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HSC - Item 3A - Attachment E7/13/23, 3:07 PM California homeless: How will CARE Courts work? - CalMatters https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/1/7 Lawyers address a judge in Madera County Superior Court in Madera on Tuesday, Sept. 29, 2021. Photo by Larry Valenzuela for CalMatters HOUSING California lawmakers approved CARE Court. What comes next? BY MANUELA TOBIAS AND JOCELYN WIENER SEPTEMBER 8, 2022 UPDATED SEPTEMBER 14, 2022 Listen to this article 7/13/23, 3:07 PM California homeless: How will CARE Courts work? - CalMatters https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/2/7 IN SUMMARY Now that Gov. Gavin Newsom’s court system for people with severe mental illness cleared the state Legislature, counties face a series of practical questions critical to turning the fuzzy concept into a reality. In the next two years, California’s 58 counties will be tasked with setting up new court systems to address the needs of people with severe mental illness who often languish on the streets. Gov. Gavin Newsom’s Community Assistance, Recovery, and Empowerment (CARE) Court proposal swept through the state Legislature with resounding approval from Democrats and Republicans in both houses on Aug. 31 — only two of the state’s 120 legislators voted against it — and was signed into law by the governor on Sept. 14. The proposal was authored by Democratic Sens. Tom Umberg of Garden Grove and Susan Talamantes Eggman of Stockton through Senate Bill 1338. “This is one of the things I think we’ll look back on with tremendous pride, when we’re done,” Newsom said during the bill signing ceremony in San Jose, where he first announced the proposal in March. “We get a moment in time, but this might live on, if we make it real. And that’s the hard work of the next year.” Originally, Newsom’s proposal — which would compel people with untreated schizophrenia and other severe mental illness into housing and treatment — had a start date of July 1, 2022. But it faced resistance from county officials who said they were unprepared to create and maintain an entire legal apparatus, much less provide the necessary services. After months of successful lobbying to slow down the timeline devised by the governor and secure more money for planning, the California State Association of Counties now says it stands ready to help implement the far-reaching proposal. Under the new timeline, seven counties will have to establish new courts by Oct. 1, 2023, followed by the remaining 51 counties in December 2024. The pilot counties are San Francisco, San Diego, Orange, Riverside, Stanislaus, Tuolumne and Glenn. The system will theoretically work like this: Family, close friends, first responders and behavioral health workers will be able to submit a petition to the court, signed under penalty of perjury, on behalf of a person with untreated schizophrenia spectrum or other psychotic disorders that shows why they qualify for CARE Court. In order to qualify, the person must be either unlikely to survive safely without supervision or be a threat to themselves or others without support. The petition must include either an affidavit from a licensed health care professional who examined them or tried to — or proof the person was recently detained under intensive treatment. 7/13/23, 3:07 PM California homeless: How will CARE Courts work? - CalMatters https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/3/7 The court would then order a clinical evaluation of the person — and review the evaluation to see if the person qualifies for CARE Court services. If they do, they’ll get legal counsel and a “supporter” — an advocate to walk them through the process, as well as a “Care Plan” that can include recommended treatment, medication and housing. Medication can be court-ordered, but not forcibly administered. During 12 months, a participant will have to attend hearings to make sure they’re adhering to the plan — and counties are providing the court-ordered services. Following that year, a person could receive another year of treatment or a graduation plan, which would not be enforceable by the court. If a person received the court-mandated services but failed to complete their treatment, they could be considered by the court for conservatorship, though refusing medication alone wouldn’t be grounds for failure. The idea is to make it easier for people who need help, but may not be seeking it, to get it before they lose legal autonomy or end up in jail. “CARE Court is a paradigm shift: providing housing and services in the community, where people can heal – and not behind locked walls of institutions and prisons,” Newsom said in a statement on Aug. 30. This is the governor’s latest and boldest strategy to address homelessness, which consistently ranks at the top of the list of voter concerns in California — albeit participants don’t have to be unhoused to qualify. The governor has previously pledged to deal with encampments and dedicated unprecedented budget funding to the issue. But his administration concedes this will only serve a