S1: Welcome in San Diego. It's Jade Hindman on today's show how statewide reforms to behavioral health care are impacting care in San Diego County. This is KPBS Midday Edition. Connecting our communities through conversation. Last spring , California voters narrowly passed proposition one to reform behavioral health care across the state. It calls for a multi-billion dollar bond to fund thousands of behavioral health beds , and a reshuffling of county funding to focus more on treating serious mental illness and addiction. Reforms don't officially take effect until July , but local agencies providing preventative services are already feeling the effects. Joining me to talk about her latest reporting is Lisa Halberstadt. She is a senior investigative reporter at Voice of San Diego. Lisa , welcome.
S2: Hi , Jade. Hi.
S1: Hi. Okay , so let's start with a refresher here. Remind us what prop one actually does.
S2: So to talk about prop one , we first have to talk about a 2004 ballot measure. So back in 2004 , California voters passed prop 63 , which created a 1% income tax on millionaires to fund mental health programs. Prop one , which voters passed last year , was an update to that measure , and basically it was a reform measure that was brought on based on concerns that there really wasn't enough focus in statewide programs on people struggling with the most severe mental health and addiction crises , especially chronically homeless people. This measure , as you said in the intro , included a $6 billion bond measure for treatment facilities and housing. and it also included reforms to that measure that I. As I mentioned , in terms of how that millionaire's tax money could be used. Hmm.
S1: Hmm. Okay , so so now that prop one is starting to take effect.
S2: And it's covered a very wide variety of services , everything from clinical care to prevention programs and more innovative pilot projects. Um , prop one gave counties starting in July 2026 less discretion over how they use this money. So the pot of money that they get for prevention programs , for innovative pilot projects in some sorts of clinical care is shrinking , and the state is going to take in more of those funds. So now the state is in charge of doling out money for prevention programs. And what we're seeing in San Diego is that many long standing prevention programs that are very popular with the community are learning that those contracts with the county have been canceled , and instead , they're now having to look at , you know , could they keep these programs alive going forward ? Hmm.
S1: Well , you know , prop one opponents , they warned about program cuts.
S2: Um , so as you mentioned , there was a lot of concern about program cuts , especially programs that serve diverse populations. That was one of the big arguments against the ballot measure. So at this point , what's happening is the county is cutting contracts , but the state is looking to also fund some prevention. And there specifically when it comes to how they're making their decisions , there's a lot still to be determined in terms of how that will look. But the general guidance is that about half the money would go to program serving people under 25 , and then it would be split among other populations. For the other half that are disproportionately likely to be facing behavioral health crises or who have faced , um , systemic discrimination historically. Hmm.
S1: Hmm. Well , let's talk about these programs here. Give us some examples.
S2: Uh , phone lines for veterans or other people who are seeking mental health support , a program that supports families who've lost loved ones to violent crimes. Uh , another one is mental health training for faith leaders who may have Congregants who are struggling with behavioral health crises. Also , programs that serve fathers and help them learn how they can reduce the risk of adverse childhood experiences for their kids. So it's a pretty , pretty big swath of programs , and those are just some of the examples as well.
S1: And prop one gives counties less discretion over spending , as you mentioned , and hands more of the money over to the state. So how are the priorities ? They're different.
S2: So , uh , as I said before , um , one of the big differences is that the state wanted to , through this initiative , which was really championed by Governor Gavin Newsom and others , was to really allow for funding for addiction treatment , but also to really emphasize people who are dealing with the most significant crises. Um , especially when we think about our homelessness crisis. I know a lot of folks when they think about mental health or addiction. That's one of the first populations that they think about. And the intent initially , um , of prop 63 back in 2004 was to really especially focus on these populations. Um , and in the end , uh , this funding ended up supporting of not of other types of programs. Um , but now the focus is really meant to try to , you know , emphasize more housing. Uh , also , uh , to provide more types of facilities for people that are most in need. Um , rather than just prevention programs. But there's a bit of a rub here , because a lot of folks would argue prevention programs are really important to help people avoid that outcome. Um , and I often do like to say , I think it bears mentioning here. I think a lot of times , um , people think of behavioral health crises occurring on the street a lot of times. Um , tends to be the most visible people in the homeless population may be struggling with these crises , but literally , I guarantee every one of your listeners knows somebody that's struggling with the mental health or addiction crisis , whether the homeless are housed. Right.
S1: Right.
S2: Um , the behavioral health director said she has told providers , too , that she knows how hard these cuts are going to be for the community and on them. And the goal has really been to try to let providers know as soon as possible so they can try to take steps to look for other funding to try to keep their programs alive without this long term funding source.
S1:
S2: I don't think they're certainty right now. Um , at least for the providers I spoke with , I I know several of them are really hoping that they can get state prevention funding to keep their programs alive , and they're there looking and watching what's happening at the state level with that process. And there's just not a lot of clarity yet on how that's going to go. Um , I've also heard , you know , others may be looking at some other avenues , for example. Are there other funders in the community that might step up to support these programs ? But it's a huge challenge and there's not a lot of certainty just yet.
S1: Well , you attended last Tuesday's Board of Supervisors meeting.
S2: Um , this is a team of people who respond to support people after they've lost a loved one to violence. So these folks literally show up on scene to provide support. They stay in touch with families. Um , it's a very meaningful program to folks who participate in it. And many of the people came to the meeting and spoke about this , uh , really just stressed how important this program had been to them , that it really supported them when they were at their lowest points and helped them to avoid more significant mental health challenges. And so they were really imploring the county to reverse this cut. Hmm.
S1: Hmm. I mean , what does what does this mean for communities who rely on some of these services.
S2: Still to be determined ? Um , you know , as I said , some of these programs could be ending. There's a lack of clarity on that , but there's still hope for some of them that maybe they could receive other funding , including from the state. Um , it's just there's still a lot that we don't know yet. I would say we're still fairly early in this process. Mm.
S1: Mm. Uh , well , you know , the reforms are coming.
S2: Um , and , you know , that will be playing out. That's when a lot of the contracts are actually ending , effective June 30th. So there's still some time for folks who may be interested in those programs or want to try to support them. Um , and as I'm sure many of your listeners have heard , um , the $6 billion bond and state funding for behavioral health facilities and housing has been rolling out much more quickly. Um , so listeners have probably heard announcements of local proposals being funded , and I'm expecting to hear more about , um , some applications from San Diego County early next year.
S1: I've been speaking with Lisa Halberstam. She is a senior investigative reporter for Voice of San Diego. Lisa will continue to follow your reporting. Thank you so very much.
S2: Thank you so much for having me.
S1: That's our show for today. I'm your host , Jade Hindman. Thanks for tuning in to Midday Edition. Be sure to have a great day on purpose , everyone.
