Questions « noprop1d1e.com

Both measures seek to undermine previous voter initiatives that dedicated new revenues to specific programs to help children and people with mental illness.

Before voters approved Prop. 10 in 1998, and Prop. 63 in 2004, the Legislature had all but ignored two critical needs: 1) reaching children in their vital, formative first years to ensure their health, safety and intellectual and emotional development; and 2) keeping the promise California made more than 40 years ago, when state mental hospitals were closed, to provide adequate community-based care for people with mental illness.

Voters stepped up and created new programs with new revenues to meet each of these long-ignored needs. And now, with Props. 1D & 1E, the Legislature and the Governor are trying to roll over what voters did to use this money to cover for their own failure to budget appropriately. These measures are some of the worst outgrowths of this year’s “budget deal.”

Do Props. 1D & 1E simply borrow funds from children’s services and mental health programs? Won’t they be paid back later after the fiscal crisis has passed?

NO, there is absolutely no provision in Prop. 1D or 1E for paying back the hundreds of millions of dollars taken out of both programs. The measures could have been written that way, but they weren’t.

The deceptive campaign in favor of these propositions has made that claim publicly, showing that they cannot win if they tell the truth about Props. 1D and 1E.

Do Prop. 1D & 1E save the state money?

By cutting funds available to children’s services (Prop. 1D) and mental health care (Prop. 1E), these measures add hundreds of millions of dollars to the state general fund. But almost all of the interventions that would be cut would normally save state and local governments much more money. That makes the “savings” from Prop. 1D & 1E an illusion.

Consider child abuse. Effectively intervening to prevent a child from being abused costs a fraction of the cost of dealing with abuse after the fact. Or the costs of untreated mental illness – a person who winds up hospitalized, jobless and/or homeless costs everyone more money than one who is treated effectively and living independently.

Only with the kind of crude, one-year-at-time budgeting that Sacramento is so good at can anyone pretend that Props. 1D & 1E save any money. In reality, they will be very costly measures if passed.

What is First 5, and how is it affected by Proposition 1D?

First 5 was established by California voters in 1998 when they passed Proposition 10. Prop 10 added a 50 cent/pack cigarette tax and targeted the proceeds to improving the health and development of children ages 0 – 5. Voters understood that the early years of a child’s life are often the most important – when their brains and bodies develop faster than at any other time. What happens during these years creates the foundation for their future success in school and in life.

Prop 10 established a First 5 commission in every county to identify the greatest needs faced by young children and invest in programs and services to address them. It also established a state level commission that works on statewide issues to improve the health and development of young children. First 5 commissions fund programs that the Legislature has failed to fund and that local communities now count on – programs that are preventing child abuse, improving the health of children, increasing immunization rates, providing quality preschool, and supporting the safety net for families in every county.

Proposition 1D will divert more than half of First 5’s revenues every year for 5 years to the state General Fund, taking away critical local resources and de-funding proven community-based programs for children and families.

How much money does Prop 1D take out of children’s services in local communities?

Prop 1D takes $268 million every year from First 5. This is more than half of the revenue that currently goes to counties to spend on critical local needs. In the first year, it also takes up to $340 million from the state First 5 commission – funds that are targeted to statewide efforts to improve the health and school readiness of young children.

Prop 1D gives the money to the Legislature and the Governor to use as they see fit for state programs. There is no assurance how the funds will be used in the future; state budget-writers have complete control over allocation of these funds on a year-by-year basis. Prop 1D states that the money will go to programs for children, but it goes to those programs at the cost of local programs that will lose their funding.

Is Prop. 1D essential to the “budget package” of initiatives on the May 19 ballot?

$268 million per year is a drop in the bucket for the state. It means a whole lot more to local communities than it does to the $________ billion state budget. Unfortunately, when the Governor and Legislature were looking for ways to fill their budget gap, it was easier to turn to voter-approved funds than to work out more meaningful and fair long-term solutions.

But doesn’t First 5 have billions of unspent funds sitting in bank accounts?

County first 5 commissions believe in managing valuable resources responsibly. That’s why they have multi-year budgets and – unlike the state budget writers – they ensure they have the funds to complete every project they start. Los Angeles Universal Preschool is an example. First 5 LA dedicated $580 million to countywide preschool expansion, to be implemented over a 10-year period. This creates the appearance of a large fund balance when, in fact, every dollar is allocated. Less than 6% of the current county fund balance is undesignated. These are the funds that make possible emergency expenditures, such as responding to natural disasters like last year’s fires in southern California, keeping provider organizations in business during state and county fiscal cut-backs, and expanding and stabilizing safety net programs to assist families suffering from the failing economy.

The ballot description says Prop. 1D provides more than $600 million to protect children’s programs in difficult economic times. Why wouldn’t we want to vote to protect children’s services?

We do want to protect children’s services – but not at the expense of other children’s services. Prop 1D takes money from local services that are determined by local decision-makers, based on the needs of local communities, and puts it into statewide “top-down” service bureaucracies.

