California voters passed Proposition 1 last year to provide $4.4 billion for mental health and substance use disorder treatment. Those funds are headed to an existing $1.8 billion program.

But the California Legislative Analyst’s Office, or LAO, which serves as the state’s legislative watchdog, wants lawmakers to examine where that money is going first, before sending more out. 

Ryan Miller is an analyst with the LAO, and authored a report on the Behavioral Health Continuum Infrastructure Program – one of several initiatives aimed at increasing the state’s capacity for behavioral health services. He said about two-thirds of small counties are missing out on program funds — in part because it gives preference to launch-ready projects. 

“To have a launch-ready project, there has to be a lot of architectural work and engineering work,” Miller said. “For a small county, it seems to us like that could be really challenging for them to put together a compelling application that would compete with counties that might have more people and more resources.”

The LAO report said the program has not added beds for mental health or substance use disorder treatment in the Southern San Joaquin Valley region – which has the most need. 

But over half the beds that have been added are in the four regions estimated to have the least need – including San Diego and Los Angeles. 

Miller also highlighted that the program has focused the bulk of the funds to benefit Medi-Cal enrollees. 

“Medi-Cal enrollees are disproportionately facing mental health and substance use challenges, so we think that the funding has been well targeted in that regard,” Miller said. 

Sacramento County Department of Health Services spokesperson Elizabeth Zelidon said the county is using the money to open several new treatment centers and create dozens of new beds for adults and children. 

“Although the projects are funded, the services provided at these projects aren’t,” she added. 

The LAO is also asking lawmakers to push for more data on how the program is reaching underserved populations – including children, people with experience in the justice system and Native American communities. 

Adriana Ramos-Yamamoto is a health policy analyst with nonprofit California Budget and Policy Center. She said the dollar amount is part of the problem. 

“The investments that have been made — it’s simply not enough to ensure equitable access to behavioral health care services,” she said. 

Ramos-Yamamoto said the funds from the program won’t fix the state’s healthcare staffing shortage, or help enough people into housing — which there isn’t new funding for in Governor Gavin Newsom’s budget proposal.

Megan Myscofski is a statehouse/politics reporter at CapRadio. CapRadio is a partner of The Intersection and CVJC.