As CARE Court faces a major vote, counties say Newsom’s proposal adds burden to overburdened behavioral health departments

A controversial new plan that could pave the way for county judges to order housing and treatment for thousands of people suffering from addiction and severe mental illness will soon face a major vote in the California assembly.

The proposal known as the Community Assistance, Recovery and Empowerment Court – or care court Establishing a new branch in the judicial system. It will allow first responders and family members to petition a county judge to seek treatment for people with addiction or severe mental illness.

But civil rights and disability rights groups, county officials and other advocates say CAIR’s court is the wrong approach and that they lack the resources to staff and provide needed treatment.

Governor Gavin Newsom and local officials He says it will be a replacement for a broken system Which cycles people through prison, hospital stays and back onto the streets. His administration estimates that CAIR’s court will serve 7,000 to 12,000 people a year.

Newsom described the growing number of people living – and dying – on the streets of California as “unacceptable” and “inhuman”. summoned Homeless woman dies under highway in San Francisco When the proposal was unveiled earlier this spring.

“There is no sympathy in reading about someone who loses their life in its shadow [Interstate] 280 are in camp,” the governor said at a news conference outside a residential mental health treatment center in San Jose in March. “We can hold our hands, hold a candlelight vigil and talk about how the world should be, or we can afford some The damned responsibility to carry out our ideals.”

Suggestion or offer It has received near-unanimous support from lawmakers, and interest groups expect it to pass in the legislature before the end of the month.

Concerns from disabled civil rights groups

For homeless resident Sharon Jones, the prospect of a CARE court is troubling.

For the past six years, Jones has lived with her wife in a campground near American River Parkway. During that time, she witnessed people suffering from mental illness and addiction.

“I see them every day,” Jones, who works for her former self, said speaking near her collection of tents in North Sacramento. But most of them are harmless. Some of them are a little elusive.”

She said she doubted Newsom’s suggestion would be effective.

“You can’t force people to get treatment if they don’t want the treatment,” Jones added. “Addiction is something that only you can fix.”

The American Civil Liberties Union and disability rights groups from 27 countries agreed that it would not work. in open letter To the governor, they detailed concerns about the autonomy of mentally disabled people and access to housing, and asked him to stop the proposal.

“CARE will not resolve the complex cases of homelessness in California, nor will it meet the needs of non-domesticated people with mental disabilities – primarily because investing money in a new court system,” the letter says.

Advocates say affordable and accessible housing and voluntary therapy would be a better way to reduce homelessness for those with severe mental illnesses.

“In our experience, compulsory treatment for any individual with mental health disabilities will result in additional resistance, frustration, and trauma,” said Eric Harris of the Center for Disability Rights in California.

He continued, “People are going to have a terrible experience and say, ‘I never want to go back there again. I don’t want to do that again.”

Harris said people with mental disabilities, especially those from marginalized backgrounds, did not participate in the discussions that took place in drafting the CARE Court proposal.

“If we’re really trying to help those communities, we should at least take a pause now and make sure all these people are at the table while we make some of these very big decisions,” he said.

Newsom’s office argues that any treatment would be mandatory. Jason Elliott, the governor’s chief adviser, insists that “there will be no closed doors in Ker’s court” and that its purpose is to help people before they end up in the criminal justice system.

“It’s a civil court process that provides people with the services they need before severe trauma, like hospitalization, like prison, like guardianship,” Elliott said in an interview.

Although a judge can order treatment, Elliott said treatment will take place outside of legal custody and in community clinics. He argues that court-ordered treatment would be different from probate, which allow a judge to appoint a legal decision-maker to oversee a person’s daily life.

“I would argue that forced therapy is what we put people into now when in fact, they can be successful in a lower level of care” in a community setting, he said.

According to the California Department of Health Care Services, 1,459 people were placed in temporary prefectures in 2020 while there were 3,672 people under permanent arrangement.