It is sad that the Legislature used such deceptive language to describe Prop 1D. They conveniently overlook the crippling blow Prop 1D will deal to successful local services, including many of the state’s most effective prevention programs.

Why is a “temporary redirection” of revenues under Prop. 1D so threatening to First 5?

Prop 1D takes First 5 dollars from local communities every year for 5 years. That’s more than half the lifetime of most First 5 commissions. And if the Legislature and Governor succeed is raiding more than half these voter-approved funds this time, what’s to keep them from taking the rest the next time the state faces a cash crunch?

An equally great threat is the way Prop 1D will take the money. It fills the state’s coffers before any money goes to the counties. Currently First 5 Commissions receive and spend tobacco taxes on a monthly basis. Prop 1D will force first 5 commissions to wait 6 months or longer each year to receive any of their funds.

What else does Prop 1D do to change First 5?

Prop 1D changes what First 5 Commissions can fund forever – not just during the 5-year diversion period – threatening many of First 5’s most significant investments. Prop 1D requires First 5 revenues to be used for “direct services,” even though direct services are only one aspect of First 5’s investment in children. Among First 5 investments at risk:

• Developing and renovating facilities for preschools in underserved communities. First 5 provides one of the few sources for upgrading facilities to expand access to preschool and quality child care in urban and rural communities alike.

• Training preschool teachers and child care providers. First 5’s investments in provider training and education has resulted in some of the highest quality early education in the nation.

• Funding Children’s Health Initiatives, which provide the state’s largest and most stable source of health insurance to low income children ineligible for other programs. Because of CHIs, more than 80,000 children have obtained access to insurance and regular health care, nearly a fourth of them under the age of 6.

• Training and recruiting dentists and other health professionals. First 5 addresses the dearth of pediatric dentists and other medical specialists through a variety of training and recruitment strategies. First 5 also funds facilities – from mobile vans to multi-county clinics – to meet pediatric health and dental needs.

• Leveraging funds and coordinating services for young children. First 5 revenues leverage millions of federal Medicaid dollars for activities that make programs run more efficiently. These activities – and these federal dollars — will be eradicated by Prop 1D.

Why doesn’t First 5 want to help with the state’s budget crisis?

First 5 commissions – at the state and county levels – have always been committed to helping solve the State’s budget problems and keeping the safety net in place for California’s most vulnerable children and families.

• In December, First 5 commissions contributed more than $16 million to fund the State Healthy Families insurance program when it faced a shortfall due to the state’s budget problems.

• In January, First 5 commissions offered further voluntary contributions to state programs at risk during the budget impasse.

Still, in the waning hours of the budget discussions, Governor Arnold Schwarzenegger and legislative leaders folded First 5 revenues into the final budget deal and – at the whim of one legislator — went even further to change how First 5 commissions can use their funds, undermining some of the most important investments First 5 is currently making – like training preschool teachers.

Which specific programs will be harmed by the cuts that Prop 1D will make?

More than 860,000 children received services funded by First 5 last year, most of them oriented toward prevention and early intervention. Prop 1D will force every First 5 commission to go back to the drawing board to figure out what to cut. Among the children at risk:

• 140,000 children in low-performing school districts participate in kindergarten readiness programs, including home visiting, family literacy, developmental screening, and summer pre-kindergarten “bridge” programs.

• 187,000 children receive oral health treatment — from fluoride varnish to extensive treatment of decay — most in communities that have no other resources to serve these children.

• 80,000 children have health insurance because of investments made by First 5, nearly a fourth of them under the age of 6. Tens of thousands more are enrolled in Healthy Families and other insurance programs because of the outreach and enrollment activities of First 5-funded Children’s Health Initiatives throughout the state.

• 11,530 children are in high quality preschool spaces funded solely with First 5 funds.

• 10,818 children are in preschool spaces that have been improved (through facilities grants, teacher training, curriculum support, or teaching assistants) with First 5 funding.

• 29,000 children receive well-child visits and immunizations through community clinics, health fairs, and preschool visits funded by First 5.

• 125,000 children annually are screened for developmental delays and receive follow-up intensive services for their special needs if warranted.

• 22,000 newborns and their mothers receive home visits that encourage breastfeeding, enhance parent-child bonding, and reduce the need for return visits to the hospital.

• 13,700 children and their parents participate in education and therapy programs for families at risk of child abuse and foster care placements.

Prop 1D will undermine one of the few efforts in California to fund prevention strategies that eliminate long-term and costly problems, saving the taxpayer money. When times are tough, prevention funding is the first to go. Prop 1D will only worsen future budget problems.

What is Proposition 63, and how is it affected by Proposition 1E?

Voters approved Prop. 63, the Mental Health Services Act, in November 2004. It creates and expands new and innovative mental health programs for children, young adults, adults and seniors. Services are paid for with a new tax surcharge of 1% on all personal income above $1 million. Prop. 1E takes almost a half billion dollars out of the revenues generated by Prop. 63’s tax surcharge. These cuts will halt the build-out of Prop. 63 programs, which reach out to new children and adults every day. Services to current clients will inevitably be cut. The revenue source is dropping off with the slowdown in the economy, magnifying Prop. 1E’s damage to future services by redirecting Prop. 63 funds.