small sliver of the 161,000 Californians who were unhoused in 2020 — an estimated 7,000 to 12,000 people a year. Implementing CARE Courts Counties now face a series of practical questions critical to turning the fuzzy concept into a reality: How will unhoused people get to court? What happens if someone doesn’t show up? Which courts will house CARE Court? Which judges will preside? Who will conduct the medical evaluations? There’s about $88 million in this year’s budget to help figure it out. The counties will get $57 million for startup costs, with $26 million earmarked for the first seven counties. Farrah McDaid Ting, public affairs director for the California State Association of Counties, said that money would go toward everything from cell phones and transportation to setting up an information sharing system that tracks data on counties’ progress. A working group for those first seven courts hasn’t yet been pulled together, she said. The state Department of Health Care Services, the Health and Human Services Agency and the Judicial Branch will get another $31 million to also help set up and coordinate the court system and train staff. 7/13/23, 3:07 PM California homeless: How will CARE Courts work? - CalMatters https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/4/7 But many of the big questions that swarmed the proposal from the start still linger — such as whether the necessary housing, mental health services or workforce would be available, or whether forcing people to receive treatment is an effective form of help. The administration’s response to many of these concerns is that there’s unprecedented funding available through the last two budgets, including $1.4 billion to support the behavioral health workforce and $14 billion for housing and clinical residential placements, including $1.5 billion in bridge housing for which CARE Court participants would be prioritized. The staggered start should allow the state’s counties to answer some current unknowns, including how many petitions come in and if housing or services are available for them, said Michelle Cabrera, executive director of the County Behavioral Health Directors Association. But with so many unanswered questions, she said, “even estimating how much staff you’ll need is a shot in the dark.” Cabrera anticipates the next few months will be devoted to coming up with a framework for how the court will look in those seven counties, including figuring out financing and training and drawing up forms. Orange County officials don’t expect their new court to represent a dramatic departure from the status quo — they already operate a drug court and a mental health court — which is partly why they volunteered to go first. “I think the bulk of the people who are going to be referred are not going to have schizophrenia,” said Veronica Kelley, chief of Mental Health and Recovery Services at the Orange County Health Care Agency. “We have many people who are clinically stable, meaning they’re not going to hurt themselves or others. They can function, but they still might shout at their voices. They still are experiencing symptoms. So if they are involved in treatment, they’re clinically stabilized, they don’t qualify for this.” Luke Bergmann, director of behavioral health in San Diego County — another of the first seven counties — says he is especially concerned about the workforce. He worries about what CARE Court will mean for long- term care, which is “already under a lot of stress.” He anticipates a substantial uptick in demand for such facilities, including board-and-care homes, where serious shortages already exist. “Even estimating how much staff you’ll need is a shot in the dark.” —MICHELLE CABRERA, EXECUTIVE DIRECTOR, COUNTY BEHAVIORAL HEALTH DIRECTORS ASSOCIATION 7/13/23, 3:07 PM California homeless: How will CARE Courts work? - CalMatters https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/5/7 In addition, he says, it is not yet clear who will pay for a lot of the ongoing operational costs of CARE Court. “We don’t currently have a good model for how that kind of work should be reimbursed,” he said, especially for people insured by Medi-Cal. The state’s Health and Human Services department told CalMatters most CARE Court participants will be either insured by or eligible for Medi-Cal. Those with commercial insurance would be required to reimburse the county for eligible behavioral health care costs. They pointed to nearly $10 billion counties already receive annually for behavioral health care. Civil rights concerns Still, advocates worry the court system will backfire. Eve Garrow, homelessness policy analyst and advocate at the ACLU of Southern California, which opposes the bill, says people who need help the most may avoid the mental health system — or even avoid family members who can file petitions — “because they fear being hauled into court.” Garrow also fears the number of people funneled into conservatorships — which restrict far more aspects of a person’s life — will climb. And she believes Black people will be disproportionately impacted because they are more likely to