Assembly Standing Committee on Housing and Community Development
- Buffy Wicks
Legislator
Good afternoon, everyone. I know, it's been a minute. Yeah, exactly. It was that legislative softball game I really like, you know. I did get one good hit, I'm not going to lie. Okay, we will start as a Subcommittee, and I believe we just adjourned in the Assembly. And I know our author will be here shortly. Welcome to the Assembly Housing and Community Development Committee hearing. We have one item on our agenda today. The bill can have two main witnesses in support and opposition. Each main witness gets two minutes each. There is no phone testimony option for this hearing. All witnesses testimony will be in person.
- Buffy Wicks
Legislator
Please feel free to submit written testimony through the position portal on the committee's website. This will become part of the official record of the bill. The hearing will be open for attendance of this hearing. All are encouraged to watch this hearing from its stream on the Assembly's website. Thank you for your patience and understanding. And if you are an Assembly Member who is on this committee, please come join the committee. And if you are the author of the bill, we also welcome your participation. So we will wait quietly for the rest of our colleagues here to show up. But we'll be starting momentarily.
- Buffy Wicks
Legislator
We will take roll, establish a quorum.
- Despina Demas
Person
Wicks? Here. Wicks here. Patterson? Here. Patterson here. Carrillo? Here. Carrillo here. Gabriel? Here. Gabriel here. Kalra? Quirk-Silva? Sanchez? Here. Sanchez here. Ward?
- Buffy Wicks
Legislator
We do have quorum. Great. We have quorum.
- Buffy Wicks
Legislator
Hi, Senator Eggman. Okay, thank you Senator, for joining us. Thank you everyone for being timely here today. Before we begin, I just want to make a couple of remarks here. Due to timing issues, the amendments will be taken in Appropriations Committee. We're going to move forward with and make sure that we're on the same page on this. We're going to move forward with amendment one in the analysis. We are going to continue to work with the Administration and author on amendments two, three, and four.
- Buffy Wicks
Legislator
I believe the amendments would add a requirement that housing funded by MHSA comply with housing first. California is a housing first state which requires any housing funded to be provided without precondition. This Bill would allow funding to go towards recovery housing which fits within housing first, except that clients cannot use drugs and alcohol. The US. Department of Housing and Urban Development has provided guidance on how recovery housing can comply with housing first.
- Buffy Wicks
Legislator
We are exploring if any exceptions to housing first can be added to allow recovery housing to comply with HUD guidance as a condition of being exempt from housing first. In addition, we are working with the Administration to make sure that the streamlining by right process for healthcare facilities works based on the current underlying zoning for those facilities. And with that, I will now turn it over to the author, Ms. Eggman to present SB 326.
- Susan Talamantes Eggman
Person
Thank you very much. Hello Members. Nice to be here. I know you all rushed down after session and of course I left caucus to come. And so thank you. And thank you for taking the time to hear this important Bill today. I know we're already done with our work, but as we know, our work never ends until the clock finally finishes.
- Susan Talamantes Eggman
Person
And this one is one that is big enough and will go to the voters that we thought that we'll take as much time as possible to work with it because it's not good to get things done if they're not done right. Just to start off to say, accepting the amendments in concept as the chair went over and why is it time now to redo our MHSA? Why is it time now?
- Susan Talamantes Eggman
Person
It's been 20 years in passing and I'll say as a social worker, as a professor of social work, I was around the first time it passed and heard and I'll say there was a lot of scares and trepidation at that time. Right. Anytime you change anything, people get nervous that what they have may shift and may change. And that's true, right? We all know that things change over time.
- Susan Talamantes Eggman
Person
And California looks very different today than it looked 20 years ago, both in, I think the level of substance abuse and addiction and mental health that we so visibly see. And additionally it has also changed in at 1.0 there was a large number 20 years ago there's a large number of people without health care insurance. Now we know that number is very small of those without health care insurance.
- Susan Talamantes Eggman
Person
A long time ago we didn't pay for housing through something like Calame or Care Court or so many of the other things that we pass. We have done all of those. So this is not done out of context, this is done as a whole continuum of care. As we last year we did care court. Hopefully this year we're also doing what it means to be gravely disabled in California.
- Susan Talamantes Eggman
Person
As we do this, as we do Cal Aim, as we've done all the behavioral health work that we've done, it's also time to change and relook at and remodenize the way that we actually use this, which is one of the biggest streams of money that goes down to care for folks. So that's why we think now is the time. And again, this will go to the voters, so the voters have a chance to weigh in on this.
