California's 'CARE Court' Program Starts Amid Concerns Over Effectiveness
California Families Can Expect Eligibility Limits in CARE Courts Rollout
California's New CARE Courts Prompt Orange County to Weigh Best Practices
San Francisco to Implement Newsom's CARE Court Plan to Treat Severe Mental Illness
San Francisco Prepares to Roll Out CARE Court
A War of Compassion: Debate Over Forced Treatment of Mental Illness Splits California Liberals
Oakland Writers Ayodele Nzinga and Leila Mottley
Newsom Signs 'CARE Court' Plan, Overhauling Mental Health Care in California
Fast Food Fight and CARE Court Plan Near Finish Line
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She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/adembosky"},"mlagos":{"type":"authors","id":"3239","meta":{"index":"authors_1591205172","id":"3239","found":true},"name":"Marisa Lagos","firstName":"Marisa","lastName":"Lagos","slug":"mlagos","email":"mlagos@kqed.org","display_author_email":false,"staff_mastheads":["news"],"title":"KQED Contributor","bio":"\u003cspan style=\"font-weight: 400;\">Marisa Lagos is a correspondent for KQED’s California Politics and Government Desk and co-hosts a weekly show and podcast, \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400;\">Political Breakdown.\u003c/span>\u003c/i> \u003cspan style=\"font-weight: 400;\">At KQED, Lagos conducts reporting, analysis and investigations into state, local and national politics for radio, TV and online. Every week, she and cohost Scott Shafer sit down with political insiders on \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400;\">Political Breakdown\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400;\">, where they offer a peek into lives and personalities of those driving politics in California and beyond. \u003c/span>\r\n\r\n\u003cspan style=\"font-weight: 400;\">Previously, she worked for nine years at the San Francisco Chronicle covering San Francisco City Hall and state politics; and at the San Francisco Examiner and Los Angeles Time,. She has won awards for her work investigating the 2017 wildfires and her ongoing coverage of criminal justice issues in California. 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She previously covered immigration. Farida was \u003ca href=\"https://www.ccnma.org/2022-most-influential-latina-journalists\">named\u003c/a> one of the 10 Most Influential Latina Journalists in California in 2022 by the California Chicano News Media Association. Her work has won awards from the Society of Professional Journalists (Northern California), as well as a national and regional Edward M. Murrow Award for the collaborative reporting projects “Dangerous Air” and “Graying California.” \u003c/span>\u003cspan style=\"font-weight: 400;\">Before joining KQED, Farida worked as a producer at Radio Bilingüe, a national public radio network. 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He's worked as a senior talk show producer for WILL in Champaign-Urbana, Illinois, and was the founding producer and editor of \u003cem>Racist Sandwich\u003c/em>, a podcast about food, race, class, and gender. 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She's a former print journalist and most recently worked as the transportation reporter for the \u003cem>Mercury News\u003c/em> and \u003cem>East Bay Times. \u003c/em>There, she focused on how the Bay Area’s housing shortage has changed the way people move around the region. She also served on the \u003cem>East Bay Times\u003c/em>’ 2017 Pulitzer Prize-winning team for coverage of the Ghost Ship Fire in Oakland. Prior to that, Erin worked as a breaking news and general assignment reporter for a variety of outlets in the Bay Area and the greater Boston area. A Tufts University alumna, Erin grew up in the foothills of the Sierra Nevada mountains and in Sonoma County. She is a life-long KQED listener.","avatar":"https://secure.gravatar.com/avatar/660ce35d088ca54ad606d7e941abc652?s=600&d=blank&r=g","twitter":"e_baldi","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["author","edit_others_posts"]},{"site":"science","roles":["editor"]}],"headData":{"title":"Erin Baldassari | KQED","description":"Staff Writer","ogImgSrc":"https://secure.gravatar.com/avatar/660ce35d088ca54ad606d7e941abc652?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/660ce35d088ca54ad606d7e941abc652?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/ebaldassari"},"mesquinca":{"type":"authors","id":"11802","meta":{"index":"authors_1591205172","id":"11802","found":true},"name":"Maria Esquinca","firstName":"Maria","lastName":"Esquinca","slug":"mesquinca","email":"mesquinca@kqed.org","display_author_email":false,"staff_mastheads":[],"title":"Producer, The Bay","bio":"María Esquinca is a producer of The Bay. Before that, she was a New York Women’s Foundation IGNITE Fellow at Latino USA. She worked at Radio Bilingue where she covered the San Joaquin Valley. Maria has interned at WLRN, News 21, The New York Times Student Journalism Institute and at Crain’s Detroit Business as a Dow Jones News Fund Business Reporting Intern. She is an MFA graduate from the University of Miami. In 2017, she graduated from the Walter Cronkite School of Journalism and Mass Communication with a Master of Mass Communication. A fronteriza, she was born in Ciudad Juárez, Chihuahua, Mexico and grew up in El Paso, Texas.","avatar":"https://secure.gravatar.com/avatar/77cedba18aae91da775038ba06dcd8d0?s=600&d=blank&r=g","twitter":"@m_esquinca","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["editor"]}],"headData":{"title":"Maria Esquinca | KQED","description":"Producer, The Bay","ogImgSrc":"https://secure.gravatar.com/avatar/77cedba18aae91da775038ba06dcd8d0?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/77cedba18aae91da775038ba06dcd8d0?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/mesquinca"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"news","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"news_11963122":{"type":"posts","id":"news_11963122","meta":{"index":"posts_1591205157","site":"news","id":"11963122","score":null,"sort":[1696278307000]},"guestAuthors":[],"slug":"californias-care-court-program-starts-amid-concerns-over-effectiveness","title":"California's 'CARE Court' Program Starts Amid Concerns Over Effectiveness","publishDate":1696278307,"format":"standard","headTitle":"California’s ‘CARE Court’ Program Starts Amid Concerns Over Effectiveness | KQED","labelTerm":{"site":"news"},"content":"\u003cp>An alternative mental health court program designed to fast-track people with untreated schizophrenia and other psychotic disorders into housing and medical care — potentially without their consent — kicked off in seven California counties, including San Francisco, on Monday.\u003c/p>\n\u003cp>Democratic Gov. Gavin Newsom created the new civil court process, \u003ca href=\"https://www.kqed.org/news/tag/care-court\">called CARE Court,\u003c/a> as part of a massive push to address the homelessness crisis in California. Lawmakers approved it despite \u003ca href=\"https://apnews.com/article/health-california-legislature-san-francisco-gavin-newsom-245e23bf1c02ea4b900649c6c54ba139\">deep misgivings over\u003c/a> insufficient housing and services, saying they needed to try something new to help those suffering in public from apparent psychotic breaks.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"San Francisco Superior Court Judge Michael Begert\"]‘It’s hopefully going to help some people who need some help, and it is probably not going to make a huge dent in what you observe in the community.’[/pullquote]Families of people diagnosed with severe mental illness rejoiced because the new law allows them to petition the court for treatment for their loved ones. Residents dismayed by the estimated 171,000 people experiencing homelessness in California cheered at the possibility of getting them help and off the streets.\u003c/p>\n\u003cp>Critics blasted the new program as ineffective and punitive, given that it could coerce people into treatment.\u003c/p>\n\u003cp>But as petitions roll in Monday, it’s not clear who the program might help nor how effective it will be. That’s because the eligibility criteria is narrow and limited largely to people with \u003ca href=\"https://www.courts.ca.gov/documents/CARE-Act-Eligibility-Criteria.pdf\">untreated schizophrenia and related disorders (PDF)\u003c/a>. Severe depression, bipolar disorder and addiction by itself do not qualify.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s hopefully going to help some people who need some help, and it is probably not going to make a huge dent in what you observe in the community,” said San Francisco Superior Court Judge Michael Begert, who will supervise the court.\u003c/p>\n\u003cp>Here are things to know about the new system:\u003c/p>\n\u003ch2>What is ‘CARE Court’ and who is eligible?\u003c/h2>\n\u003cp>Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, said in a news briefing last week that the program is aimed at catching people before their condition worsens.\u003c/p>\n\u003cp>Family members and first responders are among those who can now file a petition on behalf of an adult they believe “is unlikely to survive safely” without supervision and whose condition is rapidly deteriorating. They also can file if an adult needs services and support to prevent relapse or deterioration that would likely result in “grave disability or serious harm” to themselves or others.\u003c/p>\n\u003cp>[aside postID=\"news_11959302,news_11955211,news_11958561\" label=\"Related Stories\"]To be eligible, the person needs a diagnosis on the \u003ca href=\"https://www.courts.ca.gov/documents/CARE-Act-Eligibility-Criteria.pdf\">schizophrenia spectrum or other qualifying disorders (PDF)\u003c/a>. People with severe depression or bipolar disorder do not qualify. A person does not have to be homeless to be eligible.\u003c/p>\n\u003cp>A special civil court in each county will review each petition with the county behavioral health agency evaluating eligibility. The individual will be appointed a lawyer and a support person of their choice.\u003c/p>\n\u003cp>If the court determines the individual meets eligibility criteria, they will be asked to work with the county on a voluntary plan that includes housing, medication, counseling and other social services. The agreement would be in effect for up to a year with the possibility of extending it for another year.\u003c/p>\n\u003cp>If all parties cannot agree to a voluntary plan, the statute says the court will order they work on a plan.\u003c/p>\n\u003ch2>What happens if the person does not want to participate?\u003c/h2>\n\u003cp>Civil rights advocates have raised fears that the new process will result in vulnerable people being forced into treatment.\u003c/p>\n\u003cp>A person who does not successfully complete a plan could be subject to conservatorship and involuntary treatment, said Tal Klement, a deputy public defender in San Francisco who is among critics of the new process.\u003c/p>\n\u003cp>But the statute also allows the court to dismiss the proceedings if the individual declines to participate or to follow the agreement. Judge Begert, in San Francisco, said he cannot compel someone to engage; the best he can do is start building a relationship with the person.\u003c/p>\n\u003cp>Veronica Kelley, Orange County behavioral health director, said the county’s judges understand building rapport with eligible candidates takes time and have agreed to grant her team extra time to reach voluntary agreements, despite the statute’s deadlines.\u003c/p>\n\u003ch2>Are there enough homes, treatment beds and support?\u003c/h2>\n\u003cp>The state has allocated money for emergency shelters — but critics say there is a constant shortage of case managers, appropriate in-patient treatment facilities and supportive housing.\u003c/p>\n\u003cp>San Francisco officials said in a statement that about 10% of more than 2,500 beds are open for new people. The treatment beds range from detox to step-down care for people leaving long-term care.\u003c/p>\n\u003cp>Opponents of the program say the state should have invested in more housing and existing services rather than establishing a new court system.\u003c/p>\n\u003cp>“The issue is not that these resources are available and people aren’t using them,” said Samuel Jain, senior policy attorney at Disability Rights California. “It’s that these voluntary community-based services are under-resourced and not accessible.”\u003c/p>\n\u003ch2>What happens if the person is not eligible for care?\u003c/h2>\n\u003cp>The National Alliance on Mental Illness in California, a grassroots organization supporting people with a mental illness and their families, pushed for the new mental health program. Some family members have long wanted a way to order their loved ones into treatment, the organization said.\u003c/p>\n\u003cp>Jessica Cruz, the group’s CEO, encourages people not to give up if their family member does not qualify because other resources may be available.\u003c/p>\n\u003cp>“For us, it is just really about making sure that our loved ones have the best life that they could possibly have,” she said. “Living on the streets and dying on the streets is not the way for anybody to live.”\u003c/p>\n\u003ch2>Which counties are accepting petitions?\u003c/h2>\n\u003cp>San Francisco, Orange, San Diego, Riverside, Stanislaus, Tuolumne and Glenn counties launched the new program Monday. Los Angeles County will begin its program Dec. 1.\u003c/p>\n\u003cp>The state estimates roughly 1,800 to 3,100 people could be eligible in the first seven counties. Los Angeles could bump up estimates to 3,600 to 6,200, although uptake could take time.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The rest of the state has until December 2024 to establish mental health courts.\u003c/p>\n\n","blocks":[],"excerpt":"A program designed to help people with untreated schizophrenia to access housing and medical care launched Monday in San Francisco and 6 other California counties. But it's not clear how effective it will be.","status":"publish","parent":0,"modified":1696359691,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":1077},"headData":{"title":"California's 'CARE Court' Program Starts Amid Concerns Over Effectiveness | KQED","description":"A program designed to help people with untreated schizophrenia to access housing and medical care launched Monday in San Francisco and 6 other California counties. 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Gavin Newsom created the new civil court process, \u003ca href=\"https://www.kqed.org/news/tag/care-court\">called CARE Court,\u003c/a> as part of a massive push to address the homelessness crisis in California. Lawmakers approved it despite \u003ca href=\"https://apnews.com/article/health-california-legislature-san-francisco-gavin-newsom-245e23bf1c02ea4b900649c6c54ba139\">deep misgivings over\u003c/a> insufficient housing and services, saying they needed to try something new to help those suffering in public from apparent psychotic breaks.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘It’s hopefully going to help some people who need some help, and it is probably not going to make a huge dent in what you observe in the community.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"San Francisco Superior Court Judge Michael Begert","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Families of people diagnosed with severe mental illness rejoiced because the new law allows them to petition the court for treatment for their loved ones. Residents dismayed by the estimated 171,000 people experiencing homelessness in California cheered at the possibility of getting them help and off the streets.\u003c/p>\n\u003cp>Critics blasted the new program as ineffective and punitive, given that it could coerce people into treatment.\u003c/p>\n\u003cp>But as petitions roll in Monday, it’s not clear who the program might help nor how effective it will be. That’s because the eligibility criteria is narrow and limited largely to people with \u003ca href=\"https://www.courts.ca.gov/documents/CARE-Act-Eligibility-Criteria.pdf\">untreated schizophrenia and related disorders (PDF)\u003c/a>. Severe depression, bipolar disorder and addiction by itself do not qualify.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s hopefully going to help some people who need some help, and it is probably not going to make a huge dent in what you observe in the community,” said San Francisco Superior Court Judge Michael Begert, who will supervise the court.\u003c/p>\n\u003cp>Here are things to know about the new system:\u003c/p>\n\u003ch2>What is ‘CARE Court’ and who is eligible?\u003c/h2>\n\u003cp>Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, said in a news briefing last week that the program is aimed at catching people before their condition worsens.\u003c/p>\n\u003cp>Family members and first responders are among those who can now file a petition on behalf of an adult they believe “is unlikely to survive safely” without supervision and whose condition is rapidly deteriorating. They also can file if an adult needs services and support to prevent relapse or deterioration that would likely result in “grave disability or serious harm” to themselves or others.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11959302,news_11955211,news_11958561","label":"Related Stories "},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>To be eligible, the person needs a diagnosis on the \u003ca href=\"https://www.courts.ca.gov/documents/CARE-Act-Eligibility-Criteria.pdf\">schizophrenia spectrum or other qualifying disorders (PDF)\u003c/a>. People with severe depression or bipolar disorder do not qualify. A person does not have to be homeless to be eligible.\u003c/p>\n\u003cp>A special civil court in each county will review each petition with the county behavioral health agency evaluating eligibility. The individual will be appointed a lawyer and a support person of their choice.\u003c/p>\n\u003cp>If the court determines the individual meets eligibility criteria, they will be asked to work with the county on a voluntary plan that includes housing, medication, counseling and other social services. The agreement would be in effect for up to a year with the possibility of extending it for another year.\u003c/p>\n\u003cp>If all parties cannot agree to a voluntary plan, the statute says the court will order they work on a plan.\u003c/p>\n\u003ch2>What happens if the person does not want to participate?\u003c/h2>\n\u003cp>Civil rights advocates have raised fears that the new process will result in vulnerable people being forced into treatment.\u003c/p>\n\u003cp>A person who does not successfully complete a plan could be subject to conservatorship and involuntary treatment, said Tal Klement, a deputy public defender in San Francisco who is among critics of the new process.\u003c/p>\n\u003cp>But the statute also allows the court to dismiss the proceedings if the individual declines to participate or to follow the agreement. Judge Begert, in San Francisco, said he cannot compel someone to engage; the best he can do is start building a relationship with the person.\u003c/p>\n\u003cp>Veronica Kelley, Orange County behavioral health director, said the county’s judges understand building rapport with eligible candidates takes time and have agreed to grant her team extra time to reach voluntary agreements, despite the statute’s deadlines.\u003c/p>\n\u003ch2>Are there enough homes, treatment beds and support?\u003c/h2>\n\u003cp>The state has allocated money for emergency shelters — but critics say there is a constant shortage of case managers, appropriate in-patient treatment facilities and supportive housing.\u003c/p>\n\u003cp>San Francisco officials said in a statement that about 10% of more than 2,500 beds are open for new people. The treatment beds range from detox to step-down care for people leaving long-term care.\u003c/p>\n\u003cp>Opponents of the program say the state should have invested in more housing and existing services rather than establishing a new court system.\u003c/p>\n\u003cp>“The issue is not that these resources are available and people aren’t using them,” said Samuel Jain, senior policy attorney at Disability Rights California. “It’s that these voluntary community-based services are under-resourced and not accessible.”\u003c/p>\n\u003ch2>What happens if the person is not eligible for care?\u003c/h2>\n\u003cp>The National Alliance on Mental Illness in California, a grassroots organization supporting people with a mental illness and their families, pushed for the new mental health program. Some family members have long wanted a way to order their loved ones into treatment, the organization said.\u003c/p>\n\u003cp>Jessica Cruz, the group’s CEO, encourages people not to give up if their family member does not qualify because other resources may be available.