Homelessness, rehabilitation and health care: What to know about California Gov. Newsom’s legacy tour

Gov. Newsom starts defining his legacy on a four-day statewide tour that focuses on priorities interrupted by crisis and the COVID pandemic, including homelessness, criminal justice and health care.|

Gov. Gavin Newsom likes to talk about “the California way.” And as he barnstormed the state with sweeping plans to transform its approach to homelessness, criminal justice and health care, he laid out his ideas for what that “way” means — and his legacy.

Throughout his State of the State tour, the governor was often joking and jovial. But on Sunday, the fourth and final day, he took on a more somber tone, standing behind the lectern of a makeshift event space that was once a nine-bed emergency room to talk about improving mental health care.

He emphasized the far-reaching consequences of inadequate care and shared his own experiences, losing someone he’d attended his high school prom with, as well as his grandfather, a veteran, to suicide.

“We own this. We own this moment,” he said. “But we have now the tools and the capacity to turn this ship around.”

As he dives into his second term, Newsom chose the tour in place of the traditional speech to a joint session of the Legislature. In many ways, the events echoed the priorities that he was focused on at this same point in his first term four years ago — before unexpected crises, a recall effort and a seemingly inescapable pandemic scrambled his agenda.

In his first act as governor, shortly after he took the oath of office in January 2019, Newsom signed an executive order aimed at lowering prescription drug costs by directing state agencies to negotiate collectively with pharmaceutical companies for better prices.

On Saturday, he finally announced that California will partner with Utah-based generic drug company Civica to manufacture its own insulin, available for $30 a vial. The $50 million deal is the first major development in a plan Newsom has pursued for the past three years to create a generic label that can challenge an industry he has criticized for charging far too much for life-saving medications.

Two months into his first term, in March 2019, Newsom enacted a moratorium on executions and dismantled the lethal injection chamber at San Quentin State Prison. His decision stunned the political world by quickly reversing a campaign pledge to respect the will of California voters who have repeatedly upheld capital punishment.

On Friday, nearly four years to the day after that order, the governor was back at San Quentin touting his vision to transform California’s oldest correctional facility from the home of condemned inmates to a center for rehabilitation and training before offenders are released back into society.

In public poll after public poll, these issues are not what Californians identify as the most pressing problems in the state. Yet by regularly resurfacing them, steadily chipping away at breakthroughs on his own terms, Newsom suggests that’s what they represent to him — the issues most fundamental to his platform, those with which he seeks to build his legacy.

Governors don’t always get to define their own legacies, however.

Growing public anger over California’s ever more visible homelessness crisis has made this seemingly intractable problem the inescapable force of Newsom’s tenure. He recognized it back in 2020, devoting his entire State of the State speech to the topic, and COVID aside, no other issue has consumed more of his time and political capital since, a stark departure from his predecessor. For opponents — from those who unsuccessfully sought to recall him from office in 2021 to those already seeking to knee-cap any presidential ambitions he may possess — it is perhaps his greatest liability.

That was reflected in the central role that homelessness played in Newsom’s statewide tour, underlying his major announcements on two separate days.

The kick-off event, in Sacramento on Thursday, touted the governor’s successful push to get local officials to adopt more aggressive targets for reducing the number of people living on the streets in their communities.

The final stop, in San Diego on Sunday, launched a campaign to ask California voters to approve a $3 billion bond measure in 2024 for mental health housing and treatment beds. It builds on Newsom’s signature policy achievement from last year: A new court system aimed at compelling people with several mental illnesses, who often languish on the streets, into housing and treatment.

Wrapping up the tour, Newsom noted that the issues he discussed were connected, but especially housing and homelessness.

“I think those two issues truly do represent the twin challenges of this state — our fate and future,” he said Sunday in answer to a CalMatters question. “They’re connected to more of our challenges than any other two issues, and that’s really the thrust of this multi-day effort.”

To achieve all his goals on homelessness and other issues, Newsom needs the buy-in of state lawmakers, local officials and front-line workers.

Still, by orchestrating four days of events across the state instead of delivering a single speech in Sacramento, the governor did succeed on one score: He drew a torrent of media coverage, though reporters were often held a distance away from him at each stop. Newsom’s messaging was amplified by friendly Democratic allies at every event.