CARE Court will allow participants to choose a “volunteer supporter” to help them “understand, consider, and report decisions to ensure [participant] able to make self-directed choices to the extent possible,” According to the program FAQ. Elliott added that people in the program will maintain a level of independence, as CARE’s court will provide “out of custody” treatment that differs from medical institutes and state medical institutions.

Counties say CAIR could overburden a tax-burdened workforce

California county governments will be responsible for implementing nearly all elements of Newsom’s proposal. County attorneys general will represent people selected for the program in court. County social workers, nurses, therapists, counselors, and psychiatrists will evaluate candidates, submit evaluation reports, spend time in court, and provide treatment that was ultimately ordered by the judge.

But county leaders say CARE’s court and its additional duties are too burdensome for already overstretched behavioral health departments. During the pandemic, counties have seen a surge in demand for mental health and addiction treatment, but they have struggled to retain workers, some of whom have left their positions for higher-paying private sector jobs.

“We really have a workforce crisis where we don’t have enough doctors to provide the mental health and substance use disorder services that are needed in our community,” said Ryan Quest, director of the Sacramento County Department of Behavioral Health Services.

Quest said his department has a shortfall of more than 100 clinical workers and that the new program will tie many of its current employees to court.

“Care Court will add new administrative burdens that will take our scarce clinical resources from serving the people who need those services,” he added.

Elliott of Newsom’s management described the workforce shortage as “a real problem that we take very seriously.” He said the funding recently approved by the legislature and the governor should help.

“The answer is a $1.7 billion workforce initiative to develop more than 20,000 new clinical social workers and other professionals in nearby settings,” Elliott added. “Because we can do everything else right and if we don’t have people to do these jobs, none of that matters.”

County leaders and advocates say the money should eventually produce new, trained workers, though that could take years.

“I hope these investments have a lot of success, but it won’t happen this second. We are putting another program on top of it,” said Jacolin Wong Hernandez, deputy executive director of the California Federation of Districts, who has been lobbying for district governments in the state Capitol.

Housing first or treatment first?

There is another severe shortfall that counties will have to contend with if CARE becomes law: housing people in the program.

Advocates of the program say the program focuses on treatment before housing, when it should be the other way around.

“There is a sense that mental illness and in some cases substance abuse is one of the root causes of homelessness,” said Marie Castaldi of the California Housing Advocacy Group. “What the evidence shows is that high housing costs and low vacancy rates are the primary indicators of the rate of homelessness in a given community.”

While the bill would allow judges to order housing as part of a patient’s “care plan,” Castaldi says counties, which would be in trouble to meet these plans, have limited housing resources.

Quist with Sacramento County said there is already an acute shortage of available housing locally and across the state. The area has The deficit is estimated at 60,000 . Affordable homes for low-income renters, according to Sacramento County Housing Needs Report 2022.

The county is also short several thousand accommodations. There are only about 3,400 shelter beds and housing available by local governments, nonprofits and religious groups for people experiencing homelessness, according to a report from the nonprofit California Housing Partnership. But there are nearly 9300 homeless people in Sacramento County. Existing shelters are usually full any day.

“We can get people into the services and help them improve. But once they get better, where will they live?” Quest said.

But Elliott points to about $15 billion in government funding approved since 2020 for counties to build and acquire more housing units. For example, the state has funded 12,500 homes for people who have come out of homelessness through it Homekey projectwhich pays cities and counties to buy and convert hotels, motels, and other buildings into homes.

Do we have enough housing to provide a permanent supportive unit for every homeless person in California? No, we don’t, and that’s a goal.

But, he added, “the scarcity mentality under which we have operated so appropriately for so many decades, is no longer the case.”

Elliott also noted the $1.5 billion in the state budget approved earlier this year to house people enrolled in behavioral health therapy.

The California Assembly approved amendments to the bill Thursday to make it clear that families can be more involved in “care plans” for their loved ones. The bill must be passed before the legislative session ends at midnight on August 31 and signed by Newsom into law.

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