\u003c/p>\n\u003cp>“For us, it is just really about making sure that our loved ones have the best life that they could possibly have,” she said. “Living on the streets and dying on the streets is not the way for anybody to live.”\u003c/p>\n\u003ch2>Which counties are accepting petitions?\u003c/h2>\n\u003cp>San Francisco, Orange, San Diego, Riverside, Stanislaus, Tuolumne and Glenn counties launched the new program Monday. Los Angeles County will begin its program Dec. 1.\u003c/p>\n\u003cp>The state estimates roughly 1,800 to 3,100 people could be eligible in the first seven counties. Los Angeles could bump up estimates to 3,600 to 6,200, although uptake could take time.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The rest of the state has until December 2024 to establish mental health courts.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11963122/californias-care-court-program-starts-amid-concerns-over-effectiveness","authors":["byline_news_11963122"],"categories":["news_457","news_6266","news_8","news_356"],"tags":["news_31336","news_16","news_1775","news_33281","news_33280","news_17983"],"featImg":"news_11952219","label":"news"},"news_11959302":{"type":"posts","id":"news_11959302","meta":{"index":"posts_1591205157","site":"news","id":"11959302","score":null,"sort":[1693256756000]},"guestAuthors":[],"slug":"newsoms-care-courts-plan-limited","title":"California Families Can Expect Eligibility Limits in CARE Courts Rollout","publishDate":1693256756,"format":"standard","headTitle":"California Families Can Expect Eligibility Limits in CARE Courts Rollout | KQED","labelTerm":{},"content":"\u003cp>Under the low hum of cold fluorescent lights in a nondescript office park in Orange County, dozens of Californians gathered to find out if they could get help for their loved ones under the state’s new \u003ca href=\"https://www.kqed.org/news/tag/care-court\">CARE Court\u003c/a> system.\u003c/p>\n\u003cp>Unless that loved one has a medical diagnosis specific to schizophrenia or some other psychotic disorders, the answer is probably not.\u003c/p>\n\u003cp>The mid-August meeting was a series held by a mental health advocacy group in Orange County with the officials in charge of implementing CARE Court, which starts in October, about what the new system can and cannot do.\u003c/p>\n\u003cp>“What we’re here to do is share the facts to help manage expectations,” said Veronica Kelley, Orange County’s chief of mental health and recovery services.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Community Assistance, Recovery, and Empowerment (CARE) Court was Gov. Gavin Newsom’s \u003ca href=\"https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/\">biggest legislative priority\u003c/a> last year — what state lawmakers and local politicians hoped would be one answer to California’s dual, overlapping homelessness and mental health crises.\u003c/p>\n\u003cp>The new program allows family members and others to petition someone with untreated mental illness into civil courts, where a judge would order a treatment plan and require county mental health departments to provide it.\u003c/p>\n\u003cp>Backed by millions in new state funds, it’s a mandate for those departments at a time when Californians have become increasingly frustrated with one of the most visible consequences of the state’s trenchant homelessness crisis — people with the most severe mental illnesses languishing on the streets. [pullquote size=\"medium\" align=\"right\" citation=\"Luke Bergmann, director, San Diego County Behavioral Health Services\"]‘[CARE Court’s] not going to be this thing that dramatically changes homelessness.’[/pullquote] Counties will be judged on how well they’re able to get people, who may be resistant to help, inside and into treatment, even though CARE Court is not exclusively a program targeting homelessness. Local mental health officials are warning it won’t be a panacea.\u003c/p>\n\u003cp>“There’s been a presumption — and this is, to be clear, driven by how the administration talked about CARE Court at the outset — a broad presumption that CARE Court is going to fix homelessness or have a broad impact on the nexus of homelessness and behavioral health,” said Luke Bergmann, director of the San Diego County Behavioral Health Services department.\u003c/p>\n\u003cp>In reality, he said, it’s “actually going to be a pretty small program. It’s not going to be this thing that dramatically changes homelessness.”\u003c/p>\n\u003cp>The program aims to walk the line between forced treatment and completely voluntary treatment for those with the gravest needs. Disability rights groups decry it as a violation of a person’s civil liberties, and a potential path \u003ca href=\"https://calmatters.org/justice/2021/07/britney-spears-conservatorship/\">toward conservatorship\u003c/a> and the loss of legal rights for those who repeatedly decline care.\u003c/p>\n\u003cfigure id=\"attachment_11959338\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11959338\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02.jpg\" alt='An office full of people sit at tables looking toward a woman with a purple blouse who speaks from a microphone and holding index cards in her other hand. A flat-screen television hangs above her head displaying \"What is in a CARE Agreement Plan?\"' width=\"2000\" height=\"1333\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02.jpg 2000w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Annette Mugrditchian, deputy director, speaks to community members about CARE Court at the Behavioral Health Training Center in Orange County. \u003ccite>(Lauren Justice/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>CARE Court \u003ca href=\"https://www.latimes.com/california/story/2023-01-26/disability-advocates-lawsuit-care-court-newsom-mental-illness-addiction-homeless\">survived a legal challenge\u003c/a> from Disability Rights California and other civil rights groups earlier this year. The group sat on a state working group for the program’s implementation and will monitor its rollout.\u003c/p>\n\u003cp>The program was welcomed by some family members of those with severe mental illness, who have complained that the state’s privacy and patients’ rights laws only allow their loved ones to \u003ca href=\"https://calmatters.org/projects/mentally-ill-forced-treatment-conservatorship-california-debate/\">be compelled into treatment \u003c/a>when in crisis, trapping them in a revolving door of short-term hospital stays and homelessness.\u003c/p>\n\u003cp>The first courts will open across the state in about a month. Seven counties, urban and rural, have been deep in preparation to be the first to roll out the program in October.\u003c/p>\n\u003cp>Los Angeles County, whose roughly 75,000-person unhoused population is the state’s largest, will start the program in December; the rest of the state will follow next year.\u003c/p>\n\u003cp>Those in the first group — San Francisco, Orange, San Diego, Riverside, Stanislaus, Glenn and Tuolumne counties — have had numerous questions to address, such as:\u003c/p>\n\u003cul>\n\u003cli>Who will find and serve respondents with their CARE Court petition if the respondent is unhoused?\u003c/li>\n\u003cli>How can county courts make the paperwork-heavy petition process easy for family members?\u003c/li>\n\u003cli>How many mental health treatment beds will counties need to add?\u003c/li>\n\u003cli>Where will people live after completing the court-ordered plans?\u003c/li>\n\u003c/ul>\n\u003cp>The state estimates between 7,000 and 12,000 people will qualify. They needn’t be homeless to receive the services, though many who qualify are likely to be unhoused. The state’s homeless population on any given night last year topped 171,000. [aside postID=news_11955211 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1020x680.jpg'] A UC San Francisco \u003ca href=\"https://homelessness.ucsf.edu/sites/default/files/2023-06/CASPEH_Report_62023.pdf\">study of homelessness statewide (PDF)\u003c/a> this year found that more than a quarter of unhoused people had been hospitalized at some point in their lives for a mental health problem; the homeless services authority in Los Angeles \u003ca href=\"https://www.lahsa.org/documents?id=3422-2019-greater-los-angeles-homeless-count-los-angeles-continuum-of-care.pdf\">has estimated (PDF)\u003c/a> a quarter of the city’s homeless adults has a severe mental illness. But CARE Court is targeted at an even narrower set of diagnoses and circumstances.\u003c/p>\n\u003cp>So counties are also playing a careful game of “level-setting,” Bergman said, “about what this thing will actually be.”\u003c/p>\n\u003cp>Still, local officials see the program as an opportunity to get more people into mental health care who haven’t been treated, before their condition deteriorates to the point of being put in conservatorships.\u003c/p>\n\u003cp>And the state’s Department of Health Care Services says it will be looking out for whether the program reduces emergency room visits, police encounters, short-term hospital stays and involuntary psychiatric holds — and whether it helps people find stable housing.\u003c/p>\n\u003ch2>Managing expectations\u003c/h2>\n\u003cp>One major uncertainty counties face, officials say, is even knowing how many cases they’ll get.\u003c/p>\n\u003cp>That’s in part because the law allows a wide range of people to petition for someone to be in CARE Court, including family members, roommates, health care providers, paramedics, hospital officials or homeless outreach workers.\u003c/p>\n\u003cp>But the list of actual conditions the program targets is narrow. It’s limited to schizophrenia and related illnesses. [pullquote size=\"medium\" align=\"right\" citation=\"Michelle Doty Cabrera, director, County Behavioral Health Directors Association\"]‘What the public thinks CARE Court is and what it is are definitely two very different things.’[/pullquote] That could disappoint those whose loved ones have other diagnoses — and create an unknown amount of work for counties if a flood of those family members file petitions. Behavioral health departments must evaluate each person if it’s not clear whether they qualify for the program.\u003c/p>\n\u003cp>San Diego County estimates it will get 1,000 petitions in the first year and establish court-ordered treatment plans for 250 people; the remainder likely will either not qualify or will agree to services voluntarily, Bergmann said. Orange County expects about 1,400 petitions and anywhere from 400 to 600 treatment plans.\u003c/p>\n\u003cp>Officials in Riverside County don’t even have an estimate, citing varying data there on the prevalence of schizophrenia in the unhoused population.\u003c/p>\n\u003cp>“We really think it’s unknowable,” said Marcus Cannon, the county’s deputy behavioral health director.\u003c/p>\n\u003cp>Counties want the state to help them manage public expectations. Both Kelley and Cannon said they’ve heard from local leaders who have floated having city workers file petitions for a wide swath of unhoused residents, to get them indoors.\u003c/p>\n\u003cp>“What the public thinks CARE Court is and what it is are definitely two very different things,” said Michelle Doty Cabrera, director of \u003ca href=\"https://www.cbhda.org/\">the County Behavioral Health Directors Association\u003c/a>.\u003c/p>\n\u003cp>In an emailed statement, state Department of Health Care Services spokesperson Sami Gallegos said that counties “are managing public relations among local elected officials and others” to spread the message about who the program is and isn’t for.\u003c/p>\n\u003cp>After learning of the narrow eligibility criteria at a community meeting in August, Nancy Beltran considered her options.\u003c/p>\n\u003cp>Beltran, of Anaheim, said she lives with a family member whose psychotic condition caused him to hit another relative in 2020, landing him in the hospital against his will. She said he’s refused treatment and doesn’t believe he’s sick. Another psychotic episode earlier this year didn’t qualify him for hospitalization, she said, because the symptoms weren’t as severe.\u003c/p>\n\u003cp>“I didn’t want it to get to that point,” she said. “I don’t want him to be incarcerated. I want it to be the least restrictive, least traumatic experience.”\u003c/p>\n\u003cp>She’s still not sure whether the program is for her family member, because they haven’t gotten a clear diagnosis, she said.\u003c/p>\n\u003cp>Beltran said she also wishes the program could help a friend, who is already enrolled in therapy sessions for diagnosed schizophrenia, find a place to live. Her friend’s condition, she said, deteriorates because he is unhoused, but he remains on waiting lists for housing. But CARE Court, she was disappointed to learn at the meetings, is only for those with untreated schizophrenia.\u003c/p>\n\u003ch2>Threading a needle\u003c/h2>\n\u003cp>Everyone involved in CARE Court in Orange County — from the judge who would ultimately order treatment to the public defender who will represent respondents to the behavioral health officials responsible for finding, diagnosing and treating them — had the same message for the public: The program will be voluntary.\u003c/p>\n\u003cp>Critics, however,\u003cstrong> \u003c/strong>contend that there’s no way a court process can be voluntary, since at some point there is a judge’s order. By law, counties must try at least twice to persuade a respondent to accept treatment before a judge orders it. Even then, the treatment plan, which can include therapy, medication and housing, doesn’t come with much enforcement. Medication can be ordered, but not forcibly administered.\u003c/p>\n\u003cfigure id=\"attachment_11959344\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11959344\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03.jpg\" alt=\"A bald man in a business suit speaks to a crowd as he sits at a table holding a microphone in his hand.\" width=\"2000\" height=\"1333\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03.jpg 2000w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Judge Ebrahim Baytieh speaks to community members about CARE Court, a new program that will be implemented in the fall. \u003ccite>(Lauren Justice/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Over the course of a year, respondents will attend court hearings to see whether they’re adhering to the treatment and whether the county is providing it. Counties can be fined as much as $1,000 a day for not providing the care; if the person fails to complete treatment they could be considered for conservatorship.\u003c/p>\n\u003cp>But county officials stressed that’s not the goal.\u003c/p>\n\u003cp>“We have tried for 40 years in this wonderful country of ours to force people with mental illness” to be treated, Orange County Superior Court Judge Ebrahim Baytieh told family members at another community meeting, in a church in Cypress. “Study after study has found it doesn’t work. We all know there’s no magical answer. But we will be patient, and we will be persistent.”\u003c/p>\n\u003cp>Kelley’s department is training its workers and peer supporters — people who also have mental illness or have recovered who can help guide a respondent through CARE Court — in a well-regarded communication method \u003ca href=\"https://leapinstitute.org/about/#:~:text=LEAP%20(Listen%2DEmpathize%2DAgree,and%20the%20treatment%20they%20need.\">called LEAP\u003c/a> to persuade respondents to accept care. It will offer services to those in CARE Court under a “whatever it takes” approach, whether it’s a ride to the doctor’s office, help to enroll in food stamps, addiction treatment, or temporary housing.\u003c/p>\n\u003cp>The task will take time.\u003c/p>\n\u003cp>At the community meetings, Kelley and her colleagues repeatedly described a pilot program she ran as behavioral health director in San Bernardino County. The program took referrals from family, police or other community members who wanted to prod those who were resistant to mental health treatment. [pullquote size=\"medium\" align=\"right\" citation=\"Orange County Superior Court Judge Ebrahim Baytieh\"]‘We have tried for 40 years in this wonderful country of ours to force people with mental illness” [to be treated]. … We all know there’s no magical answer. But we will be patient, and we will be persistent.’[/pullquote] The time it took for county workers using the LEAP method to persuade respondents to enter treatment varied, Kelley said. But on average, she said it took 20 visits if a respondent was housed — and 40 visits if they were unhoused. Visit times varied, from a few minutes to a whole day so that the whole process could take weeks or months, Kelley said.\u003c/p>\n\u003cp>The timetables set by law for CARE Court are much tighter.\u003c/p>\n\u003cp>If counties initially determine a client won’t agree to treatment, they get 14 days to try again before the next court hearing. Kelley said the judges in her county are sympathetic toward those concerns, but not all counties will get such flexibility.\u003c/p>\n\u003cp>“I can’t do 40 face-to-face visits in 14 days,” she said.\u003c/p>\n\u003cp>Civil rights advocates balked at the counties’ suggestion that any program involving the pressure of the judicial system, even a non-criminal court, could be voluntary.\u003c/p>\n\u003cp>“If you’re trying to engage somebody, and there’s a petition that involves a court,” there’s less hope of building genuine trust, said Keris Myrick, a mental health advocate who lives with schizophrenia and a board member of Disability Rights California.\u003c/p>\n\u003cp>The group is particularly concerned the court process could be ineffective or harmful among Black residents, who are overrepresented both in California’s homeless population and among people diagnosed with schizophrenia.\u003c/p>\n\u003cp>Myrick, who is Black, said she has been subject to involuntary treatment and described harrowing experiences during which she was handcuffed in the back of a police car or strapped down to a gurney for hours before a doctor visited. She said one thing that actually helped her recover was having a peer supporter who was also African American and related to her experiences, eventually persuading her to get treatment on her own terms.\u003c/p>\n\u003cp>She later ran a peer support program in Los Angeles County and trained workers in the county mental health department. Myrick says the state needs to expand those services, as well as housing and social supports to help people live stable lives, without the threat of a judicial order.\u003c/p>\n\u003cp>Alex Barnard, a sociologist at New York University who has studied involuntary mental health treatment in California, is skeptical about whether the state can appease both civil libertarians and those who want more aggressive treatment. But he said the program’s mandate of a year of persistent engagement is promising.\u003c/p>\n\u003cp>“If CARE Courts work, it will probably be because of that,” he said. “It creates some accountability on the provider to keep trying to work with somebody who might be very challenging, and elsewhere in the system would just have their file closed out.”\u003c/p>\n\u003ch2>Long-term resources\u003c/h2>\n\u003cp>Those implementation questions are among a list of other practical hurdles counties face for the program to be successful.\u003c/p>\n\u003cp>There’s long-term funding. The first seven counties were given $26 million in one-time state grants to start the programs; some have estimated annual costs of the services themselves will \u003ca href=\"https://sfstandard.com/2023/04/20/newsoms-care-court-faces-50-million-hurdle-in-san-francisco-as-key-deadline-approaches/\">far exceed\u003c/a> those allotments.\u003c/p>\n\u003cp>The state says most services will be covered by Medi-Cal or private insurance, and expects counties to submit reimbursement requests, including the costs of going to court or finding respondents.\u003c/p>\n\u003cp>But the \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking#:~:text=Kaiser%20administrators%20point%20to%20what,15%20statement.\">nationwide shortage of behavioral health workers\u003c/a> has made it a challenge for some departments to hire. In San Diego County, Bergmann’s department plans to add 55 new staff, including 10 clinicians, for CARE Court. Only 35% have been hired so far, a spokesperson said. [aside label='More on Public Health' tag='public-health'] And there’s housing and beds, which all agree are crucial to making treatment a success.\u003c/p>\n\u003cp>Health officials believe most people who qualify for CARE Court will need a more intensive treatment placement in the beginning, while some may be able to be placed in residential facilities or their own apartments after being stabilized.