What is Proposition 1
Proposition 1 was passed by California voters in March 2024. The two-bill package, Senate Bill (SB) 326 (Eggman, Chapter 790, Statutes of 2023) and Assembly Bill (AB) 531 (Irwin, Chapter 789, Statutes of 2023), proposed statewide efforts to reform and expand California's behavioral health system, and was put on the ballot by the California State Legislature and the Governor. DHCS refers to the implementation of these changes as Behavioral Health Transformation. Proposition 1 consists of two parts: The Behavioral Health Services Act and the Behavioral Health Bond.
What is the Behavioral Health Services Act?
The Behavioral Health Services Act replaces the Mental Health Services Act of 2004. It reforms behavioral health care funding to prioritize services for people with the most significant mental health needs while adding the treatment of substance use disorders (SUD), expanding housing interventions, and increasing the behavioral health workforce. It also enhances oversight, transparency, and accountability at the state and local levels. Additionally, the Behavioral Health Services Act creates pathways to ensure equitable access to care by advancing equity and reducing disparities for individuals with behavioral health needs. It is one part of Proposition 1.
What is the Behavioral Health Bond?
The Behavioral Health Bond authorizes $6.4 billion in bonds to finance behavioral health treatment beds, supportive housing, community sites, and funding for housing veterans with behavioral health needs:
- $4.4 billion of these funds will be administered by DHCS for grants to public and private entities for behavioral health treatment and residential settings.
- $1.5 billion of the $4.4 billion will be awarded only to counties, cities, and tribal entities, with $30 million set aside for tribes.
- The remaining $1.972 billion will be administered by the California Department of Housing and Community Development (HCD) to support permanent supportive housing for individuals at risk of or experiencing homelessness and behavioral health challenges. Of that amount, $1.065 billion will be for veterans. All these efforts will leverage effective existing programs, including the Behavioral Health Continuum Infrastructure Program (BHCIP), Project Homekey, and Veterans Housing and Homeless Prevention Program (VHHP).
- This is the other part of Proposition 1.
Proposition 1 increases the state's capacity to provide behavioral health care and housing for vulnerable populations living with the most significant mental health needs and adds the allowance for care for individuals with only a SUD. It also reforms the funding allocations, expanding access and increasing the types of support available to all Californians — working to ensure people can get the help and support they need, when they need it, and in their own community.
Counties now have a robust array of tools to help Californians in need, including new housing interventions. We continue to champion a “do whatever it takes" approach through Full Service Partnership programs and behavioral health services and supports, including early intervention with resources dedicated to reaching Californians age 25 and younger so behavioral health challenges are addressed before they worsen.
These changes advance culturally responsive services by supporting community-defined practices as a key strategy to reduce health disparities. Counties must demonstrate how they strategically invest in early intervention and advance behavioral health innovation.
The statewide resources will support:
- Population-based prevention programming,
- Workforce investments to expand a culturally competent behavioral health workforce.
- These funds will be leveraged to invest $2.4 billion in workforce training over the first five years.
- Oversight and monitoring to increase transparency.
- $20 million annually to support a new Innovation Partnership Fund directed by the Behavioral Health Services Oversight and Accountability Commission (BHSOAC).
How does Proposition 1 address Californians' key behavioral health challenges?
Proposition 1 will:
- Improve statewide access to behavioral health services, with a focus on people with high needs and vulnerabilities, all while reducing health disparities.
- Increase behavioral health treatment facility infrastructure.
- Expand housing services and infrastructure for Californians with the most significant behavioral health needs.
- Increase investment by expanding the behavioral health workforce.
- Expand investment in early intervention services, with a focus on children and youth.
- Enhance oversight and accountability at the state and local levels and transparency to the public.
How will housing for people facing homelessness be impacted by Proposition 1?
Housing is an essential component of behavioral health treatment, recovery, and stability. As part of the Behavioral Health Services Act, 30 percent of each county's Behavioral Health Services Act funding allocation must be used for housing interventions for Californians with the most significant behavioral health needs, who are also homeless or at risk of homelessness. Half of that amount is prioritized for individuals and families experiencing long-term homelessness. The Behavioral Health Services Act provides ongoing revenue for counties to assist those with severe behavioral health needs with housing and provides a path to long-term recovery, including ongoing capital to build more housing options. Additionally, more than 11,150 new behavioral health treatment beds and supportive housing units will be funded for people experiencing or at risk of homelessness and who have behavioral health needs, with a dedicated housing investment to serve veterans.
How does Proposition 1 tie into other behavioral health initiatives?
The state is committed to ensuring Californians receive the mental health and SUD services they need. The new reforms under Proposition 1 build upon existing efforts through California Advancing and Innovating Medi-Cal (CalAIM), Children and Youth Behavioral Health Initiative (CYBHI), Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment Demonstration (BH-CONNECT), Behavioral Health Continuum Infrastructure Program (BHCIP), Community Assistance, Recovery, and Empowerment (CARE) Act, Senate Bill 43, and Behavioral Health Bridge Housing to enhance equitable access to behavioral health care across these four domains:
- Target the same priority populations.
- Invest in evidence-based practices.
- Provide new housing and residential treatment options.
- Include funding for the behavioral health workforce.
Can Proposition 1 funding be used to force people into involuntary treatment?
No. Proposition 1 makes no changes to the Lanterman-Petris-Short (LPS) Act that governs the criteria and procedures for involuntary commitment.
Does Proposition 1 raise taxes?
No, Behavioral Health Services Act funding remains the same as Mental Health Services Act funding – a 1% income tax on personal income more than $1 million per year.
Does Proposition 1 cut funding for services for people with severe mental illness?
No. The Behavioral Health Services Act prioritizes funding for services and supports for people with the most severe mental health and SUD conditions. The state has invested substantially in California's behavioral health care continuum in recent years to expand access. This recent reform to the Mental Health Services Act accelerates those efforts. Proposition 1 expands access and increases the types of support available to all Californians – working to ensure people can get the help and support they need, when they need it, and in their community.
Does Proposition 1 transfer control from the counties to the state?
The state continues to work hand in hand with counties to ensure they are quickly and correctly implementing innovative tools and modernizations to the behavioral health care system to better serve Californians in need of care, support, services, and treatment. Counties now have a robust set of tools available to help Californians in need and get them the behavioral health care they need.
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