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Governor Newsom Puts Historic Mental Health Transformation on March 2024 Ballot

WHAT YOU NEED TO KNOW: For the first time in decades, Californians will have the ability to transform the state’s mental health system – modernizing to meet the needs of all Californians. Governor Newsom signed Senate Bill 326 (Eggman), modernizing the Mental Health Services Act, and Assembly Bill 531 (Irwin), a $6.38 Billion bond to build new behavioral health housing and treatment settings across the state. Californians will vote on this package, collectively known as Proposition 1, on the March 2024 ballot.

LOS ANGELES – Today, Governor Gavin Newsom, accompanied by Legislative and local leaders, families, advocates, veterans, and health care professionals, signed Senate Bill 326 (Eggman, D – Stockton) and Assembly Bill 531 (Irwin, D – Thousand Oaks) which collectively will transform California’s mental health and substance use disorder treatment systems for the first time in decades

WHY THIS MATTERS: These reforms re-focus billions of dollars in existing funds to prioritize Californians with the deepest mental health needs, living in encampments, or suffering the worst substance use issues. The $6.38 billion bond will provide funding to build more than 11,150 new behavioral health beds and housing and 26,700 outpatient treatment slots – capacity that will touch many tens of thousands of people’s lives every year – filling critical needs across the state for homeless Californians with severe behavioral health issues, to kids suffering from depression, and everyone in between. Recent polling from the Public Policy Institute of California (PPIC) found an overwhelming majority (87%) of Californians say there is a mental health crisis in the United States.

“These reforms, and this new investment in behavioral health housing, will help California make good on promises made decades ago. 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 support or care they need. This will prioritize getting people off the streets, out of tents and into treatment.” Governor Gavin Newsom
This historic transformation comes after months of engagement with stakeholders across the state: people and families with lived experience, health care professionals, children and youth groups, veterans organizations, schools and school administrators, businesses, labor leaders, mental health and equity advocates, first responders, and local officials.
Senate Bill 326 modernizes the Mental Health Services Act to address today’s behavioral health system and demand for services. These reforms expand services to include treatment for those with substance use disorders, prioritize care for those with the most serious mental illness, provide ongoing resources for housing and workforce, and continue investments in prevention, early intervention, and innovative pilot programs. This bill reforms our system of care to prioritize what Californians need today with new and increased accountability for real results for all families and communities.
Assembly Bill 531 includes a $6.38 billion general obligation bond to build 11,150 new treatment beds and supportive housing units as well as outpatient capacity to help serve tens of thousands of people annually – from intensive services for homeless people with severe mental illness, to counseling for kids suffering from depression, and everyone in between. This investment would be the single largest expansion of California’s behavioral health treatment and residential settings in our state’s history – creating new, dedicated housing for people experiencing or at risk of homelessness who have behavioral health needs, with a dedicated investment to serve veterans. These settings will provide Californians experiencing behavioral health conditions a place to stay while safely stabilizing, healing, and receiving ongoing support. Included in the bond is a $1 billion set aside specifically for veterans’ housing.
In addition to today’s historic transformation, Governor Newsom announced the “California Mental Health Movement,” which is his sweeping plan to address the mental health and substance use disorder crises happening across the state – impacting Californians in every community.
“The mental health crisis– especially amongst youth– is the most significant public health concern of our time. I’m so proud of our nation-leading mental health movement and ongoing work to transform the state’s behavioral health system in a way that is comprehensive, holistic, and intentionally focused on recognizing the humanity in each and every Californian.” First Partner Jennifer Siebel Newsom
The multi-year “California Mental Health Movement” encompasses more than $28 billion and focuses on real results and increased accountability, includes four key pillars:
Treatment and Housing for Those Who Need it Most: $10.9 billion to create approximately 24,800 beds/units. It also creates 45,800 outpatient treatment slots for Californians with behavioral health issues across the spectrum — everything from intense, inpatient care, to substance abuse treatment, to outpatient care and counseling.
Increasing Access to Mental Health Services for All: Investing over $10.1 billion to increase access to behavioral health services for all Californians. Transforming Medi-Cal to expand behavioral health services and crucial care for one in three Californians, offering new crisis care and targeted veteran and older adult services, and developing a plan to require private and commercial health plans to raise their standards to match Medi-Cal behavioral health plans.
Building our Health Care Workforce: California is investing $5.1 billion, and proposing an additional $2.4 billion investment through reforms to the Mental Health Services Act, to train and support more than 65,000 new health care workers over the next five years to ensure we have the workforce to provide culturally responsive services and care to all who need them.
Supporting and Serving Kids: The investments include $4.6 billion to support children through the Master Plan for Kids’ Mental Health and gives California’s 10,000 public schools the opportunity to get enhanced funding to increase student behavioral health services.
