Behavioral Health Prop 1: A $6 Billion Opportunity to Build Smarter, More Impactful Facilities
By Brian Holley, Director of Healthcare
In March 2024, California voters approved Proposition 1—a $6.4 billion investment aimed at expanding behavioral health infrastructure across the state. As someone who has spent over two decades in healthcare construction, I see this as a pivotal moment. But I also see a challenge: how do we ensure this funding translates into real, lasting impact?
Why Prop 1 Matters
For years, behavioral health facilities have been underbuilt—not because the need wasn’t there, but because the economics didn’t work. The reimbursement rates for delivering behavioral health services often couldn’t support the debt service required to build and operate new facilities. Prop 1 attempts to change that by offering grant funding to offset construction costs, making it more financially viable to pursue these projects.
From a business standpoint, it’s a solid funding stream. But more importantly, these projects are critical to the health and well-being of our communities. We see ourselves not just as builders, but as part of the solution—delivering facilities that are safe, efficient, and designed to meet the unique needs of behavioral health patients.
The Real Test: Building Sustainable, Integrated Solutions
Securing funding is a critical milestone, but what truly sets Swinerton apart is how we’re leveraging expertise across markets to ensure lasting impact. By intentionally combining skill sets from our affordable housing and healthcare practices, we’re creating spaces that address complex needs where these sectors intersect. This integrated approach results in environments that are functional, sustainable, and supported by our leadership in affordable housing and strengthened through public-private partnership capabilities. It’s not just healthcare—it’s a holistic ecosystem strategy designed to close gaps and deliver meaningful outcomes.
A Holistic Approach to Delivery
We’re redefining how these projects come to life. Rather than viewing them as purely healthcare or residential, we recognize that behavioral health connects to affordable housing, substance abuse treatment, and broader community services. That’s why we’re bringing together expertise across disciplines to deliver smarter, more integrated solutions.
Equally important, we’re focused on speed and efficiency. These projects must meet urgent needs without compromising quality, safety, or cost-effectiveness. Achieving that requires deep collaboration across the Architecture, Engineering, and Construction industry, state agencies, and healthcare providers—working together to cut through red tape and deliver results that matter.
What Success Looks Like
To me, success means seeing these beds come online quickly and sustainably. It means creating spaces that are not only functional but also dignified and healing. And it means making a measurable impact on the mental health crisis that so many communities are facing.
We’ve seen what happens when the industry comes together with a shared purpose. Now, with Prop 1, we have the funding—and the responsibility—to do it again.
