How will Prop. 1 affect mental health services, homelessness in Kern?
Spanning more than half of the 112-page California voter information guide, it is one of the most complicated and consequential decisions voters must decide on the March primary ballot.
Titled Proposition 1, the measure is a two-part initiative that would authorize a $6.4 billion bond to build facilities for mental health and addiction treatment. A majority of the money, about $4.4 billion according to the Legislative Analyst’s Office, would pay for 10,000 inpatient and residential treatment beds across the state.
It would also redefine how California treats — and pays for — its efforts to curb homelessness by amending the Mental Health Services Act.
Since 2005, California has raked in between $2 billion and $3.5 billion every year through MHSA’s funding component, levied as a 1% surtax on personal incomes above $1 million. The money has funded a third of the state’s total mental health budget, used largely at the discretion of local governments to tackle needs specific to their communities.
If it passes, the measure would require counties to spend a third of their received funding on housing and rental assistance and 35% for mental health and addiction treatment.
“This is something that we’ve been advocating for for a very, very long time,” said Kern Behavioral Health and Recovery Services Director Alison Burrowes, who said the department’s substance use services have been underfunded for years. “This is a fantastic shift.”
ARGUMENT FOR PROPOSITION 1
Supporters of Proposition 1 argue the law needs to be updated to reflect the reality in California, where addiction and mental illness are often intertwined and where a huge housing shortage has driven living costs out of reach for many.
State Sen. Susan Eggman, D-Stockton, who co-authored the measure, said that the landscape of homelessness in California has changed dramatically in the past 20 years. The 2023 Point-in-Time counts statewide tallied more than 170,000 unhoused Californians, most of whom are living unsheltered on sidewalks, in parking lots or in parks. Eight in 10 of those surveyed said they struggle with some form of mental health disorder and 24% admitted to having an addiction.
Many homeless people — including in Kern — idle in shelters, vouchers in hand, as they await affordable housing to be built. Or they frequent county jails and emergency rooms, Eggman said.
In Kern County, 2023 figures portray similar struggles: For every six homeless people who exit the street, 10 more take their place. Each of the four shelters are regularly at or near capacity.
Even with the city’s more than $16 million annual investment and Kern BHRS’ $350 million annual budget, Kern reported a 22% rise in homelessness in its 2023 Point-in-Time count held earlier this year. And 71 individuals, on average, are turned away each week due to capacity limits at the city’s Brundage Lane Navigation Center.
“The governor has wasted billions on the homeless crisis over the past five years, only for the problem to increase,” said state Sen. Shannon Grove, R-Bakersfield. “Proposition 1 allows Kern County to have a seat at the table and ensure funding reaches those who suffer from mental illness, often living the worst of life’s nightmares. These people will never be free without treatment, and it is cruel to pretend otherwise.”
In Kern County specifically, a 2020 report by California Health Policy Strategies found that roughly 87% of jail-incarcerated people had an open mental health case, a 70% increase since 2009.
“Our jails are full of people with behavioral health issues,” Eggman said. “L.A. County jail is the biggest behavioral health system we have in California, which is not qualified, and our prisons are full of folks.”
Yet research released by UC San Francisco last year found that the primary cause of homelessness is income loss and the lack of affordable housing.
According to the California Budget and Policy Center, an estimated 11,150 behavioral health and supportive housing units would be constructed statewide if the measure is approved — as well as about 26,700 outpatient treatment slots. California is in need of nearly 8,000 more psychiatric beds, according to the Rand Corp.
Gov. Gavin Newsom, who has made mental health one of his chief priorities, says the bill offers the nuanced approach that California has long lacked: that the homelessness crisis statewide is an interlocked issue of homelessness, affordable housing and mental health care.
Funding needs to be focused on early prevention and housing — the first and final moments of homelessness — with an emphasis on people with mental illness, substance use disorders or both.
