Proposition 1 brings unanswered questions regarding state funding allocation to SLO County's Behavioral Health Department 

With the narrow passage of Proposition 1 in March, the SLO County Behavioral Health Department is bracing for unknown change.

Passing with a margin of 50.2 percent to 49.8 percent, the $6.4 billion bond aims to modernize the Mental Health Services Act (MHSA) and provide California with the resources to build 10,000 new beds to help those with serious mental illnesses and substance use disorders to get housing and services.

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• Photo Courtesy Of SLO County
• BRACING FOR CHANGE After Proposition 1 passed in March, the county's Behavioral Health Department has been preparing for funding changes in services it currently provides.

To help break down the measure so it's easier to understand, the county's Behavioral Health Deputy Director Frank Warren told New Times that Proposition 1 comprises three parts: It morphs the MHSA into the Behavioral Services Act, gives public access to funding reports for every California county, and generates funding through the $6.4 billion bond that gives counties competitive grants to build treatment beds.

"The bond is already moving funds into the state through the Behavioral Health Continuum Infrastructure Program [BHCIP] and that would provide us with an opportunity to expand the number of crisis or inpatient beds that we have here in the county," he said. "We don't have any crisis or residential or psychiatric beds for youth in our county, so that's our first priority with these grant funds."

Currently, youth are transported to surrounding counties for care. SLO County will submit its grant applications for beds in December and is hoping that funding will start in 2025.

But there's a lack of guidance from Proposition 1 about what will happen with current county funding. Warren said there are a few things that the county does know: It will not receive any additional funding. The money SLO County gets through the MHSA will be reallocated as the MHSA is reformed.

"What Prop. 1 does is reallocate the funding we get now for a wide variety of services into three really specific components. One of the components is something we already do, which is called Full Service Partnerships, and that is our most intense kind of wraparound services for individuals who have severe mental illness, severe use disorder, people who are regular users of inpatient services or jail or hospitalization," he said. "Our real intensive wraparound isn't going to change much; we think that is going to remain in the programs that we do."

However, he added, there's a chance that funding will be tight for other programs that the county runs.

The MHSA passed in 2004 and was designed to expand and transform California's behavioral health system to better serve individuals with and at risk of serious mental health issues and their families, provide early intervention, and provide for needed infrastructure, technology, and training.

"Where there will be change is they've added a component for housing, and about nearly a third of our allocation will be dedicated to housing—that's a really good thing. However, we don't know yet what we will be able to spend those dollars on," he said. "The way the bill was written, it does not give us a lot of funding for services, actual treatment of those individuals, which is what we spend those dollars currently on. So, what that means is the other third of the funding is where we will have to pack in a lot of the programs that we currently provide."

Warren said those programs include crisis services, outreach and education services, prevention and early intervention, counseling in schools, and special population programs for Latinos and LGBTQ-plus residents.

Around 20 years ago, Warren said, the Behavioral Health Department developed the Latino Outreach Program, which staffed clinicians who were both bilingual and bicultural to embed more representation in the county's care response. Similarly, a few years ago a QCARES (Queer Community Action, Research, Education, and Support) study helped SLO County figure out the best way to serve LGBTQ-plus residents.

According to the QCARES website, Jay Bettergracia, a psychology and child development professor at Cal Poly, formed a team to use research to create queer and transgender social change and policy recommendations by engaging with individuals and communities to understand barriers to mental health care and develop innovative solutions.

"One thing that came out of that, which was all funded through the MHSA, was training of ally clinicians who both were representatives of the community as well as allies in building affirmative care," he said. "That's something that came from those MHSA dollars, and with this new Prop. 1, we can't see now how we would build those programs going forward."

While dealing with the unknown effects of Proposition 1, the Behavioral Health Department has spent the year introducing new programs and facilities with the hopes that one of them will generate enough revenue to keep some of the at-risk programs going.

Like most counties in California, SLO is switching its Behavioral Health Department to using electronic health records. Warren said it should enable the department to get better at billing Medi-Cal to receive more revenue.

"We're hopeful that the Medi-Cal revenue will now allow us to maybe sustain some of those programs that might get threatened by the cuts from Prop. 1," he said.

The department also opened a new sobering center at 2180 Johnson Ave., and stays there could be billed to Medi-Cal.

"It's a short-term crisis facility for people who are kind of suffering from severe intoxication. It's not a locked facility; it's a stabilization and access for treatment so people who come in the door are met with compassion and de-escalation and safety," he said. "It's for sobering and then they can be linked with a therapist."

Managed by Good Samaritan Shelter, the sobering center has 12 beds and is designed to keep individuals for less than 24 hours. The center does let some residents stay for up to 72 hours on a case-by-case basis.

"One of the other big items that we're working on is establishing an access and crisis services division here in the department, so we'll have one division that oversees that 24/7 crisis system," Warren said. "Right now, all of those things exist, and we also have a mobile crisis team called Community Action Teams and those are basically psychiatric technicians who are embedded with law enforcement throughout the county.

"These programs are now going to fall under one single division, and they'll all be connected more so than they are now." Δ

Reach Staff Writer Samantha Herrera at [email protected].