Trying to compete, Republicans in the Legislature posted social media videos warning that California is in crisis — on cost of living, crime, homelessness, schools, water and wildfires — and asserting that they have solutions in what they call the California Promise. “Californians want solutions to their everyday problems,” tweeted Assembly GOP leader James Gallagher of Chico. “The Governor’s shiny object routine is tired.”

On each day, and at each event, Newsom was being Newsom — prone to sweeping pronouncements, but less clear on some of the details. At times, he was repackaging or rebranding programs already underway. At others, he urged Californians to imagine a vision for something that doesn’t exist.

Here are some key takeaways and impressions from four days on the road with the governor:

Gov. Gavin Newsom tours a “tiny home” after announcing the state’s plan to address homelessness at Cal Expo in Sacramento, on March 16, 2023. Photo by Miguel Gutierrez Jr., CalMatters

Day 1: Homelessness in Sacramento

One area where California does lead the way is homelessness — but on the sheer numbers as much as on innovative policies. About 30% of people who are homeless in the U.S. were in California in 2022, according to the Public Policy Institute of California.So it makes sense that Newsom’s first stop was Cal Expo, home of the California State Fair, and one site where the state plans to establish a community of “tiny homes” for homeless individuals.

Following his remarks, Newsom ducked into each of the “tiny home” models set up, on green turf with picnic tables off to the side, as the event’s backdrop.

The governor was flanked by industry officials and, as was the case throughout the tour, by state lawmakers and local elected leaders, including San Jose Mayor Matt Mahan, who spoke about a so-far successful pilot program in his Bay Area city.

But how much Newsom reduces homelessness will be a hallmark of his tenure — regardless of how much, or how little, it’s under his control. He acknowledged some limitations: substance abuse crises, mental health and wealth inequality. Success of the tiny homes, he said, depends on local governments ensuring the quality of the services in the long-term.

“The entire homeless strategy in California is not the state of California,” he said. “Homeless strategy is realized not just locally but also begins locally and percolates up.”

The state’s willingness to fund local efforts came after “some tough conversations,” the governor noted. Just a few months ago, he threatened to withhold funding based on plans cities and counties submitted. With cities and counties pledging to get more people off the streets, he announced that his administration plans to free up $1 billion in state money to help them.

Newsom also highlighted programs that he launched during the pandemic: Project Roomkey, which places individuals in motel and hotel rooms as a short-term solution, and Project Homekey, where the state buys properties that can be converted into homes.

The “tiny home” program is not “‘it.’ This is a component of a larger strategy,” he said, pointing to the $3.4 billion he put in his proposed budget to address homelessness, despite what he projected as a $22.5 billion deficit.

For some, Newsom’s ambitious plan wasn’t enough. Senate Republican Leader Brian Jones of El Cajon called it another “Band-Aid on a crisis.”

A row of “tiny homes” on display at Cal Expo. Gov. Gavin Newsom announced the state’s plan to address homelessness on March 16, 2023. Photo by Miguel Gutierrez Jr., CalMatters

But for others, Newsom’s proposals didn’t go far enough. Just before the governor’s event, the California State Association of Counties urged state lawmakers to set up a new system for routing state homelessness funding through regional plans with clear responsibilities assigned to local governments.

The 1,200 “tiny homes” will go to Los Angeles, San Diego County, San Jose and Sacramento — places Newsom said showed “enthusiasm.” But at least for now, the program excludes San Francisco and other cities mired in crisis.

Day 2: Criminal justice at San Quentin

San Quentin State Prison is already considered a model for prisoner rehabilitation in California — attested to by inmates made available to the press. Programs such as a news service and a 20-week coding course have been transformational, and at a minimum, offer a place outside their cells to breathe. Inmates at other state prisons request transfers to San Quentin for the opportunities.

So at Friday’s event, when the governor spoke in sweeping terms about a plan to “transform” the prison into a “national model” for rehabilitation, questions prevailed: How long will it take? How much of the Scandinavian model will it emulate?

But the big question came from Steve Brooks, editor of the San Quentin News: How will this model help inmates with overcrowding and poor living conditions? And would the Scandinavian model mean violent offenders wouldn’t get to take part in the rehabilitation programs?

“No, quite the contrary,” Newsom replied, speaking inside a warehouse that is to be converted into a training center. “And I don’t refer to it as the Scandinavian model. This is the California model, the California way…. I’m for people that are committed, not passively interested, in changing themselves, and in turn helping us keep our communities safe and changing our communities as a consequence.”

