By Yue Stella Yu and Erica Yee, CalMatters
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Three years ago, Gov. Gavin Newsom called for a court with real power both to force a government agency to treat a mentally ill patient, and to compel that patient to stick to the program.
That’s how many Californians remember his CARE Court proposal: As a mandate to bring people with severe mental illness off the street and into treatment. Noncompliance, Newsom said at the time, would lead to consequences — counties could face fines for not providing court-ordered services, and participants who fail the program could be referred to conservatorship, which often means involuntary treatment in locked facilities.
But a CalMatters review of the legislative record shows that vision is not what became law, and, as a result, the state has rarely mandated treatment of a mentally ill person or referred someone to conservatorship. It has not handed down a single fine for counties that failed to provide court-ordered services to many CARE participants.
The bill went through several amendments that:
- narrowed eligibility for CARE court,
- demanded more time and information from people filing petitions,
- favored voluntary treatment agreements over court-ordered plans,
- and eliminated requirements that counties provide certain services, according to a CalMatters analysis of versions of the 2022 bill.
Newsom had envisioned that 7,000 to 12,000 Californians would qualify for the program. But by July, only 528 people enrolled in treatment plans. Almost all — 514 — were through voluntary agreements instead of court-ordered plans.
“I think the law that was promised was pretty ambitious,” said Assemblymember Ash Kalra, a San Jose Democrat 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.”
While Newsom’s proposal sailed through the state Legislature with near-unanimous, bipartisan support, it was contentious among various interest groups.
Civil rights organizations, such as ACLU and Disability Rights California, wanted to protect the liberties of mentally ill people and fought the proposal on principle. Counties and behavioral health professionals worried about funding and execution as they pressed for adjustments to the bill text.
Some mental health advocates, including the National Alliance on Mental Illness of California, were supportive from the start. The Steinberg Institute, founded by former California Senate President Darrell Steinberg, applauded CARE Court as a “huge step forward” to protect vulnerable Californians.
But the final product pleased few, if any. The law was both too coercive for the civil rights groups and not coercive enough for many families who wanted to see their loved ones in treatment.
“I’ve wondered (about) the point of a court with no real power,” said Anita Fisher, a San Diego mother who advocated for Newsom’s idea but later called the program a “total failure” in practice.
Newsom, who campaigned on eradicating chronic homelessness, unveiled CARE Court as the state’s unhoused population surged and public frustration climbed despite the tens of billions of dollars his administration spent on homelessness and affordable housing. Cities such as Sacramento and Los Angeles were mulling ballot measures to prohibit homeless people from sleeping in public spaces when Newsom unveiled the proposal.
“There’s no compassion with people with their clothes off defecating and urinating in the middle of the streets, screaming and talking to themselves,” Newsom told the San Francisco Chronicle in 2022. “I’m increasingly outraged by what’s going on in the streets. I’m disgusted with it.”
Eve Garrow of ACLU of Southern California called Newsom’s focus on accountability a “political maneuver” that shifts the blame for homelessness onto counties while ignoring the lack of resources to support them. Without guaranteed permanent housing, CARE Court is merely “window-dressing,” she said.
The law stipulates that CARE Court participants get priority from certain existing state housing funds, but did not come with any additional money, a concern cities, counties, and care providers raised throughout the bill process.
“There’s very little political will in Sacramento for (funding permanent housing), given the price tag,” Garrow said. “I honestly think that the houselessness crisis in California has … contributed to a political climate, in which state legislators are looking for easy fixes.”
When asked by CalMatters if Newsom believed the individual and county-level accountability he spoke of materialized, Newsom spokesperson Tara Gallegos did not give a direct answer. Instead, she said the law has improved in recent years and that is evidence that “(the) government is working as it should.”
The core of CARE Court, Gallegos stressed, was “voluntary” participation. “Coercion rarely works with those who need care,” she said in a statement last week.
She took a more forceful tone on counties’ responsibility to provide care.
“It shouldn’t take stronger accountability measures for counties to do the right thing,” she said. “The public has called for action and counties should be listening and acting with urgency — or voters will do it for them. There’s no excuse for counties failing to deliver — and the variability in implementation that we are seeing now is completely unacceptable.”
State Sen. Tom Umberg, a Santa Ana Democrat who co-authored the original bill, acknowledged it’s still a “work in progress.” In recent years, he’s introduced “cleanup” bills to expand eligibility for CARE court and boost program uptake.
The law largely relies on the “soft power” of judges, leaving it at their discretion to hold counties and individuals accountable, Umberg said.
“I don’t think that we’ve done the kind of job that needs to be done,” he said. “Do we need to have more folks who are engaged and successfully complete the program? Absolutely. Have we gotten there yet? No.”
CalMatters’ Jocelyn Wiener and Marisa Kendall contributed to this report.
This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.