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Gov. Gavin Newsom promised to help thousands of homeless Californians when he launched a new mental health court in 2023. So far, it has struggled to help the sickest, most vulnerable people, but a Southern California lawmaker is carrying two proposals this year that she hopes will fix gaps in the program.
Both bills reopen the debate among families and advocates over when it’s appropriate to put someone into mental health treatment without their consent.
One bill would create a pathway for the most severely incapacitated people to go directly from Newsom’s voluntary mental health court into involuntary treatment in a hospital. The other would make it easier for EMTs and other first responders to refer people to mental health court. Both bills recently passed through the Senate Judiciary Committee, despite concerns from disability rights advocates that they would force more people into unwanted treatment.
“While early implementation shows promise,” Sen. Catherine Blakespear, a Democrat from Encinitas, said during a recent committee hearing, “barriers in the current petition process are preventing the program from reaching many of the individuals it was designed to serve.”
CARE Court launched in 2023 as a major piece of Newsom’s strategy to get people in the grip of psychosis off the streets. It allows family members of people with untreated schizophrenia and other psychotic disorders to refer them into the court-based program, where they can work with a judge, a public defender and a case worker on a plan for medication, therapy, housing, and whatever other help they may need.
But a CalMatters investigation found the program is falling short of expectations. As of January, California courts had received 3,817 petitions on behalf of prospective CARE Court participants and approved just 893 treatment agreements. At its outset, the Newsom administration estimated between 7,000 and 12,000 Californians would qualify for the program.
Some families who attempted to use CARE Court to help their severely ill loved ones told CalMatters they were disappointed by the results. They thought a judge could order their family members into treatment. But that turned out not to be the case. If someone is too sick to realize they need treatment, CARE Court can’t help, which means that their case can be dismissed while the person continues to languish on the street.
That’s the problem Blakespear is attempting to tackle with Senate Bill 1016. It would allow anyone filing a CARE Court petition to request that a judge order a mental health assessment to determine if the subject of the petition is “gravely disabled” or a danger to themselves or others – if the subject can’t comply with voluntary treatment.
Depending on the results of the assessment, a judge could order that person into a conservatorship, which would likely mean a stay in a locked psychiatric facility and mandatory medication.
The idea is to create a formal bridge between voluntary treatment under CARE Court and involuntary treatment through a conservatorship.
Adding the specter of forced care will make people with mental illness less likely to accept help from CARE Court, Samuel Jain of Disability Rights California said during the committee hearing.
“SB 1016 adds an expensive, coercive and convoluted layer to CARE Court that will drive up costs and further erode the rights and trust of the Californians that our system is supposed to help,” he said.
Family ‘frustrated’ by CARE Court
Jennifer Farrell, who filed a CARE Court petition in late 2024 for her brother in Alameda County, sees it differently. Farrell’s 59-year-old brother, who struggles with schizophrenia and meth use, had been homeless off and on since 2017. He was able to stay housed via CARE Court for a few months, but then he left his placement in September and disappeared into the streets.
It was clear he needed more help than CARE Court could provide, but the program had no way to elevate him to a higher level of care, Farrell said.
“I was really frustrated at that point,” she told CalMatters.
Farrell’s brother spent three months deteriorating on the street before a case worker found him in December. He was hospitalized on a temporary psychiatric hold and eventually placed on a conservatorship. He’s still in a locked facility, where he’s medicated and seems to be doing much better, Farrell said.
To Farrell, it’s “absurd” that there isn’t already a direct link between CARE Court and a conservatorship — a connection that she thinks could have saved her family some grief.
At CARE Court’s inception, Newsom said people who didn’t follow their CARE plans could be moved into a conservatorship. But Farrell and other families CalMatters spoke with said if their loved one couldn’t consent to treatment, there was no clear path forward.
Technically, CARE Court judges can order participants to follow mandatory “CARE plans” — something that happened just 32 times between late 2023 and January — but judges can’t force participants to comply.
Easier CARE Court petitions
Blakespear’s other bill, SB 989, addresses another CARE Court challenge: the low number of people participating.
Filing a CARE Court petition is a complicated, time-consuming process. Whoever is filing the request needs the person’s medical records. Then, they need to appear at the first court hearing — something overworked first responders don’t always have time to do.
That’s a key reason that people who work in public safety, such as firefighters and EMTs, say they don’t file CARE Court petitions, said Meagan Subers of California Professional Firefighters, who spoke in support of the bill at the Senate Judiciary Committee hearing.
SB 989 would create a framework for first responders to refer clients directly to their county behavioral health department, which could then file a CARE Court petition on their behalf. The county would have 30 days to decide whether to file.
Some counties already make an effort to train and support their first responders in filing CARE Court petitions. Stanislaus County allows first responders to refer CARE Court clients directly to the county.
Learn more about legislators mentioned in this story.
But that collaboration isn’t happening in a systematic way across the state, Subers said. This bill could help fix a broken system where first responders are constantly cycling people with severe mental illnesses in and out of emergency rooms, she said.
“When our members have to run these calls repeatedly on individuals and take them to the hospital, knowing that they’re going to have to respond to that person again, my members tell me that they feel helpless,” she said. “We see this pathway as another option for them.”
Blakespear’s bills follow a similar effort last year by Sen. Tom Umberg of Santa Ana to make CARE Court more effective. His new law, which went into effect in January, expanded CARE Court to include people who experience psychosis as a result of bipolar disorder. The program initially was exclusively for people diagnosed with schizophrenia and other limited psychotic disorders.
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