be over-policed, experience homelessness and be misdiagnosed with psychotic disorders. “The last thing I want to see is a system where, in order to get timely access to the kinds of resources that you need to survive, you have to give up all of your rights and be subjected to a court order,” Garrow said. In fact, civil rights groups argue the program would “unravel decades of progress for people with disabilities to have the same civil rights of everyone else,” said Lili Graham, litigation counsel at Disability Rights California. Her group says it plans to sue once the law goes into effect. “We’re outraged,” Graham said. “We’re horrified. We’re ready to file suit.” But vehement opposition from similar groups across the country and dozens of other civil rights groups and homelessness advocates — who are now urging Newsom to veto his own bill — was not enough to stop it “We’re outraged. We’re horrified. We’re ready to file suit.” —LILI GRAHAM, LITIGATION COUNSEL, DISABILITY RIGHTS CALIFORNIA 7/13/23, 3:07 PM California homeless: How will CARE Courts work? - CalMatters https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/6/7 from flying through both houses. As legislator after legislator took to the microphone on the penultimate day of the legislative session, they spoke to a choice between an imperfect solution and continued inaction. “I don’t think this is a great bill, but it seems to be the best idea that we have, at this point, to try to improve a God awful situation,” said Assemblymember Al Muratsuchi, a Democrat from Torrance. “To walk away and say we can’t do anything, to basically say this isn’t good enough, is to in a perverse kind of way say, ‘We really don’t care,’” said Assemblymember Jim Patterson, a Republican from Fresno. Patterson acknowledged casting a vote would not be enough, either. “This is going to take walking beside these folks, not just today, when we push the button, but next week, next year, perhaps another decade or so.” 7/13/23, 3:08 PM California Supreme Court tosses lawsuit against Newsom's CARE Court - The San Diego Union-Tribune https://www.sandiegouniontribune.com/news/california/story/2023-04-22/california-supreme-court-newsom-care-court-mentally-ill-homeless-substance…1/3 CALIFORNIA California Supreme Court rejects lawsuit challenging Newsom’s plan to treat mental illness CARE Court is Gov. Gavin Newsom’s sweeping plan to compel treatment for thousands of Californians struggling with diagnosed mental illness and addiction. (Allen J. Schaben / Los Angeles Times) Gov. Gavin Newsom’s CARE Court plan to address severe mental illness, substance use and homelessness is on track to move forward after the high court rejected a legal challenge BY HANNAH WILEY | LOS ANGELES TIMES APRIL 22, 2023 6:08 PM PT 7/13/23, 3:08 PM California Supreme Court tosses lawsuit against Newsom's CARE Court - The San Diego Union-Tribune https://www.sandiegouniontribune.com/news/california/story/2023-04-22/california-supreme-court-newsom-care-court-mentally-ill-homeless-substance…2/3 The California Supreme Court this week declined to block the rollout of Gov. Gavin Newsom’s sweeping new plan to compel people with severe mental illness into treatment, meaning the controversial program remains on track to begin this fall in several counties. Earlier this year, a coalition of disability and civil rights groups asked the state’s high court to strike down as unconstitutional Newsom’s program known as CARE Court (for Community Assistance, Recovery and Empowerment), claiming that it violated due process and equal protection rights. The court rejected the request on Wednesday without issuing an opinion. Andy Imparato, executive director of Disability Rights California, one of the main organizations that filed the lawsuit, called the decision “disappointing.” “It’s not surprising, but it’s frustrating,” he said. “There’s a vulnerable population here whose rights don’t seem to matter to these powerful political forces.” Supporters of CARE Court say it will revolutionize California’s approach to treating those with a diagnosed psychotic disorder and addiction, many of whom are also homeless. Once implemented, the program will allow family members, behavioral health providers and medical professionals, among others, to petition a judge to order an evaluation and, if warranted, a treatment plan that might include medication and housing. The same groups that filed the lawsuit opposed CARE Court from the start, saying it would infringe on personal liberties and arguing that forced treatment is not effective. In a statement, Newsom said the ruling ensures that CARE Court’s implementation won’t be delayed and that the state remains on track to launch the program this fall. Orange, Riverside, San Diego, San Francisco, Stanislaus, Glenn and Tuolumne counties 7/13/23, 3:08 PM California Supreme Court tosses lawsuit against Newsom's CARE Court - The San Diego Union-Tribune https://www.sandiegouniontribune.com/news/california/story/2023-04-22/california-supreme-court-newsom-care-court-mentally-ill-homeless-substance…3/3 Copyright © 2023, The San Diego Union-Tribune | CA