How much of a difference will a measure on the March ballot make when it comes to combating California’s dire homelessness crisis? That’s the question before voters as they weigh Proposition 1, hailed as California’s chance to finally do something about the street epidemic.
Prop. 1, the only proposition on the California ballot this March, asks voters to green-light a $6.4 billion bond for treatment beds and housing units that serve people with chronic illnesses. mental health and addiction. It will also restructure some existing funding to channel more mental health money into housing.
Gov. Gavin Newsom, who sponsored the move, said it would “primarily get people off the streets, out of tents, and into treatment.” The governor has a lot riding on its success, as voters are increasingly frustrated by the state’s lack of progress when it comes to cleaning up the camps and helping the people suffering inside them.
But experts caution against putting too much stock in Prop. 1 as a solution.
It doesn’t help at all—not by a long shot. It is also not designed to. In addition to funding 6,800 beds in facilities that treat mental illness and addiction, the $6.4 billion bond will create up to 4,350 new homes for people who need mental health and addiction services; 2,350 of these are reserved for veterans, according to the Legislative Analyst’s Office. . In a state with an estimated homeless population of more than 180,000, that’s not going to make a dent.
“It’s good for individuals, but it still leaves almost 98% outside or in shelters,” said Bob Erlenbusch, executive director of the Sacramento Regional Coalition to End Homelessness.
Prop. 1 would also require counties to spend 30% of their Mental Health Services Act funds on housing, including rent subsidies and new construction. Those funds, which come from taxing California’s millionaires, are expected to raise about $1 billion a year for housing programs.
The new houses funded under Prop. 1 will target homeless Californians who are often the most visible and the hardest to help, including those with severe psychosis and addiction. Many homeless Californians do not fit that description.
“The public sees it as everything, and it’s definitely not everything,” said Dr. Margot Kushel, who directs the UCSF Benioff Homelessness and Housing Initiative, “but there are a fair number of people with these disabling conditions.”
In a recent comprehensive study of homeless Californians, 27% of people surveyed had been hospitalized for a mental health problem in their lifetime. When asked if they had experienced long-term hallucinations, 23% said they had, according to the Homelessness and Housing Initiative study.
About one-third of those surveyed reported using drugs three or more times per week.
Even if it leaves people behind, pouring resources into the sickest subset of California’s homeless community is the humane thing to do, said Sen. Susan Talamantes Eggman, a Democrat from Stockton.
“They also count,” said Talamantes Eggman, whose bill that changed the Mental Health Services Act became half of Prop. 1. “We don’t just see people as problems. You have to look at people as people and ask, how are we doing our best to help those who need it most? ”
Targeting people with the highest needs can also be politically savvy. Voters concerned about the state’s worsening homelessness crisis—and politicians’ seeming inability to fix it—aren’t complaining about the man who drives for Uber during the day and sleeps in his car, no visible, at night. They complain about people living in camps, walking in traffic, and not shouting at anyone. Those are the people this step will help. And that’s where voters might see the move make a difference on the streets.
“We’re at the point where voters need this,” said Christopher Martin, director of policy for Housing California. “Voters feel tired of housing, and they need to see some progress, and I think we need to show that.”
But Susan Ellenberg, president of the Santa Clara County Board of Supervisors, does not expect that Prop. 1 can do a lot on that front.
“In terms of addressing homelessness, we need more housing, period,” he said. “And I worry that when people’s expectations are conflicted, they get frustrated and feel like the problems aren’t being solved even though more money is going out the door.”
He also worries that some of the unintended consequences of Prop. 1 could end up exacerbating the homelessness crisis in his county. To pour the required amount of Mental Health Services Act funding into housing, the county must take money from other programs. That means fewer dollars for things like homelessness prevention and early mental health interventions. If the county skips the types of services that keep people off the streets in the first place, Ellenberg worries that more people will fall into homelessness or that their mental health will deteriorate to the point that they need more care.
Los Angeles County’s mental health department also has “some serious concerns” about Prop. 1, said Director Lisa Wong. Last year, the county spent 32% of its Mental Health Services Act funding on outpatient services—psychiatric care, counseling, medication, and other things that help stabilize a person living outside of a psychiatric care. facility. If Prop. 1 were to pass and redirect a portion of that funding to housing, the county would spend less than 18% on outpatient services, and other programs like crisis response and homeless services should also be dipped into that fund. .
“We’re concerned that the loss of service dollars could compromise people’s ability to stay at home when they’re housed or get to a health facility where they can be successfully housed,” Wong said. .
Recent Medi-Cal expansions mean more people are covered for more services, which helps offset funding losses, Talamantes Eggman said.
“I don’t see these as cuts,” he said. “I see it as a reprioritization.”
There’s also the question of how counties will come up with the resources needed to make the necessary program changes. Santa Clara County is facing worker shortages and hiring freezes because of the budget shortfall, Ellenberg said.
“I feel like we’re being asked to do more and more work with less and less tools,” he said.
Kushel, who specializes in the intersection of homelessness and health, said the authors of Prop. 1—Talamantes Eggman and Democratic Assemblymember Jacqui Irwin of Thousand Oaks—have their priorities in the right place.
It is almost impossible to improve someone’s mental health or treat their addiction while they are living on the streets and pouring all their efforts into surviving day to day, Kushel said. But when given shelter along with the right treatment plan, even people who seem seriously ill can improve.
“Is this enough? I don’t know,” he said. “But it looks like we should try.”
How will Prop. funds be used? one of the best? In San Diego, Deacon Jim Vargas says: detox beds. He runs Father Joe’s Villages, which has more than 1,000 shelter beds—none of them specifically for detox. The entire county has only 77 detox beds—not enough, he said.
Vargas hopes to use Prop. 1 to unlock more.
“I’d like to think that yes, it will make a difference on the streets,” he said.
Martin, of Housing California, has more upbeat expectations.
“This is a step in the right direction,” he said. “But this is not all.”
This article was originally published on CalMatters.