates to be between 7,000 and 12,000. Eight counties, including Los Angeles, are expected to implement CARE Courts this year, with the rest of the state joining in 2024.
CARE Court will allow family members, first responders, health professionals, and others to ask a judge to order an evaluation of an adult with a diagnosed psychotic disorder to determine what services that person needs.
Organizations representing the families of affected loved ones strongly supported Newsom’s ambitious new program, but the proposal drew intense opposition from disability and civil rights advocates, who spent much of the year expressing serious concerns that CARE courts would take away personal liberties and funnel people at risk into the legal system.
In January, many of the same groups that had lobbied against the CARE Court filed a lawsuit asking the state Supreme Court to block implementation of the new law, which Newsom signed in September as Senate Bill 1338.
This year, Eggman introduced a bill to expand the definition of “severely disabled,” which is used to determine whether someone qualifies for guardianship. The change could mean more people could qualify for a conservatorship if their mental or physical health poses “substantial risk of serious harm” due to their conditions.
“I think all these pieces that we put together, and this renewal of (the Mental Health Services Act), will be the last big game changer,” Eggman said.
Andy Imparato, executive director of Disability Rights California, said more money for mental health housing is a good thing, and Newsom’s announcement seemed like good news.
While an integral part of Newsom’s reform effort would be to strengthen accountability and transparency around access, quality and spending for county Medi-Cal and behavioral health plans, Imparato said concerns remained about how some counties are spending Proposition 63 funds. He wants to make sure money for new housing isn’t taken from other treatment services.
Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association, agreed.
“We want to thank the governor for listening to our pleas to address the shortage of housing options for clients,” Cabrera said. “However, we need these investments to be cumulative rather than diverting resources away from upstream prevention and treatment. There is no way we are going to end this crisis without both: housing and treatment services.”
Imparato also said that Disability Rights California and other organizations that fiercely opposed CARE Court might still hesitate to work with Newsom on another mental health initiative.
It will be critical, Imparato said, that peer supporters and those with lived experience with mental illness and substance use disorders have a seat at the table in this year’s proposal.
“My hope is that we are going to see more of a collaborative approach,” he said.
