On Thursday, at a mental health treatment center in San Jose, Gov. Gavin Newsom unveiled CARE Court, a new framework to provide individuals with mental health and substance use disorders the care and services they need to get healthy.
The proposal, which must be approved by the Legislature, would require counties to provide comprehensive treatment to the most severely impaired and untreated Californians and hold patients accountable to their treatment plan.
“CARE Court is about meeting people where they are and acting with compassion to support the thousands of Californians living on our streets with severe mental health and substance use disorders,” said Gov. Newsom. “We are taking action to break the pattern that leaves people without hope and cycling repeatedly through homelessness and incarceration. This is a new approach to stabilize people with the hardest-to-treat behavioral health conditions.”
CARE Court does not wait until someone is hospitalized or arrested before providing treatment.
CARE Court will provide an opportunity for a range of people, including family members, first responders, intervention teams, and mental health service providers, among others, to refer individuals suffering from a list of specific ailments, many of them unhoused, and get them into community-based services.
Based on the initial information from the governor, the CARE Courts will be housed within each superior court.
However, Krista LeVier, court executive officer of the Lake County Superior Court, said they have no details yet about how the proposal will work and its impact on the local court.
“It’s time we face the painful, but obvious truth: our behavioral health system in California is broken. All of us see it every day on our streets — and it’s long past time we fix it,” said San Diego Mayor Todd Gloria, who called the proposal “a major step forward.”
CARE Court offers court-ordered individualized interventions and services, stabilization medication, advanced mental health directives, and housing assistance — all while remaining community-based. Plans can be up to 12 to 24 months.
In addition to their full clinical team, the client-centered approach also includes a public defender and a supporter to help individuals make self-directed care decisions.
“We need to stop trying to fix a failed system,” said Santa Clara County Superior Court Judge Stephen V. Manley. “We are rapidly moving back to where we were 100 years ago in using incarceration as the only alternative for those persons who are severely mentally ill. We need new ideas and a fresh approach and Gov. Newsom is offering us one.”
The CARE Court framework was created using the evidence that many people can stabilize, begin healing, and exit homelessness in less restrictive, community-based care settings.
The plan focuses on people with schizophrenia spectrum and other psychotic disorders, who may also have substance use challenges, and who lack medical decision-making capacity, and advances an upstream diversion from more restrictive conservatorships or incarceration.
The framework provides individuals with a clinically appropriate, community-based and court-ordered Care Plan consisting of culturally and linguistically competent county mental health and substance use disorder treatment services. These include short-term stabilization medications, wellness and recovery supports, and connection to social services, including a housing plan.
Services are provided to the individual through an outpatient model while they live in the community.
“After 30 years in the field serving vulnerable individuals and experiencing difficulty in getting these individuals the appropriate level of care, I welcome the discussion around a definitive evaluation process and look forward to participating in discussions to find solutions that better serve this population,” said California Professional Firefighters President Brian K Rice.
In the event that a participant cannot successfully complete a care plan, the individual may be referred for a conservatorship, consistent with current law, with a presumption that no suitable alternatives to conservatorship are available.
All counties across the state will participate in CARE Court under the proposal. If local governments do not meet their specified duties under court-ordered care plans, the court will have the ability to order sanctions and, in extreme cases, appoint an agent to ensure services are provided.
The California State Association of Public Administrators, Public Guardians, and Public Conservators called for increased resources to serve California’s most vulnerable populations.
“Gov. Newsom has proposed sweeping changes to the continuum of care to serve a growing number of Californians with severe mental illness and cognitive deficits, people who are seriously and persistently mentally ill and homeless, and adults who have been victimized and exploited,” said Scarlet Hughes, executive director of the California State Association of Public Administrators, Public Guardians, and Public Conservators.
“As experts on the front lines serving the most vulnerable Californians, we look forward to working with the governor and the Legislature to strengthen the CARE Courts proposal and address the significant impacts it will undoubtedly have on demand for local county public conservators and public guardian safety net programs,” said Hughes. “We share the governor’s goal to provide care and compassion for vulnerable individuals and ensure our guardians and conservators have the resources to meet both current demand and increasing needs.”
Governor launches new plan to help Californians struggling with mental health challenges, homelessness
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