Newsom Expands Mental Health Court Program — and Calls Out SF for Falling Behind

Gov. Gavin Newsom announced Monday that California is expanding resources to support its first-of-its-kind mental health court program, but threatened to divert those funds from counties, including multiple in the Bay Area, where implementation is falling behind.

Two years after the launch of the CARE Court program, which aims to connect unhoused Californians suffering from psychosis with housing and treatment plans, Newsom’s office awarded an additional $291 million toward housing and behavioral health services. The governor’s office is also adding accountability measures to speed up the adoption of CARE Court programs for counties like San Francisco, where the programs are struggling to connect people to services.

“Through CARE Court, we have seen inspirational stories of recovery and resilience, but many counties continue to lag behind their peers,” Newsom said in a statement. “Local leaders have a moral and legal obligation to deliver this transformational tool for those who need it most. We will not accept failure and excuses when lives are on the line.”

In October 2023, counties across the state began rolling out CARE Court programs created by the Community Assistance, Recovery, and Empowerment Act. All 58 counties implemented the programs by the end of 2024. The legislation aims to make it easier for first responders, doctors and family members to petition the court to help people suffering from psychosis due to schizophrenia and other behavioral health challenges.

If a case is accepted, a civil court judge presents a voluntary treatment plan, which can include access to housing, mental health counseling, medication and other services. If the person refuses, a judge can compel them into treatment.

So far, it’s failed to keep up with expectations in some parts of the state. While Newsom’s office predicted CARE could reach 7,000 to 12,000 people annually when it was introduced, only about 3,800 CARE petitions have been submitted to courts. An additional 4,000 cases where people have been considered for CARE have been diverted by connecting them with services without court participation, Newsom’s office said.

Le Ondra Clark Harvey, the CEO of the advocacy organization California Council of Community Behavioral Health Agencies, said she had “expected more” when the program was initially announced.

“I do believe that the trickle [of cases] may represent that there’s not enough thoughtfulness and planning around coordination and tracking,” she told KQED. “We know as providers on the ground that every handoff matters and that people can easily fall through the safety net if that’s not done and crafted very well.”

Still, CARE expanded in October to include people experiencing psychotic symptoms as a result of bipolar disorder. Now, Newsom is throwing additional resources behind the program — and calling out counties, like San Francisco, that are underperforming.

Newsom said that his office would direct $131.8 million in Proposition 1 funding to eight Homekey+ affordable housing projects, which provide supportive housing with services for veterans, people who are at-risk or experiencing homelessness, or living with behavioral health challenges.

Newsom’s office estimates that the funding will create 443 additional homes across the communities, including in Stockton and Contra Costa County.

The other $159 million is in newly awarded Homeless Housing Assistance and Prevention funding, which will go toward 20 regions throughout the state to create permanent housing, sustain interim housing and “accelerate proven local interventions.”

Among those counties is Alameda, which Newsom called a “shining example” of CARE implementation. The county has one of the highest rates of petitions submitted per capita, and has seen an 11% drop in unsheltered homelessness since 2023.

San Francisco and Santa Clara counties, by contrast, are among 10 that have struggled to implement CARE programs. Both had fewer than 100 petitions in 2025, according to a new state dashboard, and San Francisco has seen a significantly lower percentage decrease in unsheltered homelessness than the state average since 2023.

“There are counties that haven’t gotten it done, like Santa Clara County,” Newsom said. “We’re calling [San Francisco] out as well.”

“They’re the care court ICU,” Newsom said, referring to the term his office has coined for the 10 “bottom” counties in terms of implementation.

Santa Clara recorded just 47 CARE petitions in 2025, equaling a rate of about two petitions per 100,000 residents, compared to the state’s six. New state data tracking counties’ progress on reducing unsheltered homelessness says that the county does not have publicly available data. But last year’s point-in-time count in its most populous city, San José — where Mayor Matt Mahan has also cracked down on street homelessness and encampments — reported a 10% drop between 2023 and 2025.

“Long before the creation of CARE Court, the County of Santa Clara has been at the forefront of innovative strategies to address the behavioral health crisis facing California,” Santa Clara County Executive James Williams said in a statement. “Our approach is grounded in what works: rapidly connecting people to clinically appropriate treatment and housing, rather than defaulting to lengthy, costly, and often inadequate court-based processes that do not produce better outcomes.”

Williams called the CARE program “one tool among many. He said via email that counties need sustained funding and partnership, not “reducing a complex system to a single scorecard.”

In a statement, San Francisco Mayor Daniel Lurie’s office, which has been focused on the homelessness crisis since taking office in 2024, said it  “has been using every tool in our toolbox to address the crisis on our streets — reimagining street outreach and adding recovery and treatment resources so we can get people off the street and connected to the support they need.”

“Today, encampments are at record lows, more people are getting connected to shelter and treatment, and San Franciscans feel safer than they have in years,” a spokesperson for the office said in a statement.

But state data shows that the city has seen just a 1% decline in unsheltered homelessness since 2023, compared to California’s 9% drop. Fifty CARE petitions were filed in 2025. As of last September, about two-thirds of submitted petitions were dismissed, according to an investigation by CalMatters.

The state dashboard notes that the city has increased its number of beds available for unhoused residents by nearly 10% since 2024.

Clark Harvey said flagging the counties that are performing both well and poorly is important to identify what is and isn’t working, and help bring struggling counties up to speed.

“It’s really now time to drill down and say, ‘Why aren’t things working well for these 10 counties? What can we do to support them? And what can we do to ensure that people aren’t cycling back through the system?’” she said.

But Monica Porter Gilbert with the advocacy group Disability Rights California said she was concerned about how the governor’s office is measuring a county’s performance on its new accountability dashboard.

 “We’re not seeing a ton of rigor in how the governor is defining performance or underperformance,” she told KQED. 

She said she was concerned about the number of petitions a county receives being considered a marker of success. 

“What CARE Court does is it orders people into services without increasing access to them,” she told KQED. 

She said that the program’s first annual report found that more than half of CARE participants were unable to receive at least one mental health service that was part of their treatment plan, such as peer support, medication or therapy. 

The report cited administrative delays like pending applications for services, or a lack of availability of some services in some counties, as well as coordination mishaps that led to these issues.

“The California Legislature did some analysis this past summer and found CARE Court to be — and this is a quote from them — a very expensive way to coordinate but not directly provide important services,” Gilbert said.

Despite awarding San Francisco nearly $40 million in HHAP funding in January, the governor suggested that money could be diverted from those counties in his May budget revision if they don’t improve implementation.

“I’m happy to direct every damn penny in these programs to the counties that are getting things done,” Newsom said. “I’m not interested in funding failure.”

KQED’s Vanessa Rancaño contributed to this report.