Would Prop. 1 Divert Money From LA County’s Unarmed Crisis Response Efforts?

As voters prepare to decide the fate of Proposition 1 — which could bring big changes to mental health funding in California — some L.A. County authorities worry the measure would pull money away from existing services, like the teams of health professionals who respond to crisis situations instead of police.

In a letter to the board of supervisors earlier this week, the Los Angeles County CEO’s Office acknowledged the potential benefits of Prop. 1 if it passes, including funding for more treatment beds — the lack of which is a perennial problem.

But the letter also points to a couple of challenges. One, it says, is that Prop. 1 could limit local control of money from a key source: the Mental Health Services Act, also known as the “Millionaire Tax.”

The CEO’s office said shifting that revenue away from mental health services would affect several services offered by the county Department of Mental Health, including the psychiatric mobile response teams and other parts of its crisis care system.

The letter reads, in part: “The provisions of Proposition 1 that restrict the County’s flexibility and local control over one of its biggest and most flexible funding streams … would make it more difficult for the County to continue meeting both the mental health needs of the rest of the County’s residents and the State mandated requirements to ensure access to care.”

Why Prop. 1 would be a major change

State and local authorities, including Gov. Gavin Newsom, have said Prop. 1 would constitute the first major change in California’s approach to mental health in decades. It would create more than $6 billion in bonds to fund treatment beds and housing.

But one of the biggest changes the proposition would require is that counties spend 30% of Mental Health Services Act dollars—- the funding that comes from the state’s 1% surtax on personal incomes above $1 million — on housing programs. That would mean there could be less money from that particular funding source for several services the county already provides, including:

• Adult and child outpatient clinics
• Urgent care centers
• Crisis residential treatment programs, and
• Homeless outreach engagement teams

In the Feb. 26 letter, county CEO Fesia Davenport noted that the Department of Mental Health “does not have an ongoing revenue source to replace this loss” of Mental Health Services Act funding. Her office also says losing access to some of that funding would make it “challenging” for the department to increase staffing and lower caseloads.

According to county authorities, Millionaire Tax dollars are the biggest contributor to the county’s alternative crisis budget, which includes the mobile crisis teams, at more than $120 million last year.

“Of course it’s a concern we have, we have some work to do,” Kalene Gilbert, the department’s Mental Health Services Act coordinator, told LAist.

The county has not taken an official position on Prop. 1, and officials have said they would work to find other sources of funding if it passes so that services are not cut.

Gilbert said the Department of Mental Health would have to figure out a way to continue those services. She also noted that the county would have until at least 2026 before some of the funding changes set in.

L.A. County is still struggling on mental health response

The inclusion of Prop. 1 on the March 5 ballot comes at a time when L.A. County is struggling to build out its mobile mental health crisis response system, a service local leaders say they want to expand.

When someone in the community is experiencing a mental-health crisis, a two-person team of clinicians can be deployed to the scene, where they try to intervene and de-escalate the situation.

The program launched in 2000 and consisted of 33 teams as of last summer, according to the county. The county has said more than 23 “entities” send referrals to the psychiatric mobile response team program “making it a critical source of care and response.” The teams served more than 20,000 clients in fiscal year 2020 alone, according to a department fact sheet.

Law enforcement interactions with people in the midst of a mental health crisis often have violent or deadly outcomes. Of the 34 people Los Angeles police officers shot at last year, 12 had a perceived mental illness, according to department data.

County sheriff’s officials reported 13 shootings by deputies in 2023 that resulted in injury or fatality, according to data posted on the department’s website. At least one of those shootings, in March of last year, involved a 47-year-old man in Altadena who was reported to be experiencing a mental health crisis. It was not immediately clear how many other incidents involved someone with behavioral health issues.

County leaders, families living with mental illness and mental health advocates have long called for ramping up the unarmed response system. But people who have made requests for a mobile team response during a psychiatric emergency have reported having to wait hours — in some cases all day.

That’s a problem that could be exacerbated if funding is diverted elsewhere. But county officials say they will adjust as needed.

Connie Draxler, acting chief deputy director for the county Department of Mental Health, told L.A. County’s Mental Health Commission last month that this isn’t the first time the agency has braced for a potential loss of funding.

“This isn’t the first time the department has faced adversity, and fortunately we can plan for it a little bit,” Draxler said. “And I think we will do our best to ensure that there is not a dramatic change in services or any reduction in services.”

Why L.A. County has no position on Prop. 1

While Prop. 1 has gained wide-ranging support from local leaders, including L.A. Mayor Karen Bass and county Sheriff Robert Luna, the board of supervisors has not taken an official stance.

The county CEO’s letter outlines other possible funding difficulties if Prop. 1 passes. Specifically, it says the measure would create an “unclear revenue outlook” as the county works to expand certain services and meet state requirements.

For example, Davenport asserts in the letter that the burden of sustaining funding for substance-use treatment facilities could fall on the county if the state doesn’t provide continued funding later. She also says the measure could affect L.A. County’s ability to draw matching funds from Medicaid.

It’s unclear, according to Davenport’s letter, how bond money would be allocated to the counties to support housing initiatives.

But the CEO also acknowledges that Prop. 1 could “expand the county’s ability to provide access to community-based treatment” for people with behavioral health conditions” including those experiencing homelessness, veterans and people with serious mental illness or substance-use disorder.

Mark Gale, criminal justice chair for the National Alliance on Mental Illness of Greater L.A. County, said the thousands of treatment beds that are promised if Prop. 1 passes are “incredibly important,” even if the measure isn’t perfect.

“We’ve been screaming for more beds and more funding for years [and] Proposition 1 is the best chance — maybe the last best chance — we have of completing California’s mental health system and finally providing a full continuum of care for the mental health population,” he said.

A new poll from UC Berkeley's Institute of Governmental Studies found Prop 1 supporters outnumbering opponents 50% to 34%, with 16% undecided.