The new facility will be designed by an advisory committee that includes crime victims, formerly incarcerated people and academics, the governor’s office said. Newsom is also asking the Legislature for $20 million for the plan.

Asked whether he plans to ask voters to make permanent his moratorium on the death penalty, Newsom didn’t commit to a ballot measure. As of March 8, there were 668 people sentenced to death in California.

Inmate Gregory Eskridge (right) and others reporting for the San Quentin News attend Gov. Gavin Newsom’s press event at San Quentin State Prison announcing the transformation of the facility to focus on training and rehabilitation on March 17, 2023. Photo by Martin do Nascimento, CalMatters

San Quentin currently houses 3,906 people, with security levels ranging from medium to maximum security. One is Angelo Mecchi. Newsom said that on a visit several weeks ago, Mecchi saw him and flagged that they’d played in the same Little League in Marin County.

“That spoke to me on a different level,” Newsom said. “We are many journeys, many parts — but one body. When one part suffers, we all suffer.”

Day 3: Health care costs in Downey

Three days into the tour, Newsom seemed particularly upbeat about Saturday’s announcement: Securing a contractor to produce insulin, bringing the costs down for patients with diabetes to $30.

“What this does is a game-changer,” he said. “This fundamentally lowers the cost, period, full stop.”

“I’m just really proud of this,” he added later, standing in front of a row of refrigerators that contained insulin medications at a Kaiser Permanente warehouse.

Advocacy groups were just as excited. “California’s investment to directly manufacture prescription drugs is a game-changer with national impact,” Anthony Wright, executive director of Health Access California said in a statement. “Even a modest decrease in the cost of key drugs could save hundreds of millions or even billions of dollars.”

A girl shows off her insulin pod that continuously gives her insulin throughout the day to help manage her Type 1 diabetes. Photo by Anne Wernikoff, CalMatters

If manufacturing begins as planned later this year, the state would then seek approval from the Food and Drug Administration and start distributing early next year.

The governor said the long-term plan is to have Civica make the insulin in California. “The future happens here first. We are America’s coming attraction,” he said during what turned out to be the shortest of the four stops.

And he doesn’t plan to stop with insulin. Newsom disclosed that the state’s CalRx is exploring making its own naloxone (better known by its brand name Narcan) to treat opioid overdoses.

He also said this push to lower health care costs builds on California’s record of universal health care regardless of pre-existing conditions or immigration status.

“If we are arguably the fourth largest economy on planet earth, we’ve got to start acting like it,” he said, adding one of his common boasts: “Only in California. Eat your heart out, the rest of the United States.”

Day 4: Mental health in San Diego

In between the official tour events, Newsom made other stops, including at the City of Refuge social service nonprofit in Sacramento, at the Los Angeles River with Assembly Speaker Anthony Rendon, and at the Scripps Institution of Oceanography in San Diego.

So, on the final day of the tour, Newsom seemed a little less energized before his turn to speak at Alvarado Hospital Medical Center about his mental health initiative.

Mark Ghaly, secretary of the California Health & Human Services Agency, who accompanied Newsom on both Saturday and Sunday, took on some of the more detailed policy questions, such as how many beds are needed.

Besides the $3 billion bond issue to build new treatment centers to treat 10,000 more people a year, Newsom wants to redirect another $1 billion from an income tax on millionaires — approved by voters in 2004 — to operate them. That concerns county officials, who say any loss of state behavioral health money could also cost them federal matching funds.

The governor’s packed schedule meant zipping off quickly to the next event, and his team declined an interview request for Newsom to discuss the tour as a whole.

And while details of the tour stops were closely guarded, protestors managed to get word of his Sunday appearance. About 10 people stood outside the hospital with signs asking Newsom to speak out against the construction of a controversial barrier at Friendship Park, which straddles the border of California and Mexico.

“The governor of California should understand this is not a sideline issue,” said John Fanestil, a member of the Friends of Friendship Park community group, who was at the protest. “It should be his central issue on a visit to San Diego.”

Newsom hasn’t made an official statement, but told reporters at the border Sunday that he was trying to understand the Biden administration’s support for the barrier.

But back on message, he also announced $30 million to beef up the California National Guard’s efforts to stop drug trafficking, especially fentanyl — and to shore up his legacy, this time on the opioid crisis.

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