CARE The court should focus on hard-to-reach homeless people

By Darrell Steinberg, especially for CalMatters

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After more than two years of realization CARE Court of California homeless intervention program, judges have approved fewer than 900 treatment plans and only 32 have been finally ordered by the court.

There is a good explanation why CARE Court has produces such low numbers. The first results show that the state’s most vulnerable population – homeless people who are mentally ill—are not CARE Court’s true priority.

This priority needs to change.

The purpose of the forward-looking CARE Court Act is to allow judges to order treatment plans for people who are homeless, suffering from serious mental illness and who cannot receive services.

CARE Court grew out of Governor Gavin Newsom’s continued focus on getting more Californians off the streets. This followed years of budget and policy action by the administration and the Legislature, culminating in the passage of Proposition 1, which sought to focus massive dollars from my 2004 initiative, the Mental Health Services Act, toward more direct intervention and assistance for chronically homeless people living with severe mental illness.

CARE Court is a key strategy for the success of Proposition 1.

Large programs often take time to gain traction. But one statistic within these early results is both troubling and fixable: Only about a third of CARE Court petitions involve people living on the streets. In Los Angeles County, the figure is under 25%.

CARE Court is not sufficiently focused on chronically homeless people living with schizophrenia or other psychotic disorders. With few exceptions, chronically homeless participants are no preference is given to housing vouchers or other public assistance.

This deficit is not surprising given the history of previous state mental health initiatives.

When the Mental Health Services Act was passed in 2004, it dramatically expanded funding for public mental health. His “full service partnerships” were intended to replicate and scale earlier successes from my early 2000s pilot projects specifically aimed at helping homeless mentally ill people.

Over 20 years, counties gradually shifted funding from mentally ill homeless people to other populations — many of whom, while still in need, already had some form of housing.

By 2022, more than 200,000 people have been engaged in full-service partnerships. Only 25% of these partnerships served homeless adults living with severe mental illness. The percentage is even lower for chronically homeless individuals living for months or years in dilapidated tent camps.

It’s baffling that California’s signature mental health initiatives — even after legal reforms to ease the requirement for treatment — aren’t doing more to address the homelessness crisis. In the absence of a clear legal obligation for the state and counties to intervene, those most visibly suffering will continue to be passed over.

The system often bypasses the sickest people because they are the hardest and most expensive to treat. Limited resources and human nature push agencies to serve those who are easier to reach and more likely to succeed.

This may be rational, but it is also wrong.

The number of petitions, court orders, and—most importantly—people receiving treatment will only increase across the country if state and local governments and courts act in more targeted and collaborative ways to reach those most in need.

Today, petitions are filed and decided sporadically.

There is a better way to expand CARE Court’s reach. Cities and counties map the locations of major homeless encampments in detail. A modest state and county investment would allow trained CARE Court staff to proactively work in these camps, identify eligible participants, and petition for more eligible individuals in specific geographic areas.

The state and counties must then prioritize Proposition 1 funds, specifically the 30% housing set aside for CARE Court participants.

Courts should be full partners by expanding their judicial cooperation models. Larger dockets, which prioritize hearing and deciding more cases filed at once, would still allow each individual petition to be heard on its merits.

If CARE Court and getting more people off our streets is the priority we claim it to be, then all branches of government need to commit to greater numbers.

We may not be able to help everyone. But we should never accept modest results for people living in conditions no human being should have to endure.

This article was originally published on CalMatters and is republished under Creative Commons Attribution-NonCommercial-No Derivatives license.