- Susan Talamantes Eggman
Person
Two of the key things, I've got all my talking points, but the key things that are going to be changing are the buckets in how we spend the money. We are going to reprioritize, the state is going to say we really need to focus and prioritize on those that are the most ill. And we're also going to say, and again, when we initially did mental health legislation, way back with LPs, we included alcoholism. So why wouldn't we include substance abuse now?
- Susan Talamantes Eggman
Person
Because we know there are so few people who only have one, but there are some people who just have used substance abuse to the extent that they have become psychotic, schizophrenic, whatever. So we need to be able to treat them as well. Those are the biggest portions that we're changing. And the pots and how they're divided more intentionality about serving those with the greatest need through our full service partnerships, which are evidence based, people know they work, being able to treat substance abuse.
- Susan Talamantes Eggman
Person
And then the other big change will be to able to use part of this funding for housing. Of course, the bond that we're doing is the one that's going to provide hopefully 10,000 new units. Thank you for the chair, for continuing to work on those kinds of language of the villages and cottages and the things that we knew way back when we first did LPs that would need to come afterward, the living supports. Was it right to close our state hospitals and say institutionalized is bad?
- Susan Talamantes Eggman
Person
Of course it was, but I think at that time we forgot. And 20 years after that LPs passed, we saw, oh my goodness. But that housing that was there, that wraparound care that was there, that medication management was there was an important part of what was happening and we began to see right away a rush of folks to the streets after we closed those.
- Susan Talamantes Eggman
Person
So this is going back to the promises we made to say let's provide all that cottage type housing, that community housing, because there will always be those amongst us who are not going to be able to live totally independently. There just is. We've accepted that for some populations, not for others. So now we're back saying, let's redo this. Let's make sure we use every money available to us through all the other avenues.
- Susan Talamantes Eggman
Person
We have to pull down federal funding to do insurance, billing, all of those things. Let's be able to reprioritize this money on the ones that need it the most. And we know that people don't get better unless they're in housing. So really being able to provide a housing component for those who are the most ill. And I have with me Michelle Boss from the Health Department, as well as Miles White, our Acting Deputy of Secretary of Legislation at the BSCA. Thank you.
- Michelle Baass
Person
Good afternoon, chair Members. Michelle Baass, Director of the Department of Healthcare Services. As you know, and as the Senator mentioned, since 2019, we've really embarked on Massive investments together in the behavioral health space. This includes CalAIM, our behavioral health continuum, infrastructure program Care, the Children and Youth Behavioral Health Initiative, behavioral Health, Bridge, housing dollars, just to name a few.
- Michelle Baass
Person
And really this proposal builds upon and complements those efforts and really addresses the remaining gaps, most notably housing workforce, and really the ability to serve those with substance use disorder needs. The Governor's proposal really is composed of two different bills, SB Three Two Six, which you're here to discuss, and then AB Five three One, which contains the General obligation bond to build out the behavioral health treatment and residential facilities and permanent support of housing units.
- Michelle Baass
Person
Just to highlight some of the key changes with regard to SB Three Two Six and the Mental Health Services Act, we are renaming it the Behavioral Health Services Act just to really recognize that these dollars can be used as a tool by counties to serve those who have just substances, use disorder needs. We are also reimagining how those local dollars so most of the MHSA or BHSA dollars go directly to our county partners and how those dollars must be sent.
- Michelle Baass
Person
So we have now a housing intervention bucket, where 30% of the local revenues will be deposited to be used for housing interventions, such as rental subsidies, operating subsidies, shared housing, 35% of the local dollars for full service partnerships.
- Michelle Baass
Person
This is really a whatever it takes approach to serve individuals with behavioral health conditions and really standardizing what FSP means at the county level and providing some levels and standards of care based on acuity and needs so that we can understand kind of it's an apples to apple comparison across the counties on what FSP means. And then 35% for behavioral health services and supports. And this is where the early intervention dollars will be.
- Michelle Baass
Person
This is 50% of our BHSS pot is for early intervention, and then some of the changes that we've had recently with that 51% of those dollars be directed for children and youth. And then we've also provided the ability for counties to move dollars between these pots depending on their local planning needs, depending on stakeholder engagement at the local level.
- Michelle Baass
Person
And really reflecting some of the conversations we've had in the recent weeks with regard to counties needing some flexibility to move some of the dollars between these two pots. And then just to maybe kind of quickly conclude, one of the other key pieces as part of our proposal is really to rethink how counties plan for their MHSA or BHSA dollars. Today, that three year planning process is focused really only on Mental Health Services Act Dollars.
- Michelle Baass
Person
Under this proposal, we are proposing a county integrated behavioral health plan where counties will really pull together all of their community behavioral health funding and programs. So this includes Medi, Cal, Realignment, some of the federal block grants in addition to BHSA, and we'll include many more partners who are really contributors to this space, who really have a role in helping individuals with behavioral health needs.
