The proposal known as Community Assistance, Recovery and Empowerment Court 鈥� 鈥� would set up a new branch in the judicial system. It would allow first responders and family members to petition a county judge to order treatment for people suffering from addiction or severe mental illness.
But civil and disability rights groups, county officials and other advocates say CARE Court is the wrong approach and that they lack the resources to staff and deliver the treatment required.
Governor Gavin Newsom and local officials that cycles people through jail, hospital stays and back onto the streets. His administration estimates CARE Court would serve 7,000 to 12,000 people per year.
Newsom has called the growing number of people living 鈥� and dying 鈥� on California鈥檚 streets 鈥渦nacceptable鈥� and 鈥渋nhumane.鈥� He invoked the when he unveiled the proposal earlier this spring.
鈥淭here鈥檚 no compassion in reading about someone losing their life under [Interstate] 280 in an encampment,鈥� the governor said at a news conference outside a San Jose residential mental health treatment center in March. 鈥淲e could hold hands, have a candlelight vigil and talk about the way the world should be, or we could take some damn responsibility to implement our ideals.鈥�
has received near-unanimous support from lawmakers, and interest groups expect it to pass the legislature before the end of the month.
Concerns from civil, disability rights groups
For unhoused resident Sharon Jones, the prospect of CARE Court is troubling.
Jones has lived for the past six years with her wife at an encampment near the American River Parkway. During that time, she鈥檚 witnessed people struggle with mental illness and addiction.
鈥淚 see them everyday,鈥� said Jones, a former bookkeeper, speaking near her collection of tents in North Sacramento. 鈥淏ut most of them are harmless. Some of them are a little off the hook.鈥�
She said she doubts Newsom鈥檚 proposal will be effective.
鈥淵ou can鈥檛 force people into treatment if they don鈥檛 want to be treated,鈥� Jones added. 鈥淎ddiction is something that only you can fix.鈥�
The ACLU and disability rights groups from 27 states agree it won鈥檛 work. In to the governor, they detailed concerns about the autonomy of mentally disabled people and access to housing, and asked him to halt the proposal.
鈥淐ARE Court will not solve the complex issues of homelessness in California, nor will it meet the needs of unhoused people with mental health disabilities 鈥� primarily because the investment of funds is in a new court system,鈥� the letter reads.
Advocates say affordable, accessible housing and voluntary treatment would be a better path to reducing homelessness for those with severe mental illnesses.
鈥淚n our experience, compulsory treatment for any individuals with mental health disabilities will end up resulting in resistance, frustration and additional trauma,鈥� said Eric Harris with Disability Rights California.
He continued: 鈥淔olks will have one terrible experience and say, 鈥業 never want to go back there again. I never want to do that again.鈥欌��
Harris said people with mental disabilities, especially those with marginalized backgrounds, haven鈥檛 been part of the discussions crafting the CARE Court proposal.
鈥淚f we're really trying to help those communities, then we should at least pause right now and make sure that all of those folks are at the table as we make some of these very big decisions,鈥� he said.
Newsom鈥檚 office disputes that any treatment would be compulsory. Jason Elliott, a senior advisor to the governor, is adamant that there 鈥渨ill be no locked doors in CARE Court鈥� and that it is meant to help people before they end up in the criminal justice system.
鈥淚t鈥檚 a civil court process that provides people the services they need before extreme trauma, like a hospitalization, like incarceration, like a conservatorship,鈥� Elliott said in an interview.
Even though treatment could be ordered by a judge, Elliott said it would take place out of legal custody and in community clinics. He argues that court-ordered treatment would be different from conservatorships, which allow a judge to appoint a legal decision maker to oversee someone鈥檚 day-to-day life.
鈥淚 would argue that forced treatment is right now what we are putting people into when in fact, they could be successful in a lower level of care鈥� in a community setting, he said.
1,459 people were placed on temporary conservatorships in 2020 while 3,672 people were under a permanent arrangement.
CARE Court would allow participants to select a 鈥渧olunteer supporter鈥� to help them 鈥渦nderstand, consider, and communicate decisions to ensure the [participant] is able to make self-directed choices to the greatest extent possible,鈥� . People in the program would retain a level of independence, as CARE Court would offer 鈥渙ut-of-custody鈥� treatment different from conservatorships and state medical institutions, Elliott added.
