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Politics & Policy

California mental health advocates divided on Newsom’s Prop. 1

Man and woman look on as another man speaks in front of a podium
California Gov. Gavin Newsom has created a significant war chest for Proposition 1, a measure that would raise billions of dollars for housing and treatment facilities. | Source: Rich Pedroncelli/AP Photo

Gov. Gavin Newsom has amassed more than $14.2 million in a campaign war chest for his hallmark mental health initiative, which will appear on the March 5 primary ballot, a sum that eclipses the resources of the measure’s opponents.

He’s drawing from longtime allies in health care, unions and tribes to fund the campaign for Proposition 1, which would issue $6.4 billion in bonds to pay for housing and treatment facilities while also redistributing money raised for mental health services through a tax on high earners.

In contrast, the Californians Against Proposition 1 campaign raised a mere $1,000, according to campaign finance records. Newsom’s opponents mostly are small mental health providers and current users of the mental health system who fear losing resources if voters pass the measure. 

To the opponents, this David vs. Goliath matchup represents a fight to save community services, like crisis response teams and peer counseling.

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Paul Simmons, director of Californians Against Prop. 1, said opponents include groups “that are actually going to be affected” should the measure pass.

“We are generally the consumer,” Simmons said. “A lot of us are white collar professionals; a lot of us are on the verge of homelessness. We’re a broad range, but we’re not the people that are going to give $20,000 or a million dollars.”

But the powerful Yes on 1 campaign, including Newsom, counters that opponents are propping up a broken system that doesn’t reach those with the most critical needs.

“Prop. 1 has a broad and diverse coalition … because it will finally fix our broken mental health care system and move people permanently off the streets, out of tents and into treatment,” the Yes on 1 campaign told CalMatters in a statement. “That’s why first responders, mental health professionals, doctors, nurses, veteran groups and more support the measure, unlike the opposition, which is funded by extremists who want to maintain the status quo.”

Newsom and supporters tout the proposition as a potential solution to the state’s dual opioid and homelessness crises. According to their estimates, the bond would build 4,350 housing units, with roughly half set aside for veterans, as well as 6,800 mental health and addiction disorder treatment slots.

Researchers estimate California has a shortage of roughly 8,000 in-patient adult treatment beds. More than 171,000 Californians live on the streets, 6% of whom are veterans.

Newsom, who has championed mental health reform more than any other governor in recent history, says the state has invested a total of $28 billion in the system during his tenure.

Sen. Susan Eggman, a Democrat from Stockton and former social worker, authored part of the legislation that created Prop. 1. She said the measure will provide the final funding and infrastructure to complete California’s mental health transformation.

“We have tried to patch all of those holes, re-created the system, and this is the final piece,” Eggman said during a January campaign event. “Californians really want to do something about the crisis they see every day on their streets and be able to feel proud about where they live and how we treat the least of us.”

Hospitals, Unions and Tribes Give to Prop. 1

Some of California’s largest health care companies put money on the line in support of Newsom’s ballot measure. Sutter Health cut a check for $1.15 million, Kaiser Permanente donated $1 million and the California Hospital Association, representing hospitals across the state, contributed another $1 million.

Carmela Coyle, president of the California Hospital Association, said emergency departments are currently one of the only options for people suffering a behavioral health crisis. Frequently, patients languish in emergency rooms for days, and even weeks, waiting for mental health treatment beds to open. 

“Proposition 1 will provide the resources necessary to build a better system for the millions of Californians with behavioral health needs,” Coyle said.

Prop. 1 comes on the heels of several other seismic changes to the state’s mental health system. These changes include the launch of Newsom’s CARE Court system for people with serious mental illness and dramatic eligibility changes for conservatorship that are expected to result in more people being placed in involuntary treatment. CARE Court established a process for family members, clinicians and law enforcement to petition a court to compel people with untreated serious mental illness into a treatment program.

Many of the big-ticket donors are long-time Newsom supporters. The Federated Indians of Graton Rancheria contributed the single largest donation at $1.5 million, making the tribe, which operates the Graton Casino in southern Sonoma County, one of the largest campaign contributors across all of the state races this election cycle. It has cut big checks for Newsom before, including contributing $750,000 to help him defeat the 2021 campaign to recall him.

The State Building and Constructions Trade Council is another million-dollar contributor. Chris Hannan, president of the group, said the investment is worth it. “Trades members are well-skilled and positioned to help the state build out the mental health facilities as well as the housing,” he said.

In other words, this proposition means jobs for union members.

The final contributor donating at least seven figures is another regular Newsom supporter: The state prison guard union, the California Correctional Peace Officers Association, donated $1 million for Prop. 1. Glen Stailey, president of the association, said his members have a lot at stake.

“Correctional officers experience firsthand the failures of our mental health system every single day,” he said in a written statement to CalMatters. “With this investment, [we] are demonstrating our serious commitment to addressing the crisis.”

The association has contributed to all four of Newsom’s campaign committees in the last decade. The union represents 26,000 workers, and it recently negotiated a contract with raises and bonuses that are expected to cost the state about $1 billion over three years.

Prop. 1 Opponents’ Election Plan

Newsom’s opponents don’t have much money, but they gained a boost in recent weeks from groups that represent dedicated voters. The League of Women Voters of California and the Howard Jarvis Taxpayers Association recommended their members vote no on Prop. 1.

In its opposition statement, the League of Women Voters of California critiqued the way the measure was “rushed through the Legislature” with last-minute amendments and without substantial debate. That process excluded marginalized communities and Californians who could be affected by the measure, Executive Director Stephanie Doute said in a statement to CalMatters.

The league also highlighted that Newsom’s plan to reallocate money from the so-called millionaire’s tax will diminish the services counties currently provide and restrict local control. Newsom wants to spend 30% of the tax revenue—about $1 billion a year—on housing.

“The League of Women Voters of California does not support robbing Peter to pay Paul,” Doute said. “California has a desperate need for counties to both continue their current (mental health) work … and to expand it to housing interventions and substance use disorder treatment. Prop. 1 does not provide adequate funding for California’s needed mental health care system.”

It’s unclear exactly how much money specific programs stand to lose if voters pass the measure, but an analysis by the nonpartisan Legislative Analyst’s Office suggests cuts could be significant. Los Angeles County’s behavioral health department estimates that the proportion of the money it currently spends on outpatient care services will likely be slashed from 32% to 18%.

Other opponents include Mental Health America of California, CalVoices and Disability Rights California. They argue the measure will vastly increase involuntary treatment among people with serious mental illness and addiction disorders. They also say community mental health services like outpatient care and peer counseling will be cut as a result of redirecting money toward housing.

“You don’t fix the system by creating more harm for the people for whom the system is supposed to be beneficial,” said Simmons, the opposition campaign director.

The campaign is using its tiny pocketbook of donations to pay for travel to speak to local community organizations and editorial boards, Simmons said, and is encouraged by the results.

“That tells me that we have the better argument,” Simmons said.

But mental health advocates aren’t unified on the ballot measure. The “yes” campaign is also supported by NAMI California, the largest mental health advocacy organization in the state, representing thousands of people with serious mental illness and their families.

“Let’s make sure that families are just as part of that voice in ensuring that the systems that are changing are family-driven and consumer-driven, and that is why NAMI across the state supports Prop. 1,” executive director Jessica Cruz said during a campaign event.