Notice of Collection | Do Not Sell or Share My Personal Information have until Oct. 1 to begin implementation, with Los Angeles County on track to join two months later. The rest of the state has until December 2024. “This ruling holds significant importance for thousands of Californians and their families experiencing untreated serious mental illness and substance use disorders,” Newsom said. “The CARE Act was passed with overwhelming, bipartisan support from the Legislature, and has been endorsed by a broad coalition of partners committed to implementing this transformative initiative in communities across California.” The Supreme Court’s choice not to intervene could complicate future legal challenges to the program, considering it’s the state’s highest court and lower courts will be aware of the decision. Imparato acknowledged that taking the suit straight to the state Supreme Court was a “creative,” albeit “low-probability” legal strategy, and said his coalition will continue looking for other ways to block the program. It will carefully monitor CARE Court’s rollout this fall, Imparato said, and consider filing legal challenges in trial courts on a case-by-case basis on behalf of individuals in the program. “We will look at opportunities to stop bad things from happening and can definitely go back to the courts at that point,” Imparato said. “We have lots of options.” Hannah Wiley 7/13/23, 3:04 PM California counties scramble ahead of CARE Court launch - Los Angeles Times https://www.latimes.com/california/story/2023-05-21/counties-scramble-care-court-preparations 1/9 Youth Mental Health Therapy Guide 988 Hotline How to Save a Life CALIFORNIA ‘Deep in the weeds’: California counties face unknowns in launching mental illness court Gov. Gavin Newsom announces the CARE Court program in 2022. Seven counties are scheduled to launch the program on Oct. 1. (Karl Mondon / Associated Press) BY THOMAS CURWEN | STAFF WRITER MAY 21, 2023 5 AM PT In four months, the gavel will fall, and the state’s first CARE Courts will be in session. 7/13/23, 3:04 PM California counties scramble ahead of CARE Court launch - Los Angeles Times https://www.latimes.com/california/story/2023-05-21/counties-scramble-care-court-preparations 2/9 Seven counties opted for an Oct. 1 rollout of the law that orders each county to create special courts, whose judges have the authority to order treatment plans for individuals with untreated schizophrenia and related disorders. Even though the plans are not compulsory, the courts hope for compliance as the law tries to straddle a line between voluntary and mandated treatment. The CARE Act, signed into law by Gov. Gavin Newsom last September, requires counties to come up with the bureaucratic mechanisms that will support the goal of easing an epidemic of severe mental illness on the streets and in communities. “We’re deep in the weeds, thinking about what will be the daily lives of the people who engage in this work,” said Luke Bergmann, the behavioral health director for San Diego County. Among the many challenges of the CARE Act is developing a manageable workflow for disparate groups. For every individual appearing in the court, there will be the clerks who processed the petitions that initiated the proceedings, the outreach teams that found the individual and served the paperwork, the psychiatrists who prepared a treatment plan, defense attorneys who will represent the individual, behavioral health clinicians who will present the plan and the judges who will negotiate its implementation. In addition, there will be insurance companies that pay for the plan, administrators who manage the paperwork associated with the plan and healthcare providers who execute the plan. CALIFORNIA CARE Court will change how California addresses serious, untreated mental illness. Here’s how Sept. 15, 2022 7/13/23, 3:04 PM California counties scramble ahead of CARE Court launch - Los Angeles Times https://www.latimes.com/california/story/2023-05-21/counties-scramble-care-court-preparations 3/9 The first group — San Diego, Orange, Riverside, San Francisco, Stanislaus, Tuolumne and Glenn — reflects the geographic and demographic diversity of California. Their courts will serve as a template for Los Angeles and the 50 other counties. (L.A. County will open its court on Dec. 1; the rest of the state has until Oct. 1, 2024.) Many counties will be playing catch-up with a crisis that has gone unchecked for decades. County supervisors and behavioral health directors describe a neglected system with an unknown number of people who may be eligible for a CARE Court. The state has estimated that 7,000 to 12,000 people will qualify for a treatment plan. The range is so broad, officials say, in part because the law allows roommates or family members to initiate an assessment of a family member suspected of having a severe mental illness. Some counties are concerned that they will be overwhelmed by families who have been unable to seek assistance caring for individuals with mental illness by laws that protect their rights and privacy. They are braced as well for the frustration