How much money does Prop. 1E take out of mental health care?

The proposal would take $226 million in FY 2009-10 and up to $234 million in FY 2010-11 out of the Mental Health Services Fund established by Proposition 63. This is nearly a half billion dollars over two years.

Is Prop. 1E essential to the “budget package” of initiatives on the May 19 ballot?

No. The first three propositions (1A-1C) have the greatest budgetary impact by far, impacting tens of billions of dollars over the next four fiscal years. Prop. 1E would provide less than a quarter of a percent (0.25%) of the state budget. By cutting mental health care, Prop. 1E would increase state costs. The Legislative Analyst warns that “state and local governments could incur added costs for homeless shelters, social services programs, medical care, law enforcement, and county jail and state prison operations.” These are the costs of untreated mental illness – precisely what the voters were trying to address when they approved Prop. 63 just a few years ago.

The ballot description says Prop. 1E funds services for children with the money it takes from Prop. 63. How can we decide between helping kids and people with mental illness?

This is a false choice created by the Legislature in writing Prop. 1E to make it sound good to voters.

In fact, the children’s mental health program referenced in Prop. 1E is a federally mandated program that legally must be fully funded. Prop. 1E does not add money to that program or guarantee it. The new budget already funds that program regardless of the passage or failure of Prop. 1E. (The program, provided through Medi-Cal, is called Early and Periodic Screening, Diagnosis and Treatment (EPSDT).)

In reality, the money that Prop. 1E would transfer out of Prop. 63 programs simply increases the amount of money in the state General Fund by a half billion dollars over two years. There are no strings attached to the money in the General Fund; legislators may allocate it as they see fit. This goes directly against the voters’ demand that Prop. 63 revenues go to new and expanded mental health programs and that strict oversight and accountability be applied to those dollars.

Are EPSDT programs facing cuts or “at risk of elimination” without Prop. 1E?

Absolutely not. This is a falsehood promoted early on by the unified campaign in favor of all the legislature’s ballot measures. The Medi-Cal programs at issue are federally mandated. The state cannot substantially reduce funding or “eliminate” those programs without “opting out” of Medicaid altogether - a step no state has ever taken. The state has lost lawsuits that resulted from previous efforts to cut EPSDT funds.

The No on Prop. 1E campaign has called this false claim by the “yes” campaign “cruel and cynical.”

Why is a “temporary reallocation” of revenues so threatening to Prop. 63?

We know where Prop. 1E began – as a legislative budget proposal to redirect ALL Prop. 63 revenues to the state General Fund. This would eliminate Mental Health Services Act programs within a few years, leaving only the inadequate system of care that voters were reacting against when they supported Prop. 63. If voters approve Prop. 1E, there can be no doubt that similar proposals will come back, taking more and more money each time. Once legislators see the Prop. 63 tax surcharge as a revenue source, the initiative’s programs will be in dire jeopardy each budget year. That reality makes the fight against Prop. 1E a fundamental battle to preserve Prop. 63 and avoid having California slip back to the days when far too little care was available for people with mental illnesses.

Why did voters support Prop. 63?

We learned during the campaign for Prop. 63 that many voters know how California broke its promise, made more than 40 years ago when the state mental hospitals were closed, to provide adequate mental health care. Voters were aware of the consequences of that promise not kept – literally millions of people whose mental illnesses went untreated and who wound up in hospitals, on the street, or in jail or prison. Voters supported Prop. 63 because it would finally make good on that promise, and would do so in part by building on model programs providing innovative services to people living with mental illnesses.

Is Prop. 63 working?

Yes. Current estimates point to 200,000 people receiving mental health services now who had no prior care. Of these, about 50,000 are children and young adults. Prop. 63 created many tiers of services. For some people, Prop. 63’s early diagnosis and intervention services prevent the onset of more debilitating mental illnesses. For others, Prop. 63’s programs provide “whatever it takes” to help people with mental illnesses to live safely, independently and with access to care. Counties are empowered to create their own approaches to developing Prop. 63 programs, tailor for local conditions. Some counties are moving faster than others; in some cases, mental health care providers have only recently started up or expanded to meet the need. Four years into implementation, the program is beginning to hit its stride, which makes Prop. 1E all the more untimely.

Which specific programs are impacted by these cuts?

The only certainty is that this money comes out of Prop. 63 programs. Programs might be reduced in the short term or in a few years. Legislators wrote Prop. 1E in such a way that we won’t know the exact areas to be hit by the cuts until those cuts are determined later by the state Department of Mental Health. As to what is at risk, there are two areas of direct services funded by Prop. 63: 1) Community services & supports for children, adults and seniors with life-threatening mental health problems, and 2) Prevention and early intervention programs that identify mental illnesses early in their onset and provide modest services before there is a need for more extensive, expensive care. Also, Prop. 63 pays for facilities, technology, training and development to improve operations. Innovative services grants are targeted at improving efficiencies and creating new, model programs.