Despite being roundly rejected by Central Valley voters, Proposition 1 has passed by a razor-thin margin statewide, which means counties across California will begin the process of overhauling their mental health services in an effort to fight the state’s chronic homelessness crisis.
The Associated Press called the race Wednesday night as officials continue to count ballots more than two weeks after the March 5 primary.
Once considered a slam dunk for Gov. Gavin Newsom, who put his name and formidable political muscle behind the initiative, the ballot measure led by fewer than 29,000 votes, or less than half a percentage point, Wednesday.
The state has more than 22 million registered voters, and final results will be certified by the Secretary of State April 12.
Now that it has passed, all California counties will begin the transition process to implement the initiative, which shifts a third of the state’s mental health funding toward housing programs and approves $6.4 billion in bonds to build largely institutional housing and treatment facilities.
The proposition’s passage is also a win for state Sen. Susan Talamantes Eggman, D-Stockton, who wrote part of the initiative and authored another major legislative change to the state’s mental health system that was passed last year allowing for more involuntary commitments and conservatorships.
The proposition redistributes mental health funding and places guidelines on how counties must use money from the Mental Health Services Act (the so-called “Millionaire’s Tax” passed by ballot initiative in 2004 that provides about $3 billion to support behavioral health services).
Since its passage, county officials have had considerable freedom in how to spend their funding, leading to different approaches and priorities across regions.
Eggman has said Prop. 1 prioritizes funding through MHSA (which now will be renamed the Behavioral Health Services Act) for “the sickest of the sick,” with an emphasis on people living in encampments. Now a third of county MHSA dollars must go to housing intervention programs.
The bonds are projected to pay for some 6,800 treatment beds and 4,350 housing units (with about half of the latter going specifically for veterans experiencing homelessness).
While it eked out a win, Newsom’s ambitious plan was roundly rejected by Central Valley voters.
San Joaquin, Stanislaus, Merced and Fresno counties voted firmly no on the proposition, with it failing by 51.9%, 57.5%, 56.3% and 56.7%, respectively. Sacramento was the only Central Valley county to vote for the measure by about the same narrow percentage as the statewide results.
Coastal and metro communities pushed the initiative across the finish line, with Los Angeles and the Bay Area along with all the coastal counties from Monterey to Humboldt voting yes.
Now counties will begin grappling with how to implement changes to their behavioral health and treatment services. The proposition has built in an 18-month window, from January 1, 2025 to June 30, 2026, to be enacted.
Before the election in a public forum about Prop. 1, San Joaquin County Behavioral Health Director Genevieve Valentine said it is expected to cost the county $1.7 million in administrative costs to make the necessary changes. About $900,000 of that would be ongoing administrative costs, she said.
The governor celebrated the proposition’s slim win Wednesday morning with a press conference, saying once it is implemented voters “will be proud” of the results.
“We are here to modernize the Mental Health Services Act, we’re here to modernize our thinking. We are here today celebrating this journey and this successful effort to fundamentally reshape and reform the approach we take to address the issue of mental health, substance abuse disorder and challenges that continue to vex us out on the streets and sidewalks and those that are suffering alone,” Newsom said while flanked by supporters of the initiative.
Opponents of Prop. 1, including many working in the behavioral health field, fought what they described as a David vs. Goliath battles against the initiative, having been vastly outraised and outspent by Newsom’s “Tents Not Treatment” campaign. The yes campaign even aired a local network advertisement during the Super Bowl.
They have argued that the changes will take money away from programs that are successfully keeping people out of homelessness, including peer support and community-based organizations which receive MHSA dollars.
Despite the loss, No campaigners like Merced-based peer support specialist LaTanya Ri’Chard said they felt victorious in pushing the governor and the proposition’s supporters as much as they could.
“The fact that the Central Valley voted ‘no’ should really inform the state’s next moves with this. State Sen. Eggman’s own county voted against her…,” Ri’Chard said. “We are not done. (Californians Against Prop. 1) will be fighting to either repeal, delay or reform Proposition 1 ASAP. This is a testament to the power of peers. The underdogs can win.”
Marijke Rowland is the senior health equity reporter for the Central Valley Journalism Collaborative, a nonprofit newsroom based in Merced, in collaboration with the California Health Care Foundation (CHCF).