- Michelle Baass
Person
So now Continuums of Care, for example, Area Agencies on Aging, Child Welfare, really how do we pull together all of the different entities and community based organizations and organizations that really have an understanding of their communities and what works in their communities to define what a county's integrated plan will be for the next three years.
- Michelle Baass
Person
And then finally, as part of that, also requiring a lot more reporting at the county level on the dollars that go into the community behavioral health system, how those dollars are used, what's in reserve, what still needs to be spent. So we have a comprehensive understanding for here's the three year plan. Here are the state goals and the local goals. How did you use those dollars to achieve the metrics or outcomes that we're all working to achieve? I'm here to answer any questions. Thank you.
- Myles White
Person
Myles White with the business, consumer services and housing agency. Just to briefly supplement the Director and senator's points here. Really the tremendous resources that we put to bear at the state level on homelessness and housing, permit supportive housing, really the full kind of spectrum of supports that are necessary, right, to make these long term viable units.
- Myles White
Person
Whether it's homekey or other countless no place like home units throughout the state that we've really seen targeted long term success that's really going to be augmented here by these incredible amount of resources on an ongoing nature that I know this committee and the Legislature have prioritized efforts to continue to put the state's resources to bear and to scale our progress. Thank you.
- Buffy Wicks
Legislator
Good afternoon, chair and Members. Tara Gambo Eastman with the Steinberg Institute in support.
- Buffy Wicks
Legislator
Thank you. Let's go to additional folks in the room wish to express support for the Bill name, organization and position, please.
- Nico Molina
Person
Nico Molina on behalf of the Silicon Valley Leadership Group in support. Thank you.
- Marina Wiant
Person
Marina Wiant, with the California Housing Consortium in support.
- Moira Topp
Person
Good afternoon. Moira Topp on behalf of the Big City Mayors Coalition. It's the coalition of mayors of the 13 largest cities in the state. Ask for your aye vote.
- Alexis Rodriguez
Person
Alexis Rodriguez of the California Medical Association in support.
- Rand Martin
Person
Madam chair Members, Rand Martin here on behalf of Big Brothers Big Sisters of California, in a support if amended position. Thank you.
- Lizzie Cootsona
Person
Good afternoon. Lizzie Cootsona here on behalf of the San Francisco Mayor London Breed, the City and county of San Francisco board of Supervisors, Beverly Hills Mayor Julian A. Gold, and the city of West Hollywood in support. Thank you.
- Chione Flegal
Person
Good afternoon. Chioni Flegal with Housing California here in support.
- Chris Martin
Person
Chris Martin on behalf of the Corporation for Supportive Housing and the National Alliance to End Homelessness in supportive...
- Mark Stivers
Person
Mark Stivers of the California Housing Partnership in support. Thank you.
- Ross Buckley
Person
Good afternoon. Ross Buckley, on behalf of Sacramento Mayor Dale Steinberg, in support.
- Caroline Cirrincione
Person
Caroline Cirrincione, on behalf of the League of California Cities, in support.
- Nur Kausar
Person
Nur Kausar on behalf of the Sacramento housing alliance. We represent over a dozen nonprofit, affordable housing developers in the Sacramento region. In support.
- Unidentified Speaker
Person
For the Greater Sacramento Urban League. In support.
- Sharon Gonsalves
Person
Sharon Gonsalves on behalf of the cities of Bakersfield and Carlsbad in support.
- Kyra Ross
Person
Good afternoon. Or evening. Kyra Ross, on behalf of the Mayor Lincoln and the city of Stockton in support.
- Andres Ramirez
Person
Good afternoon. Madam Chair and Members Andres Ramirez, on behalf of the cities of Oakland, Berkeley, San Leandro, Emeryville, Palo Alto, Tracy and Compton, as well as the mayor of Half Moon Bay, all in strong support.
- Richardson Davis
Person
Hello, everybody. Richardson Davis with the California alliance of Behavioral Health Agencies. We have a neutral position on the Bill. Thank you.
- Buffy Wicks
Legislator
Thank you. We will now go to primary witnesses in opposition.
- Danny Thirakul
Person
Hello. Thank you. Good afternoon, chair and committee Members. My name is Danny Thirakul with the California Youth Empowerment Network and with Mental Health America of California. I'm a peer transition age youth as well as a family Member. I'd like to first thank the Administration staff and committee for working with some stakeholders on amendments. We have submitted amendments that would increase the peer voice, ensure that youth can access mental health services, and encourage peer led services. That being said, we remain in opposition to SB 326.
