Where is the Sonoma County tax money for mental health, drug addiction, homeless services?

Sonoma County health officials this week released the latest accounting for highly pressured, voter-approved tax revenue streams that help bolster local mental health, substance abuse and homeless services.

The quarter-cent Measure O tax, adopted in 2020, would generate $33.1 million during the 2024-25 fiscal year for services in five voter-approved categories, according to the district.

County spending of Measure O dollars in the same period amounted to $54.7 million, offset by $22.1 million in state and federal reimbursements.

Measure O funds other local government and nonprofit programs that would be greatly reduced or non-existent, said Nolan Sullivan, director of the Sonoma County Health Department. On Tuesday, Sullivan presented the 2024-25 annual report for Measure O to the Board of Supervisors.

On the district side, Programs covered include local mobile psychiatric crisis teams, the county’s psychiatric emergency department, inpatient psych beds and homeless housing services. The 10-year tax, billed at the time as a stopgap measure to provide local services amid a shift in state and federal funding, expires in 2031.

“Measure O, every day, helps some of the sickest, poorest people here in the county,” Sullivan said. “If we don’t have these resources, frankly, the behavioral health team is going to sink.”

Increasingly, and especially over the past year amid sharp shifts in social safety net funding under the Trump administration, local cities have lobbied counties to share more funding to support their own mobile crisis intervention teams and homeless services.

Several school districts in the county have requested Measure O money to help fund their behavioral health programs. The district’s Crisis, Assessment, Prevention & Education Program, which provides a mobile crisis response program serving local high schools and some middle and elementary schools, received $1.5 million in Measure O funding last year but only operates at 34 campuses.

Sullivan said last year, the CAPE team responded to 56 different crises, including 33 on-campus crises and 23 phone consultations; 109 early intervention referrals; and served 2,240 prevention participants through educational and outreach activities.

“You have a lot of your constituents and partners asking for funding to support the program — I hope we have the money to do it,” Sullivan said. “But I want to remind the district that we inject our services into 34 different campuses in Sonoma County.”

Superintendent David Rabbitt, whose district covers southern Sonoma County, raised concerns that none of the Petaluma City Schools campuses currently participate in the CAPE program.

Supervisor Lynda Hopkins said the three rapid response, mobile crisis teams funded by Measure O offer different services in their respective jurisdictions. He was joined by other supervisors who called for greater uniformity in the delivery of Measure O services, even as they acknowledged the sales tax will expire in a few years.

Sullivan raised concerns about the impact on the region when the tax expires.

“Finally, I just want to thank the voters and taxpayers of Sonoma County,” Sullivan said. “Without their support, we wouldn’t be able to serve thousands of people … probably some of the most intensive support for people in Sonoma County who really need it.”

Only O generates more than $30 million a year and has been maintaining a fund balance for the past few years. However, the balance of the fund was expended to be depleted during the next few years and should be zero by tax time.

The absence of replacement funding or the extended measure could “devastate” thousands of local residents who receive services, Sullivan said, calling on the county to launch a campaign to support tax reform.

In addition to Measure O, the county has six other countywide, voter-approved taxes that help fund libraries, SMART, transit and road projects, park upgrades, open space protection and fire services.

During the supervisors’ meeting, Sullivan detailed fiscal year 2024-25 spending for Measure O. The largest portion of Measure O funding, nearly $30 million a year, goes to emergency and crisis psychiatric services.

That includes nearly $10 million for the county’s Crisis Stabilization Unit, an emergency department for psychiatric patients; more than $9 million for adult inpatient hospital services; $5 million for mobile crisis services; $1.5 million for the CAPE program; and $3 million for residential crisis services, an alternative to hospitals.

Other 2024-25 fiscal year expenditures by category include:

• $15.4 million for mental health facilities.
• $3,671,981 for mental health and substance use disorder outpatient services.
• $5,164,950 for homeless behavioral health and care coordination
• $625,740 for transitional and permanent supportive housing.

Funds going to mental health facilities include $5.8 million for a psychiatric hospital facility serving 208 people; $9 million for a residential care facility serving 328 people and a total of 81,448 bed days; and $348,976 to place 325 people in transitional housing after they were discharged from a crisis facility.

Nearly $3.7 million for mental health and drug addiction services covered peer & family supportive housing in Women’s Recovery Services, recovery programs for pregnant women and parenting; mental health services for children and youth at Santa Rosa Junior College; mental health services at Moon Valley Children’s Shelter; and the expansion of existing drug addiction services.

The 2024-25 fiscal year report marks the fourth full year of accounting for Measure O funding, which was reviewed by an oversight committee headed by former Sonoma County Supervisor Shirlee Zane, a longtime advocate for mental health services.

Gregory Fearon, a member of the oversight committee who attended the Measure O presentation at the Board of Supervisors meeting on Tuesday, called the funds raised by the tax a “saving grace” for behavioral health and substance use disorder services.

He expressed the need for better communication with the public about the importance of funds and how they are used.

Supervisors James Gore and Chris Coursey sit on a board committee formed to review the implementation of Measure O expenditures and programs.

Coursey also raised concerns about how best to communicate the importance of Measure O spending and the impact of losing those funds over several years.

“Keep the pedal to the metal and how we’re doing this, but understand that we’re going to run out of gas in a few years,” he said.

“I think it’s a responsibility for all of us to tell this story to our constituents, to the community,” he said.

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com.