Board-and-care home operators fear they may get overlooked for Prop. 1 funds

California is gearing up to spend billions of dollars from Proposition 1 on behavioral health treatment and housing. But some mental health advocates are raising concerns over whether a particular type of housing — board-and-care facilities — could be overlooked.

Operators who spoke with LAist said they believed when voters approved Prop. 1 in March, that some funding would go toward board and care, which they say is a crucial housing option for people with serious mental illness.

Now, they say they're hearing from state officials that board-and-care facilities may not be eligible for funding they thought was guaranteed.

“I was literally shocked because we had met previously with the state,” said Bennie Tinson, executive director of the Licensed Adult Residential Care Association. “We were in Sacramento. I think we met with over 30 legislators at one point. We were left with the impression that we would be included.”

State officials told LAist they are still deciding which housing options will be approved for funding under Prop. 1 and will provide that guidance for counties by early next year.

An ongoing crisis

Board-and-care homes — also known as adult residential facilities — offer housing, daily meals and medication management for thousands of Angelenos living with serious mental illness, such as schizophrenia. Low-income residents on supplemental Social Security income pay board-and-care operators around $44 a day to live in these homes.

L.A. County and the state offer some subsidies to the owners if certain conditions are met, for example, if the facility has brought in new residents.

Board-and-care owners say $44 a day per resident is not enough to house and feed people. Many operators say they are struggling to stay in business because of inflation, rising insurance costs and other pressures.

A study released last year that surveyed more than 600 board-and-care residents in L.A. County found that about half had experienced homelessness as adults.

The study by the consultant group Future Organization also found that 56% of board-and-care owners and operators are looking to the government to increase funding.

“They serve people with nowhere else left to go,” Aimery Thomas, managing director of the Future Organization, said in an interview with LAist. “And one of the key aspects of why they’re critically endangered is there isn’t consistent funding.”

Fears of displacement

According to the study, there are about 750 board-and-care and licensed residential care facilities for the elderly in Los Angeles County that specifically serve people living with mental illness. The size of those facilities can vary widely, ranging from only a few beds to dozens, and in total have an estimated capacity of 25,000 beds.

Since 2016, more than 2,000 board-and-care beds in L.A. County have been lost because the facilities closed, according to a recent report from the county Department of Mental Health.

Michelle Pullum operates a six-bed facility in South L.A. She said board-and-care facilities will continue to close unless they get further investment from the state.

“And it’s unfortunate because then those people will then be displaced back on the street,” Pullum told LAist.

Pullum said she prides herself on providing support for people living with serious mental illness and strives to make her residents feel like a part of the community. But, despite the major funds the state has spent in an effort to solve California’s mental health and homelessness crises, she said she hasn’t seen much of that money.

“I know the governor has given billions of dollars. Billions,” she said. “And for us to be as [adult residential facilities] still saying, ‘Where’s the money?’ It seems like there’s no accountability.”

‘Part of the conversation’

Prop. 1 requires that counties spend 30% of Mental Health Services Act dollars on housing programs. The so-called “millionaires tax” generates hundreds of millions of dollars a year for counties' public mental health budgets.

That money is expected to fund several types of what are called housing interventions, which could include rental subsidies.

Marlies Perez, a division chief with the California Department of Health Care Services, said because the statute created by Prop. 1 does not specifically define which types of “housing interventions” will be eligible for funding, her office is working to provide guidance on those decisions by early next year.

She added that board and care facilities were “definitely a part of the conversation.”

“Adult residential facilities, they may be one of the entities that can receive funding for these housing services that they provide at the local level, but we haven’t set that policy yet,” Perez told LAist.

It’s unclear if board-and-care facilities would be eligible for funding from the millionaire tax or a different pot of money set up by Prop. 1: $2 billion in bond funds set aside for housing infrastructure.

A spokesperson with the state’s Housing and Community Development Department said in an email that if a housing project has no limit on length of stay, is linked to onsite or offsite services, it could be eligible, but did not name adult residential facilities specifically.

Last month, Gov. Gavin Newsom announced that $3.3 billion in Prop. 1 bond funding is available for inpatient beds and outpatient treatment. Adult residential facilities would not qualify for that funding because they are not considered treatment beds.

Barbara Wilson, a social worker who runs a local nonprofit that helps connect families with services, said she is concerned about the outlook for board-and-care homes, not just for people living with mental illness, but their families, too.

Many of her clients are aging mothers who worry what will happen to their children living with mental illness if there are fewer board-and-care facilities available in L.A. County.

Wilson said licensed board-and-care facilities have protected thousands of people living with mental illness from becoming unhoused. And she’s calling on Prop. 1 decision makers not to forget about these homes.

“You guys owe us this,” she said.