Gov. Gavin Newsom dropped his signed mental health plan this week in an effort to appease critics who said his reform would deprive youth services and other county programs of millions of dollars in tax revenue.
The proposal marks the second time in many years that Newsom has advocated for significant changes to the state’s mental health system since the passage of the controversial CARE Court Act last year. This year’s proposal seeks to update the Mental Health Services Act, a 20-year-old ballot initiative that raised billions of dollars a year for mental health programs through a high income tax. The taxes fund nearly a third of the state’s mental health infrastructure and raised $4.8 billion last year.
In effect, Newsom’s proposal would require counties to spend two-thirds of their tax revenue on housing and around-the-clock services for the state’s homeless with severe mental illness. That equates to about $3.1 billion, based on revenue from last year’s Mental Health Services Act.
Some of the concessions introduced this week will loosen the definition of “housing interventions” that counties must fund, restore some flexibility in local spending, remove the requirement to add services for people with addictions, and distribute money to programs for children and youth.
Newsom’s reform needs more than just legislature approval. It also requires voter support to change the original voting initiative. His proposal to voters: redirect some of the money to help deal with California’s uncontrollable homelessness crisis. The state has spent more than $20 billion on the homeless in the past five years with little effect.
However, leading mental health advocates remain skeptical. Many of the organizations that expressed concern about the original proposal say the recent amendments are “weak” and continue to drain vital resources.
“We’re still not sharing the pie too much,” said Claire Cortright, political director of Cal Voices, a coalition of peer support organizations in the mental health field. “What about people with services now? What is happening to people who have housing now?
The plan, which mental health groups have criticized as rushed, will have its first full hearing in the legislature next week. Thus, lawmakers will have four weeks before the end of the session to decide whether to include the measure on the March 2024 ballot.
Newsom claims his administration has spent “years preparing for this” review, along with other major changes to the state’s healthcare system.
“We set it up very deliberately,” Newsom told reporters last week. “It’s very methodical, very purposeful. Not ready, shoot, aim. He’s ready, aim, shoot. It is too late, and the consequences of neglect delay the denial: it is too great.
While Tuesday night’s amendments keep Newsom’s most significant change, as much of the money is used for housing interventions and intensive homeless services, gives counties more local control.
Amended proposal allows counties to move some money between spending categories such as housing and prevention, proposes exemption from some mandates for smaller counties with more variable annual budgets, increases the amount of money allocated to a “flexible” spending basket by 5 percent, expands the definition of housing interventions to include a wide range of social services such as housing navigation rather than just “hard” costs such as rent requires 51 percent of money spent on prevention housing programs to go to children and youth, and restores some of the power previously deprived of power. Committee on Oversight and Accountability for Mental Health Services.
“We’ve seen some changes, and certainly changes that seem to be helpful in addressing some of the issues we’ve had. But there’s also a lot of new stuff here that we’re trying to figure out,” said Jacqueline Wong-Hernandez, policy director for the California State Association of Counties.
County leaders and directors of mental health are most concerned about the proposed minimum spending mandates, which are funded by volatile income tax revenue. The Mental Health Act imposes a 1 percent tax on incomes over $1 million, an income level that is based on capital gains. They also questioned how much of existing services would be cut to meet the new housing mandate.
The amendments came after several reports from the Legislative Review Office suggesting $718 million will be cut from existing county mental health programs, including early intervention services for children and youth, to fund the housing mandate. Reports say the Newsom administration has given “incomplete justification” for the changes without analyzing the implications.
While Newsom had invested significant political capital in pushing for this reform, it was becoming increasingly difficult to ignore objections from child mental health advocates who said the governor was doing nothing to address the state’s homeless population. Prevention and early intervention services will be hit the hardest, they say, eventually exacerbating the parallel mental health crisis.
Last week, a coalition of nearly 300 groups representing local mental health agencies, school districts and family resource centers, among others, sent a letter to Newsom and Senate Health Committee Chair Susan Talamantes-Eggman urging them to continue funding programs targeted at children. under the age of 0 years. -25. Eggman, a Stockton Democrat, is backing a bill that would bring Newsom’s proposal to a vote and was instrumental in passing Newsom’s CARE Court bill last year. Eggman did not respond to multiple requests for comment.
“Children’s rights advocates have worked for years to ensure that (this) funding prioritizes children and youth, given the historical lack of attention to this population,” the letter said. “We are deeply concerned about the current proposal…to severely limit and redirect the investments that have fought so hard to phase out childcare programs.”
The amendments address key issues raised by the coalition and retain much of the estimated $448 million annually spent on mental health programs for children and youth, said Adrienne Shilton, lobbyist for the California Alliance for Child and Family Services.
“Here we are moving in a positive direction,” said Shilton. “The Administration has come a long way in partnership with us.”
Newsom administration officials say the proposal is part of a larger effort to overhaul the state’s healthcare system. As alternative sources of funding for ongoing programs, they point to a $4.3 billion budget allocated last year for child and youth mental health services and the Medi-Cal program. But advocates say most of that investment comes from one-time allocations and comprehensive programs such as family support groups, parenting courses and suicide prevention programs that are not eligible for Medi-Cal reimbursement.
Courtney Armstrong, director of government relations for the California First 5 Association, said about 95 percent of statewide programs that serve infants and children under 5 are non-reimbursable through Medi-Cal.
OUT OF THE PLAN
Despite the concessions, disability advocacy groups, peer advocacy advocates and many advocates who opposed last year’s CARE Court law still oppose this version of Newsom’s review. They want more assurance that the money will not be used to place the homeless in closed treatment centers against their will.
“The average Californian definitely wants more services and more housing for those who need it most, but they don’t want to be tricked into funding the legal system, criminalizing communities of color, and forced institutionalization,” said Carolina Valle, senior policy director. . for the California Panethnic Health Network.
According to Valle, historically, institutionalization and prison services have disproportionately affected communities of color. Critics also point out that California’s homelessness crisis is primarily due to a lack of affordable housing and incomes that have not kept pace with the cost of living, rather than mental illness.
“This budget fight over (the Mental Health Act) is not a moment in time. This is a continuation of a failed mental health policy and a failed housing policy in California,” Valle said.
CalMatters.org is a non-profit, non-partisan media organization that explains public policy and political issues in California.
The article was originally published at https://calmatters.org/health/mental-health/2023/08/california-mental-health-services-newsom/.
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