SAN JOSE — In a major move to tackle the state’s homelessness crisis, Gov. Gavin Newsom signed legislation Wednesday to push some Californians with severe mental illness into treatment — kicking off what’s sure to be a long and challenging process to get the unprecedented program up and running across the state.
The new system, dubbed CARE Court, overhauls the state’s mental health care system by allowing courts to order people in crisis to submit to treatment plans — including those living on the street who may be too sick to accept care voluntarily. The legislation marks a victory for Newsom, who has made it a priority to clear the state’s extensive homeless encampments that often serve as a home of last resort for those whom California’s mental health system has failed.
Newsom dreamed up the idea of CARE Court and first announced it in March at Crossroads Village — a San Jose treatment facility run by Momentum for Health. On Wednesday, he returned to the same spot, surrounded by supportive legislators and local city and county officials, to sign the bill into law.
“The problem is solvable. We know that. We don’t have to fall prey to the cynicism and all the negativity that it’s just too big,” Newsom said. “It’s hard. It’s big. But we can meet this moment and we can create many, many moments in the future to do justice to those that need us and are suffering and struggling.”
The new framework targets people with severe, untreated schizophrenia and other psychotic disorders and allows their families, first responders and other stakeholders to refer them to CARE Court. A judge could then order them to follow an individually tailored plan that addresses their mental health and substance abuse treatment, medication and housing needs.
Such a plan would last for one year and could be renewed for a second year. If the patient does not comply, they could be referred to a more restrictive form of treatment in a locked facility or they could be jailed if they have a pending criminal case. But CARE Court participants cannot be forcibly medicated or jailed solely for refusing to comply with a care plan.
Seven counties, including San Francisco, will be first to implement the new program and must set up CARE Courts by Oct. 1, 2023. The rest of the state, including the remaining Bay Area counties, must follow by Dec. 1, 2024. The state estimates between about 7,000 and 12,000 Californians would be eligible for CARE Court. Newsom set aside $63 million to help counties roll out the new system. But at the local level, concerns remain about whether there will be enough resources.
“I am absolutely worried about that,” said Santa Clara County Supervisor Susan Ellenberg, who attended Wednesday’s news conference. “And I know that the judges are worried about that, at least the judges that I’ve spoken to are very concerned about what happens when they direct somebody to care and the facility or the housing isn’t there.”
The county will look for every available dollar from the state to help it build out those resources, she said, while applauding the money the governor has set aside so far.
In addition to the $63 million in grants that will go to courts and to the first counties to roll out the program, Newsom set aside $1.4 billion to hire, train and retain new social workers, counselors and other employees in an effort to fight the state’s shortage of mental health care workers. Last year, he funneled $12 billion into housing and services for homeless Californians and those at risk of losing their homes.
Senate Bill 1338, dubbed Community Assistance, Recovery & Empowerment (or CARE) Court, passed out of the state legislature at the end of August amid criticism from some civil rights groups that it unduly takes away patients’ agency and right to decide whether to enter treatment.
“There is nothing ‘caring’ about his so-called ‘CARE Court’ bill,” the ACLU of Southern California tweeted Wednesday. “Civil and disability rights advocates around the state agree: this plan is ethically and legally wrong.”
The group said it expects to see legal challenges to the new policy.
But the bill’s supporters applauded the legislation as a necessary move to break the endless cycle of the street, jail and ineffective stays in psychiatric hospitals faced by many Californians struggling with mental illness and addiction.
“This is about demanding accountability for the human suffering on our streets,” said San Jose Mayor Sam Liccardo.
Oakland Mayor Libby Schaaf called the new legislation a “desperately needed paradigm shift.” In just one year in Oakland, more than 4,000 people were transported by ambulance to a psychiatric hospital — and more than 100 of those people had been hospitalized more than six times during that same year, Schaaf said.
“The current conditions on our streets are wholly unacceptable,” she said.
Sen. Susan Talamantes Eggman, D-Stockton, agreed.
“Imagine the heat wave we’ve had these last couple weeks, and imagine what it’s like going out in my city when it’s 115 degrees and seeing people in the throes of a mental health crisis, without their shoes, on the streets,” said Eggman, who co-authored the bill. “If that doesn’t break your heart and tell you that we have a crisis, I don’t know what does.”
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