Gov. Gavin Newsom’s office said CARE Court would be a “paradigm shift.”
When he announced the new program, one news story called it “Newsom’s new homeless plan.”
Another report declared, “California focuses on mental illness to reduce homelessness.”
Even if the Community Assistance, Recovery, and Empowerment (CARE) Courts work exactly as designed, Newsom and his allies could face some blowback. That’s because expectations grew, at least initially, way beyond what the new courts are intended to do.
The CARE Court system, which launches in San Diego on Oct. 2, will provide a path to treatment for a relatively small group of people with severe, but narrowly defined mental illnesses. Being homeless is not among the eligibility requirements.
It was widely believed that part of the aim of CARE Court was to make a substantial dent in California’s burgeoning homeless population. That wasn’t just overblown, it was flat-out wrong.
Health care officials involved in implementing the system have been trying to set the record straight.
“I think what people imagine, if they’ve been sort of consuming the public discourse around CARE Court in the months leading up to its launch, is that the folks for who it is designed would include nearly everyone who is homeless, who has a mental illness, but that’s not the case,” Luke Bergmann, director of behavioral health services for San Diego County, told Paul Sisson of The San Diego Union-Tribune.
The nexus of mental illness and homelessness has created an overarching societal concern that is driving policy and political decisions.
There’s general agreement that people become homeless for many reasons, with the lack of housing, economic stress and behavioral issues among them. But there is disagreement about the primary cause and how best to address it.
For years, Democrats who control the state government and California’s large cities have focused largely on housing, and have come up woefully short.
Republicans have often disparaged the “housing first” approach, which seeks to get a roof over a homeless person’s head with no conditions, then quickly provide services that may be needed, such as economic and employment assistance, substance abuse counseling and mental health treatment.
GOP officeholders have argued such things as sobriety and mental health treatment should be the first order of business before housing, along with clearing out illegal homeless encampments. Increasingly, Democrats have put greater emphasis on these steps.
That’s not to say Democrats weren’t trying to address behavioral issues before. The county of San Diego, for example, has been expanding programs addressing this in recent years under Democratic leadership, more so than when Republicans were in control.
CARE Court is an effort to pressure people who have been reluctant to seek or have refused mental health treatment they need. While the new process may represent a sea change in getting these people help, the scope of the program is limited.
“Indeed,” Sisson wrote, “the legislative analysis of the CARE Act estimates that just 5,657 Californians would qualify for the program. That’s a small fraction of the 1.5 million Californians said to be experiencing severe mental illness.”
For further context, California has more than 170,000 homeless people, according to the latest estimates.
Some families have expressed concern their troubled loved ones may not be eligible.
Not surprisingly, even before the CARE Courts open, there has been discussion of including people with a broader array of diagnoses and behavioral issues.
Meanwhile, there’s other movement on the mental health front. The Legislature recently approved the hotly disputed Senate Bill 43, which would loosen the guidelines for when someone can be placed in an involuntary hold that can lead to conservatorship.
The governor and Legislature also are moving ahead with ballot measures next year for a $6.4 billion bond to provide more facilities for people with mental illness, and an amendment to the 20-year-old Mental Health Services Act — which levied the so-called “millionaire’s tax” — to allow some of the money to be spent on homelessness.
The Legislature also agreed to redirect $1 billion to operate the new mental health facilities.
The failure of CARE Courts to live up to the hype may lead to some disappointment. Whether that would make voters skeptical of those two ballot measures remains to be seen.
Both the bond and flexibility on the millionaire’s tax revenue had overwhelming bipartisan support in the Legislature. So did the CARE Act, which will cost hundreds of millions of dollars. But Democrats, including San Diego Mayor Todd Gloria, were among the biggest supporters of these proposals.
How did the expectations for CARE Court grow so wildly out of proportion? It may have started with the governor, who made the CARE Act his top legislative priority last year.
Bergmann, the San Diego health official, told CalMatters the presumption the program would have a substantial impact on homelessness “is, to be clear, driven by how the administration talked about CARE Court at the outset.”
The California public wants mental health issues to be addressed and homelessness to be reduced.
It would seem unlikely, not to mention unseemly, for supporters to quickly turn on these initiatives because of the planned incremental start of CARE Courts, which are being phased in in San Diego and a handful of other counties.
But then patience isn’t always a prized virtue in politics.
What they said
As relayed by Frank Thorp V (@frankthorp) of NBC News on X.
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