\u003c/p>\n\u003cp>But there are shortages across that spectrum. A \u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1824-1-v2.html\">2021 Rand analysis\u003c/a> found the state is short more than 4,700 psychiatric inpatient treatment beds and nearly 3,000 residential facility beds such as \u003ca href=\"https://calmatters.org/projects/board-and-care-homes-closing-in-california-mental-health-crisis/\">board-and-cares\u003c/a>—long-term housing for people with severe mental illness and one option for respondents to live after they complete CARE Court.\u003c/p>\n\u003cp>Included in last year’s state budget was \u003ca href=\"https://bridgehousing.buildingcalhhs.com/county-behavioral-health-agencies/\">nearly $1 billion\u003c/a> in new funding for counties to expand temporary housing placements for those with mental illness, with priority given to people in CARE Court.\u003c/p>\n\u003cp>Orange County and some others are using the grants to open new treatment beds. In San Diego, Bergmann’s department will use the money to pay for board-and-care placements. Significant new infrastructure, however, will take years to complete. Over the past five years, Bergmann said, the county has lost a fifth of those residential facilities.\u003c/p>\n\u003cp>“In the near term, those funds will help us help people with the fewest resources to compete more” for placements, he said. “It’s not going to all of a sudden create a net increase in infrastructure.”\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://calmatters.org/author/marisa-kendall/\">Marisa Kendall\u003c/a> contributed to this reporting.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"Gov. Gavin Newsom’s plan to encourage people with mental illnesses to accept treatment starts this fall. Counties responsible say it may be more modest than advertised.","status":"publish","parent":0,"modified":1693256756,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":63,"wordCount":2944},"headData":{"title":"California Families Can Expect Eligibility Limits in CARE Courts Rollout | KQED","description":"Gov. Gavin Newsom’s plan to encourage people with mental illnesses to accept treatment starts this fall. Counties responsible say it may be more modest than advertised.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"California Families Can Expect Eligibility Limits in CARE Courts Rollout","datePublished":"2023-08-28T21:05:56.000Z","dateModified":"2023-08-28T21:05:56.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"source":"CalMatters","sourceUrl":"https://calmatters.org/","nprByline":"\u003ca href=\"https://calmatters.org/author/jeanne-kuang/\">Jeanne Kuang\u003c/a>","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","articleAge":"0","path":"/news/11959302/newsoms-care-courts-plan-limited","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Under the low hum of cold fluorescent lights in a nondescript office park in Orange County, dozens of Californians gathered to find out if they could get help for their loved ones under the state’s new \u003ca href=\"https://www.kqed.org/news/tag/care-court\">CARE Court\u003c/a> system.\u003c/p>\n\u003cp>Unless that loved one has a medical diagnosis specific to schizophrenia or some other psychotic disorders, the answer is probably not.\u003c/p>\n\u003cp>The mid-August meeting was a series held by a mental health advocacy group in Orange County with the officials in charge of implementing CARE Court, which starts in October, about what the new system can and cannot do.\u003c/p>\n\u003cp>“What we’re here to do is share the facts to help manage expectations,” said Veronica Kelley, Orange County’s chief of mental health and recovery services.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Community Assistance, Recovery, and Empowerment (CARE) Court was Gov. Gavin Newsom’s \u003ca href=\"https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/\">biggest legislative priority\u003c/a> last year — what state lawmakers and local politicians hoped would be one answer to California’s dual, overlapping homelessness and mental health crises.\u003c/p>\n\u003cp>The new program allows family members and others to petition someone with untreated mental illness into civil courts, where a judge would order a treatment plan and require county mental health departments to provide it.\u003c/p>\n\u003cp>Backed by millions in new state funds, it’s a mandate for those departments at a time when Californians have become increasingly frustrated with one of the most visible consequences of the state’s trenchant homelessness crisis — people with the most severe mental illnesses languishing on the streets. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘[CARE Court’s] not going to be this thing that dramatically changes homelessness.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Luke Bergmann, director, San Diego County Behavioral Health Services","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp> Counties will be judged on how well they’re able to get people, who may be resistant to help, inside and into treatment, even though CARE Court is not exclusively a program targeting homelessness. Local mental health officials are warning it won’t be a panacea.\u003c/p>\n\u003cp>“There’s been a presumption — and this is, to be clear, driven by how the administration talked about CARE Court at the outset — a broad presumption that CARE Court is going to fix homelessness or have a broad impact on the nexus of homelessness and behavioral health,” said Luke Bergmann, director of the San Diego County Behavioral Health Services department.\u003c/p>\n\u003cp>In reality, he said, it’s “actually going to be a pretty small program. It’s not going to be this thing that dramatically changes homelessness.”\u003c/p>\n\u003cp>The program aims to walk the line between forced treatment and completely voluntary treatment for those with the gravest needs. Disability rights groups decry it as a violation of a person’s civil liberties, and a potential path \u003ca href=\"https://calmatters.org/justice/2021/07/britney-spears-conservatorship/\">toward conservatorship\u003c/a> and the loss of legal rights for those who repeatedly decline care.\u003c/p>\n\u003cfigure id=\"attachment_11959338\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11959338\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02.jpg\" alt='An office full of people sit at tables looking toward a woman with a purple blouse who speaks from a microphone and holding index cards in her other hand. A flat-screen television hangs above her head displaying \"What is in a CARE Agreement Plan?\"' width=\"2000\" height=\"1333\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02.jpg 2000w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Annette Mugrditchian, deputy director, speaks to community members about CARE Court at the Behavioral Health Training Center in Orange County. \u003ccite>(Lauren Justice/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>CARE Court \u003ca href=\"https://www.latimes.com/california/story/2023-01-26/disability-advocates-lawsuit-care-court-newsom-mental-illness-addiction-homeless\">survived a legal challenge\u003c/a> from Disability Rights California and other civil rights groups earlier this year. The group sat on a state working group for the program’s implementation and will monitor its rollout.\u003c/p>\n\u003cp>The program was welcomed by some family members of those with severe mental illness, who have complained that the state’s privacy and patients’ rights laws only allow their loved ones to \u003ca href=\"https://calmatters.org/projects/mentally-ill-forced-treatment-conservatorship-california-debate/\">be compelled into treatment \u003c/a>when in crisis, trapping them in a revolving door of short-term hospital stays and homelessness.\u003c/p>\n\u003cp>The first courts will open across the state in about a month. Seven counties, urban and rural, have been deep in preparation to be the first to roll out the program in October.\u003c/p>\n\u003cp>Los Angeles County, whose roughly 75,000-person unhoused population is the state’s largest, will start the program in December; the rest of the state will follow next year.\u003c/p>\n\u003cp>Those in the first group — San Francisco, Orange, San Diego, Riverside, Stanislaus, Glenn and Tuolumne counties — have had numerous questions to address, such as:\u003c/p>\n\u003cul>\n\u003cli>Who will find and serve respondents with their CARE Court petition if the respondent is unhoused?\u003c/li>\n\u003cli>How can county courts make the paperwork-heavy petition process easy for family members?\u003c/li>\n\u003cli>How many mental health treatment beds will counties need to add?\u003c/li>\n\u003cli>Where will people live after completing the court-ordered plans?\u003c/li>\n\u003c/ul>\n\u003cp>The state estimates between 7,000 and 12,000 people will qualify. They needn’t be homeless to receive the services, though many who qualify are likely to be unhoused. The state’s homeless population on any given night last year topped 171,000. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11955211","hero":"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1020x680.jpg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp> A UC San Francisco \u003ca href=\"https://homelessness.ucsf.edu/sites/default/files/2023-06/CASPEH_Report_62023.pdf\">study of homelessness statewide (PDF)\u003c/a> this year found that more than a quarter of unhoused people had been hospitalized at some point in their lives for a mental health problem; the homeless services authority in Los Angeles \u003ca href=\"https://www.lahsa.org/documents?id=3422-2019-greater-los-angeles-homeless-count-los-angeles-continuum-of-care.pdf\">has estimated (PDF)\u003c/a> a quarter of the city’s homeless adults has a severe mental illness. But CARE Court is targeted at an even narrower set of diagnoses and circumstances.\u003c/p>\n\u003cp>So counties are also playing a careful game of “level-setting,” Bergman said, “about what this thing will actually be.”\u003c/p>\n\u003cp>Still, local officials see the program as an opportunity to get more people into mental health care who haven’t been treated, before their condition deteriorates to the point of being put in conservatorships.\u003c/p>\n\u003cp>And the state’s Department of Health Care Services says it will be looking out for whether the program reduces emergency room visits, police encounters, short-term hospital stays and involuntary psychiatric holds — and whether it helps people find stable housing.\u003c/p>\n\u003ch2>Managing expectations\u003c/h2>\n\u003cp>One major uncertainty counties face, officials say, is even knowing how many cases they’ll get.\u003c/p>\n\u003cp>That’s in part because the law allows a wide range of people to petition for someone to be in CARE Court, including family members, roommates, health care providers, paramedics, hospital officials or homeless outreach workers.\u003c/p>\n\u003cp>But the list of actual conditions the program targets is narrow. It’s limited to schizophrenia and related illnesses. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘What the public thinks CARE Court is and what it is are definitely two very different things.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Michelle Doty Cabrera, director, County Behavioral Health Directors Association","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp> That could disappoint those whose loved ones have other diagnoses — and create an unknown amount of work for counties if a flood of those family members file petitions. Behavioral health departments must evaluate each person if it’s not clear whether they qualify for the program.\u003c/p>\n\u003cp>San Diego County estimates it will get 1,000 petitions in the first year and establish court-ordered treatment plans for 250 people; the remainder likely will either not qualify or will agree to services voluntarily, Bergmann said. Orange County expects about 1,400 petitions and anywhere from 400 to 600 treatment plans.\u003c/p>\n\u003cp>Officials in Riverside County don’t even have an estimate, citing varying data there on the prevalence of schizophrenia in the unhoused population.\u003c/p>\n\u003cp>“We really think it’s unknowable,” said Marcus Cannon, the county’s deputy behavioral health director.\u003c/p>\n\u003cp>Counties want the state to help them manage public expectations. Both Kelley and Cannon said they’ve heard from local leaders who have floated having city workers file petitions for a wide swath of unhoused residents, to get them indoors.\u003c/p>\n\u003cp>“What the public thinks CARE Court is and what it is are definitely two very different things,” said Michelle Doty Cabrera, director of \u003ca href=\"https://www.cbhda.org/\">the County Behavioral Health Directors Association\u003c/a>.\u003c/p>\n\u003cp>In an emailed statement, state Department of Health Care Services spokesperson Sami Gallegos said that counties “are managing public relations among local elected officials and others” to spread the message about who the program is and isn’t for.\u003c/p>\n\u003cp>After learning of the narrow eligibility criteria at a community meeting in August, Nancy Beltran considered her options.\u003c/p>\n\u003cp>Beltran, of Anaheim, said she lives with a family member whose psychotic condition caused him to hit another relative in 2020, landing him in the hospital against his will. She said he’s refused treatment and doesn’t believe he’s sick. Another psychotic episode earlier this year didn’t qualify him for hospitalization, she said, because the symptoms weren’t as severe.\u003c/p>\n\u003cp>“I didn’t want it to get to that point,” she said. “I don’t want him to be incarcerated. I want it to be the least restrictive, least traumatic experience.”\u003c/p>\n\u003cp>She’s still not sure whether the program is for her family member, because they haven’t gotten a clear diagnosis, she said.\u003c/p>\n\u003cp>Beltran said she also wishes the program could help a friend, who is already enrolled in therapy sessions for diagnosed schizophrenia, find a place to live. Her friend’s condition, she said, deteriorates because he is unhoused, but he remains on waiting lists for housing. But CARE Court, she was disappointed to learn at the meetings, is only for those with untreated schizophrenia.\u003c/p>\n\u003ch2>Threading a needle\u003c/h2>\n\u003cp>Everyone involved in CARE Court in Orange County — from the judge who would ultimately order treatment to the public defender who will represent respondents to the behavioral health officials responsible for finding, diagnosing and treating them — had the same message for the public: The program will be voluntary.\u003c/p>\n\u003cp>Critics, however,\u003cstrong> \u003c/strong>contend that there’s no way a court process can be voluntary, since at some point there is a judge’s order. By law, counties must try at least twice to persuade a respondent to accept treatment before a judge orders it. Even then, the treatment plan, which can include therapy, medication and housing, doesn’t come with much enforcement. Medication can be ordered, but not forcibly administered.\u003c/p>\n\u003cfigure id=\"attachment_11959344\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11959344\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03.jpg\" alt=\"A bald man in a business suit speaks to a crowd as he sits at a table holding a microphone in his hand.\" width=\"2000\" height=\"1333\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03.jpg 2000w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Judge Ebrahim Baytieh speaks to community members about CARE Court, a new program that will be implemented in the fall. \u003ccite>(Lauren Justice/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Over the course of a year, respondents will attend court hearings to see whether they’re adhering to the treatment and whether the county is providing it. Counties can be fined as much as $1,000 a day for not providing the care; if the person fails to complete treatment they could be considered for conservatorship.\u003c/p>\n\u003cp>But county officials stressed that’s not the goal.\u003c/p>\n\u003cp>“We have tried for 40 years in this wonderful country of ours to force people with mental illness” to be treated, Orange County Superior Court Judge Ebrahim Baytieh told family members at another community meeting, in a church in Cypress. “Study after study has found it doesn’t work. We all know there’s no magical answer. But we will be patient, and we will be persistent.”\u003c/p>\n\u003cp>Kelley’s department is training its workers and peer supporters — people who also have mental illness or have recovered who can help guide a respondent through CARE Court — in a well-regarded communication method \u003ca href=\"https://leapinstitute.org/about/#:~:text=LEAP%20(Listen%2DEmpathize%2DAgree,and%20the%20treatment%20they%20need.\">called LEAP\u003c/a> to persuade respondents to accept care. It will offer services to those in CARE Court under a “whatever it takes” approach, whether it’s a ride to the doctor’s office, help to enroll in food stamps, addiction treatment, or temporary housing.\u003c/p>\n\u003cp>The task will take time.\u003c/p>\n\u003cp>At the community meetings, Kelley and her colleagues repeatedly described a pilot program she ran as behavioral health director in San Bernardino County. The program took referrals from family, police or other community members who wanted to prod those who were resistant to mental health treatment. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘We have tried for 40 years in this wonderful country of ours to force people with mental illness” [to be treated]. … We all know there’s no magical answer. But we will be patient, and we will be persistent.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Orange County Superior Court Judge Ebrahim Baytieh","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp> The time it took for county workers using the LEAP method to persuade respondents to enter treatment varied, Kelley said. But on average, she said it took 20 visits if a respondent was housed — and 40 visits if they were unhoused. Visit times varied, from a few minutes to a whole day so that the whole process could take weeks or months, Kelley said.\u003c/p>\n\u003cp>The timetables set by law for CARE Court are much tighter.\u003c/p>\n\u003cp>If counties initially determine a client won’t agree to treatment, they get 14 days to try again before the next court hearing. Kelley said the judges in her county are sympathetic toward those concerns, but not all counties will get such flexibility.\u003c/p>\n\u003cp>“I can’t do 40 face-to-face visits in 14 days,” she said.\u003c/p>\n\u003cp>Civil rights advocates balked at the counties’ suggestion that any program involving the pressure of the judicial system, even a non-criminal court, could be voluntary.\u003c/p>\n\u003cp>“If you’re trying to engage somebody, and there’s a petition that involves a court,” there’s less hope of building genuine trust, said Keris Myrick, a mental health advocate who lives with schizophrenia and a board member of Disability Rights California.\u003c/p>\n\u003cp>The group is particularly concerned the court process could be ineffective or harmful among Black residents, who are overrepresented both in California’s homeless population and among people diagnosed with schizophrenia.\u003c/p>\n\u003cp>Myrick, who is Black, said she has been subject to involuntary treatment and described harrowing experiences during which she was handcuffed in the back of a police car or strapped down to a gurney for hours before a doctor visited. She said one thing that actually helped her recover was having a peer supporter who was also African American and related to her experiences, eventually persuading her to get treatment on her own terms.\u003c/p>\n\u003cp>She later ran a peer support program in Los Angeles County and trained workers in the county mental health department. Myrick says the state needs to expand those services, as well as housing and social supports to help people live stable lives, without the threat of a judicial order.\u003c/p>\n\u003cp>Alex Barnard, a sociologist at New York University who has studied involuntary mental health treatment in California, is skeptical about whether the state can appease both civil libertarians and those who want more aggressive treatment. But he said the program’s mandate of a year of persistent engagement is promising.\u003c/p>\n\u003cp>“If CARE Courts work, it will probably be because of that,” he said. “It creates some accountability on the provider to keep trying to work with somebody who might be very challenging, and elsewhere in the system would just have their file closed out.”\u003c/p>\n\u003ch2>Long-term resources\u003c/h2>\n\u003cp>Those implementation questions are among a list of other practical hurdles counties face for the program to be successful.