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San Francisco advocates and county officials urge change to Prop 63 allocation as city receives far less per capita
Summary
At a Board of Supervisors committee hearing, city behavioral-health leaders and advocates said San Francisco receives one of the lowest per-capita shares of Proposition 63 funding, called for formula changes that would account for homelessness and local investment, and described local programs funded by MHSA.
Supervisor Amiano convened a special hearing to review how Proposition 63 (the Mental Health Services Act) funds are being allocated and used in San Francisco. City and community witnesses told supervisors they support the law's goals but said the state allocation formula and administrative processes have left San Francisco with far less funding than expected.
Alicia Hopper, public policy coordinator at the Mental Health Association of San Francisco, said the city voted strongly for Prop 63 but has gotten a low share of the money. "We're getting 11.5; L.A. County is getting 183," Hopper said to illustrate per-year service allocations. She identified three problems with the state's allocation: heavy weight on total county population (which disadvantages smaller, high-need urban counties), an adjustment that counts local resources and thereby reduces MHSA allocations to counties that already spend local funds, and reliance on a single non-California prevalence study that underestimates San Francisco's need.
Dr. Bob Sabai, director of Community Behavioral Health Services, reviewed local uses of MHSA funding and operational constraints. He told the committee that the county has launched eight full-service partnership (FSP) programs across age groups, used MHSA dollars to hire consumer-peer staff, and set aside $9,000,000 for long-term housing units reserved for MHSA clients. Cleghorn noted legal limits on capital facilities spending, which generally restrict use to county-owned property and complicate housing capital projects.
Several providers described program-level outcomes and capacity limits. Kathleen Connolly Lacey, who runs a forensic FSP focused on people leaving jail, said three adult FSPs serve about 90 clients and reported large reductions in jail and homeless bed days for enrolled participants. Tracy Helton, CBHS consumer employment manager, said 16 MHSA-funded consumer employees now work at CBHS and that the county's consumer-employment pool has grown to roughly 62 positions.
Speakers urged stronger advocacy with Sacramento. Linford Gale, an Oversight and Accountability Commission member, said he has raised allocation concerns at the state level and urged revision of how prevalence and need are measured. Multiple witnesses and supervisors pressed for the state to factor homelessness and local prevalence into the allocation formula.
The committee did not adopt policy changes at the hearing; the chair directed staff to file the item and continue advocacy with state lawmakers and the Mental Health Services Act oversight bodies. The hearing organizers said they will seek follow-up meetings in Sacramento and return to the committee with additional information.
Next steps: staff will return with further information on the city's MHSA-funded programs, available and upcoming dollars, and potential legislative or administrative strategies to adjust the allocation formula.