“These reforms, and this new investment in behavioral health housing, will help California make good on promises made decades ago,” Newsom said in a news release. “We see the signs of our broken system every day — too many Californians suffering from mental health needs or substance use disorders and unable to get (the) support or care they need.”
Proponents of the bill include the governor’s office, much of the state Legislature, advocacy groups, and unions representing first responders and mental health associations.
“When you see people in the street, they’re covered in urine or covered in feces,” said Brian Rice with the California Professional Firefighters Association. “They’re dirty and they’re pacing and they’re talking or screaming at each other ... what you are witnessing is human pain and suffering.”
The measure has also garnered some public support; two-thirds of “likely voters” in a November poll of 1,660 adult California residents by the Public Policy Institute of California said they support Proposition 1, with 67% of Central Valley respondents voting “yes.”
OPPOSITION TO PROPOSITION 1
Yet the measure has come with its doubters. If approved, it would shift nearly $140 million in existing tax revenue from county mental health departments toward the state’s newly mandated categories.
A July report by the Legislative Analyst’s Office, which advises the Legislature on policy and fiscal matters, estimated the housing mandate could result in a $718 million loss to existing county mental health programs. The state would also incur more debt — $310 million each year for 30 years, according to LAO, an unsettling total when considering the state expects a $38 billion deficit in the upcoming year.
County officials have characterized the measure as shifting money from one crisis to another.
“I think the disappointment for us is that there’s no additional funding,” Burrowes said. “So anything we do to move over to substance use again we would have to find where we’re going to move that funding from and it would take away from other treatment services ... that’s really the tough position that we’re being put in with this.”
Kern officials first raised an alarm in September, when Stacy Kuwahara, then the director of Kern BHRS, warned a state liaison that the measure would potentially force her department to slash existing programs proved to be successful. She gave Flood Ministries — Bakersfield and Kern’s primary street outreach provider — as an example of one program that could be axed.
“There’s no way I can get around cutting services,” Kuwahara said at the time.
Groups such as Disability Rights California, the Howard Jarvis Taxpayers Association and the League of Women Voters make the respective arguments that passing Proposition 1 would lead to more involuntary treatment, increased costs to the state, and the diversion of critical funds from other mental health services offered by counties, such as crisis response and outreach efforts.
“Prop. 1 wipes out what this community has fought for and accomplished over the last 20 years,” said Clare Cortright, the policy director at Cal Voices, a health care-focused nonprofit.
There is also concern that the measure would further the state’s reliance on involuntary treatment, which representatives with the American Civil Liberties Union worry would negatively impact poor and marginalized communities.
“Prop. 1 would reduce already-strapped community-based and culturally responsive mental health services and thwart efforts to minimize contact with law enforcement and legal systems for people in mental health crisis,” said Eve Garrow, senior policy analyst at the ACLU of Southern California. “We shouldn’t fall prey to a false zero-sum game that pits our needs for mental health services and housing against one another. Instead, we should expand the pie to meet all our basic human needs.”
Currently, the MHSA is controlled at the community level. Counties receive funds based on formulas with few restrictions and are required to design programs and spend the funds by involving people living with serious mental illness and their families, including those from marginalized communities.
Passage of the measure would strengthen state oversight, with stricter requirements to prove the money spent is helping solve the problem. Penalties and sanctions, while still largely undefined by the state, would be levied against counties that do not meet funding requirements.
When asked, Burrowes said it’s too early to say whether programs or staffing will be axed, and the county will try to stay optimistic, looking to supplement redirected funding with grants or “community partnerships.”
“I think over the past few months we’ve had more time to analyze and take a look at the impacts,” Burrowes said. “We are still hopeful that we’re not going to have to cut services.”
That said, the measure would not change things overnight; the rules — including the penalties and sanctions for noncompliance — are still vague, Burrowes said, and the final implementation of the measure won’t be until the end of 2026.
“So it’s not going to be an overnight shift,” Burrowes said. “So we’ve got some time to think about what the impacts are going to be and make some very thoughtful decisions.”