\u003c/p>\n\u003cp>There’s long-term funding. The first seven counties were given $26 million in one-time state grants to start the programs; some have estimated annual costs of the services themselves will \u003ca href=\"https://sfstandard.com/2023/04/20/newsoms-care-court-faces-50-million-hurdle-in-san-francisco-as-key-deadline-approaches/\">far exceed\u003c/a> those allotments.\u003c/p>\n\u003cp>The state says most services will be covered by Medi-Cal or private insurance, and expects counties to submit reimbursement requests, including the costs of going to court or finding respondents.\u003c/p>\n\u003cp>But the \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking#:~:text=Kaiser%20administrators%20point%20to%20what,15%20statement.\">nationwide shortage of behavioral health workers\u003c/a> has made it a challenge for some departments to hire. In San Diego County, Bergmann’s department plans to add 55 new staff, including 10 clinicians, for CARE Court. Only 35% have been hired so far, a spokesperson said. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"More on Public Health ","tag":"public-health"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp> And there’s housing and beds, which all agree are crucial to making treatment a success.\u003c/p>\n\u003cp>Health officials believe most people who qualify for CARE Court will need a more intensive treatment placement in the beginning, while some may be able to be placed in residential facilities or their own apartments after being stabilized.\u003c/p>\n\u003cp>But there are shortages across that spectrum. A \u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1824-1-v2.html\">2021 Rand analysis\u003c/a> found the state is short more than 4,700 psychiatric inpatient treatment beds and nearly 3,000 residential facility beds such as \u003ca href=\"https://calmatters.org/projects/board-and-care-homes-closing-in-california-mental-health-crisis/\">board-and-cares\u003c/a>—long-term housing for people with severe mental illness and one option for respondents to live after they complete CARE Court.\u003c/p>\n\u003cp>Included in last year’s state budget was \u003ca href=\"https://bridgehousing.buildingcalhhs.com/county-behavioral-health-agencies/\">nearly $1 billion\u003c/a> in new funding for counties to expand temporary housing placements for those with mental illness, with priority given to people in CARE Court.\u003c/p>\n\u003cp>Orange County and some others are using the grants to open new treatment beds. In San Diego, Bergmann’s department will use the money to pay for board-and-care placements. Significant new infrastructure, however, will take years to complete. Over the past five years, Bergmann said, the county has lost a fifth of those residential facilities.\u003c/p>\n\u003cp>“In the near term, those funds will help us help people with the fewest resources to compete more” for placements, he said. “It’s not going to all of a sudden create a net increase in infrastructure.”\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://calmatters.org/author/marisa-kendall/\">Marisa Kendall\u003c/a> contributed to this reporting.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11959302/newsoms-care-courts-plan-limited","authors":["byline_news_11959302"],"categories":["news_457","news_8"],"tags":["news_18538","news_26042","news_31336","news_16"],"affiliates":["news_18481"],"featImg":"news_11959337","label":"source_news_11959302"},"news_11955211":{"type":"posts","id":"news_11955211","meta":{"index":"posts_1591205157","site":"news","id":"11955211","score":null,"sort":[1689681640000]},"guestAuthors":[],"slug":"californias-new-care-courts-prompt-orange-county-to-weigh-best-practices","title":"California's New CARE Courts Prompt Orange County to Weigh Best Practices","publishDate":1689681640,"format":"standard","headTitle":"California’s New CARE Courts Prompt Orange County to Weigh Best Practices | KQED","labelTerm":{"term":72,"site":"news"},"content":"\u003cp>\u003cstrong>\u003cem>Editor’s note:\u003c/em>\u003c/strong>\u003cem> This story is part of an occasional series examining the rollout of CARE Courts across the state. \u003c/em>\u003ca href=\"https://www.kqed.org/news/11952228/san-francisco-to-implement-newsoms-care-court-plan-to-treat-severe-mental-illness\">\u003cem>Read or listen to KQED’s reporting on San Francisco County here.\u003c/em>\u003c/a>\u003c/p>\n\u003cp>When Heidi Sweeney first began hallucinating, the voices in her head told her Orange County’s Huntington Beach was where she would be safe. There, behind the bikini-clad crowds playing volleyball and riding beach cruisers, she slept in homeless encampments, then beside a bush outside a liquor store, drinking vodka to drown out the din only she could hear.\u003c/p>\n\u003cp>For years, she refused help, insisting to all who offered, “I’m not sick,” until police arrested her for petty theft and public drunkenness. A judge gave her an ultimatum: jail, or treatment. She chose treatment.\u003c/p>\n\u003cp>“I’m so thankful that they did that,” said Sweeney, now 52. “I needed that. I think there’s others out there that need it, too.”\u003c/p>\n\u003cp>If she hadn’t been compelled to get care, Sweeney said she wouldn’t be alive today, back at work and reunited with her husband. It’s why she supports California’s new civil CARE Courts, which will launch this fall in eight counties, including \u003ca href=\"https://www.kqed.org/news/11952228/san-francisco-to-implement-newsoms-care-court-plan-to-treat-severe-mental-illness\">San Francisco\u003c/a>, \u003ca href=\"https://www.kcrw.com/news/shows/greater-la/psych-treatment/care-court\">Los Angeles\u003c/a> and Orange, followed by the rest of the state in 2024.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Under the new system, family members and first responders can ask county judges to order people with psychotic illness into treatment, even if they are not unhoused or haven’t committed a crime.\u003c/p>\n\u003cp>The bill creating the program sailed through the state Legislature with near unanimous support last year amid growing frustration from voters over the state’s increasing population of unhoused residents, even as it drew vehement opposition from disability rights groups, who argued CARE Courts’ hallmark — compelling people who have done nothing wrong into mental health care — is a violation of civil rights.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Maria Hernandez, presiding judge, Orange County Superior Court\"]‘We don’t want to punish people. We want them to maintain their dignity.’[/pullquote]\u003c/p>\n\u003cp>In Orange County, that tension — between those who advocate for voluntary treatment and those who say the status quo allows people to die in the streets “\u003ca href=\"https://www.kqed.org/news/11944448/a-war-of-compassion-debate-over-forced-treatment-of-mental-illness-splits-california-liberals\">with their rights on\u003c/a>” — is playing out in the implementation of the program.\u003c/p>\n\u003cp>Its officials are threading a delicate needle: particularly, how to convince people to accept care without coercion, when their illness causes them to believe they are not ill.\u003c/p>\n\u003cp>“We don’t want to punish people,” said Maria Hernandez, the presiding judge for Orange County Superior Court. “We want them to maintain their dignity.”\u003c/p>\n\u003cfigure id=\"attachment_11955163\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11955163 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED.jpg\" alt=\"A light-skinned middle-aged woman with long brown hair and wearing black judge's robes smiles at the camera from behind a desk.\" width=\"2000\" height=\"1333\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED.jpg 2000w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Orange County Superior Court Presiding Judge Maria Hernandez says CARE Court will resemble the county’s other collaborative courts, like her young adult diversion court, where compassion and science drive her decisions. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Orange County is expecting that between 900 and 1,500 residents will be eligible for CARE Court in any given year, according to the county public defender’s office. Local lawyers, judges and health officials all have aligned in designing their program with a distinct patient focus, endeavoring to make the process as benign and nonthreatening as possible.\u003c/p>\n\u003cp>[aside label='More Stories on CARE Court' tag='care-court']\u003c/p>\n\u003cp>Hernandez said that means modeling the new civil court after the county’s other collaborative courts, where judges often lose the black robe and come down off the bench to work \u003cem>with \u003c/em>people, eye to eye.\u003c/p>\n\u003cp>One prototype, she said, is her \u003ca href=\"https://www.occourts.org/directory/collaborative-courts/YAC_Pamphlet.pdf\">Young Adult Court (PDF)\u003c/a>, where, on a day in June, the mood was downright jovial. Defendants and their family members were chatting and laughing, munching on snacks laid out on a table in the back as three young men “graduated” from the diversion program.\u003c/p>\n\u003cp>“Judge Hernandez is so awesome,” said Abraham, 25, a former graduate, who asked to be identified only by his first name because he was charged with a felony that has since been expunged from his record. “I don’t even look at her as the judge. She’s just like a mom figure. She’s only trying to push you to be the better you.”\u003c/p>\n\u003cp>A minute later, Hernandez walked through the aisle of the courtroom and gave Abraham a hug.\u003c/p>\n\u003ch2>‘Disaster preparedness’\u003c/h2>\n\u003cp>Even if CARE Court is ruled by the likes of Mary Poppins, Orlando Vera, who lives with bipolar disorder, said helping a vulnerable person heal from mental illness shouldn’t involve dragging them into a courtroom.\u003c/p>\n\u003cfigure id=\"attachment_11955161\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11955161 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED.jpg\" alt=\"A very fair-skinned bald man wearing glasses sits in an office setting, smiling and wearing a short-sleeved blue collared polo shirt.\" width=\"2000\" height=\"1333\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED.jpg 2000w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Orlando Vera, co-founder of Peer Voices of Orange County, says he and other people with lived experience of mental illness will attend CARE Court proceedings on behalf of patients. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s not a place [where] you resolve your emotions. It is a very business-oriented environment. So I do feel that this is not the place for it,” Vera said, adding, “Can we stop it? I would say we can’t.”\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Orlando Vera, founder, Peer Voices of Orange County\"]‘Our focus is how do we support those that are going through the system. We need to be their voice.’[/pullquote]\u003c/p>\n\u003cp>After advocates \u003ca href=\"https://www.sacbee.com/news/politics-government/capitol-alert/article274547296.html\">failed to convince the state Supreme Court\u003c/a> to block the program on constitutional grounds, some started referring to the rollout of CARE Court as “disaster preparedness.”\u003c/p>\n\u003cp>\u003ca href=\"https://peervoices.org/\">Peer Voices of Orange County\u003c/a>, a group Vera co-founded and runs, plans to install patient advocates at the courthouse to attend any and all CARE Court hearings.\u003c/p>\n\u003cp>“Our focus is how do we support those that are going through the system,” he said. “We need to be their voice.”\u003c/p>\n\u003ch2>‘CARE’ without coercion\u003c/h2>\n\u003cp>Orange County behavioral health director Veronica Kelley is sympathetic to advocates’ concerns. She said CARE Court is not the program she would have created to improve the state’s mental health system. But she serves at the will of the governor and other elected officials who control her budget.\u003c/p>\n\u003cp>“So we end up building the Winchester Mystery House,” she said. “It is a structure that was OK, but then it just started adding hallways to nowhere and basements that are on top of the building. That’s what our system looks like.”\u003c/p>\n\u003cfigure id=\"attachment_11955162\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11955162 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED.jpg\" alt=\"A white woman with long blond hair and long earrings sits in front of a bookshelf filled with books. She is unsmiling.\" width=\"2000\" height=\"1333\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED.jpg 2000w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Veronica Kelley, behavioral health director for Orange County, will oversee mental health outreach and care provided through the local CARE Court, launching Oct. 1. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But Kelley is committed to making sure CARE Court is not a hallway to nowhere.\u003c/p>\n\u003cp>“It is a hallway that I’m going to, at the end, construct a door that opens out to a bunch of different options,” she said.\u003c/p>\n\u003cp>Kelley is shaping the new court process into something its critics can accept. This is why she wanted Orange County to go first.\u003c/p>\n\u003cp>“So we can help craft it into something that’s not another colossal waste of time and funds, and that we don’t destroy the people we’re trying to serve at the same time,” she told a roomful of patient advocates during a meeting of the state \u003ca href=\"https://www.dhcs.ca.gov/services/MH/Pages/PatientsRights.aspx#:~:text=California%20Office%20of%20Patients'%20Rights,training%20and%20technical%20assistance%20to\">Patient Rights’ Committee\u003c/a>, held in Santa Ana.\u003c/p>\n\u003cp>This means social workers from her \u003ca href=\"https://www.ochealthinfo.com/services-programs/mental-health-crisis-recovery/mental-health\">behavioral health department\u003c/a> or the \u003ca href=\"https://www.pubdef.ocgov.com/\">public defender’s office\u003c/a> might visit people 20, 30 or 40 times to build trust, listen and set goals.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Veronica Kelley, behavioral health director, Orange County\"]‘If someone agrees to do something of their own accord, it is far more probable that there will be long-term success and long-term commitment to the services being provided.’[/pullquote]\u003c/p>\n\u003cp>“If they can’t be convinced, CARE Court isn’t for them. But we’re not going to give up on folks because they say no the first time,” said Martin Schwarz, Orange County’s public defender, who plans to devote eight full-time staff to represent the interests of patients referred into the program.\u003c/p>\n\u003cp>Under the CARE legislation, the court is allowed to fine behavioral health agencies $1,000 per day if they can’t find a patient and enroll them in treatment by certain deadlines.\u003c/p>\n\u003cp>Kelley said her county’s judges have agreed to give her staff the time and extensions they need to do their jobs right. She also vowed that no one who declines services in her county would be institutionalized, as the legislation allows.\u003c/p>\n\u003cp>“If someone agrees to do something of their own accord, it is far more probable that there will be long-term success and long-term commitment to the services being provided,” she said.\u003c/p>\n\u003cp>Kelley and Schwarz pointed to their success with another civil court process established by Laura’s Law in 2002, where for each individual involved in court-ordered outpatient care, there were another 20 who accepted treatment willingly.\u003c/p>\n\u003cp>They say they have the same goal for CARE Court, where the focus will be on finding a treatment plan people accept voluntarily — before a judge has to order it.\u003c/p>\n\u003cp>“Success is measured by who we keep out of the court system,” Schwarz said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"In Orange County, officials weigh how to convince people with psychosis to accept care without coercion as the state's new CARE Courts roll out in October.","status":"publish","parent":0,"modified":1689700165,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":40,"wordCount":1589},"headData":{"title":"California's New CARE Courts Prompt Orange County to Weigh Best Practices | KQED","description":"In Orange County, officials weigh how to convince people with psychosis to accept care without coercion as the state's new CARE Courts roll out in October.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"California's New CARE Courts Prompt Orange County to Weigh Best Practices","datePublished":"2023-07-18T12:00:40.000Z","dateModified":"2023-07-18T17:09:25.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-41c5-bcaf-aaef00f5a073/b7860621-8fe9-4172-bbcb-b0430100ba58/audio.mp3","excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11955211/californias-new-care-courts-prompt-orange-county-to-weigh-best-practices","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>\u003cem>Editor’s note:\u003c/em>\u003c/strong>\u003cem> This story is part of an occasional series examining the rollout of CARE Courts across the state. \u003c/em>\u003ca href=\"https://www.kqed.org/news/11952228/san-francisco-to-implement-newsoms-care-court-plan-to-treat-severe-mental-illness\">\u003cem>Read or listen to KQED’s reporting on San Francisco County here.\u003c/em>\u003c/a>\u003c/p>\n\u003cp>When Heidi Sweeney first began hallucinating, the voices in her head told her Orange County’s Huntington Beach was where she would be safe. There, behind the bikini-clad crowds playing volleyball and riding beach cruisers, she slept in homeless encampments, then beside a bush outside a liquor store, drinking vodka to drown out the din only she could hear.\u003c/p>\n\u003cp>For years, she refused help, insisting to all who offered, “I’m not sick,” until police arrested her for petty theft and public drunkenness. A judge gave her an ultimatum: jail, or treatment. She chose treatment.\u003c/p>\n\u003cp>“I’m so thankful that they did that,” said Sweeney, now 52. “I needed that. I think there’s others out there that need it, too.”\u003c/p>\n\u003cp>If she hadn’t been compelled to get care, Sweeney said she wouldn’t be alive today, back at work and reunited with her husband. It’s why she supports California’s new civil CARE Courts, which will launch this fall in eight counties, including \u003ca href=\"https://www.kqed.org/news/11952228/san-francisco-to-implement-newsoms-care-court-plan-to-treat-severe-mental-illness\">San Francisco\u003c/a>, \u003ca href=\"https://www.kcrw.com/news/shows/greater-la/psych-treatment/care-court\">Los Angeles\u003c/a> and Orange, followed by the rest of the state in 2024.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Under the new system, family members and first responders can ask county judges to order people with psychotic illness into treatment, even if they are not unhoused or haven’t committed a crime.\u003c/p>\n\u003cp>The bill creating the program sailed through the state Legislature with near unanimous support last year amid growing frustration from voters over the state’s increasing population of unhoused residents, even as it drew vehement opposition from disability rights groups, who argued CARE Courts’ hallmark — compelling people who have done nothing wrong into mental health care — is a violation of civil rights.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘We don’t want to punish people. We want them to maintain their dignity.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Maria Hernandez, presiding judge, Orange County Superior Court","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In Orange County, that tension — between those who advocate for voluntary treatment and those who say the status quo allows people to die in the streets “\u003ca href=\"https://www.kqed.org/news/11944448/a-war-of-compassion-debate-over-forced-treatment-of-mental-illness-splits-california-liberals\">with their rights on\u003c/a>” — is playing out in the implementation of the program.\u003c/p>\n\u003cp>Its officials are threading a delicate needle: particularly, how to convince people to accept care without coercion, when their illness causes them to believe they are not ill.\u003c/p>\n\u003cp>“We don’t want to punish people,” said Maria Hernandez, the presiding judge for Orange County Superior Court. “We want them to maintain their dignity.”\u003c/p>\n\u003cfigure id=\"attachment_11955163\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11955163 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED.jpg\" alt=\"A light-skinned middle-aged woman with long brown hair and wearing black judge's robes smiles at the camera from behind a desk.\" width=\"2000\" height=\"1333\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED.jpg 2000w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-05-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Orange County Superior Court Presiding Judge Maria Hernandez says CARE Court will resemble the county’s other collaborative courts, like her young adult diversion court, where compassion and science drive her decisions. