Newsom’s court-ordered treatment plan for homeless Californians passes final test

Gov. Gavin Newsom’s sweeping proposal to provide court-ordered treatment for homeless Californians struggling with mental illness and addiction problems was passed by lawmakers on Wednesday after a lengthy debate that ended with overwhelming approval of the plan.

Newsom in March introduced the Community Assistance, Recovery and Empowerment (CARE) Court Framework as an innovative tool to treat and accommodate thousands of people suffering from a combination of homelessness, substance use and serious mental illness.

“Today’s passage of the CARE Act brings hope to thousands of Californians suffering from severe forms of mental illness that too often languish on our streets without the treatment they desperately need and deserve,” Newsom said in a statement following the final vote via SB 1338. “With our partners, we will make CARE Court a reality, bringing hope not only to those who suffer from severe, untreated mental illness with psychosis, but also to the friends and family members of those people who have been in pain for too long, a Lifeline bid hopeless to get help for their loved ones.”

Families with dependents who might qualify for a CARE plan celebrated the proposal, Senate Bill 1338, while civil rights groups and disability advocates strongly opposed it.

Lawmakers from across the political spectrum spent months raising questions about the funding, infrastructure and manpower available to successfully implement the CARE Court, but ultimately decided that solving California’s homelessness and addiction crises warranted a bold approach.

“This is a phenomenal start. But it’s just the beginning of real politics, real solutions to tackle our homelessness crisis,” MP Suzette Martinez Valladares (R-Newhall) said during a debate on Tuesday. “This bill is great, but we need resources for the programs, for the services, for the workforce and so on [don’t] currently available.”

The assembly approved the measure 62-2 after more than 30 minutes of discussion, and the Senate unanimously sent it to Newsom by a final 40-0 vote.

“This is a new good start, a new way forward to serve some of California’s most vulnerable,” said State Senator Susan Eggman (D-Stockton). “We have a crisis. Everybody knows it. It’s not a secret from anyone and this is another way to bring it up with true professionals and everyone involved at the table.”

Proponents of the CARE Court describe it as a voluntary alternative for those who, because of their conditions, transition in and out of incarceration and hospitalization or are on the way to ending up in a more restrictive, court-ordered conservatory. Newsom estimates the system will serve 7,000 to 12,000 of California’s most vulnerable residents.

CARE Court focuses on individuals with a diagnosis of schizophrenia or other psychotic disorders. Not every participant would have to be homeless to qualify, but would have to be “unlikely to survive safely in the community without supervision” or have a condition that, without intervention, worsens into relapse or serious harm to self or others could.

To initiate a CARE plan, family members, first responders, healthcare professionals, and behavioral health professionals, among others, would seek a civil judge to determine if the person meets the criteria. In this case, the court would initiate a series of hearings and assessments to determine an individual treatment plan.

Newsom has called CARE Court a “paradigm shift” that differs from prescribed treatment because it was designed to ensure participants have autonomy in their recovery. Throughout the process, participants have a clinical team, an attorney, and a volunteer supporter they can choose as their personal advocate to explain the options available and help with decision making.

A CARE plan would provide adult participants with stabilization medication, treatment and social services for up to two years and prioritize them appropriate housing to meet their needs.

Local governments and officials from California’s most populous cities quickly endorsed CARE Court, hailing it as a new way to tackle homelessness at a time of mounting crisis. According to a 2021 analysis of census data by the Legislative Analyst’s Office, 23 percent of California’s 151,000 homeless residents have a serious mental illness, and 17 percent have a chronic substance use disorder.

Opinion polls that year showed that one of Newsom’s major policy vulnerabilities was rising homelessness and drug addiction across the state, increasing pressure on CARE Court to succeed and live up to advocates’ hopes for a breakthrough solution.

In a statement of support for SB 1338, San Diego City and County CARE Court cited a “prudent approach to addressing the behavioral crisis we’re experiencing on our streets” and a way to connect individuals “with the care they need sooner.”

But county officials, who would be responsible for setting up the system and could face thousands of dollars in fines for poor execution, spent months urging Newsom to budget more money to implement the proposal and consider phased implementation to pull.

The Newsom government eventually agreed to roll out the policy in two waves: Glenn, Orange, Riverside, San Diego, San Francisco, Stanislaus, and Tuolumne counties must have their systems in place by October 1, 2023, as must the rest of the state’s counties by December 1, 2024.

The governor also approved $63 million to help local governments and courts implement it, and more broadly, he has budgeted $14.7 billion for homelessness solutions over the past two years. That includes $1.5 billion available for so-called bridge housing, temporary shelters for vulnerable homeless people with behavioral health problems.

The changes failed to allay concerns raised by the American Civil Liberties Union, Disability Rights California and other groups, which argued during this year’s legislative session that the CARE Court would criminalize homelessness and disproportionately target Californians of color. Their opposition often made Democrats, who are normally allied with the groups on similar issues but ultimately supportive of CARE Court, uncomfortable.

“Another suggestion could have been to allocate big money for housing, affordable housing and the continued strengthening of mental health and social services that would actually be helpful to people who are homeless and people with mental health problems to the people they love.” , said Brandon Greene, director of the racial and economic justice program at the ACLU in Northern California.

Newsom has until September 30 to sign the bill into law. He is expected to do so. Newsom’s court-ordered treatment plan for homeless Californians passes final test

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