WHAT PEOPLE ARE SAYING
  • SB 326 Author & Senate Health Committee Chair Senator Susan Talamantes Eggman: “The Mental Health Services Act has been a great success – but after nearly 20 years it’s time to update it in a manner that is consistent with reforms in health care coverage and our increased understanding of behavioral health. The new Behavioral Health Services Act will drive resources to those with the greatest needs, including those with substance use disorders, and provide for real accountability with a focus on outcomes. Paired with Assemblymember Irwin’s essential bond, these new and restructured investments deliver on exactly what Californians deserve to address this crisis of behavioral health and homelessness. I’m grateful to this Governor for his commitment to those suffering and for his laser focus on critical reform.”
  • AB 531 Author Assemblymember Jacqui Irwin“Getting veterans experiencing homelessness off the streets has long been a priority for California, but getting some of our most vulnerable veterans into needed treatment for behavioral health challenges will be transformative. One of the only groups that has seen a recent significant decline in percent of homelessness are veterans, thanks primarily to the very successful Veterans Housing and Homeless Prevention (VHHP) program. By placing a renewed focus on existing programs like Homekey and the Behavioral Health Continuum Infrastructure program, AB 531 and SB 326 will provide housing and treatment services to veterans that focus on serious mental illness and substance use disorders.  Funding and expanding this program is the right thing to do, and I look forward to working with the Governor and veterans organizations to put these important advances before the voters.”
  • AB 531 Co-Author Senator Richard Roth: “This is a terrific day for California as the Governor’s signature sets in motion the transformation of our state’s behavioral health system to fully reflect the many challenges we face today. The bond provides, among other things, $1.5 billion dollars to expand the continuum of behavioral health treatment resources, specifically including, for the first time, new acute care inpatient psychiatric beds which are critically needed for emergency situations where a short-term stay is essential for mental health stabilization and treatment.”
  • SB 326 Co-Author & Assembly Health Committee Chair Assemblymember Jim Wood: “Modernizing the 20-year-old MHSA as the Behavioral Health Services Act responds to the critical need to address the tragic reality of unhoused people we see on our streets and the mental health and substance use issues that many experience, but also pays heed to the housing and critical wraparound support services that people struggling with homelessness need. The services and funding provided in both SB 326 and AB 531 help the very young to the elderly, those in desperate need of affordable housing as well as those with the most serious need for treatment and support services to help people suffering from serious mental illness and substance use disorder.”
  • Original Author of the Mental Health Services Act Sacramento Mayor Darrell Steinberg“When we proposed and passed the Mental Health Services Act in 2004, our goal was ambitious. We sought to uphold that failed promise made by prior generations of state leaders: to fully fund whatever it takes to ensure that people living with serious mental illness live with dignity, independence, and safety in our communities. MHSA’s twenty-year history and $31 billion of community based services has saved many lives and moved us farther towards keeping our word. But the work is incomplete. Today’s historic signing of SB 326 and AB 531 moves us dramatically closer to making good on our sixty-year promise and will ensure that the original intent of the MHSA is met. Governor Newsom is the first Governor in history to make mental health and substance abuse care a signature state priority. Thanks to his leadership and the leadership of Senator Eggman, and Assemblymember Irwin, these billions will now be focused much more effectively on people who are the most vulnerable and help ensure that fewer people with serious illnesses live in conditions that no one should have to endure.”
  • San Diego Mayor and Chair of the CA Big City Mayors Coalition Todd Gloria: “Thanks to Governor Newsom and the Legislature, Californians will have an opportunity to vote to create more than 10,000 new beds to provide residential settings for people struggling with mental illness and addiction to get the care they need. We can no longer leave people to languish on our streets, often ending up in emergency rooms or jails. California is reforming our behavioral health system by taking action that addresses the lack of services and includes desperately needed accountability.”
  • Los Angeles Mayor Karen Bass: “We cannot address the homelessness crisis if we do not also address the mental health and substance abuse crisis on our streets. Thank you to Governor Newsom for locking arms with us by signing these two critical bills, and thank you to Senator Eggman and Assemblymember Irwin for their leadership. This is an emergency and that’s exactly how we’re treating it.”
  • Los Angeles County Board of Supervisors Chair Janice Hahn“We all know that those with the most serious mental illness have been the most difficult to help, but this Governor did not give up on them. This problem demands bold change, and with voters’ support we can build tens of thousands of places where we can treat mental illness and where people with severe mental illness can live and get well. Californians want a pathway forward to help people who are suffering, and this is it.”
  • San Diego County Board of Supervisors Chair Nora Vargas: “I’m honored to stand with Governor Newsom as he delivers major mental health care for all Californians,” said Chairwoman Nora Vargas. “The monumental reform of the Mental Health Services Act represents a step forward in our commitment to providing comprehensive, compassionate, and effective mental health services for all Californians. As Chairwoman of the Board of Supervisors for San Diego County, I have seen firsthand the profound impact that untreated mental illness can have on individuals, families, and communities. We stand united in our commitment to ensuring that every Californian can access the mental health care they need and that they are treated with dignity and respect.”
