Gov. Gavin Newsom asks lawmakers and voters to pass sweeping mental health reforms

billions of dollars in new at least $4 billion in

government funding for behavior-based housing and

treatment facilities throughout California.

The Democratic governor’s proposal, unveiled Sunday in San Diego, would increase

about at least

$3 billion through a bond measure to fund the construction of new mental health campuses, residential environments and permanent supportive housing. Newsom wants to divert another $1 billion in funds

annual

of an existing income tax on top earners to operate the facilities, his office said.

“It’s unacceptable what we’re dealing with on a large scale in the state of California right now,” Newsom said at an event at Alvarado Hospital Medical Center to announce his plan. “We need to address and face the realities of mental health in this state and our country.”

The governor’s call for a 2024 ballot measure to modernize the state’s behavioral health system is the capstone of his State of the State tour.

Instead of giving a traditional speech to lawmakers at the Capitol this year, Newsom traveled across California to launch his political agenda for his second term in office. the

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 facility, and touted a new contract in Downey to produce low-cost insulin under a state label.

The governor’s aides billed his efforts to rework the state’s mental health system as an opportunity to turn the page after decades of failure to build an effective community-based system in California. Newsom often points to former Gov. Ronald Reagan’s attempt to end involuntary admission and the closure of state-run mental hospitals in the late 1960s was the main reason why so many people live on the streets or behind bars today.

A stronger mental health system is imperative to Newsom’s agenda to reduce homelessness and restore the criminal justice system.At a time when violent crime is on the rise

and voters continue to be frustrated with the lack of progress in the housing-less crisis, it is also critical to the Democratic governor’s legacy.

“He’s committed to it,” said Sean Clegg, one of Newsom’s senior political strategist

S

. “He’s going to lead and he’s going to spend his political capital.”

A key part of Newsom’s plan is the reform of the Mental Health Services Act of 2004, which was approved by voters under Proposition 63 to impose a 1% income tax on California millionaires as a way to increase funding. for provincial services.

Funding has fluctuated over the years, but totaled about $3.3 billion in fiscal year 2022-23, according to the impartial Legislative Analysts Office. Proposal 63 funding now accounts for about 30% of the state’s public mental health system, the governor’s office said.

Newsom’s announcement would review the funding structure to redirect

30% in Proposition 63 finance each year, or about

$1 billion

every year, or about 30%,

towards operating community housing for people at risk of homelessness or currently homeless and

individuals

people with severe mental illness and substance use disorders. Part of the created homes would be reserved

specifically

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 eligible people, which is not currently allowed, according to the governor’s office.

The governor’s office said the bond measure he proposed for the 2024 vote would pay for enough new mental health beds to serve more than 10,000 more people each year. The state

currently

is facing a shortfall 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 grand idea. It’s half a century late 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 come 20 years from now, and after nearly two decades, it’s always time to update and modernize a good law and make it more focused on the most serious consequences of untreated mental illness, Steinberg said.

Steinberg said Proposition 63 has helped hundreds of thousands of people, but there is now a need for more focus on those living in homeless camps with severe mental illness and those coming out of the criminal justice system.

There is already attention. There just needs to be more focus, he 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 in more Angelenos 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 in the vote.”

State Senator Susan Eggman (D-Stockton) said she would unveil legislation to implement Newsom’s plan and put it on the ballot. Proposition 63 was a strong start to addressing California’s mental health crisis, Eggman said, but she agrees it’s time for a rebuild.”

The changes will ramp up construction and sustainable financing for the kind of housing that is healing but is so scarce, she added. That could be new cottage communities or adult housing that is less restrictive and more neighborhood-oriented, rather than gated facilities that separate people from the general population.

Sunday’s announcement would add to a series of recent changes made by lawmakers to redesign

California’s mental and behavioral health system since the last major overhaul six decades ago.

That includes expanding Medi-Cal and allowing some benefits to incarcerated people before they are released from prison. Eggman was one of two legislators

who last year helped pass Newsom’s new program for the treatment of people with severe mental illness, known as CARE Court (for Community Assistance, Recovery and Empowerment).

The plan established a new justice system that would complete treatment for people suffering from severe mental illness, a population the state estimates

is at the moment

be between 7,000

Unpleasant

and 12,000 people. Eight counties, including Los Angeles, are expected to roll out CARE Courts this year, with the rest of the state to join in 2024.

CARE Court will allow family members, first responders and health care professionals, among others, to request that a judge order an evaluation of an adult with a diagnosed psychotic disorder to determine what services that person needs.

Organizations representing 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 would take away freedoms and persons at risk to the justice 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 the rollout of the new law, which Newsom signed into law as Senate Bill 1338 in September.

This year, Eggman introduced a bill

expanding the definition of severely disabled,

used to determine eligibility for a conservatory. The change could mean more people qualify for a conservatorship if their mental or physical health poses a significant risk of serious harm due to their circumstances. [the Mental Health Services Act]will be the last major transformational piece, Eggman said.

Andy Imparato, executive director of Disability Rights California, said more money for mental health housing is a good thing

,

and that Newsom’s announcement seemed to bring largely welcome news.

while on

While an integral part of Newsom’s reform efforts would be to strengthen accountability and transparency around access, quality and spending of behavioral health and Medi-Cal plans in the counties, Imparato said concerns remained about how some counties spend

i.e

Proposal 63 financing. He wants to make sure that the money for new housing is not taken from other treatment services.

Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Assn., agreed.

“We want to thank the governor for hearing our pleas to address the shortage of housing options for clients,” said Cabrera. “However, we need these investments to be additive rather than shift resources away from upstream prevention and treatment. There is no way we can end this crisis without both: housing and treatment services.”

Imparato also said that Disability Rights California and other organizations that strongly opposed the CARE Court may still be hesitant to partner with Newsom on yet another mental health initiative.

It will be critical, Imparato said, that supporters and those with lived experience of mental illness and substance abuse sit at the table

in this year’s proposal.

I hope we will see more of a collaborative approach, he said.

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