- Danny Thirakul
Person
California is facing a housing crisis. People cannot access affordable housing, and the state needs to make meaningful investments to reduce the number of unhoused residences in the state. This should not happen at the expense of people living with a mental health challenge losing services. This narrative that mental and behavioral health challenges causes homelessness is false. We heard from Dr. Kushal and her statewide study of people experiencing homelessness at last week's informational, hearing that mental and behavioral health challenges are a symptom of homelessness.
- Danny Thirakul
Person
If we are to work together to address the housing crisis, the state should hold local municipalities accountable for the billions of dollars already allocated to build the required housing for Low and very Low income earners as identified in the regional housing needs allocation process. The state has already invested billions of dollars towards numerous housing programs without the appropriate oversight or intended outcome. Let's make sure that the money spent are being spent effectively. The Mental Health Services Act funds should not be reallocated.
- Danny Thirakul
Person
The funds should continue to serve our most vulnerable populations with a serious mental illness so that it can receive the supports and services they need, including housing interventions which are already allowed and available in full service partnerships. Diverting 30% of mental health services Fund from housing interventions to address encampments will result in significant reductions of accessible, culturally responsive, community based services. We urge this committee to examine the true cause of the rise in homelessness.
- Danny Thirakul
Person
Without a thorough and comprehensive plan, we risk the same outcomes we are currently attempting to resolve. Please vote no on SB 326.
- Katy Sommerfeld
Person
Hello everybody. My name is Katy Sommerfeld, and respectfully I ask that everybody please listen to what I have to say. I am a proud peer with lived experience with mental health diagnoess and I work at CAMHPRO, the California Association of Mental Health peer run organizations.
- Katy Sommerfeld
Person
When I was in a deep depression contemplating my own suicide five years ago, I finally got help through peer support and after working professionally in behavioral health and mental health spaces for over more than ten years, and after going through intensive outpatient treatment, I was surprised I didn't know more about peer oriented recovery. Without peer support, I don't know if I would be here today. The impact was so profoundly positive, I followed up with training to become a peer support specialist myself.
- Katy Sommerfeld
Person
Stigma runs deep in the mental health profession, but the MHSA made it possible for me to give back with a meaningful and purposeful career in mental health without feeling stigmatized. We need peer programs, but they could lose funding under this Bill. It's way overdue for the Administration to consult and collaborate with and hear the peer community.
- Katy Sommerfeld
Person
I was encouraged to hear the Administration did meet with a group of peers last week and I do hope that the amendments suggested by peers, especially related to peer oriented recovery, are added to this Bill. We are the very community that these changes are purported to target and help. Peers have developed a strong mistrust of this Administration because we haven't been brought to the table to shape policy. In its current form, this Bill will cause people like me to lose the life changing, life saving opportunities of true empowering recovery services.
- Katy Sommerfeld
Person
Going forward with these proposed changes will set us back decades on how we treat people with mental health and behavioral health challenges. It took over a decade of advocacy efforts and community organizing to pass Prop 63 and it should not be dismantled under the guise of modernization in a matter of months. I strongly oppose SB. Three, two, six.
- Buffy Wicks
Legislator
Thank you for your testimony. We will now hear from other folks in the room who wish to express opposition. Please name, organization and position.
- Susan Gallagher
Person
Susan Gallagher, Executive Director, Cal Voices. Nobody's talking about the people who are being deprioritized. Thank you. In opposition if I didn't say that.
- Nora Lynn
Person
Nora Lynn, on behalf of Children Now we're in an opposed unless amended position.
- Kimberly Lewis
Person
Kim Lewis with the California Coalition for Youth, also in a regretful opposition unless amended position.
- Rachel Bhagwat
Person
Hi there. Rachel Bhagwat with ACLU California action respectfully opposing this Bill. Thank you.
- Nicole Wordelman
Person
Nicole Wardelman, on behalf of the Orange County Board of Supervisors with a concerns position and on behalf of the Children's Partnership with a support if amended position.
- Michelle Baass
Person
Andrea Rivera, on behalf of the California Pan Ethnic Health Network in oppose unless amend position.
- Isabeau 'Izzy' C. Swindler
Person
Izzy Swindler, on behalf of Kern, Nevada, Solano County Board of Supervisors with a position of concerns and in terms of Fresno County Board of Supervisors with an opposed unless amended position. Thank you.
- Paul Simmons
Person
Hi. Paul Simmons with the Depression and Bipolar Support Alliance of California in strong opposition.
- Debra Roth
Person
Deb Roth with Disability Rights California in opposition. We did meet with the Administration last week. We look forward to further conversations about amendments. Thank you.
- Buffy Wicks
Legislator
Do we have tweeners? Okay? We'll do tweeners now.
