How Gavin Newsom’s CARE Court Lost Its Teeth in the Legislature

from Yue Stella Yu and Erica YeeCalMatters

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Three years ago, the manager Gavin Newsom called for a court with real power both to compel a state agency to treat a mentally ill patient and to compel that patient to adhere to the program.

Here’s how many Californians remember his CARE Court proposal: As a mandate to get people with severe disabilities out mental illness off the street and into treatment. A discrepancy, Newsom said at the time, would lead to consequences — counties can face court-ordered fines for failing to provide services, and participants who fail the program can be sent to conservatories, which often means forced treatment in locked facilities.

But a CalMatters review of the legislative record shows that vision isn’t what became law, and as a result, the state has rarely mandated treatment for a mentally ill person or referred someone to a conservatorship. It has not issued a single fine for counties which failed to provide court-ordered services to many CARE participants.

The bill underwent several amendments which:

• limited right to participate in the CARE Court,
• asked for more time and information from petitioners,
• favored voluntary treatment agreements over court-ordered plans,
• and eliminates requirements that counties provide certain services, according to a CalMatters analysis of versions of the 2022 bill.

Newsom projected that 7,000 to 12,000 Californians would qualify for the program. But in Julyonly 528 people are enrolled in treatment plans. Almost all – 514 – were through voluntary agreements rather than court-ordered plans.

“I think the law that was promised was pretty ambitious,” he said Assembly Member Ash KalraDemocrat from San Jose and the only lawmaker to consistently vote against the 2022 measure. “It’s not surprising to me that it didn’t live up to all the hype of what was promised.”

Although Newsom’s proposal passed the state legislature with near-unanimous bipartisan support, it sparked controversy among various interest groups.

Civil rights organizations such as the ACLU and Disabled Rights California wanted to protect the liberties of the mentally ill and opposed the proposal on principle. Counties and behavioral health professionals worry about funding and enforcement as they push for tweaks to the bill’s text.

Some mental health advocates, including the National Alliance on Mental Illness of California, have been supportive from the start. The Steinberg Institute, founded by former California Senate President Darrell Steinberg, hailed the CARE Court as a “huge step forward” in protecting vulnerable Californians.

But the end product pleased few, if any. The law was too coercive for civil rights groups and not coercive enough for many families who wanted to see their loved ones in treatment.

“I wondered (about) the point of a court with no real power,” said Anita Fisher, a San Diego mother who championed Newsom’s idea but later called the program a “total failure” in practice.

Newsom, who campaigned on eradicating chronic homelessness, the CARE Court found, as the state’s homeless population increased and public disillusionment rose despite the tens of billions of dollars his administration spent on homeless and affordable housing. Cities like Sacramento and Los Angeles were considering ballot measures to ban homeless people from sleeping in public places when Newsom unveiled the proposal.

“There is no compassion for people with their clothes off, defecating and urinating in the middle of the street, screaming and talking to themselves,” Newsom told San Francisco Chronicle in 2022. “I am increasingly outraged by what is happening in the streets. I am disgusted by it.”

Eve Garrow of the ACLU of Southern California called Newsom’s focus on accountability a “political maneuver” that shifts the blame for homelessness onto counties while ignoring a lack of resources to support them. Without guaranteed permanent housing, CARE Court is just “window dressing,” she said.

The law mandated that CARE Court participants receive priority from some existing public housing funds but did not come with any additional money, a concern that cities, counties and care providers raised during the bill’s process.

“There is very little political will in Sacramento for (funding permanent housing) given the cost,” Garrow said. “Frankly, I think the homelessness crisis in California … has contributed to a political climate where state legislators are looking for easy solutions.”

Asked by CalMatters whether Newsom believes the individual and district-level accountability he talked about has materialized, Newsom spokeswoman Tara Gallegos did not give a direct answer. Instead, she said the law had improved in recent years and was proof that “(the government) is working as it should.”

The core of the CARE Court, Gallegos emphasized, is “voluntary” participation. “Coercion rarely works with those who need care,” she said in a statement last week.

She took a stronger tone on counties’ responsibility to provide care.

“There should be no tougher accountability measures for counties to do the right thing,” she said. “The public has called for action, and counties must listen and act urgently — or voters will do it for them. There is no excuse for counties to fail to deliver — and the variability in enforcement we’re seeing now is completely unacceptable.”

State Senator Tom UmbergA Santa Ana Democrat who co-authored the original bill acknowledged it is still a “work in progress.” In recent years, he introduced “clean-up” bills. extending eligibility for CARE trial and mastery of the promotion program.

The law relies heavily on the “soft power” of judges, leaving it up to them to hold counties and individuals accountable, Umberg said.

“I don’t think we’ve done the work that needs to be done,” he said. “Should we have more people who are engaged and successfully completing the program? Absolutely. Are we there yet? No.”

CalMatters’ Jocelyn Wiener and Marissa Kendall contributed to this report.

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