Committee forwards DPH three-year MHSA expenditure plan as Prop 1 reshapes funding categories

The Budget and Finance Committee on May 22 forwarded to the full Board the Department of Public Health’s three-year expenditure plan for the Mental Health Services Act (now called the Behavioral Health Services Act), while members and community speakers pressed the department to clarify how the plan will align with changes under Proposition 1.

Jessica Brown, who introduced the plan for DPH, said the original MHSA (enacted in 2005) is funded by a 1% tax on personal income over $1 million and supports culturally responsive, community-based behavioral health programs. Brown told the committee the plan was developed before the passage of Proposition 1 and that the state’s reform will reduce MHSA funding components from five to three — full service partnerships, housing, and a new behavioral health services and support category — requiring local plans to realign over the next 24 months.

Brown described several recent program outcomes and reporting practices: DPH reported decreases in arrests for older adults served by full service partnerships, improved substance-use and mental-health outcomes among adult participants, expansion of culturally congruent clinics and peer specialist certification work with community-based organizations, and 16 community engagement meetings involving about 165 participants to inform the plan. She said DPH projects revenue volatility and will work with the Department of Healthcare Services’ timeline; bond applications for housing are expected to open in early 2025 and counties must integrate Prop 1 requirements by mid-2026.

Vice Chair Rafael Mendelmann said he supported forwarding the plan but voiced concern that the plan did not clearly map to the most acute behavioral-health needs he sees on city streets — including severe mental illness, addiction and homelessness — and urged DPH to provide clearer, prioritized metrics. Brown and DPH staff said the new Prop 1 reporting and the forthcoming state guidance should give supervisors a clearer picture and that DPH will provide briefings ahead of the next plan submission.

Public commenters — including peers, program participants and nonprofit providers — urged the supervisors to maintain or protect funding for peer-run vocational and prevention programs that speakers said would be at risk under the new alignment. Tracy Helton and several speakers linked MHSA-funded services such as Rams HireAbility and Fuerte to employment, school-based prevention and housing outcomes and asked the city not to cut effective programs.

Chair Connie Chan moved the expenditure plan to the full Board with a positive recommendation. The committee voted unanimously (Vice Chair Rafael Mendelmann, Member Melgar, Chair Chan) to forward the plan and asked DPH for periodic briefings and for the department to return with an updated plan that aligns to Prop 1 requirements.