On May 19, voters will be presented with a handful of propositions designed by the state Legislature to help close California’s $42 billion deficit.
Two of those propositions—1D and 1E—directly impact programs in the state health care system. Some health-care experts are worried that the propositions’ passage would hurt more than it would help.
“The propositions have a major impact on the mentally ill and children—two of the most vulnerable populations in our society,” said Pat Wheatley, executive director of First 5 Santa Barbara County, which distributes tobacco tax money to local care programs.
Proposition 1D would allow the Legislature to redirect about $1.68 billion in California’s First 5 funding to other state health programs for children, according to documents on the California Secretary of State’s website, sos.ca.gov.
The funding reductions would come from First 5 programs at both the state and county levels, including a one-time move of $340 million from First 5 California, and five years of annual redirections of $268 million from First 5 California and First 5 programs in 58 counties.
“It would cut First 5 funding by at least 50 percent,” Wheatley said.
Since 1998, funding for First 5 has been guaranteed through Proposition 10 (the California Children and Families Act), which put a 50-cent tax on cigarettes and other tobacco products. But those funds won’t last forever, Wheatley explained, because “one of the intents of the act is to decrease smoking.”
And the act is working, according to the Secretary of State’s office. Based on current trends in tobacco consumption, the office estimates that future Proposition 10 revenue will decrease each year by about three percent.
The combined reductions in funding, Wheatley said, would lead to drastic cuts in local First 5 programs, some of which could even face elimination.
“Our programs act as a safety net for families, especially during hard economic times,” Wheatley said.
From 2007 to 2008, First 5 Santa Barbara County served almost 9,000 local children, family members, and health-care professionals.
And if 1D passes, Wheatley said, there’s no guarantee the money taken from First 5 programs would be redistributed to help children and families on the county level.
“When you read the language of [Proposition 1D], there’s no formulary or accountability to how the money will be spent,” Wheatley said. “That money would be redirected to the General Fund, and the Legislature would decide how to administer it.”
According to documents from the Secretary of State, under Proposition 1D, money intended for First 5 would be used to offset existing state General Fund costs by funding “other state health and human services programs” for children up to age 5.
In a recent interview with the Sun, Consumer Advocacy Coalition Executive Director Roger Thompson spoke out even more strongly against propositions 1D and 1E.
“Propositions 1D and 1E are both raiding propositions that go after money specifically required to fund mental health and children’s health,” said Thompson, whose coalition advocates for county residents living with mental illness.
If passed, Proposition 1E would amend the Mental Health Services Act—known to California voters as 2004’s Proposition 63—to transfer up to $460 million, over a two-year period, to mental health services for children and young adults.
The funds would be used to pay for the Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT), a federally mandated effort that requires states to provide medical treatment services, including mental health services, to Medi-Cal recipients younger than 21.
When explaining the Consumer Advocacy Coalition’s stance against Proposition 1E, however, Thompson called the proposed legislation “a little deceptive.”
“It’s easy to look at Prop. 1E as just taking funds from one mental health cause and giving it to another,” Thompson said. “But EPSDT is a mandated program. Even if Prop. 1E doesn’t pass, the program will get funded.”
According to documents from the Secretary of State, EPSDT funding costs about $1 billion each year. Half of the program is paid for by the federal government; the rest comes from the state and individual counties.
Thompson said approval of Proposition 1E would “destroy” the framework put in place by Proposition 63 by setting a precedent for increased future spending. Decreased funding for mental health programs, he said, would also put more of a financial strain on homeless shelters, social services programs, jails, and law enforcement agencies throughout the state.
Even so, many lawmakers see Proposition 1E as the only solution to the state’s budget problems.
In a written statement arguing in favor of Proposition 1E, State Sen. Darrell Steinberg (D-Sacramento), who co-authored Proposition 63, said he supported diverting funds from the Mental Health Services Act “only as a last resort to help balance the state budget this year.”
Still, other mental health advocates, including Thompson and Proposition 63’s other author Rusty Selix, believe the cuts would do very little to close the deficit.
“When you look at it, the impact of the $2.5 million is only about .25 percent of the budget,” Thompson said. “But three years from now, if 1E passes, there are going to be fewer mental health services available to Californians.”
Contact Staff Writer Amy Asman at aasman@santamariasun.com.
This article appears in Apr 9-16, 2009.