- Jolie Onodera
Person
Good afternoon, Madam Chair and Members. Jolie Onodera with the California State Association of Counties. CSAC and several of our county partners have submitted a letter outlining the amendments that counties are still seeking to address to address our concerns.
- Jolie Onodera
Person
With the loss of funding to core services to address volatility, as well as to secure some necessary fiscal protections for counties, I would like to thank the engagement to date of the Administration and your committee. Specific to your committee, we are seeking some more flexibility in the housing interventions bucket and specifically some amendments to expand the eligible uses of the funds to include housing support and on site services that we think are desperately needed for this group. Thank you.
- Sarah Dukett
Person
Sarah Dukett, on behalf of the Rural County Representatives of California with a position of concerns, echoing the comments of CSAC.
- Chris Lee
Person
Chris Lee, on behalf of the urban counties of California, also echoing CSAC's concerns.
- Lisa Gardiner
Person
Good afternoon. Lisa Gardiner with a county Behavioral Health Directors Association. We align our comments with those of CSAC and have a position of concerns. Thank you.
- Patricia Wentzel
Person
My name is Patricia Wentzel. I'm the odd person out, I'm just here representing myself. Although I am an appointed Member of the Sacramento County Mental Health Board, but I'm speaking only for myself. I echo the CSAC concerns in Sacramento County. The need for flexibility in the housing bucket is significant, and we will not be able to effectively use those housing dollars given the way the Bill is structured now.
- Buffy Wicks
Legislator
Thank you. Thank you. We will bring it back to committee for questions.
- Susan Talamantes Eggman
Person
Madam Chair, if I could just say, because there's a lot of I'll talk about we're taking out peer support. We're not taking out peer support. Right. I mean, every funding stream that we have sent down has money for peer support. This simply says it's not mandated in the same kind of ways. And again, just to remind Members that the planning is still done on the local level, right. And people will have inputs into their own counties about what services will be provided. Just to say that.
- Michelle Baass
Person
Thank you. We'll go to Ms. Quirk-Silva and then Mr. Ward.
- Sharon Quirk-Silva
Legislator
Thank you, Senator, for bringing this forward. You as the author brings a lot of respect, as I know this has been your life work. I do have questions, particularly about the housing part, the 30%. As you know, I'm a strong advocate for housing. My concerns are two or three things. So if you could just address them. It's been mentioned that some of this money could be used for additional home key type of style housing. And I guess my big question is I'll just take Orange County.
- Sharon Quirk-Silva
Legislator
We only had four applicants out of 34 cities to take advantage of that program. So how do we ensure with taking 30% now, using this from the current budget, that we can even cross that finish line when we know what we've all endured of just housing production as a whole?
- Sharon Quirk-Silva
Legislator
And then when you kind of put this element on it so that we don't go back to kind of the institutional type of housing, but we can clearly continue to build or create creative models of housing for this population.
- Sharon Quirk-Silva
Legislator
So if you can just address the Nimbianism and then was mentioned just here today, which is this regional housing that we still have fights even about that, where we have some cities who strive to get to their goal and others who just sustain it and won't even work towards that spirit. So, in essence, the big question is, even if we are set aside this type of 30% funding, what is your vision on how we can actually attain that?
- Susan Talamantes Eggman
Person
Yeah, thank you, Assembly Member, and thank you for your longtime support on this issue. I know it's very dear to you. I don't have the magic answers. I mean, we all have to come up with those magic answers about how we're going to get all this housing built. I'll say the bond part of this does not, but it goes on the ballot next year. And so by the time that money gets allocated, we're going to probably be at least a year out, probably two.
- Susan Talamantes Eggman
Person
And that gives, I think, counties time to plan and the state time to help with that, because that's part of what we're saying is the county shouldn't have to do it all and then us get angry because they're not doing it right. We should take a larger planning role in setting those priorities and helping. So I don't have the magic ball about how we're going to make sure it's equitable across all regions.
- Susan Talamantes Eggman
Person
But I know this Governor and this Administration and this Legislature is very key on really finding creative ways to make sure that housing is built. I think these new cottages and villages styles will be different than trying to redo a hotel because there's always a lot in my own community, right? A lot of pushback on those, because I envision a lot of these, like around our own county hospital, that there's a lot of space out there, right? A lot of services out there.
- Susan Talamantes Eggman
Person
So I would envision them already being built around places that have capacity. That's in my thought, I think I'd ask the housing person how better to answer that, but I hear you. It's going to be ongoing work for all of us, and the bond part will be for that construction. This would just be for the ongoing operations and care.