from families whose requests are denied for not meeting the criteria specified by the law. Those brought into a CARE Court must be 18 or older, diagnosed with “schizophrenia spectrum and other psychotic disorders” and not currently being treated. “We’re just not sure who this law will bring to the door,” said Veronica Kelley, Orange County’s behavioral health director. Orange County estimates it will receive petitions for about 1,500 people the first year, with about 1,000 of them meeting the court’s criteria. Of those, officials estimate, nearly 300 are expected to agree to a treatment plan without having to be brought into CARE Court, leaving 700 for the court to monitor for at least a year. 7/13/23, 3:04 PM California counties scramble ahead of CARE Court launch - Los Angeles Times https://www.latimes.com/california/story/2023-05-21/counties-scramble-care-court-preparations 4/9 Family members demonstrating at the state Capitol in support of the CARE Court proposal. (Anita Chabria / Los Angeles Times) One of the smaller counties, Stanislaus, has identified 150 people who will qualify based on frequent emergency room visits. “Beyond that,” said county Supervisor Terry Withrow, “it’s anyone’s guess.” Such estimates are critical for counties needing to hire staff at a time when the state is experiencing a shortage of behavioral health workers. Meeting that need will be harder on rural counties, which have fewer providers capable of working with people suffering from acute mental illness. “In a small county, it’s not like staffing will grow to meet capacity, especially when it comes to administration and management,” said Joe Hallett, behavioral health director 7/13/23, 3:04 PM California counties scramble ahead of CARE Court launch - Los Angeles Times https://www.latimes.com/california/story/2023-05-21/counties-scramble-care-court-preparations 5/9 for Glenn County, 60 miles north of Sacramento. “Instead, we just add these new responsibilities to the existing workload.” Health directors like Hallett are looking to lawmakers in Sacramento for continued advocacy and support. Glenn County will receive nearly $1.4 million in early allocations. Startup funding for the CARE Act was $57 million. The state budgeted $26 million to be divided among the first group of counties as they work out whatever kinks arise in implementation. Another distribution of $31 million will be shared among all counties in advance of full implementation in 2024. While Orange County received one of the highest allocations — $7.1 million — Kelley is concerned about lawmakers’ resolve keeping the CARE Act fully funded. “That’s good for one year,” she said, “but for the ensuing year, we don’t know.” Funding behavioral health services was one reason Riverside County signed up early, said Jeff Van Wagenen, the county’s chief executive officer, who argues that it has not received support from the state commensurate with its population growth. The first allocation of $6.6 million will help, but what comes after the first year is unknown. “One of the concerns of CARE Court is that it could be the latest unfunded mandate from the state,” he said. Reflected in Sacramento’s budget for CARE Court is the presumption that the initial counties will work out kinks in the legislation so that other counties can start up their courts at less expense. This means answering a number of mundane yet critical questions left unaddressed by the law itself. For instance, who should serve the petition and transport individuals to the court? 7/13/23, 3:04 PM California counties scramble ahead of CARE Court launch - Los Angeles Times https://www.latimes.com/california/story/2023-05-21/counties-scramble-care-court-preparations 6/9 While behavioral health departments may seem the logical choice, Bergmann is concerned that it creates a conflict of interest when the agency bringing the person to court represents the interests of the party who petitioned the court. Enlisting law enforcement for this task is equally problematic for encounters on the street that will likely require more trust than authority, he said. Building that trust is one reason why Orange County is making provisions for its staff to help family members fill out the petitions that the court needs to initiate the intervention. “We imagine a loved one at wit’s end — agitated, frustrated and tired — for all they have been through getting to this moment,” Kelley said. “So, the court staff has to be ready for that. We’re also trying to get the $433 filing fee waived. That’s a lot of money.” CALIFORNIA Why California’s much-touted CARE Court is ‘no one-and-done program’ Jan. 1, 2023 To help families understand the process, Riverside County is developing an app that will chart individual progress through the CARE system. The county also might conduct remote civil hearings, so that someone living in Blythe, for instance, would not have to go to court in Riverside, 170 miles away. “All we need is a table, chair and laptop,” Van Wagenen said. “So we could buy a van and convert it into a mobile courtroom. This would avoid the problem of having to store property or board pets for those who are experiencing homelessness.” Homeless people create a unique dilemma for counties required to hold a case management hearing within two weeks of determining the validity of the applicant’s petition. 