Advocates Hope Tax on Rich Will Fund MH Treatment

Ballot initiatives typically are a favorite tool for those trying to keep taxes low.

The famed Proposition 13, passed in California in 1978, restricted increases in property taxes and required that all state tax increases be approved by a two-thirds vote of the state legislature.

Now, however, California mental health advocates hope to use a ballot initiative to raise taxes—on the very rich.

The Campaign for Mental Health is proposing a tax surcharge of 1 percent on the taxable personal income above $1 million. State officials have estimated that the new tax would generate $680 million in 2005-06, the first year in which the program would be fully operational.

The funds, channeled through the state’s existing mental health system, would be directed to a wide range of services, including training and educational programs, but would be targeted primarily to those with severe mental illness or likely to develop it.

The effort has two major antecedents. In 2000, California voters passed Proposition 36, which stipulated that anyone convicted of simple drug use would be offered drug treatment, rather than incarceration. Money saved on incarceration—an estimated $120 million a year—is slated to be spent on rehabilitation.

The previous year, the state legislature passed AB 34, a pilot program providing funds for services to adults with mental illness who are homeless or at risk of becoming homeless or incarcerated. The New Freedom Commission on Mental Health cited it as a model program.

Both Assembly member Darrell Steinberg (D), who introduced AB 34, and organizers of the Proposition 36 campaign are key advocates in the Campaign for Mental Health effort.

Members of a coalition supporting the initiative include the California Psychiatric Association (CPA), NAMI-California, California Academy of Child and Adolescent Psychiatry, Mental Health Association in California, Service Employees International Union, American Federation of State, County, and Municipal Employees, and other advocacy organizations.

The California Council of Community Mental Health Agencies, which represents nonprofit organizations that provide mental health services under contract with county governments, is a key member of the coalition.

As described in the attorney general’s official description of the Mental Health Services Act, the initiative would fund outreach activities encouraging prevention; promote reduction in stigma and discrimination; and emphasize strategies that would reduce suicide, unemployment, removal of children from their homes, and other negative outcomes of mental illness.

It would provide funds to counties for services for children, adults, and seniors who have severe mental illness or are likely to develop it.

County mental health programs would be required to submit needs assessments identifying shortages in relevant professional and occupational categories to the Department of Mental Health, which would develop and fund a five-year education and training development plan.

The act would establish the Mental Health Services Oversight and Accountability Commission, which would review plans submitted by county mental health programs and their expenditures

The campaign has 150 days from the time the initiative was authorized by the state’s attorney general to collect 378,000 legal signatures for the initiative to appear on the ballot in November. Authorization occurred October 16, 2003.

Andrea Jackson, Steinberg’s chief of staff, said members of the campaign are confident of passage if the initiative makes it to the ballot stage and funding is available to get the campaign’s messages to the public.

Randall Hager, CPA’s legislative director, told Psychiatric News that CPA was encouraging members to host fundraising and petition-signing parties. He has developed materials that can be used at various levels of involvement

In February and March 2003, an opinion research firm conducted polls and focus groups to determine likely support for the initiative and to identify messages and themes that would promote passage.

The poll found that “when presented with a potential ballot title and summary along with a fiscal impact statement for an initiative that would provide comprehensive mental health care services to children and adults who suffer from a disabling mental illness, nearly two-thirds of voters (63 percent) support such a measure.” (Original article: See box for themes and messages that appealed to voters.)

Information about the initiative is posted on the Web at www.campaignformentalhealth.org. ▪