SACRAMENTO, Calif. — Two years after passing by a razor-thin margin of 50.2% to 49.8%, Gov. Gavin Newsom says California’s Proposition 1 has exceeded its projected goals, expanding treatment capacity and housing resources as part of an effort to overhaul the state’s behavioral health system.
“Proposition 1 is doing exactly what we promised it would do: transforming California’s behavioral health system,” stated Gov. Newsom. “We’re building a system that actually meets the scale of the crisis — one that delivers treatment, support, and real stability. This is about more than short-term wins; it is about laying the foundation for lasting, statewide change.”
Proposition 1 included a two-part strategy aimed at redirecting revenue to build a larger infrastructure that directly benefits those in need. CalMatters breaks down the proposals, the first change being a revision of the Mental Health Services Act, a 2004 measure that puts a 1% tax on personal income over $1 million.
This tax supports one-third of California’s mental health care system and, in 2022, totaled $3 billion. Unlike Medi-Cal, which only covers treatment, this act covers prevention programs as well as inpatient treatment at larger facilities.
In Gov. Newsom’s new addendum, counties are mandated to invest 30% of their Mental Health Services Act tax dollars into housing programs. Fifty percent of the money is required to go toward supporting chronically homeless individuals, and 25% can go toward new housing construction or purchases.
Sacramento Mayor Darrell Steinberg, who co-authored the Mental Health Services Act in 2004, spoke out in support of the proposition. “Not enough of the Mental Health Services Act dollars are getting out to the people with the most persistent mental illnesses, specifically people who are chronically homeless and living with those underlying conditions.”
The second part of the strategy included a voter-approved bond of $6.4 billion for the Behavioral Health Continuum Infrastructure Program (BHCIP), a pre-existing program. Of this sum, $4.4 billion would go toward building 6,800 inpatient and residential treatment beds.
Two billion dollars would go toward Project Homekey, which focuses on building permanent housing, 50% of which would be reserved for veterans in need of behavioral health care.
A major positive change is the number of treatment beds created, as California suffers from a shortage of treatment beds. The state exceeded its goal of 6,800 beds by more than 100 and its goal of creating 26,700 outpatient treatment slots by more than 800.
Since its inception, the BHCIP fund has created more than 9,500 inpatient beds and 47,000 outpatient slots, providing substantial support to an estimated 5 million Californians annually.
About the successes, Michelle Baass, director of the California Department of Health Care Services, stated: “From urgent care and crisis stabilization to residential treatment and peer respite, these projects at hundreds of facilities establish capacity so families in rural, Tribal, and underserved areas can count on consistent, high-quality care for the next three decades.”
The BHCIP bond under Proposition 1 created community-focused models that aimed to target specific crises and accessible care. This included $12 million to create California’s first Tribal Peer Respite with the Yurok Tribe, offering tribal communities direct support.
It also included $27 million to establish a residential substance use disorder facility serving families in the San Joaquin Valley and $24 million to establish a substance use disorder facility that assists formerly incarcerated individuals reentering society in San Bernardino and Riverside counties.
Additionally, seven small counties were awarded funding for projects, including Del Norte, Inyo, Shasta, Siskiyou, Sutter, Trinity and Yuba counties.
These programs aim to create a stronger infrastructure for behavioral health care across California. They are targeted to benefit homeless individuals, for whom substance use, mental health treatment and shelter can be difficult struggles.
Under Proposition 1, accessible housing is prioritized. The revision of the Mental Health Services Act mandates counties invest in housing programs aimed at eliminating potentially dangerous encampments and providing permanent shelter.
Alongside that, the continued growth of inpatient and outpatient mental health facilities provides help to homeless individuals who may struggle to afford health care, medication, food and other resources.
Some who opposed the proposition’s focused directives argued it could take rights from or exclude certain individuals under CARE Court (Community Assistance, Recovery and Empowerment Court).
In the style of a conservatorship, individuals — including family members, health care employees, paramedics or homeless outreach workers — can petition for someone to be placed into a court-ordered treatment plan. However, those who can be accepted are narrowly defined as individuals suffering from schizophrenia or other forms of psychosis.
“‘If you’re trying to engage somebody, and there’s a petition that involves a court, there’s less hope of building genuine trust,” said Keris Myrick, a mental health advocate and board member of Disability Rights California who has schizophrenia.
CARE Court does use a communication model called LEAP — Listen, Emphasize, Agree, Partner — and trains its workers and peer supporters, individuals with mental illnesses who have recovered and can provide guidance throughout CARE Court, to create this sense of trust.
Despite the opposition, Gov. Newsom’s proposals in Proposition 1 have demonstrated change in strengthening the behavioral health system in California. A government website aimed at accountability is accessible to the public and displays data, resource links and comprehensive information regarding the impact of the proposition.
“When California voters passed Proposition 1 in March [of 2024], we promised you transformational change. Today, we’re continuing to show our work — for you, the people of California. Counties have the tools to create change, and now Californians will have the tools to track their county’s progress. It’s up to all of us to make sure these life-saving transformations are happening urgently on the local level,” Newsom stated.
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