The state is asking voters for money to build or convert thousands of new supportive housing units — more than half of which will be set aside for veterans without housing — and expand substance use and mental health treatment for thousands more Californians.
Berkeley Election 2024
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Proposition 1, which will be on the presidential primary ballot March 5, is projected to provide 6,800 new treatment beds and 4,350 new units of housing, according to state estimates. The new services come with some financial strings, however, which would affect how Alameda County uses more than $100 million in funding each year.
In addition to bonding $6.38 billion for the new treatment centers and housing for veterans and those with behavioral health challenges, Proposition 1 would also set up new, stricter rules on how counties use the funds they do get under the Mental Health Services Act, a tax enacted in 2004 on residents with annual incomes over $1 million.
The proposition would shift 5%, or roughly $140 million, of that funding pool out of county coffers and into statewide programs, doubling what the state could play with directly beforehand. Counties would still keep 90% of the funds, but with new guidelines.
Several local leaders have expressed support for the proposition, which has been championed by Gov. Gavin Newsom, and it has drawn widespread support from health care providers, law enforcement and first responders.
Alameda County’s piece of the pie
About one third of county behavioral health services statewide are funded by the MHSA, according to state data. In Alameda County that comes out to a little more than $129 million projected for the next fiscal year, not counting unspent funds from previous years, according to the county’s estimates.
The county estimates that 15,786 people here experience homelessness at some point annually, more than half of whom are in Oakland alone. Of those, 49% had psychiatric or emotional conditions, 34% had a chronic health condition, 33% had a physical disability and 30% had a substance use disorder, according to county data. Homelessness disproportionally affects people of color, especially Black residents, who comprise just 10% of the county but make up 43% of its unhoused residents. And in recent years the number of encampments of people without housing has been on the rise, according to a county health needs assessment.
MHSA funding is broken into different segments by each county or other jurisdiction that receives it. Community services and supports — including housing, treatment and services for the most seriously mentally ill — make up the largest part. Other funds go to prevention and early intervention, innovation, workforce education and training and other items.
That funding is already subject to different restrictions than revenue the county raises elsewhere; its Behavioral Health Services Agency has a handful of staffers who only deal with MHSA funding and programs.
If Proposition 1 passes, counties would have to devote 30% of MHSA funds to housing interventions.
That means Alameda County would nearly triple the amount it spends from the funds on housing, from about $15 million to just over $43 million. Doing so could require shifting money away from prevention programs, capital facilities and technology, and other programs, according to an analysis by the agency. A more precise accounting of how much Alameda County receives, and how those funds are allotted, was not immediately available.
“While the county supports additional treatment beds and housing, the sweeping of local MHSA funds would severely inhibit the county’s ability to provide critical services to our residents,” according to a 2023 county budget analysis.
Opponents have pointed out the new funding allocations will inevitably result in cuts to existing services, both by reducing the amount of money doled out to counties and also by changing how counties can spend it.
Most Californians who are unhoused — roughly four out of five — said they have dealt with serious mental health conditions at some point, according to an analysis by the California Budget and Policy Center. Many dealing with mental health conditions now said they had limited access to treatment. Of those Californians who were unhoused and had sought substance use treatment, one in five said they couldn’t find any.
“A key flaw of this initiative is that it expands the scope of the MHSA and prioritizes funding for people who are or at risk of experiencing homelessness without increasing the tax of providing new revenue to support existing county behavioral programs,” according to the analysis. “This approach is concerning, as it redirects funds originally allocated for a specific purpose to address a different need.”
Even without taking Proposition 1 into account, MHSA “revenues, which had seen explosive growth as stock and other asset prices rose substantially in prior years, are anticipated to be lower in the future as tax receipts from high-income earners have decreased,” according to a 2023 county budget analysis.
Alameda County actually has a higher number of mental health providers by population than the state average, and more than twice the national average, but nevertheless, “mental health remains a serious issue in the county,” according to the needs assessment.
Still, the measure has attracted dozens of high-profile endorsements from law enforcement officials and unions, veterans groups and health care worker groups and hospital associations. Supporters have pointed to the statewide need for treatment and housing for the state’s most vulnerable residents.
Berkeley leaders support proposition
The city of Berkeley may feel the effects differently than the rest of the Alameda County, since the city’s public health agency stands alone and receives some of the funding in question directly.
Berkeley receives around $9 million in funding annually through the MHSA, according to the city’s Department of Health, Housing and Community Services. As with the county, the new rules will mean slightly less direct funding and less flexibility for what the city can do with the funding it will receive.
Within Berkeley, there were about 1,000 people experiencing some form of homelessness as of a 2022 “point in time” assessment, of which fewer than a quarter had found shelter space. A survey found that 17% of Berkeleyans facing homelessness also had mental health needs, according to city records.
“The city’s unhoused population is growing, and this population’s need for high-level mental health services is growing as well,” according to a 2023 report on Berkeley’s MHSA programs. “Also, as the percentage of older adults increases in our community, need for mental health services for this sub-population will also increase, including resources and referrals related to dementia.”
As with Alameda County, the precise impact of Proposition 1, if it passes, remains unclear in Berkeley.
“It is possible there will be a waiver for this (housing) requirement which would allow the city to continue funding services, but any waiver options or required investments shifts from current mental health services to housing will not be determined until after the bill’s expected passage,” Lisa Warhuus, the city’s departing health and housing director, said in an email in response to a Berkeleyside inquiry.
Nevertheless, with thousands of new housing units and treatment beds at stake, the Berkeley City Council adopted a resolution supporting Proposition 1 on Jan. 16.
“This investment would be the single largest expansion of California’s behavioral health treatment and residential settings in our state’s histories,” councilmembers Susan Wengraf, Sophie Hahn and Rashi Kesarwani wrote. “The state funding granted by Proposition 1 will directly support Berkeley’s work to solve our homeless and behavioral health crisis.”
