Budget Decisions Matter — Part II
As I mentioned in my June post, we are what we invest in when it comes to the budget, and the lead-up to the final budget vote entails putting dollars behind our ideas and values. The FY 22–23 budget largely does that — but it also failed to square a critical contradiction.
In January, the Board of Supervisors unanimously declared the soaring rates of mental illness and substance use disorders in the County a public health crisis. That same month, a majority of the Board voted to move ahead with the construction of a new jail, which I strongly opposed.
This vote translated to $689 million in approved budgetary spending for the construction of the new jail (which will cost at least $1.2 billion if bonds are later approved to cover the expenditure), plus another $10 million to pay off the current debt on Main Jail North — in contrast to only $6.3 million for new behavioral health facilities and services.
The contradictory investment in incarceration over public health will lead to commensurate outcomes. As the County continues with an absolute dearth of a continuum of behavioral health facilities, many of our community members struggling with mental illness lack access to the care they need. Instead, they are too often winding up in jail, where their conditions worsen and a vicious cycle of mental illness and incarceration begins.
Though our current three jails are indeed in poor condition, County-owned subacute mental health facilities (secure facilities designed for care for more than just a few weeks) are nonexistent. Emergency Psychiatric Services and Barbara Aarons Pavilion — a locked inpatient hospital facility for people in acute mental health crisis — are also in poor condition and backed up with people who cannot move to subacute facilities. The County pays dearly when people languish in Barbara Aarons Pavilion beyond their covered stays.
Investing in behavioral health over carceral facilities not only provides greater and much more urgent value to our residents, but it also saves public dollars. Treating substance use disorders costs a small fraction of what associated incarceration, victimization, and lost productivity costs. New behavioral health facilities could also draw new revenue to the County from insurance providers.
By focusing on the jail before behavioral health facilities, we may also be walking ourselves into a crippling financial burden if we are unable to sufficiently provide services mandated by CARE Court, Governor Newsom’s signature legislation. CARE Court is slated to be enacted into law later this summer and would place an even larger responsibility on counties for providing behavioral health treatment when judges direct people to such. As the bill stands now, Counties will face daily sanctions for failure to meet this responsibility.
For the vision of CARE Court to be successful, the county must invest much more in the professionals who conduct mental health evaluations in the courts, the people who connect defendants to services, in programs that are alternatives to incarceration for people with mental illnesses, in other myriad forensic professionals and in a continuum of facilities from secure locked to subacute to community basic care.
Many judges want to place people in treatment settings rather than jail, but their hands are tied without the county’s political and financial commitment to providing those alternative settings.
We cannot do everything at once. We don’t have unlimited capacity to take on debt and we must prioritize what to build and when. I carved out my objection to inclusion of the jail in the budget while still approving the budget overall, and look forward to the discussion of prioritization of Capital Improvement Plan projects planned for the September Board meeting. During those discussions and beyond, I will continue to advocate for investments of great and urgent value to all residents and consistent with our stated values.
We are what we invest in.