- Myles White
Person
Thank you, Assembly Member, I think you really hit on the crux of what we hope this proposal can achieve. So to your point, Orange County and other counties across the state, ultimately, the consistent theme that we've seen through homekey, even with its success last several years, record amount of units provided long term 55 year covenants that we have for these properties. One of the challenges we've witnessed consistently is the level of ongoing operating supports that would be necessary for this deep level of affordability we're seeing really is the critical limiting factor often.
- Myles White
Person
So when we're looking at a lot of the efforts that the Legislature is committed to with streamlining and ultimately the level of capital dollars that we're putting out there, that is always really limited by the fact of how much resources we can for the ongoing supports necessary. So these dollars that would be made available ultimately are augmenting our approach that we've seen successfully with homekey.
- Myles White
Person
With homekey, for example, we provide initial three years of operating subsidy, but at the same time, all of our competitive dollars we underwrite to look at what jurisdiction can provide ongoing supports, we want to incentivize that. So these very features here braiding the supportive services and the level of housing investments this Legislature, through the budget and Administration have really prioritized, really provides that solution that we hope to really scale in the coming years with this proposal.
- Buffy Wicks
Legislator
Mr. Ward.
- Chris Ward
Legislator
Thank you. I want to echo as well my faith that this author has had for several years working on better approaches when it comes to mental health and behavioral solutions. That gives me a lot of comfort in addressing some of the local concerns I've heard, and I just wanted to articulate those two and see if there was some response from UN Administration. The concern that we might be redistributing existing funds that are going to certain functions and services right.
- Chris Ward
Legislator
Whether it's outpatient care, crisis care, peer support, other activities that are reaching people right now. And I'm wondering how well I guess this depends on how well we're tracking those outcomes at the statewide level. Do we know how many hundreds of thousands of clients are supported through all of that? And then that shift that goes now to be able to provide more of an emphasis towards housing solutions which we need, and I think I would also argue are a greater importance of investment.
- Chris Ward
Legislator
But what might that come to, what expense? Right? And if these services and these outcomes here are now at risk, what's that trade off there? Right? I was hopeful that generally we think about solutions that are going to grow the pie, right. So that we're adding value over here. We're not robbing Peter to pay Paul and we're sustaining the level of service that is needed on an ongoing basis.
- Chris Ward
Legislator
And I wondered if you can kind of talk about that careful balancing, hopefully through evidence based outcomes and monitoring so that we're not unduly shifting something that's going to cause a problem.
- Susan Talamantes Eggman
Person
Right. I'll address that, try to address it from the housing perspective since we're in housing committee. But I know your question is more broad than I think what has happened in the last few years? So when the MHSA money first came down, right, it was the biggest, easiest pot for counties to be able to use and kind of a new influx of money right before services had been paid for kind of as they go from state funded. So this was like a whole new right.
- Susan Talamantes Eggman
Person
So people are like, oh, be innovative, do this, do that. But what we didn't do at that time, again, which is better, we know better now, is we didn't kind of bring some of that up to the state to really develop. And people don't like you to say, right, that the things that we actually know that really work that are evidence based, even if that's clinically evidence based or if that's community evidence based, there's a lot of ways to think about innovation, right.
- Susan Talamantes Eggman
Person
A lot of money we put towards innovation. But some of the things that we know now can be globalized to a larger community. Like say, let's just say, for example, San Diego County is doing a fantastic job, but Siskyou County not so much, right? They're a smaller county, less resources. And right, currently we don't have a system in which we know, oh, this is working really well here, perhaps we can take these models. We don't have to hire experts, we already have those.
- Susan Talamantes Eggman
Person
So that's part of what we're talking about is a state taking a larger leadership role and being able to say, here are things that could work with this population, this population, this population, since they're already more standardized, to try to make things more streamlined and direct and really count the money. Also, what the Director talked about is before we were just looking at behavioral health MHSA dollars and not all the other dollars that are going in, so it was very hard to see.
- Susan Talamantes Eggman
Person
How successful are we being now with our advisory committee? We're going to have a look at all of that to be able to actually track that. And again, another thing that's changed historically, none of the services that are currently paid for in the MHSA were paid for by any other means. Now there are a lot more ways to pay for those services. Again, people before couldn't go to counseling if they didn't have health care.
- Susan Talamantes Eggman
Person
Almost over 80%, I think it's only 8% who don't have some kind of health care. The work we did around schools, to be able to have schools have therapists come in and Bill for it that way. The CalAIM program we developed, the Youth and Child Behavioral Health, that we stood up a lot of new resources that have come down and also to be able to now that CMS has provided a lot more guidelines.
- Susan Talamantes Eggman
Person
California has been able to apply for every waiver that comes so we can pull federal dollars down to supplement our state dollars and meet the same money. Right now it's just state money. We should be able to for the services. And that's what we said to everybody who says our stuff is going to get cut. Tell us what your stuff is, because there could be another way that we can bill for that. We're not saying things should go away. We're saying we should reprioritize.
