Health Officials, Lawmakers Anticipate Effect of Mental Health Services Initiative

Public health officials, legislators and mental health advocates are "gearing up to compete for the windfall" that Proposition 63 is expected to provide for mental health services, the San Mateo County Times reports (Vesely, San Mateo County Times, 11/4).

Voters on Tuesday approved Proposition 63, a measure on the statewide ballot that will increase the state personal income tax by 1% on residents with annual incomes that exceed $1 million to pay for mental health services. The measure, which will take effect Jan. 1, was approved by 53.4% of state residents and opposed by 46.6% (California Healthline, 11/3). Proposition 63 will raise about $275 million this fiscal year and almost $800 million annually thereafter.

During this fiscal year, 45% of revenues from the tax must be spent on education and training for mental health workers, and 45% will go toward capital improvements and technology projects. In addition, 5% of revenues is allocated for local planning, and 5% will go to state implementation expenses.

From 2005 to 2008, 10% of funding will be spent on education and staff training; 20% will go toward prevention and early intervention projects; 5% is allocated for innovative programs to increase access to care; and state costs and county planning each will receive up to 5% of revenue.

Remaining funds can be spent on a "wide range of programs as long as they serve adults and children with severe mental illness," according to the Times.

Programs eligible for the funding include services for uninsured or underinsured children with mental illnesses, case management for people who live independently but require assistance and people who have mental health and substance abuse problems.

Gov. Arnold Schwarzenegger (R) plans to appoint a 16-member Mental Health Services Oversight and Accountability Commission to approve counties' spending plans. Commission members will include a mental health professional, state and local officials, two people with mental illnesses and a county sheriff.

Steve Bischoff, executive director of the Mental Health Association of Alameda County, said, "It's exciting because it allows us to take a fresh look at our system in the county -- that's something that hasn't been done before."

Harvey Tureck, mental health administrator for Berkeley, said, "New money is great, but it comes with responsibilities. I think it's a smart way to stage it." He added, "This is really the first major expansion of mental health services in many, many years. It indicates a tremendous recognition that mental health services are underfunded."

Rusty Selix, executive director of the California Council of Community Mental Health Agencies, who helped lead the campaign urging voters to approve the initiative, said, "No child or adult with a severe mental illness will be left behind" (San Mateo County Times, 11/4).

"We're really excited in an otherwise very awful time. This proposition will stop us from being cut, which in itself is a windfall because every other department is going to be cut," Nancy Pena, director of Santa Clara County's mental health department, said.

Approval of Proposition 63 has raised a "red flag" for some opponents who caution that the move could "ope[n] the door for similar initiatives" that target specific populations, according to the San Jose Mercury News.

Sherry Bebitch Jeffe, a senior scholar in the University of Southern California's School of Policy, Planning and Development, said Proposition 63 is the first she has seen in which a special interest group successfully campaigned to tax high-income residents to benefit a specific population. She noted, "Once something works in politics, people will try it again."

Edward Oates, a retired co-founder of Oracle, said, "Two years from now, we'll forget about this one, and there will be some other lofty goal. There's lots of subsets of the population you can pick on from time to time. We're certainly an easier target.''

David Yow, who helped lead the "No on Proposition 63" campaign, said, "This is a slippery slope that's been adopted. You're going to see more and more IV drips stuck in [higher-income residents'] arms."

University of California-Irvine political scientist Mark Petracca, who supports Proposition 63 and similar initiatives, said, "Tapping into the general revenue stream goes nowhere in a state that's massively in debt" (Reang, San Jose Mercury News, 11/5).