7/13/23, 3:04 PM California counties scramble ahead of CARE Court launch - Los Angeles Times https://www.latimes.com/california/story/2023-05-21/counties-scramble-care-court-preparations 7/9 “We will need more than 14 days to find the person and to try to get them to agree to treatment,” Kelley said. “What if a person has moved to a different county? We can’t extend all our resources, trying to find them. We’re not investigators.” “We’re deep in the weeds, thinking about what will be the daily lives of the people who engage in this work,” said Luke Bergmann, the behavioral health director for San Diego County. (Kristian Carreon / For the San Diego Union-Tribune) Hallett, with Glenn County, has similar concerns. The two-week window is “really, really fast to find someone, do outreach and process a report,” he said. “A month would be more reasonable.” Yet lawmakers wrote the law with the intention of pressuring counties to act quickly, leaving counties to meet that timeline or pay a price. “The CARE plan is like a settlement agreement between the county and the respondent,” said Jacqueline Wong-Hernandez, chief policy officer for the California 7/13/23, 3:04 PM California counties scramble ahead of CARE Court launch - Los Angeles Times https://www.latimes.com/california/story/2023-05-21/counties-scramble-care-court-preparations 8/9 State Assn. of Counties. “Once a plan is in place, the petitioner falls away, and an agreement to comply has to be struck between the county behavioral health department and participants in the court.” The stakes for not meeting the 14-day deadline are high. If the court finds the county to be noncompliant, a $1,000-a-day sanction per case can be levied. Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, calls the counties’ efforts so far “very promising.” Not only does the legislation hope to change “the arc of lives of some of the most vulnerable among us,” but it also represents “a culture shift in how we collectively as a system do business, which will take time and repetition.“ “Frankly,” he said, “it is our responsibility to do better.“ As much as behavioral health directors welcome the CARE Act, they emphasize that additional work is required to address broader and deeper problems in the state’s behavioral health system. “We’re moving too quickly,” Kelley said. “Give us five years, which is how long the county needs in order to build anything. Without the infrastructure, these programs won’t be as successful as the Legislature wants, and we might lose people whom we could be serving in the process.” Newsom hopes to address this deficiency by creating new revenue streams for housing and services, but his proposals are contingent on voters and will take years to put in place. “We’re standing at the front door,” Bergmann said. “We’re painting it, we’re putting in windows, we’re outlining it with mother of pearl, and yet when we walk in, we find a 7/13/23, 3:04 PM California counties scramble ahead of CARE Court launch - Los Angeles Times https://www.latimes.com/california/story/2023-05-21/counties-scramble-care-court-preparations 9/9 Copyright © 2023, Los Angeles Times | Terms of Service | Privacy Policy | CA Notice of Collection | Do Not Sell or Share My Personal Information building without a roof.” Thomas Curwen Thomas Curwen is staff writer for the Los Angeles Times, specializing in long-form narratives, and was a Pulitzer Prize finalist in 2008 for feature writing. 7/13/23, 3:05 PM LA County Moves To Expedite CARE Court Hiring To Help More People With Mental Illness | LAist https://laist.com/news/health/la-county-moves-to-expedite-care-court-hiring-to-help-more-people-with-mental-illnesses 1/10 Breaking News: Hollywood actors are on strike — joining writers on the picket lines. The rare double strike marks rst time both unions are striking at the same time since 1960. Support your source for local news! The local news you read here every day is crafted for you, but right now, we need your help to keep it going. In these uncertain times, your support is even more important. Today, put a dollar value on the trustworthy reporting you rely on all year long. We can't hold those in power accountable and uplift voices from the community without your partnership. HEALTH LA County Moves To Expedite CARE Court Hiring To Help More People With Mental Illness By Robert Garrova Published Jun 8, 2023 2:17 PM Gov. Newsom gives comments in March 2022, when the rst details of the CARE Court proposal were released. (YouTube screenshot ) Support for LAist comes from Become a sponsor DONATE 7/13/23, 3:05 PM LA County Moves To Expedite CARE Court Hiring To Help More People With Mental Illness | LAist https://laist.com/news/health/la-county-moves-to-expedite-care-court-hiring-to-help-more-people-with-mental-illnesses 2/10 Monthly Donation One-Time Donation $5/mo $10/mo $15/mo $20/mo CONTINUE $ other amount /month