- Susan Talamantes Eggman
Person
What's the best use of the greater taxpayer dollars at this point? And as far as the Pot. I'm a good Democrat, I don't mind making the Pot bigger. But we're not in that situation right now. And so we're going to work with the Pot that we have. But we do know that during the last few years that has been a lot of hard on. A lot of Californians, very wealthy Californians, have done exceptionally well, right? So it used to be just a couple million dollars that's going into BHSA.
- Susan Talamantes Eggman
Person
Now it's billions that goes in every single year that we should be able to have a lot more successes to show for that. And I think this kind of marshaling of all of our resources and putting all heads together, making outcomes much more transparent, that anybody will be able to go on and see still leaving decisions at the county level, but them being more help facilitating from the state level with more consequences if people are outside of the line. So we think this is modernization.
- Susan Talamantes Eggman
Person
I know it's hard. I know some of the groups are concerned about their funding. Again, we don't think things necessarily need to go away, but be paid for in a different type of way. That's my answer to you. Is that helpful?
- Chris Ward
Legislator
Very helpful. And I'm very encouraging about the thoughtfulness that is going through that. I particularly like that there could be, if and as this is implemented, more intentional work to be able to work with some of these local organizations to help them with grant assistance and support that they would need to be able to find other resources. I like the commission aspect here that would be able to be charged with doing a lot of this work too.
- Chris Ward
Legislator
And I think it's important as things would be implementing right, that there's more flexibility at the front end right now. And so to CSAC's points and some of the things that counties let's make sure that flexibility is built in that can maybe change over time towards a more perfect ratio and more defined goals.
- Chris Ward
Legislator
But to change programs so drastically just in year one and be so abrupt about it might cause some implementation hiccups and the end result is Californians that are left without the support that they need and suffering while we're building all that up. But I do appreciate that we need to do more in housing solutions and I know that this can get us towards that.
- Chris Ward
Legislator
And by growing the pie though the bond, which proposed through a different Bill over there, at one point these were linked and they're today not linked, is that correct? This Bill is not conditional on the passage of the bond.
- Susan Talamantes Eggman
Person
That's correct.
- Chris Ward
Legislator
Passage of the ballot, though.
- Chris Ward
Legislator
Passage of the whole passage of the ballot, right. And so if that would have helped to grow the resources right, to ensure effective implementation of these changes under this Bill, why did you decide to go ahead and sever that?
- Susan Talamantes Eggman
Person
Well, they're attached in the same ballot initiative, right?
- Chris Ward
Legislator
But one's not conditional on the other or they are. I thought the amendments from August 15 removed the contingency.
- Susan Talamantes Eggman
Person
Our understanding is it's one ballot measure. There was some talk about making the same Bill, making it two bills, but my understanding is it is one ballot measure unless the Administration tells me on that. But we can get more clarification.
- Chris Ward
Legislator
I'll keep monitoring this and I'll be very happy to support this today. And obviously we want to get this right and I know that you're the right author to be able to help us get there.
- Susan Talamantes Eggman
Person
Thank you. You'll take it on after I leave.
- Buffy Wicks
Legislator
My understanding is they are linked. I believe so, yeah.
- Michelle Baass
Person
Mr. Patterson. And then Mr. Collar.
- Joe Patterson
Legislator
Great, thank you so much. Just wanted know, obviously there's a long hearing on this and a long discussion about this. Just a comment I wanted to make and I've referenced this in this committee before. First of all, I want to say that I think people with substance use disorder deserve a chance to be successful and get out of the situation that they're in.
- Joe Patterson
Legislator
Obviously, I do have concerns generally with housing first policies and I'll say why. There's a shelter locally, actually that has had a lot of success getting women and children into permanent housing. 96 this particular place, tens of thousands of women have been helped 96% of them have received who've gotten on the job training have gone on to get non subsidized employment afterwards and 75% of the women and children who have gone through their program have found stable and permanent housing after.
- Joe Patterson
Legislator
And so it's just generally speaking, we should be promoting also situations like that. They don't allow, for example, substances because they have children within their home, within their shelter and significant actually about half of them are children. And so I understand why they would want to not have substances on their property. And so it concerns me that we can't help somebody like that with various funding sources and especially with a proven successful track record.
- Joe Patterson
Legislator
It's a great program here and obviously I know that you wouldn't want to exclude or I think you wouldn't want to exclude helping a great program like that. But that's what concerns me generally with the Housing First concept and I know it's well intentioned but I'd also like to see programs with proven track record of success move forward but appreciate your leadership on this issue and a lot of conversations obviously I'm sure will occur in the next few weeks, so thank you.