Counties say CARE Court could burden overtaxed workforce
California鈥檚 county governments would be responsible for carrying out nearly all elements of Newsom鈥檚 proposal. County public defenders would represent people selected for the program in court. County social workers, nurses, therapists, counselors and psychiatrists would evaluate the candidates, file assessment reports, spend time in court and eventually provide the judge-ordered treatment.
But county leaders say CARE Court and its added duties represent a major burden on their already overtaxed behavioral health departments. During the pandemic, counties saw a spike in demand for mental health and addiction treatment but struggled to retain workers, some of whom left their positions for higher-paying private sector jobs.
鈥淲e already have a workforce crisis where we don鈥檛 have enough clinicians to be delivering the mental health, substance use disorder services that are needed out in our community,鈥� said Ryan Quist, director of Sacramento County鈥檚 department of behavioral health services.
Quist said his department has a deficit of more than 100 clinical workers and that the new program would tie up many of his existing staff in court.
鈥淐ARE Court would add on new administrative burdens that would take our scarce clinical resources away from actually serving the folks that need those services,鈥� he added.
Elliott with the Newsom administration described the workforce shortage 鈥渁s a real problem and one that we鈥檙e taking very seriously.鈥� He said funding recently approved by the Legislature and governor should help.
鈥淭he answer to it is a $1.7 billion workforce initiative to develop more than 20,000 new clinical social workers and other professionals in adjacent space,鈥� Elliott added. 鈥淏ecause we can do everything else right and if we don鈥檛 have people to do the jobs, then none of it matters.鈥�
County leaders and their advocates say that money should eventually produce new, trained workers, though it could take years.
鈥淚 hope that those investments will yield a lot of success, but it鈥檚 not happening this second. And we鈥檙e layering another program on top of it,鈥� said Jacquline Wong-Hernandez, deputy executive director at the California State Association of Counties, which lobbies for county governments at the state Capitol.
Housing first or treatment first?
There鈥檚 another severe shortage counties would have to contend with if CARE Court were to become law: housing for people in the program.
Advocates say the program emphasizes treatment before housing, when it should be the other way around.
鈥淭here's this sense that mental illness and in some cases substance use are one of the root causes of homelessness,鈥� said Mari Castaldi with the advocacy group Housing California. 鈥淲hat evidence shows is that high housing costs and low housing vacancy rates are the primary predictors of the rate of homelessness in a given community.鈥�
While the bill would allow judges to order housing as part of a patient鈥檚 鈥淐ARE plan,鈥� Castaldi says counties, which would be on the hook for meeting those plans, have limited housing resources.
Quist with Sacramento County said there鈥檚 already a severe lack of available housing locally and across the state. The region has an affordable homes for its lowest-income renters, according to the
The county is also short several thousand shelter spaces. There are only about 3,400 shelter and housing beds available by local governments, nonprofits and faith groups for people experiencing homelessness, according to a report from the nonprofit California Housing Partnership. But there are nearly in Sacramento County. The existing shelters are typically full on any given day.
鈥淲e can get individuals into services, help them get better. But then once they鈥檙e better, where are they going to live?鈥� Quist said.
But Elliott points to some $15 billion in state funding approved since 2020 for counties to build and acquire more housing units. For example, the state has funded 12,500 homes for people exiting homelessness through its , which pays cities and counties to buy and convert hotels, motels and other buildings into homes.
鈥淒o we have enough housing to provide a permanent supportive unit to every single person experiencing homelessness in California? No, we do not, and it's a goal,鈥� he said.
But, he added: 鈥淭he scarcity mindset that we very appropriately operated under for many, many decades is now no longer the case.鈥�
Elliott also pointed to $1.5 billion in the state budget approved earlier this year to house people enrolled in behavioral health treatment.
The California Assembly approved amendments to the bill Thursday to make clear that families can be more involved in the 鈥淐ARE plans鈥� of their loved ones. The bill must pass before the legislative session ends at midnight Aug. 31 and be signed by Newsom to become law.
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