HI, I’M AARICKA! SUBSCRIBE The L.A. County Board of Supervisors voted Tuesday to use an emergency declaration on homelessness to expedite hiring for CARE Court, a state-mandated program that aims to create new avenues for people living with a serious mental illness such as schizophrenia to get lifesaving treatment. With L.A. County’s launch of CARE Court set for Dec. 1, some supervisors expressed concerns the county would not be ready to provide care for the estimated 4,500 people who would qualify. Historically, the county’s Department of Mental Health has struggled to ll open positions. Last fall, California Governor Gavin Newsom signed the Community Assistance, Recovery, and Empowerment (CARE) Act into law, which requires all counties to set up a new framework for the program. If you're enjoying this article, you'll love my daily morning newsletter, How To LA. Every weekday, you'll get fresh, community- driven stories that catch you up with our independent local news. Email 7/13/23, 3:05 PM LA County Moves To Expedite CARE Court Hiring To Help More People With Mental Illness | LAist https://laist.com/news/health/la-county-moves-to-expedite-care-court-hiring-to-help-more-people-with-mental-illnesses 3/10 The Brief VIEW ALL Mega El Niño Year And this weather system is likely a strong one 6 minutes ago 3rd Migrant Bus Arrives Texas sent 35 more migrants to Union Station today 1 hour ago FDA Approves Opill First daily birth control pill w/o prescription 2 hours ago Under CARE Court, people living with a serious, untreated mental illness could be referred for a court-ordered care plan. The court intervention could be initiated by a family member, county behavioral health workers or even rst responders. If the care plan fails, the person could be hospitalized or referred to a conservatorship. CARE Court in L.A. County will begin with one courtroom and one judge within the Superior Court in Norwalk. At the board meeting Tuesday, Supervisor Holly Mitchell pointed out that the success of CARE Court would also be contingent on the county’s ability to build out badly needed mental health treatment beds. “In order to meet a variety of our expectations, including CARE Court — we’re focused on setting up the court infrastructure — Support for LAist comes from Become a sponsor 7/13/23, 3:05 PM LA County Moves To Expedite CARE Court Hiring To Help More People With Mental Illness | LAist https://laist.com/news/health/la-county-moves-to-expedite-care-court-hiring-to-help-more-people-with-mental-illnesses 4/10 the point is the judge will have to have a place to send that individual,” Mitchell said. “That’s a bed that we have to build,” Mitchell said, noting that the initial planned state funding of $15 million may not be enough. Experts say L.A. County likely needs thousands more psychiatric beds at varying levels of care in order to meet demand. According to a report from the California Health Care Foundation, in California “the number of acute psychiatric beds per 100,000 people decreased about 30 percent from 1998 through 2017.” Some have also questioned how much strain CARE Court will put on public guardians’ oces throughout the state. Those oces are responsible for guiding care for people who are deemed too unable to do so themselves because of a serious mental illness. “You ask any guardian, conservator in this state and [they’ll say] we just don’t have facilities,” Tom Scott, executive director of the California State Association of Public Administrators, Public Guardians, and Public Conservators, told LAist. “CARE Court in its concept is great; but how is it implemented, how does it actually play out?, ” Scott said. Many families who have struggled to get their loved ones living with a serious mental illness to accept treatment see CARE Court Support for LAist comes from Become a sponsor 7/13/23, 3:05 PM LA County Moves To Expedite CARE Court Hiring To Help More People With Mental Illness | LAist https://laist.com/news/health/la-county-moves-to-expedite-care-court-hiring-to-help-more-people-with-mental-illnesses 5/10 Most Read as an invaluable tool, while civil liberties groups have fought the new framework in court, citing concerns around misuse and forced treatment. Supervisor Lindsey Horvath was the sole "no" vote on Tuesday’s motion, which was authored by Supervisors Janice Hahn and Kathryn Barger. “I’m concerned that there may be misuse or maybe even abuse of this tool and that it will be used to sweep people instead of to help people which is not what anyone wants to see happen,” Horvath said. The motion passed Tuesday also directs county workers to identify properties that could be used to support CARE Court as it rolls out, among other provisions. “We have been struggling for decades to gure out a way to get real, compassionate help to people with severe mental illness, and I believe CARE Court could be the missing piece of the puzzle,” Hahn said in an emailed statement. What questions do you have about mental health in SoCal? One of my goals on the mental health beat is to make the seemingly intractable mental health care system more navigable. ASK A QUESTION