  • NAMI California CEO Jessica Cruz: “NAMI California is proud to support the modernization of the Behavioral Health Services Act through SB 326 and AB 531. We thank Governor Newsom for signing this critical legislation and Senator Eggman and Assemblymember Irwin for their instrumental leadership. We are proud of the collaboration with the Administration and partner agencies listening to families and individuals impacted by severe mental illness and substance use. This partnership ensured that the MHSA’s original intent was upheld as our state reforms its behavioral health system to better serve Californians in need.”
  • California Association of Alcohol and Drug Program Executives Executive Director Robb Layne: “For far too long Californians have been battling substance abuse disorder without fully funded community treatment. We applaud the Governor for recognizing an opportunity to take a full circle approach and provide solutions that includes an “every tool in the toolbox” strategy to save lives and combat this epidemic. Our state is on the cusp of revolutionizing care through systemwide reform that paves the way for more accessible, human-centered treatment. This will provide a lifeline for those grappling with homelessness, substance abuse disorder, and mental illness.”
  • U.S. Vets President and CEO Stephen Peck“California continues to reduce the number of veterans living on our streets—a feat to be celebrated—but there are still thousands more who won’t have a place to sleep tonight. Governor Newsom’s successful legislative push to reform the Mental Health Services Act will allow providers to attack this problem head on. Refocusing funding that prioritizes care for those with the most serious mental illnesses combined with the promise of thousands of new, dedicated veteran housing units offers one of the state’s most sweeping and welcome reforms in favor of vulnerable veterans who need the stability and services to live a life of dignity.”
  • California Medical Association President Donaldo Hernandez, MD, FACP: “For decades we have chronically under-resourced our community-based safety nets, which has now led us to a humanitarian crisis for which we don’t have the adequate tools to address.  A sustainable model of care delivery for our residents struggling with serious mental health and substance use disorders must include, not only expanded access to services, but also stable and reliable access to housing. I applaud the Governor for continuing to remove barriers while working to assure that we can overcome the gaps that exist in serving those suffering from mental health and substance use disorders.”
  • California Alliance of Child and Family Services CEO Chris Stoner-Mertz: “The Behavioral Health Services Act is strengthened by the Governor’s commitment to children and youth. California’s non profit providers of community based services to children and families are particularly proud that SB326 prioritizes Prevention and Early Intervention services that are culturally responsive, help keep families together, and improve long-term behavioral health outcomes.”
  • SEIU California Executive Board Member and President of SEIU Local 721 David Green: “California’s approach to mental health services, though well-intentioned, has suffered from a lack of coordination, transparency, and accountability – in addition to limits on housing that no longer serve the urgent mental health crises playing out on our cities’ streets. Governor Newsom’s leadership on this complex issue has moved California toward a more coordinated and effective system of behavioral health services. SEIU members do the essential and emotionally difficult work of reaching out to Californians  living in encampments, under freeways, and in our city parks, so we know better than anyone that a safe place to sleep and receive services is almost always the best medicine for people who are in crisis. Increasing program accountability and expanding access to housing and substance use disorder treatment options are the right things to do for our communities. This plan provides the opportunity to remove silos and ensure resources are aligned with the greatest needs. SEIU members are confident this reform effort will put California on a path toward more accountable and responsive behavioral health services. Meanwhile, we know the crises of housing affordability, inequality, and racism driving our state’s surge in homelessness won’t be solved overnight. SEIU members pledge our continued partnership in the critical work ahead.”
  • California Professional Firefighters President Brian Rice: “We applaud Governor Newsom, Senator Eggman and Assemblymember Irwin for their leadership on SB 326 and AB 531. Every day, our firefighters and paramedics see the impact of severe mental illness and substance use disorder in our communities. We have to do more than just take people through a revolving door in the emergency room. By focusing on housing and treating those most in need, the Behavioral Health Modernization package can transform our approach to homelessness, mental illness and substance use disorder.”
  • California Conference of Carpenters Director Danny Curtin: “We applaud Governor Newsom and the state legislature for not only recognizing the critical link between stable housing and mental health but actually doing something about it. We especially thank Senator Eggman and Assemblywoman Irwin for taking the reins on this issue.”
  • California Chamber of Commerce CEO Jennifer Berrera: “We applaud Governor Newsom and the legislature for taking these bold steps to address the social crises manifesting on our streets. California employers, especially retailers, public-facing leisure and hospitality businesses, and health care, are at the front lines, and many struggle daily to stay open and provide a safe and welcoming business environment for their workers and customers. This ambitious response provides the necessary resources to enable a more effective response by service providers and get help to those most in need.”