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Orange County is expecting that between 900 and 1,500 residents will be eligible for CARE Court in any given year, according to the county public defender’s office. Local lawyers, judges and health officials all have aligned in designing their program with a distinct patient focus, endeavoring to make the process as benign and nonthreatening as possible.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"More Stories on CARE Court ","tag":"care-court"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Hernandez said that means modeling the new civil court after the county’s other collaborative courts, where judges often lose the black robe and come down off the bench to work \u003cem>with \u003c/em>people, eye to eye.\u003c/p>\n\u003cp>One prototype, she said, is her \u003ca href=\"https://www.occourts.org/directory/collaborative-courts/YAC_Pamphlet.pdf\">Young Adult Court (PDF)\u003c/a>, where, on a day in June, the mood was downright jovial. Defendants and their family members were chatting and laughing, munching on snacks laid out on a table in the back as three young men “graduated” from the diversion program.\u003c/p>\n\u003cp>“Judge Hernandez is so awesome,” said Abraham, 25, a former graduate, who asked to be identified only by his first name because he was charged with a felony that has since been expunged from his record. “I don’t even look at her as the judge. She’s just like a mom figure. She’s only trying to push you to be the better you.”\u003c/p>\n\u003cp>A minute later, Hernandez walked through the aisle of the courtroom and gave Abraham a hug.\u003c/p>\n\u003ch2>‘Disaster preparedness’\u003c/h2>\n\u003cp>Even if CARE Court is ruled by the likes of Mary Poppins, Orlando Vera, who lives with bipolar disorder, said helping a vulnerable person heal from mental illness shouldn’t involve dragging them into a courtroom.\u003c/p>\n\u003cfigure id=\"attachment_11955161\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11955161 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED.jpg\" alt=\"A very fair-skinned bald man wearing glasses sits in an office setting, smiling and wearing a short-sleeved blue collared polo shirt.\" width=\"2000\" height=\"1333\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED.jpg 2000w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-03-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Orlando Vera, co-founder of Peer Voices of Orange County, says he and other people with lived experience of mental illness will attend CARE Court proceedings on behalf of patients. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s not a place [where] you resolve your emotions. It is a very business-oriented environment. So I do feel that this is not the place for it,” Vera said, adding, “Can we stop it? I would say we can’t.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘Our focus is how do we support those that are going through the system. We need to be their voice.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Orlando Vera, founder, Peer Voices of Orange County","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>After advocates \u003ca href=\"https://www.sacbee.com/news/politics-government/capitol-alert/article274547296.html\">failed to convince the state Supreme Court\u003c/a> to block the program on constitutional grounds, some started referring to the rollout of CARE Court as “disaster preparedness.”\u003c/p>\n\u003cp>\u003ca href=\"https://peervoices.org/\">Peer Voices of Orange County\u003c/a>, a group Vera co-founded and runs, plans to install patient advocates at the courthouse to attend any and all CARE Court hearings.\u003c/p>\n\u003cp>“Our focus is how do we support those that are going through the system,” he said. “We need to be their voice.”\u003c/p>\n\u003ch2>‘CARE’ without coercion\u003c/h2>\n\u003cp>Orange County behavioral health director Veronica Kelley is sympathetic to advocates’ concerns. She said CARE Court is not the program she would have created to improve the state’s mental health system. But she serves at the will of the governor and other elected officials who control her budget.\u003c/p>\n\u003cp>“So we end up building the Winchester Mystery House,” she said. “It is a structure that was OK, but then it just started adding hallways to nowhere and basements that are on top of the building. That’s what our system looks like.”\u003c/p>\n\u003cfigure id=\"attachment_11955162\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11955162 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED.jpg\" alt=\"A white woman with long blond hair and long earrings sits in front of a bookshelf filled with books. She is unsmiling.\" width=\"2000\" height=\"1333\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED.jpg 2000w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-04-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Veronica Kelley, behavioral health director for Orange County, will oversee mental health outreach and care provided through the local CARE Court, launching Oct. 1. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But Kelley is committed to making sure CARE Court is not a hallway to nowhere.\u003c/p>\n\u003cp>“It is a hallway that I’m going to, at the end, construct a door that opens out to a bunch of different options,” she said.\u003c/p>\n\u003cp>Kelley is shaping the new court process into something its critics can accept. This is why she wanted Orange County to go first.\u003c/p>\n\u003cp>“So we can help craft it into something that’s not another colossal waste of time and funds, and that we don’t destroy the people we’re trying to serve at the same time,” she told a roomful of patient advocates during a meeting of the state \u003ca href=\"https://www.dhcs.ca.gov/services/MH/Pages/PatientsRights.aspx#:~:text=California%20Office%20of%20Patients'%20Rights,training%20and%20technical%20assistance%20to\">Patient Rights’ Committee\u003c/a>, held in Santa Ana.\u003c/p>\n\u003cp>This means social workers from her \u003ca href=\"https://www.ochealthinfo.com/services-programs/mental-health-crisis-recovery/mental-health\">behavioral health department\u003c/a> or the \u003ca href=\"https://www.pubdef.ocgov.com/\">public defender’s office\u003c/a> might visit people 20, 30 or 40 times to build trust, listen and set goals.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘If someone agrees to do something of their own accord, it is far more probable that there will be long-term success and long-term commitment to the services being provided.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Veronica Kelley, behavioral health director, Orange County","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“If they can’t be convinced, CARE Court isn’t for them. But we’re not going to give up on folks because they say no the first time,” said Martin Schwarz, Orange County’s public defender, who plans to devote eight full-time staff to represent the interests of patients referred into the program.\u003c/p>\n\u003cp>Under the CARE legislation, the court is allowed to fine behavioral health agencies $1,000 per day if they can’t find a patient and enroll them in treatment by certain deadlines.\u003c/p>\n\u003cp>Kelley said her county’s judges have agreed to give her staff the time and extensions they need to do their jobs right. She also vowed that no one who declines services in her county would be institutionalized, as the legislation allows.\u003c/p>\n\u003cp>“If someone agrees to do something of their own accord, it is far more probable that there will be long-term success and long-term commitment to the services being provided,” she said.\u003c/p>\n\u003cp>Kelley and Schwarz pointed to their success with another civil court process established by Laura’s Law in 2002, where for each individual involved in court-ordered outpatient care, there were another 20 who accepted treatment willingly.\u003c/p>\n\u003cp>They say they have the same goal for CARE Court, where the focus will be on finding a treatment plan people accept voluntarily — before a judge has to order it.\u003c/p>\n\u003cp>“Success is measured by who we keep out of the court system,” Schwarz said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11955211/californias-new-care-courts-prompt-orange-county-to-weigh-best-practices","authors":["3205"],"programs":["news_72"],"categories":["news_457","news_8"],"tags":["news_18538","news_31336","news_4750","news_683","news_24221","news_4","news_31651","news_18371","news_38"],"featImg":"news_11955160","label":"news_72"},"news_11952228":{"type":"posts","id":"news_11952228","meta":{"index":"posts_1591205157","site":"news","id":"11952228","score":null,"sort":[1686056444000]},"guestAuthors":[],"slug":"san-francisco-to-implement-newsoms-care-court-plan-to-treat-severe-mental-illness","title":"San Francisco to Implement Newsom's CARE Court Plan to Treat Severe Mental Illness","publishDate":1686056444,"format":"standard","headTitle":"San Francisco to Implement Newsom’s CARE Court Plan to Treat Severe Mental Illness | KQED","labelTerm":{"term":72,"site":"news"},"content":"\u003cp>For the past few years, San Francisco’s international reputation as a vibrant and scenic destination for tourists and conventions has been overtaken by a drumbeat of stories focused on homelessness, an epidemic of fentanyl overdose deaths and people with severe and untreated psychoses living on the streets.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"San Francisco Mayor London Breed\"]‘There’s never enough money for anything. Period. But the fact is that can’t be an excuse for not trying.’[/pullquote]Now, San Francisco is poised to be among the first eight counties in California this year to implement CARE Court, a new approach to treating severe mental illness that Gov. Gavin Newsom calls a “paradigm shift,” but which supporters and opponents alike fear will fail to deliver on its sweeping promises.\u003c/p>\n\u003cp>Supporters of the program, like Mayor London Breed, said it’s time for the city to undergo a course correction.\u003c/p>\n\u003cfigure id=\"attachment_11952229\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11952229 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED-800x533.jpg\" alt=\"A Black woman with shoulder-length black, curly hair and bright red lipstick, wearing a blue blazer and an ochre blouse, gestures as she speaks in front of a flag of California inside what appears to be a large room.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">San Francisco Mayor London Breed speaks at a press event at City Hall on July 7, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We’ve got to start having honest conversations about the fact that things are changing, and it is not OK to allow what’s happening on the street to happen on the streets,” she recently told KQED.\u003c/p>\n\u003cp>The new courts — CARE stands for Community Assistance, Recovery and Empowerment — will allow first responders, family members, clinicians and others to ask a judge to order treatment plans for people diagnosed with schizophrenia and other psychotic disorders. While not limited to people who are also experiencing homelessness, the program focuses on people who are not currently receiving mental health treatment. Every county in California will have to implement the new civil courts by 2024.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Participation is voluntary, but supporters hope the so-called “black robe effect” — where people ordered to do something by a judge feel compelled to do so — will increase compliance.\u003c/p>\n\u003cp>Opponents of the program, including the American Civil Liberties Union and Disability Rights California, have argued that people, particularly Black Californians, will be targeted to enter the program because Black residents are overrepresented in both the number of \u003ca href=\"https://files.hudexchange.info/reports/published/CoC_PopSub_State_CA_2020.pdf\">people experiencing homelessness (PDF)\u003c/a> and the number of \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274585/\">people diagnosed with psychotic disorders\u003c/a>.\u003c/p>\n\u003cp>Johnny Crawford, who works on a cleaning crew in San Francisco, said he shared those concerns.\u003c/p>\n\u003cp>“I have mental health issues and I’ve dealt with addiction,” he said. “I think trying to push somebody into doing something they don’t want to do, it’s not fair. It’s not right. I wouldn’t do it.”\u003c/p>\n\u003cp>Supervisor Rafael Mandelman said those \u003ca href=\"https://www.kqed.org/news/11944448/a-war-of-compassion-debate-over-forced-treatment-of-mental-illness-splits-california-liberals\">civil liberty concerns\u003c/a> were being trumped by a larger concern: how to get people who aren’t engaged in mental health services into treatment.\u003c/p>\n\u003cp>“There are certainly folks on the Board of Supervisors and there are certainly people in the broader ballot body politic who really don’t want to see any more coercion of people into care who are not voluntarily seeking it,” Mandelman said, adding, “There’s a larger group of people who want these problems solved and want to see people get care.”\u003c/p>\n\u003cp>[aside postID=\"news_11944448,news_11924117,news_11914873\" label=\"Related Posts\"]Supporters argue a treatment plan developed through CARE Court will be less restrictive than alternatives, such as state hospitalization or conservatorship.\u003c/p>\n\u003cp>To qualify, an individual must be 18 years or older, diagnosed with schizophrenia or another psychotic disorder, deemed likely to benefit from a supervised treatment plan and found to be at risk of harming themselves or others.\u003c/p>\n\u003cp>A recent analysis by the Benioff Homelessness and Housing Initiative at UCSF and the California Policy Lab found that, based on data from hospital emergency rooms and the criminal justice system, \u003ca href=\"https://www.capolicylab.org/news/new-analysis-estimates-766-people-may-be-eligible-for-referral-to-care-court-in-san-francisco-though-capacity-is-a-concern/\">upwards of 760 people in San Francisco might be eligible\u003c/a> for referral to CARE Court when the program begins in October. Some experts expect the number to be more than 1,000.\u003c/p>\n\u003cp>Ensuring counties have enough funding to run the new CARE Courts is a concern shared by critics and supporters alike. Among the agencies involved in implementing CARE Court will be the Superior Court, the Department of Public Health, the Human Services Agency, the Department of Homelessness and Supportive Housing, the City Attorney’s Office and the Public Defender’s Office.\u003c/p>\n\u003cp>San Francisco City Attorney David Chiu said each participant will be required to go through five court hearings before a treatment plan is approved. But, he said, the state hasn’t allocated any additional funds for that.\u003c/p>\n\u003cp>“In addition to the work our office is going to do, there’s the work of, say, public defenders and other advocates, work of the court itself. And all of these actors are going to need additional resources,” Chiu said.\u003c/p>\n\u003cp>And, once someone has a treatment plan in place, San Francisco social worker Charlie Berman said, it isn’t clear whether the city’s existing facilities will be able to absorb new patients. For the past decade, Berman has worked on the streets of San Francisco with people suffering from severe mental illness — exactly the population CARE Court targets.\u003c/p>\n\u003cp>“I think CARE Court really isn’t going to do much of anything more than the existing programs we have, because those existing programs are already not really able to do their job as well as they should due to lack of capacity,” he said. “And that means so many people who are cycling in and out of the [psychiatric] emergency room aren’t getting inpatient services because half the people at S.F. General [Hospital] are awaiting placement.”\u003c/p>\n\u003cp>Supervisor Hillary Ronen is frustrated and worried that CARE Courts will simply shift attention and funding away from other programs aimed at helping the city’s unhoused population, including those with serious mental illness.\u003c/p>\n\u003cp>“It’s not the design of CARE Court that I have a problem with,” she said. “It’s the constant diversion of attention and strategies and the inability to just stick with one strategy and see it through.”\u003c/p>\n\u003cp>Ronen added, “Overall, the diversion from everything that we were already doing in San Francisco towards implementing CARE Court is a net negative for the city.”\u003c/p>\n\u003cp>Breed — who may ultimately be held accountable for the success or failure of the program — dismisses those concerns.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“There’s never enough money for anything. Period. But the fact is that can’t be an excuse for not trying,” she said. “People are sick and tired, and we have to clean up the streets.”\u003c/p>\n\n","blocks":[],"excerpt":"San Francisco is poised to be among the first eight counties in California this year to implement CARE Court, a new approach to treating severe mental illness.","status":"publish","parent":0,"modified":1686067204,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":1137},"headData":{"title":"San Francisco to Implement Newsom's CARE Court Plan to Treat Severe Mental Illness | KQED","description":"San Francisco is poised to be among the first eight counties in California this year to implement CARE Court, a new approach to treating severe mental illness.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"San Francisco to Implement Newsom's CARE Court Plan to Treat Severe Mental Illness","datePublished":"2023-06-06T13:00:44.000Z","dateModified":"2023-06-06T16:00:04.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-41c5-bcaf-aaef00f5a073/811e205c-b26e-404c-ba90-b01400eaa4f6/audio.mp3","excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11952228/san-francisco-to-implement-newsoms-care-court-plan-to-treat-severe-mental-illness","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>For the past few years, San Francisco’s international reputation as a vibrant and scenic destination for tourists and conventions has been overtaken by a drumbeat of stories focused on homelessness, an epidemic of fentanyl overdose deaths and people with severe and untreated psychoses living on the streets.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘There’s never enough money for anything. Period. But the fact is that can’t be an excuse for not trying.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"San Francisco Mayor London Breed","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Now, San Francisco is poised to be among the first eight counties in California this year to implement CARE Court, a new approach to treating severe mental illness that Gov. Gavin Newsom calls a “paradigm shift,” but which supporters and opponents alike fear will fail to deliver on its sweeping promises.\u003c/p>\n\u003cp>Supporters of the program, like Mayor London Breed, said it’s time for the city to undergo a course correction.\u003c/p>\n\u003cfigure id=\"attachment_11952229\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11952229 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED-800x533.jpg\" alt=\"A Black woman with shoulder-length black, curly hair and bright red lipstick, wearing a blue blazer and an ochre blouse, gestures as she speaks in front of a flag of California inside what appears to be a large room.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS57121_006_KQED_DABrookeJenkins_07072022-qut-KQED.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">San Francisco Mayor London Breed speaks at a press event at City Hall on July 7, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We’ve got to start having honest conversations about the fact that things are changing, and it is not OK to allow what’s happening on the street to happen on the streets,” she recently told KQED.\u003c/p>\n\u003cp>The new courts — CARE stands for Community Assistance, Recovery and Empowerment — will allow first responders, family members, clinicians and others to ask a judge to order treatment plans for people diagnosed with schizophrenia and other psychotic disorders. While not limited to people who are also experiencing homelessness, the program focuses on people who are not currently receiving mental health treatment. Every county in California will have to implement the new civil courts by 2024.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Participation is voluntary, but supporters hope the so-called “black robe effect” — where people ordered to do something by a judge feel compelled to do so — will increase compliance.