Supervisors Ronen and Haney’s proposed Mental Health SF program would be paid for by a tax on the city’s wealthiest CEOs, so get ready for election-season attack ads and tech titan Twitter fights.

Mayor Breed’s proposed conservatorship legislation, essentially forced treatment for people with chronic mental illnesses and repeated incidents with the law, may have died in committee earlier this month. SF Weekly reports that Sups. Hillary Ronen, Gordon Mar and Shamann Walton all oppose it, and their Rules Committee may see that it never gets a full board vote. It may be no coincidence that Sup. Ronen, along with Sup. Matt Haney, just trotted out what looks like a competing measure, with Mar and Walton’s support already announced. In a carefully rolled out “scoop” in today’s Chronicle, clearly timed to coincide with this morning’s rally introducing the measure, Ronen and Haney are proposing universal mental health care to any San Franciscan who wants it.

The proposed program is already named Mental Health SF (a nod to Healthy SF), it would probably cover far more people than the mayor’s conservatorship efforts, and it would likely cost plenty more too. The program would ensure mental health and addiction services to anyone seeking them, and per the Chron, would be paid for “with a new gross receipts tax on those companies that pay their CEOs upward of 100 times more than the median compensation paid to employees.”  

If that structure seems complicated, wait til you hear about how they propose to pass it. The proposal seems likely to spawn two separate ballot measures; one creating Mental Health SF that would go before San Francisco voters this November, and another that might appear in November or in the March 2020 Primary Election that would ask approval for funding the measure with the CEO tax. The measure creating Mental Health SF only needs a 50% majority, the CEO tax would need a two-thirds majority. We obviously have the issue of what would happen if one passed and the other didn’t, but that’s getting ahead of ourselves on a measure just announced this morning.  

And there are scant mentions of overall cost so far, with some of the revenue based on complete uncertainties. The Chronicle’s report mentions construction of a whole new treatment center at SF General Hospital, to be “open every day, around-the-clock,” and completed by June 1, 2022. There is no price tag for that mentioned or even estimated. Much of the funding would come from Sup. Mar’s proposed IPO tax, which also has not yet passed, nor is it even guaranteed to be on November’s ballot. The only aspect to this with even a ballpark cost projection is a proposed new Department of Public Health Office of Coordinated Care, which would cost $40 million to $60 million annually.

The prospect of a tax levied specifically on high-paid CEOs might already have Ron Conway furiously typing emails telling his entire address book to vote against it. That said, both Ronen and Haney claim Mental Health SF would save the city money in the long run, as the DPH currently spends $370 million a year on mental health services.

It’s time for some Board of Supervisors game theory on whether we’ll really be voting on Mental Health SF. The Chronicle says the measure "will almost certainly" be on the November ballot, and Ronen tweeted "Mental Health SF will be on the ballot in Nov." This confidence is likely a reflection that with Haney’s co-sponsorship, and announced support from Sups. Walton and Mar,  the measure is already close to majority Board approval. Presumably Ronen and Haney know they’ve got at least one more yes vote in their pocket, and are speaking on confident terms that they will get the measure on the November 5, 2019 ballot. The proposed CEO tax appears to be on a slower track, with no confident announcements that we’ll be voting on it in November. And keep in mind this measure is an indirect-but-pointed rejection of Mayor Breed’s conservatorship efforts. So even though it sounds nice, expect sharp knives to be unsheathed as very clear ‘for’ and ‘against’ camps come together for a general election fight.          

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