- Buffy Wicks
Legislator
Mr. Kalra.
- Ash Kalra
Legislator
Thank you Madam Chair and thank you Senator for your continued diligence on this important issue. I agree with the sentiments of other colleagues that you've definitely taken on this most challenging issue and put your heart and soul into it as well as your expertise and I think we all appreciate that. And to the Chair's point, I think my understanding is that it would be on the same ballot with the bond. SB 531 with the bond initiative would all go on one ballot.
- Ash Kalra
Legislator
So there's a funding piece along with it. Then the voters can kind of see a comprehensive kind of picture as well as and I do appreciate the amendments taken regarding the Housing First philosophy which I think is really important. I think that again, the issue that I think that arises in conversation about that is just the competing interest aspect, right? Whether it's the housing dollars, the services dollars.
- Ash Kalra
Legislator
I think that a lot of the concerns raised from counties is a lot of the unknowns and I think part of it and I am glad to hear, I know I think a lot of folks, myself included, probably would have appreciated a little sooner but I'm glad to hear the Administration is starting to have those conversations. I think when the MHSA was done there were months long conversations bringing in stakeholders, bringing in providers which hasn't necessarily happened from the Administration standpoint.
- Ash Kalra
Legislator
So I think in this case it is better late than never in that at least those conversations seem to be happening. I do share concerns expressed by some of the counties and disability rights organizations, Disability Rights California as well as some of the other organizations.
- Ash Kalra
Legislator
But I do hope that in the final days, which is sometimes how it happens, there could be some understanding and some sense of comfort as to the concerns that many share regarding those programs that are working, making sure that we're not disrupting what is working. Because I think that's kind of the challenge is that you have this it's great to have the state support what's happening on the ground, what the counties are doing, what the organizations are doing.
- Ash Kalra
Legislator
But there's also a downside of the state coming in and say, we want you to do it this way. I don't believe that's your intention, but sometimes that happens, whether it's our intention or not. And so hopefully these continued conversations can get the language to even more make it even more clear on how we will go about protecting those programs and those mental health services that are working and the housing programs and housing services that are working.
- Ash Kalra
Legislator
I know that a Bill doesn't necessarily allow legislation doesn't necessarily allow for or should have that great degree of specificity in it, but there needs to be some of that flexibility or some sense that there will be a process in determining how those that have legitimate concerns about programs that are working on the ground, whether it's housing services, wraparound services, mental health, substance abuse services, that they won't get disrupted in their work, because I don't think anyone wants that.
- Ash Kalra
Legislator
Although I was kind of coming in here thinking I was going to abstain, I'm actually going to vote for it as a courtesy to allow the conversations to continue, particularly in regards to now it seems like the Administration is talking to some of those that have expressed concerns over several months. And so I'm encouraged by that and we'll give the opportunity to see how those conversations and discussions go.
- Buffy Wicks
Legislator
Mr. Gabriel. We have a motion. We have a second. Any other questions? Would you like to close?
- Susan Talamantes Eggman
Person
It seems like you've all had a long day and I would ask for your aye vote on this important piece of legislation.
- Buffy Wicks
Legislator
Thank you Senator. Really appreciate your leadership in this space. For years you've been a tremendous leader for us. And obviously the aim of this Bill and a lot of the work that you do is to really help our most vulnerable folks who desperately need the help. I think this Bill has the potential to help people experience homelessness and get access and maintain housing, which is obviously something I care deeply about.
- Buffy Wicks
Legislator
I think the long term we really need to think through how we're going to Fund supportive housing and adequate services and the operating funds that go with that. I think we have to realize this is going to be a very long term investment of public funds, which I think is critical. We know that the existing resources are not sufficient and I know that's come up quite a few times. I fully support more funding for housing, have a $10 billion bond I'm trying to move through.
- Buffy Wicks
Legislator
So we know that a lack of affordable housing is the number one reason people fall into homelessness to begin with, so we have to increase the supply. So with that, I'm happy to support the Bill today. I know there's still work to be done on it, but we want to make sure we continue to have those conversations. With that, we have a motion and a second and take the roll.
- Buffy Wicks
Legislator
Motion is due pass, and we refer to the Committee and appropriations. Wicks aye. Patterson? Carrillo aye. Gabriel aye. Kalra aye. Quirk-Silva aye. Sanchez not voting. Ward aye.
- Susan Talamantes Eggman
Person
Thank you all.
- Buffy Wicks
Legislator
Six. That Bill is out. Six to zero. And we will adjourn.
Committee Action:Passed
Next bill discussion: September 8, 2023
Previous bill discussion: August 22, 2023
Speakers
State Agency Representative