\u003c/p>\n\u003cp>Opponents of the program, including the American Civil Liberties Union and Disability Rights California, have argued that people, particularly Black Californians, will be targeted to enter the program because Black residents are overrepresented in both the number of \u003ca href=\"https://files.hudexchange.info/reports/published/CoC_PopSub_State_CA_2020.pdf\">people experiencing homelessness (PDF)\u003c/a> and the number of \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274585/\">people diagnosed with psychotic disorders\u003c/a>.\u003c/p>\n\u003cp>Johnny Crawford, who works on a cleaning crew in San Francisco, said he shared those concerns.\u003c/p>\n\u003cp>“I have mental health issues and I’ve dealt with addiction,” he said. “I think trying to push somebody into doing something they don’t want to do, it’s not fair. It’s not right. I wouldn’t do it.”\u003c/p>\n\u003cp>Supervisor Rafael Mandelman said those \u003ca href=\"https://www.kqed.org/news/11944448/a-war-of-compassion-debate-over-forced-treatment-of-mental-illness-splits-california-liberals\">civil liberty concerns\u003c/a> were being trumped by a larger concern: how to get people who aren’t engaged in mental health services into treatment.\u003c/p>\n\u003cp>“There are certainly folks on the Board of Supervisors and there are certainly people in the broader ballot body politic who really don’t want to see any more coercion of people into care who are not voluntarily seeking it,” Mandelman said, adding, “There’s a larger group of people who want these problems solved and want to see people get care.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11944448,news_11924117,news_11914873","label":"Related Posts "},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Supporters argue a treatment plan developed through CARE Court will be less restrictive than alternatives, such as state hospitalization or conservatorship.\u003c/p>\n\u003cp>To qualify, an individual must be 18 years or older, diagnosed with schizophrenia or another psychotic disorder, deemed likely to benefit from a supervised treatment plan and found to be at risk of harming themselves or others.\u003c/p>\n\u003cp>A recent analysis by the Benioff Homelessness and Housing Initiative at UCSF and the California Policy Lab found that, based on data from hospital emergency rooms and the criminal justice system, \u003ca href=\"https://www.capolicylab.org/news/new-analysis-estimates-766-people-may-be-eligible-for-referral-to-care-court-in-san-francisco-though-capacity-is-a-concern/\">upwards of 760 people in San Francisco might be eligible\u003c/a> for referral to CARE Court when the program begins in October. Some experts expect the number to be more than 1,000.\u003c/p>\n\u003cp>Ensuring counties have enough funding to run the new CARE Courts is a concern shared by critics and supporters alike. Among the agencies involved in implementing CARE Court will be the Superior Court, the Department of Public Health, the Human Services Agency, the Department of Homelessness and Supportive Housing, the City Attorney’s Office and the Public Defender’s Office.\u003c/p>\n\u003cp>San Francisco City Attorney David Chiu said each participant will be required to go through five court hearings before a treatment plan is approved. But, he said, the state hasn’t allocated any additional funds for that.\u003c/p>\n\u003cp>“In addition to the work our office is going to do, there’s the work of, say, public defenders and other advocates, work of the court itself. And all of these actors are going to need additional resources,” Chiu said.\u003c/p>\n\u003cp>And, once someone has a treatment plan in place, San Francisco social worker Charlie Berman said, it isn’t clear whether the city’s existing facilities will be able to absorb new patients. For the past decade, Berman has worked on the streets of San Francisco with people suffering from severe mental illness — exactly the population CARE Court targets.\u003c/p>\n\u003cp>“I think CARE Court really isn’t going to do much of anything more than the existing programs we have, because those existing programs are already not really able to do their job as well as they should due to lack of capacity,” he said. “And that means so many people who are cycling in and out of the [psychiatric] emergency room aren’t getting inpatient services because half the people at S.F. General [Hospital] are awaiting placement.”\u003c/p>\n\u003cp>Supervisor Hillary Ronen is frustrated and worried that CARE Courts will simply shift attention and funding away from other programs aimed at helping the city’s unhoused population, including those with serious mental illness.\u003c/p>\n\u003cp>“It’s not the design of CARE Court that I have a problem with,” she said. “It’s the constant diversion of attention and strategies and the inability to just stick with one strategy and see it through.”\u003c/p>\n\u003cp>Ronen added, “Overall, the diversion from everything that we were already doing in San Francisco towards implementing CARE Court is a net negative for the city.”\u003c/p>\n\u003cp>Breed — who may ultimately be held accountable for the success or failure of the program — dismisses those concerns.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There’s never enough money for anything. Period. But the fact is that can’t be an excuse for not trying,” she said. “People are sick and tired, and we have to clean up the streets.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11952228/san-francisco-to-implement-newsoms-care-court-plan-to-treat-severe-mental-illness","authors":["255"],"programs":["news_72"],"categories":["news_6266","news_8"],"tags":["news_31336","news_16","news_4020","news_1775","news_6931","news_31538","news_17983","news_17968","news_30602"],"featImg":"news_11952219","label":"news_72"},"news_11951103":{"type":"posts","id":"news_11951103","meta":{"index":"posts_1591205157","site":"news","id":"11951103","score":null,"sort":[1685527258000]},"guestAuthors":[],"slug":"san-francisco-prepares-to-roll-out-care-court","title":"San Francisco Prepares to Roll Out CARE Court","publishDate":1685527258,"format":"audio","headTitle":"San Francisco Prepares to Roll Out CARE Court | KQED","labelTerm":{},"content":"\u003cp>\u003cspan style=\"font-weight: 400\">Gov. Gavin Newsom has been talking a big game about CARE (Community Assistance, Recovery and Empowerment) Court, the state’s new plan for treating people with severe mental illness. CARE Court, which every county in California will have to implement by next year, focuses on steering people suffering from severe psychosis, such as schizophrenia, and addiction into treatment. It will allow first responders, family members, clinicians and others to ask a judge to order treatment plans for unhoused people with severe psychotic disorders.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">San Francisco is gearing up to launch this program by Oct. 1. Can CARE Court actually deliver what the governor promises?\u003c/span>\u003c/p>\n\u003cp>\u003ca href=\"https://bit.ly/42AlWVW\">\u003cem>Episode transcript\u003c/em>\u003c/a>\u003c/p>\n\u003cp>\u003cb>Guest: \u003c/b>\u003ca href=\"https://twitter.com/scottshafer\">\u003cspan style=\"font-weight: 400\">Scott Shafer\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, senior editor of KQED’s Politics and Government Desk\u003c/span>\u003c/p>\n\u003cp id=\"embed-code\" class=\"inconsolata\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm/?e=KQINC5972549195&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n","blocks":[],"excerpt":"San Francisco is gearing up to launch its CARE (Community Assistance, Recovery and Empowerment) Court program, the state’s new plan for treating people with severe mental illness.\r\n","status":"publish","parent":0,"modified":1700689329,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":6,"wordCount":122},"headData":{"title":"San Francisco Prepares to Roll Out CARE Court | KQED","description":"San Francisco is gearing up to launch its CARE (Community Assistance, Recovery and Empowerment) Court program, the state’s new plan for treating people with severe mental illness.\r\n","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"San Francisco Prepares to Roll Out CARE Court","datePublished":"2023-05-31T10:00:58.000Z","dateModified":"2023-11-22T21:42:09.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"source":"The Bay","sourceUrl":"https://www.kqed.org/podcasts/thebay","audioUrl":"https://www.podtrac.com/pts/redirect.mp3/chrt.fm/track/G6C7C3/traffic.megaphone.fm/KQINC5972549195.mp3?updated=1685480019","excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11951103/san-francisco-prepares-to-roll-out-care-court","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">Gov. Gavin Newsom has been talking a big game about CARE (Community Assistance, Recovery and Empowerment) Court, the state’s new plan for treating people with severe mental illness. CARE Court, which every county in California will have to implement by next year, focuses on steering people suffering from severe psychosis, such as schizophrenia, and addiction into treatment. It will allow first responders, family members, clinicians and others to ask a judge to order treatment plans for unhoused people with severe psychotic disorders.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">San Francisco is gearing up to launch this program by Oct. 1. Can CARE Court actually deliver what the governor promises?\u003c/span>\u003c/p>\n\u003cp>\u003ca href=\"https://bit.ly/42AlWVW\">\u003cem>Episode transcript\u003c/em>\u003c/a>\u003c/p>\n\u003cp>\u003cb>Guest: \u003c/b>\u003ca href=\"https://twitter.com/scottshafer\">\u003cspan style=\"font-weight: 400\">Scott Shafer\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, senior editor of KQED’s Politics and Government Desk\u003c/span>\u003c/p>\n\u003cp id=\"embed-code\" class=\"inconsolata\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm/?e=KQINC5972549195&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11951103/san-francisco-prepares-to-roll-out-care-court","authors":["8654","11649","11802","255"],"programs":["news_28779"],"categories":["news_8","news_33520"],"tags":["news_28991","news_31336","news_31340","news_16","news_31538","news_22598"],"featImg":"news_11924205","label":"source_news_11951103"},"news_11944448":{"type":"posts","id":"news_11944448","meta":{"index":"posts_1591205157","site":"news","id":"11944448","score":null,"sort":[1679914830000]},"guestAuthors":[],"slug":"a-war-of-compassion-debate-over-forced-treatment-of-mental-illness-splits-california-liberals","title":"A War of Compassion: Debate Over Forced Treatment of Mental Illness Splits California Liberals","publishDate":1679914830,"format":"standard","headTitle":"KQED News","labelTerm":{},"content":"\u003cp>Half a century after California policymakers \u003ca href=\"https://www.pbs.org/wgbh/pages/frontline/shows/asylums/special/excerpt.html\">shuttered\u003c/a> state psychiatric institutions, denouncing them as inhumane, today’s progressive leaders are now reconsidering involuntary commitments, saying not helping people who are seriously ill, and living in squalor on the streets, is inhumane.\u003c/p>\n\u003cp>The shift is pitting liberals against liberals over the very meaning of compassion. Disability rights advocates say the renewed push for forced treatment violates people’s civil rights, while Democratic leaders and doctors counter that doing nothing violates people’s right to medical care, particularly when the nature of their illness prevents them from recognizing they need help. [pullquote align='right' citation='State Sen. Scott Wiener']'It is neither progressive nor compassionate to just sit by and let people deteriorate, fall apart and ultimately die on our streets. That is the opposite of progressive.'[/pullquote]\u003c/p>\n\u003cp>“The status quo has forced too many of our loved ones to die with their rights on,” said Teresa Pasquini, an advocate whose son has schizophrenia and has spent the past 20 years being “failed, jailed, treated, and streeted” by what she calls a broken public health system.\u003c/p>\n\u003cp>\u003ca href=\"https://www.huduser.gov/portal/sites/default/files/pdf/2022-AHAR-Part-1.pdf\">Half of the country’s unsheltered (PDF)\u003c/a> people live in California, and though only a quarter of them have a serious mental illness, state lawmakers say they need more tools to get people into treatment, even if it’s against their will. One proposal aims to expand who qualifies for a yearlong conservatorship, or involuntary psychiatric hold, while a new system of \u003ca href=\"https://www.kqed.org/news/11924117/governors-care-court-plan-passes-assembly-clearing-way-to-become-law\">CARE Courts\u003c/a>, where judges issue treatment plans, are scheduled to roll out in eight counties this fall. [pullquote align='right' citation='Keris Myrick']'When people are told that they have to go to court to get what they should be getting voluntarily in the community, and then they get a care plan that subjugates them to services that still do not meet their cultural needs, that is not compassion.'[/pullquote]\u003c/p>\n\u003cp>To opponents, California is reverting to a draconian policy of locking people up just for being sick, but psychiatrists argue they are seeking a modest update to \u003ca href=\"https://www.lacourt.org/division/mentalhealth/MH0017.aspx\">a 56-year-old law\u003c/a>. Without more intervention options, they say, patients will continue to cycle into the emergency room and back to the street.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We are doctors who have to watch these people die,” said Dr. Emily Wood of the\u003ca href=\"https://www.calpsychiatrists.org/\"> California State Association of Psychiatrists\u003c/a>, a sponsor of the conservatorship bill,\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB43\"> SB 43\u003c/a>. “We have to talk to their families who know that they need that care, and we have to say we don’t have any legal basis to bring them into the hospital right now.”\u003c/p>\n\u003cp>Under current state law, a person can be held in the hospital involuntarily if they are a danger to themselves or others, or if they are unable to seek food, clothing or shelter as a result of mental illness or alcoholism. Doctors want to incorporate substance use disorder into the law and include in the criteria the inability to look out for one’s own safety and medical care. (Mental health conservatorship is separate from the \u003ca href=\"https://www.scscourt.org/self_help/probate/conservatorship/conservatorship_overview.shtml\">probate conservatorship\u003c/a> that Brittney Spears was held under.)\u003c/p>\n\u003cp>Dr. Wood, who practices in Los Angeles, gave two examples of people she and her colleagues tried to care for, but who slipped through the cracks under the current rules: a man didn't take his diabetes medication because he wasn't taking his schizophrenia medication and didn't understand the consequences of not managing either condition. He repeatedly ended up in the ER with dangerously high blood sugar, but no one could compel him to take either medication, because poorly managing one’s health is not a trigger for conservatorship.\u003c/p>\n\u003cp>Another man had a developmental disability that was never treated in childhood and developed an addiction to methamphetamine in his 20s. He’s now regularly found sleeping in a park and acting inappropriately in public. His family begged doctors to treat him, but they can’t because drug misuse is not a trigger for conservatorship.\u003c/p>\n\u003cp>To Dr. Wood, treating these people, even when they’re unable to consent, is the compassionate, moral thing to do.\u003c/p>\n\u003cp>\"It's essential that we respect all the rights of our patients, including the right to receive care from us,” she said.\u003c/p>\n\u003cp>But other advocates and people with mental illness see the issue very differently. Lawyers from the nonprofit \u003ca href=\"https://www.disabilityrightsca.org/\">Disability Rights California\u003c/a> say the expansion of conservatorship and the advance of CARE Courts are misguided, focused on depriving people of their liberty and privacy, instead of investing in better voluntary mental health services that maintain people's dignity and civil rights. The group filed a lawsuit to try \u003ca href=\"https://www.disabilityrightsca.org/press-release/disability-rights-advocates-file-petition-challenging-the-constitutional-validity-of\">to block the implementation\u003c/a> of CARE Courts.\u003c/p>\n\u003cp>They’re concerned that people of color, specifically Black residents who are overrepresented in the homeless population and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274585/\" target=\"_blank\" rel=\"noopener\">overdiagnosed\u003c/a> with schizophrenia, will be disproportionately targeted by these more forceful measures.\u003c/p>\n\u003cp>“When people are told that they have to go to court to get what they should be getting voluntarily in the community, and then they get a care plan that subjugates them to services that still do not meet their cultural needs, that is not compassion,” said Keris Myrick, an advocate who has schizophrenia and has experienced homelessness.\u003c/p>\n\u003cp>Opponents’ other main objection is focused on capacity. Once people are compelled into treatment, where in the overextended, understaffed public mental health system are they supposed to go? Already, there aren’t enough psychiatric hospital beds or appropriate substance abuse centers or housing options for the people who need them, said Michelle Doty Cabrera, executive director of the \u003ca href=\"https://www.cbhda.org/\">California Behavioral Health Directors Association\u003c/a>.\u003c/p>\n\u003cp>“Expanding conservatorships doesn't solve for those structural issues around the lack of housing and the lack of funding for treatment services,” she said.\u003c/p>\n\u003cp>Cabrera’s group also questions the premise that forced treatment works. Especially when it comes to substance use disorder,\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/26790691/\"> research suggests\u003c/a> compulsory treatment is less effective and could even be harmful, elevating overdose risk. In Massachusetts, people who were involuntarily committed for drug treatment\u003ca href=\"https://www.mass.gov/service-details/chapter-55-overdose-report\"> were twice as likely to die\u003c/a> from an overdose as those who received treatment willingly.\u003c/p>\n\u003cp>More broadly, if the ultimate goal of forced treatment is reducing homelessness — and easing the moral heartbreak of witnessing ill people sleeping on the street or using drugs in the open — then lawmakers are writing the wrong prescription, some researchers say.\u003c/p>\n\u003cp>“The problem of homelessness is that people don't have housing,” said Dr. Margot Kushel, director of the UCSF’s\u003ca href=\"https://homelessness.ucsf.edu/\"> Benioff Homelessness and Housing Initiative\u003c/a>. “If you had all the treatment in the world and you didn't have the housing, we would still have this problem.”\u003c/p>\n\u003cp>She compares homelessness to a game of musical chairs, where the kid on crutches is the one left standing when the music stops. In California, there are \u003ca href=\"https://nlihc.org/gap\">24 units of affordable housing\u003c/a> for every 100 very low-income households, she said, and people with mental illness or substance use disorder are the ones who have the hardest time competing for those scarce spots. That’s why they’re overrepresented among the homeless population, she said, not because conservatorship laws aren’t strong enough.\u003c/p>\n\u003cp>“If you try to fix the problem of homelessness by tinkering with the health care system, we're not going to get anywhere,” Kushel said.\u003c/p>\n\u003cp>Supporters of involuntary commitments say both are needed: treatment and housing. The same lawmakers who are backing expanded conservatorship and CARE Courts are also backing efforts to increase the housing supply, including \u003ca href=\"https://www.gov.ca.gov/2023/03/19/governor-newsom-proposes-modernization-of-californias-behavioral-health-system-and-more-mental-health-housing/\">a $3 billion bond measure\u003c/a> for the construction of small, neighborhood-oriented residences for people with mental illness.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"They need housing, but they need additional support so that they can thrive,” said Sen. Scott Wiener. “It is neither progressive nor compassionate to just sit by and let people deteriorate, fall apart and ultimately die on our streets. That is the opposite of progressive.”\u003c/p>\n\n","blocks":[],"excerpt":"Is compelling people into treatment a violation of their civil rights? Or does doing nothing violate their right to medical care?","status":"publish","parent":0,"modified":1679933444,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":1347},"headData":{"title":"A War of Compassion: Debate Over Forced Treatment of Mental Illness Splits California Liberals | KQED","description":"Is compelling people into treatment a violation of their civil rights? Or does doing nothing violate their right to medical care?","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"A War of Compassion: Debate Over Forced Treatment of Mental Illness Splits California Liberals","datePublished":"2023-03-27T11:00:30.000Z","dateModified":"2023-03-27T16:10:44.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"source":"Mental Health","subhead":"Debate Over How to Care for People With Severe Mental Illness is Redefining What Is Compassionate, Humane, and Moral","excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11944448/a-war-of-compassion-debate-over-forced-treatment-of-mental-illness-splits-california-liberals","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Half a century after California policymakers \u003ca href=\"https://www.pbs.org/wgbh/pages/frontline/shows/asylums/special/excerpt.html\">shuttered\u003c/a> state psychiatric institutions, denouncing them as inhumane, today’s progressive leaders are now reconsidering involuntary commitments, saying not helping people who are seriously ill, and living in squalor on the streets, is inhumane.\u003c/p>\n\u003cp>The shift is pitting liberals against liberals over the very meaning of compassion. Disability rights advocates say the renewed push for forced treatment violates people’s civil rights, while Democratic leaders and doctors counter that doing nothing violates people’s right to medical care, particularly when the nature of their illness prevents them from recognizing they need help. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'It is neither progressive nor compassionate to just sit by and let people deteriorate, fall apart and ultimately die on our streets. That is the opposite of progressive.'","name":"pullquote","attributes":{"named":{"align":"right","citation":"State Sen. Scott Wiener","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The status quo has forced too many of our loved ones to die with their rights on,” said Teresa Pasquini, an advocate whose son has schizophrenia and has spent the past 20 years being “failed, jailed, treated, and streeted” by what she calls a broken public health system.\u003c/p>\n\u003cp>\u003ca href=\"https://www.huduser.gov/portal/sites/default/files/pdf/2022-AHAR-Part-1.pdf\">Half of the country’s unsheltered (PDF)\u003c/a> people live in California, and though only a quarter of them have a serious mental illness, state lawmakers say they need more tools to get people into treatment, even if it’s against their will. One proposal aims to expand who qualifies for a yearlong conservatorship, or involuntary psychiatric hold, while a new system of \u003ca href=\"https://www.kqed.org/news/11924117/governors-care-court-plan-passes-assembly-clearing-way-to-become-law\">CARE Courts\u003c/a>, where judges issue treatment plans, are scheduled to roll out in eight counties this fall. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'When people are told that they have to go to court to get what they should be getting voluntarily in the community, and then they get a care plan that subjugates them to services that still do not meet their cultural needs, that is not compassion.'","name":"pullquote","attributes":{"named":{"align":"right","citation":"Keris Myrick","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To opponents, California is reverting to a draconian policy of locking people up just for being sick, but psychiatrists argue they are seeking a modest update to \u003ca href=\"https://www.lacourt.org/division/mentalhealth/MH0017.aspx\">a 56-year-old law\u003c/a>. Without more intervention options, they say, patients will continue to cycle into the emergency room and back to the street.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We are doctors who have to watch these people die,” said Dr. Emily Wood of the\u003ca href=\"https://www.calpsychiatrists.org/\"> California State Association of Psychiatrists\u003c/a>, a sponsor of the conservatorship bill,\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB43\"> SB 43\u003c/a>. “We have to talk to their families who know that they need that care, and we have to say we don’t have any legal basis to bring them into the hospital right now.”\u003c/p>\n\u003cp>Under current state law, a person can be held in the hospital involuntarily if they are a danger to themselves or others, or if they are unable to seek food, clothing or shelter as a result of mental illness or alcoholism. Doctors want to incorporate substance use disorder into the law and include in the criteria the inability to look out for one’s own safety and medical care. (Mental health conservatorship is separate from the \u003ca href=\"https://www.scscourt.org/self_help/probate/conservatorship/conservatorship_overview.shtml\">probate conservatorship\u003c/a> that Brittney Spears was held under.)\u003c/p>\n\u003cp>Dr. Wood, who practices in Los Angeles, gave two examples of people she and her colleagues tried to care for, but who slipped through the cracks under the current rules: a man didn't take his diabetes medication because he wasn't taking his schizophrenia medication and didn't understand the consequences of not managing either condition. He repeatedly ended up in the ER with dangerously high blood sugar, but no one could compel him to take either medication, because poorly managing one’s health is not a trigger for conservatorship.\u003c/p>\n\u003cp>Another man had a developmental disability that was never treated in childhood and developed an addiction to methamphetamine in his 20s. He’s now regularly found sleeping in a park and acting inappropriately in public. His family begged doctors to treat him, but they can’t because drug misuse is not a trigger for conservatorship.\u003c/p>\n\u003cp>To Dr. Wood, treating these people, even when they’re unable to consent, is the compassionate, moral thing to do.\u003c/p>\n\u003cp>\"It's essential that we respect all the rights of our patients, including the right to receive care from us,” she said.\u003c/p>\n\u003cp>But other advocates and people with mental illness see the issue very differently. Lawyers from the nonprofit \u003ca href=\"https://www.disabilityrightsca.org/\">Disability Rights California\u003c/a> say the expansion of conservatorship and the advance of CARE Courts are misguided, focused on depriving people of their liberty and privacy, instead of investing in better voluntary mental health services that maintain people's dignity and civil rights. The group filed a lawsuit to try \u003ca href=\"https://www.disabilityrightsca.org/press-release/disability-rights-advocates-file-petition-challenging-the-constitutional-validity-of\">to block the implementation\u003c/a> of CARE Courts.\u003c/p>\n\u003cp>They’re concerned that people of color, specifically Black residents who are overrepresented in the homeless population and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274585/\" target=\"_blank\" rel=\"noopener\">overdiagnosed\u003c/a> with schizophrenia, will be disproportionately targeted by these more forceful measures.\u003c/p>\n\u003cp>“When people are told that they have to go to court to get what they should be getting voluntarily in the community, and then they get a care plan that subjugates them to services that still do not meet their cultural needs, that is not compassion,” said Keris Myrick, an advocate who has schizophrenia and has experienced homelessness.\u003c/p>\n\u003cp>Opponents’ other main objection is focused on capacity. Once people are compelled into treatment, where in the overextended, understaffed public mental health system are they supposed to go? Already, there aren’t enough psychiatric hospital beds or appropriate substance abuse centers or housing options for the people who need them, said Michelle Doty Cabrera, executive director of the \u003ca href=\"https://www.cbhda.org/\">California Behavioral Health Directors Association\u003c/a>.\u003c/p>\n\u003cp>“Expanding conservatorships doesn't solve for those structural issues around the lack of housing and the lack of funding for treatment services,” she said.\u003c/p>\n\u003cp>Cabrera’s group also questions the premise that forced treatment works. Especially when it comes to substance use disorder,\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/26790691/\"> research suggests\u003c/a> compulsory treatment is less effective and could even be harmful, elevating overdose risk. In Massachusetts, people who were involuntarily committed for drug treatment\u003ca href=\"https://www.mass.gov/service-details/chapter-55-overdose-report\"> were twice as likely to die\u003c/a> from an overdose as those who received treatment willingly.\u003c/p>\n\u003cp>More broadly, if the ultimate goal of forced treatment is reducing homelessness — and easing the moral heartbreak of witnessing ill people sleeping on the street or using drugs in the open — then lawmakers are writing the wrong prescription, some researchers say.\u003c/p>\n\u003cp>“The problem of homelessness is that people don't have housing,” said Dr. Margot Kushel, director of the UCSF’s\u003ca href=\"https://homelessness.ucsf.edu/\"> Benioff Homelessness and Housing Initiative\u003c/a>. “If you had all the treatment in the world and you didn't have the housing, we would still have this problem.”\u003c/p>\n\u003cp>She compares homelessness to a game of musical chairs, where the kid on crutches is the one left standing when the music stops. In California, there are \u003ca href=\"https://nlihc.org/gap\">24 units of affordable housing\u003c/a> for every 100 very low-income households, she said, and people with mental illness or substance use disorder are the ones who have the hardest time competing for those scarce spots. That’s why they’re overrepresented among the homeless population, she said, not because conservatorship laws aren’t strong enough.\u003c/p>\n\u003cp>“If you try to fix the problem of homelessness by tinkering with the health care system, we're not going to get anywhere,” Kushel said.\u003c/p>\n\u003cp>Supporters of involuntary commitments say both are needed: treatment and housing. The same lawmakers who are backing expanded conservatorship and CARE Courts are also backing efforts to increase the housing supply, including \u003ca href=\"https://www.gov.ca.gov/2023/03/19/governor-newsom-proposes-modernization-of-californias-behavioral-health-system-and-more-mental-health-housing/\">a $3 billion bond measure\u003c/a> for the construction of small, neighborhood-oriented residences for people with mental illness.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"They need housing, but they need additional support so that they can thrive,” said Sen. Scott Wiener. “It is neither progressive nor compassionate to just sit by and let people deteriorate, fall apart and ultimately die on our streets. That is the opposite of progressive.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11944448/a-war-of-compassion-debate-over-forced-treatment-of-mental-illness-splits-california-liberals","authors":["3205"],"categories":["news_457","news_8","news_356"],"tags":["news_31336","news_31340","news_27626","news_4020","news_32570","news_17983","news_32569","news_6720"],"featImg":"news_11944721","label":"source_news_11944448"},"news_11928031":{"type":"posts","id":"news_11928031","meta":{"index":"posts_1591205157","site":"news","id":"11928031","score":null,"sort":[1665184344000]},"guestAuthors":[],"slug":"oakland-writers-ayodele-nzinga-and-leila-mottley","title":"Oakland Writers Ayodele Nzinga and Leila Mottley","publishDate":1665184344,"format":"video","headTitle":"KQED Newsroom | KQED News","labelTerm":{"term":7052,"site":"news"},"content":"\u003cp>\u003cb>Oakland Writers Ayodele Nzinga and Leila Mottley\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">This week, we welcome two contemporary Oakland authors: Leila Mottley and Dr. Ayodele Nzinga. Mottley is an Oakland Youth Poet Laureate, who at just 19 years old published \"Nightcrawling\" — an immersive novel and an Oprah's Book Club selection — based on local events. She's joined by Oakland's inaugural Poet Laureate, Dr. Ayodele Nzinga, who shines not only as an author but also as a director, actor and educator. \u003c/span>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Leila Mottley, \"Nightcrawling\" author\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Ayodele Nzinga, Oakland Poet Laureate\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cb>This Week in California News and Politics\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">San Francisco Mayor London Breed, together with San Francisco Police Chief Bill Scott and San Francisco District Attorney Brooke Jenkins, announced a renewed push to prosecute drug dealers while also helping people dealing with substance use disorder. We talk with \u003c/span>\u003cb>Scott Shafer,\u003c/b> \u003cb>KQED politics and government senior editor\u003c/b>\u003cspan style=\"font-weight: 400\">, who spoke with Mayor Breed this week.\u003c/span>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003cb>Something Beautiful: West Oakland Mural Project\u003c/b>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The West Oakland Mural Project highlights the vital role women played in the revolutionary Black Panther Party.\u003c/span>\u003c/p>\n\n","blocks":[],"excerpt":null,"status":"publish","parent":0,"modified":1665184344,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":9,"wordCount":180},"headData":{"title":"Oakland Writers Ayodele Nzinga and Leila Mottley | KQED","description":"Oakland Writers Ayodele Nzinga and Leila Mottley This week, we welcome two contemporary Oakland authors: Leila Mottley and Dr. Ayodele Nzinga. Mottley is an Oakland Youth Poet Laureate, who at just 19 years old published "Nightcrawling" — an immersive novel and an Oprah's Book Club selection — based on local events. She's joined by Oakland's","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"Oakland Writers Ayodele Nzinga and Leila Mottley","datePublished":"2022-10-07T23:12:24.000Z","dateModified":"2022-10-07T23:12:24.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"disqusIdentifier":"11928031 https://ww2.kqed.org/news/?p=11928031","disqusUrl":"https://ww2.kqed.org/news/2022/10/07/oakland-writers-ayodele-nzinga-and-leila-mottley/","disqusTitle":"Oakland Writers Ayodele Nzinga and Leila Mottley","videoEmbed":"https://youtu.be/v-_ee2Q1jFY","excludeFromSiteSearch":"Include","path":"/news/11928031/oakland-writers-ayodele-nzinga-and-leila-mottley","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Oakland Writers Ayodele Nzinga and Leila Mottley\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">This week, we welcome two contemporary Oakland authors: Leila Mottley and Dr. Ayodele Nzinga. Mottley is an Oakland Youth Poet Laureate, who at just 19 years old published \"Nightcrawling\" — an immersive novel and an Oprah's Book Club selection — based on local events. She's joined by Oakland's inaugural Poet Laureate, Dr. Ayodele Nzinga, who shines not only as an author but also as a director, actor and educator. \u003c/span>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Leila Mottley, \"Nightcrawling\" author\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Ayodele Nzinga, Oakland Poet Laureate\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cb>This Week in California News and Politics\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">San Francisco Mayor London Breed, together with San Francisco Police Chief Bill Scott and San Francisco District Attorney Brooke Jenkins, announced a renewed push to prosecute drug dealers while also helping people dealing with substance use disorder. We talk with \u003c/span>\u003cb>Scott Shafer,\u003c/b> \u003cb>KQED politics and government senior editor\u003c/b>\u003cspan style=\"font-weight: 400\">, who spoke with Mayor Breed this week.\u003c/span>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003cb>Something Beautiful: West Oakland Mural Project\u003c/b>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The West Oakland Mural Project highlights the vital role women played in the revolutionary Black Panther Party.\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11928031/oakland-writers-ayodele-nzinga-and-leila-mottley","authors":["236"],"programs":["news_7052"],"categories":["news_29992","news_223","news_1758","news_28750","news_457","news_6266","news_6188","news_28250","news_13"],"tags":["news_30878","news_31781","news_18880","news_18012","news_31336","news_22903","news_1775","news_31780","news_24474","news_18","news_1222","news_30740","news_31782","news_31783","news_163"],"featImg":"news_11928107","label":"news_7052"},"news_11924117":{"type":"posts","id":"news_11924117","meta":{"index":"posts_1591205157","site":"news","id":"11924117","score":null,"sort":[1663192821000]},"guestAuthors":[],"slug":"governors-care-court-plan-passes-assembly-clearing-way-to-become-law","title":"Newsom Signs 'CARE Court' Plan, Overhauling Mental Health Care in California","publishDate":1663192821,"format":"standard","headTitle":"KQED News","labelTerm":{"site":"news"},"content":"\u003cp>\u003cem>Updated Wednesday 2 p.m.\u003c/em>\u003c/p>\n\u003cp>Gov. Gavin Newsom signed a controversial bill Wednesday overhauling the state's approach to mental health care for people diagnosed with schizophrenia and other psychotic disorders.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state Senate last month approved the\u003c/span> Community Assistance, Recovery and Empowerment Act, which will allow family members and first responders to ask a judge to draw up a treatment plan for people deemed to be suffering from those disorders. Those who refuse could be placed under a conservatorship and ordered to comply.\u003c/p>\n\u003cp>Currently, unhoused people with severe mental health disorders can be held against their will at psychiatric hospitals, but must be released after three days if they promise to follow up with other services and take prescribed medication.\u003c/p>\n\u003cp>The new law will let a court order a treatment plan for up to two years, which may include medication, housing and therapy.\u003cspan style=\"font-weight: 400\"> Participants will have access to a public defender and an advocate to help make decisions about treatment programs and housing. In turn, the behavioral health department in that county would be compelled to provide treatment.\u003c/span>\u003c/p>\n\u003cp>While it shares some elements of mental health programs in some other states, California's new system will be the first of its kind in the country, according to state Sen. Tom Umberg, D-Santa Ana, who co-authored the law.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Standing outside Momentum for Health, a nonprofit mental health care provider in San José, Newsom on Wednesday said the bill was about redesigning a broken system \u003c/span>\u003cspan style=\"font-weight: 400\">that often leaves people cycling among homelessness, jail and emergency rooms. \u003c/span>\u003c/p>\n\u003cp>\"I'm not interested in the status quo,\" he said. \"I'm not interested in the compassionless-ness of the approach we have today of people moralizing and normalizing that suffering on the streets and sidewalks.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But critics of the bill say it coerces people into care, which is less effective than voluntary treatment, and doesn’t provide the necessary health and housing resources.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">James Burch, deputy director of the Anti Police-Terror Project, which is part of a statewide coalition opposing CARE Court, called the bill's signing \"devastating.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It ignores the very stark reality that we're living in in this moment,” he said. “We are tens of thousands of beds short in the Bay Area of the permanent housing that we need. … And we are woefully short on voluntary treatment programs.”\u003c/span>\u003c/p>\n\u003cp>[aside postID=news_11914873 hero='https://ww2.kqed.org/app/uploads/sites/10/2022/05/RS16522_GettyImages-73453883-qut-1020x682.jpg']\u003cspan style=\"font-weight: 400\">Gov. Gavin Newsom introduced the proposal in March. \u003c/span>It passed the Legislature with overwhelming support, despite vehement opposition from disability rights and homeless advocates.\u003c/p>\n\u003cp>\"It was just a matter of months ago that we stood right here and we laid out a vision,\" Newsom said Wednesday. \"And here we are. We've made it a reality, and that is rare in politics, particularly on issues as vexing and challenging as this issue.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Santa Clara County Superior Court Judge Stephen Manley said every day he sees people caught in a cycle of homelessness, jail and emergency rooms, without ever getting the adequate care or housing they need. Manley oversees a \u003ca href=\"https://steinberginstitute.org/champion/stephen-v-manley/\" target=\"_blank\" rel=\"noopener noreferrer\">mental health care diversion court\u003c/a> for people awaiting trial for suspected crimes. \u003c/span>\u003c/p>\n\u003cp>\"I think this is a major step towards building a system that is going to be effective, as opposed to the present system,\" Manley said, \"where these individuals simply cycle through our jails over to the emergency room of a hospital, back to the streets, back to the jail, back to the hospital. And it doesn't stop.\"\u003c/p>\n\u003cp>Assemblymember Suzette Martinez Valladares, R-Santa Clarita, said CARE Court was coming 10 years too late. She shared the story of her cousin, a Vietnam veteran, who was homeless and living in an encampment for five years before he died.\u003c/p>\n\u003cp>\"I wish that my family had the tools that this bill is going to bring forward so that he might still be alive and with us,\" she said, adding, \"But there's more work to be done. This bill is great, but we need resources for the programs, for the services, for the workforce that doesn't currently exist.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state faces a shortage of not only \u003c/span>\u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1824-1-v2.html\">\u003cspan style=\"font-weight: 400\">psychiatric facilities\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, but also the \u003c/span>\u003ca href=\"https://healthforce.ucsf.edu/sites/healthforce.ucsf.edu/files/publication-pdf/California%E2%80%99s%20Current%20and%20Future%20Behavioral%20Health%20Workforce.pdf\">\u003cspan style=\"font-weight: 400\">health care staff\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> needed to operate those facilities. And Newsom’s administration estimates that between 7,000 and 12,000 people across the state will be eligible for CARE Court. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We're guessing there will be demand for this,” said Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association of California. “There's not a lot of give in terms of our workforce currently.”\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state is allocating $65 million to implement CARE Court within the judicial system, as well as additional money for county behavioral health care agencies, which would manage cases. To help pay for start-up and training costs, the first seven counties to implement CARE Court will receive $26 million, with another $31 million going to counties across the state, Doty Cabrera said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Those first seven counties are Glenn, Orange, Riverside, San Diego, Stanislaus, Tuolumne and San Francisco, which will implement CARE Courts by Oct. 1, 2023. The remaining counties would have until Dec. 1, 2024.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“And, there’s an ongoing conversation around long-term funding,” Doty Cabrera said. The bill now requires the state to provide funding to county behavioral health care agencies for programs and services before counties are required to implement CARE Court. “What that is, what it looks like, how much — all of that is still to be worked out between counties and the state,” she said.\u003c/span>\u003c/p>\n\u003cp>[aside postID=news_11916040 hero='https://ww2.kqed.org/app/uploads/sites/10/2022/02/GettyImages-1236267426-1020x680.jpg']The other looming question is housing. \u003cspan style=\"font-weight: 400\">The current version of the bill allows judges to order other government agencies, such as housing authorities, to prioritize CARE Court participants for housing. But in more rural parts of the state, housing with the appropriate services just doesn't exist, Doty Cabrera added. \u003c/span>\u003c/p>\n\u003cp>\"Who exactly are we going to pull into the order?\" she said. \"No one. There is nothing.\"\u003c/p>\n\u003cp>Last year, nearly 14,000 people experiencing homelessness voluntarily sought mental health services, but only half were placed into housing, according to a survey conducted earlier this year by the County Behavioral Health Directors Association of California.\u003c/p>\n\u003cp>Beyond the logistics, members of the Assembly grappled with CARE Court's reliance on the judicial system. Although voluntary, the legislation also comes with a threat: Continued refusal could be used as a justification for conservatorship, where people could be forced into care against their will.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"At what point does compassion end and our desire to just get people off the streets and out of public sight begin?\" said Assemblymember Al Muratsuchi, D-Torrance. \"\u003c/span>I don't think this is a great bill, but it seems to be the best idea that we have at this point to try to improve a god-awful situation.\"\u003c/p>\n\u003cp>Others worry whether it will do more harm than good, by disproportionately affecting \u003cspan style=\"font-weight: 400\">Black residents in the state, who are diagnosed with schizophrenia, on average, \u003c/span>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274585/\">\u003cspan style=\"font-weight: 400\">three to four times more often\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> than white residents. Black residents also represent\u003c/span>\u003ca href=\"https://files.hudexchange.info/reports/published/CoC_PopSub_State_CA_2020.pdf\">\u003cspan style=\"font-weight: 400\"> 30% of those experiencing homelessness\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> in the state, but only 6.5% of the general population. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s Black men, Black trans folks, Black folks in general who will be the ones who are disproportionately forced into CARE Court and disproportionately affected by this horribly myopic legislation,” said Burch, of the Anti Police-Terror Project. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The bill requires an annual report on CARE Court, along with an independent, research-based entity to evaluate the effectiveness of the program, including “through the lens of health equity” to identify racial bias. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Now that CARE Court has been signed into law, Doty Cabrera said it will be critical to keep those concerns in mind as counties try to imagine all of the program's \"unknown variables.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“This is sort of like Chapter One of a novel,” she said. “We'll be working on this for a long time to come.”\u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"The governor signed into law his controversial plan to implement a new civil court system to oversee treatment for people diagnosed with schizophrenia and other psychotic disorders.","status":"publish","parent":0,"modified":1663205234,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":34,"wordCount":1380},"headData":{"title":"Newsom Signs 'CARE Court' Plan, Overhauling Mental Health Care in California | KQED","description":"The governor signed into law his controversial plan to implement a new civil court system to oversee treatment for people diagnosed with schizophrenia and other psychotic disorders.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"Newsom Signs 'CARE Court' Plan, Overhauling Mental Health Care in California","datePublished":"2022-09-14T22:00:21.000Z","dateModified":"2022-09-15T01:27:14.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"disqusIdentifier":"11924117 https://ww2.kqed.org/news/?p=11924117","disqusUrl":"https://ww2.kqed.org/news/2022/09/14/governors-care-court-plan-passes-assembly-clearing-way-to-become-law/","disqusTitle":"Newsom Signs 'CARE Court' Plan, Overhauling Mental Health Care in California","excludeFromSiteSearch":"Include","path":"/news/11924117/governors-care-court-plan-passes-assembly-clearing-way-to-become-law","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated Wednesday 2 p.m.\u003c/em>\u003c/p>\n\u003cp>Gov. Gavin Newsom signed a controversial bill Wednesday overhauling the state's approach to mental health care for people diagnosed with schizophrenia and other psychotic disorders.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state Senate last month approved the\u003c/span> Community Assistance, Recovery and Empowerment Act, which will allow family members and first responders to ask a judge to draw up a treatment plan for people deemed to be suffering from those disorders. Those who refuse could be placed under a conservatorship and ordered to comply.\u003c/p>\n\u003cp>Currently, unhoused people with severe mental health disorders can be held against their will at psychiatric hospitals, but must be released after three days if they promise to follow up with other services and take prescribed medication.\u003c/p>\n\u003cp>The new law will let a court order a treatment plan for up to two years, which may include medication, housing and therapy.\u003cspan style=\"font-weight: 400\"> Participants will have access to a public defender and an advocate to help make decisions about treatment programs and housing. In turn, the behavioral health department in that county would be compelled to provide treatment.\u003c/span>\u003c/p>\n\u003cp>While it shares some elements of mental health programs in some other states, California's new system will be the first of its kind in the country, according to state Sen. Tom Umberg, D-Santa Ana, who co-authored the law.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Standing outside Momentum for Health, a nonprofit mental health care provider in San José, Newsom on Wednesday said the bill was about redesigning a broken system \u003c/span>\u003cspan style=\"font-weight: 400\">that often leaves people cycling among homelessness, jail and emergency rooms. \u003c/span>\u003c/p>\n\u003cp>\"I'm not interested in the status quo,\" he said. \"I'm not interested in the compassionless-ness of the approach we have today of people moralizing and normalizing that suffering on the streets and sidewalks.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But critics of the bill say it coerces people into care, which is less effective than voluntary treatment, and doesn’t provide the necessary health and housing resources.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">James Burch, deputy director of the Anti Police-Terror Project, which is part of a statewide coalition opposing CARE Court, called the bill's signing \"devastating.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It ignores the very stark reality that we're living in in this moment,” he said. “We are tens of thousands of beds short in the Bay Area of the permanent housing that we need. … And we are woefully short on voluntary treatment programs.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11914873","hero":"https://ww2.kqed.org/app/uploads/sites/10/2022/05/RS16522_GettyImages-73453883-qut-1020x682.jpg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cspan style=\"font-weight: 400\">Gov. Gavin Newsom introduced the proposal in March. \u003c/span>It passed the Legislature with overwhelming support, despite vehement opposition from disability rights and homeless advocates.\u003c/p>\n\u003cp>\"It was just a matter of months ago that we stood right here and we laid out a vision,\" Newsom said Wednesday. \"And here we are. We've made it a reality, and that is rare in politics, particularly on issues as vexing and challenging as this issue.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Santa Clara County Superior Court Judge Stephen Manley said every day he sees people caught in a cycle of homelessness, jail and emergency rooms, without ever getting the adequate care or housing they need. Manley oversees a \u003ca href=\"https://steinberginstitute.org/champion/stephen-v-manley/\" target=\"_blank\" rel=\"noopener noreferrer\">mental health care diversion court\u003c/a> for people awaiting trial for suspected crimes. \u003c/span>\u003c/p>\n\u003cp>\"I think this is a major step towards building a system that is going to be effective, as opposed to the present system,\" Manley said, \"where these individuals simply cycle through our jails over to the emergency room of a hospital, back to the streets, back to the jail, back to the hospital. And it doesn't stop.\"\u003c/p>\n\u003cp>Assemblymember Suzette Martinez Valladares, R-Santa Clarita, said CARE Court was coming 10 years too late. She shared the story of her cousin, a Vietnam veteran, who was homeless and living in an encampment for five years before he died.\u003c/p>\n\u003cp>\"I wish that my family had the tools that this bill is going to bring forward so that he might still be alive and with us,\" she said, adding, \"But there's more work to be done. This bill is great, but we need resources for the programs, for the services, for the workforce that doesn't currently exist.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state faces a shortage of not only \u003c/span>\u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1824-1-v2.html\">\u003cspan style=\"font-weight: 400\">psychiatric facilities\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, but also the \u003c/span>\u003ca href=\"https://healthforce.ucsf.edu/sites/healthforce.ucsf.edu/files/publication-pdf/California%E2%80%99s%20Current%20and%20Future%20Behavioral%20Health%20Workforce.pdf\">\u003cspan style=\"font-weight: 400\">health care staff\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> needed to operate those facilities. And Newsom’s administration estimates that between 7,000 and 12,000 people across the state will be eligible for CARE Court. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We're guessing there will be demand for this,” said Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association of California. “There's not a lot of give in terms of our workforce currently.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state is allocating $65 million to implement CARE Court within the judicial system, as well as additional money for county behavioral health care agencies, which would manage cases. To help pay for start-up and training costs, the first seven counties to implement CARE Court will receive $26 million, with another $31 million going to counties across the state, Doty Cabrera said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Those first seven counties are Glenn, Orange, Riverside, San Diego, Stanislaus, Tuolumne and San Francisco, which will implement CARE Courts by Oct. 1, 2023. The remaining counties would have until Dec. 1, 2024.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“And, there’s an ongoing conversation around long-term funding,” Doty Cabrera said. The bill now requires the state to provide funding to county behavioral health care agencies for programs and services before counties are required to implement CARE Court. “What that is, what it looks like, how much — all of that is still to be worked out between counties and the state,” she said.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11916040","hero":"https://ww2.kqed.org/app/uploads/sites/10/2022/02/GettyImages-1236267426-1020x680.jpg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>The other looming question is housing. \u003cspan style=\"font-weight: 400\">The current version of the bill allows judges to order other government agencies, such as housing authorities, to prioritize CARE Court participants for housing. But in more rural parts of the state, housing with the appropriate services just doesn't exist, Doty Cabrera added. \u003c/span>\u003c/p>\n\u003cp>\"Who exactly are we going to pull into the order?\" she said. \"No one. There is nothing.\"\u003c/p>\n\u003cp>Last year, nearly 14,000 people experiencing homelessness voluntarily sought mental health services, but only half were placed into housing, according to a survey conducted earlier this year by the County Behavioral Health Directors Association of California.\u003c/p>\n\u003cp>Beyond the logistics, members of the Assembly grappled with CARE Court's reliance on the judicial system. Although voluntary, the legislation also comes with a threat: Continued refusal could be used as a justification for conservatorship, where people could be forced into care against their will.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"At what point does compassion end and our desire to just get people off the streets and out of public sight begin?\" said Assemblymember Al Muratsuchi, D-Torrance. \"\u003c/span>I don't think this is a great bill, but it seems to be the best idea that we have at this point to try to improve a god-awful situation.\"\u003c/p>\n\u003cp>Others worry whether it will do more harm than good, by disproportionately affecting \u003cspan style=\"font-weight: 400\">Black residents in the state, who are diagnosed with schizophrenia, on average, \u003c/span>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274585/\">\u003cspan style=\"font-weight: 400\">three to four times more often\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> than white residents. Black residents also represent\u003c/span>\u003ca href=\"https://files.hudexchange.info/reports/published/CoC_PopSub_State_CA_2020.pdf\">\u003cspan style=\"font-weight: 400\"> 30% of those experiencing homelessness\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> in the state, but only 6.5% of the general population. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s Black men, Black trans folks, Black folks in general who will be the ones who are disproportionately forced into CARE Court and disproportionately affected by this horribly myopic legislation,” said Burch, of the Anti Police-Terror Project. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The bill requires an annual report on CARE Court, along with an independent, research-based entity to evaluate the effectiveness of the program, including “through the lens of health equity” to identify racial bias. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Now that CARE Court has been signed into law, Doty Cabrera said it will be critical to keep those concerns in mind as counties try to imagine all of the program's \"unknown variables.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“This is sort of like Chapter One of a novel,” she said. “We'll be working on this for a long time to come.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11924117/governors-care-court-plan-passes-assembly-clearing-way-to-become-law","authors":["11652"],"categories":["news_1758","news_457","news_6266","news_8"],"tags":["news_31336","news_31537","news_27626","news_16","news_4020","news_1775","news_31539","news_31538"],"featImg":"news_11924205","label":"news"},"news_11922990":{"type":"posts","id":"news_11922990","meta":{"index":"posts_1591205157","site":"news","id":"11922990","score":null,"sort":[1660872341000]},"guestAuthors":[],"slug":"fast-food-fight-and-care-court-plan-near-finish-line","title":"Fast Food Fight and CARE Court Plan Near Finish Line","publishDate":1660872341,"format":"audio","headTitle":"Fast Food Fight and CARE Court Plan Near Finish Line | KQED","labelTerm":{},"content":"\u003cp>With two weeks left in the legislative session, Marisa and Guy Marzorati discuss two of the most controversial bills in the state capitol. First, KQED Labor Correspondent Farida Jhabvala-Romero joins to talk about the changes to the fast food industry proposed in Assembly Bill 257 and Jason Elliot, Senior Counselor to Governor Gavin Newsom on housing and homelessness, discusses the administration’s CARE Court proposal (Senate Bill 1338) for Californians with severe mental illness.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n","blocks":[],"excerpt":null,"status":"publish","parent":0,"modified":1700874859,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":3,"wordCount":78},"headData":{"title":"Fast Food Fight and CARE Court Plan Near Finish Line | KQED","description":"With two weeks left in the legislative session, Marisa and Guy Marzorati discuss two of the most controversial bills in the state capitol. First, KQED Labor Correspondent Farida Jhabvala-Romero joins to talk about the changes to the fast food industry proposed in Assembly Bill 257 and Jason Elliot, Senior Counselor to Governor Gavin Newsom on","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"Fast Food Fight and CARE Court Plan Near Finish Line","datePublished":"2022-08-19T01:25:41.000Z","dateModified":"2023-11-25T01:14:19.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"source":"Political Breakdown","audioUrl":"https://www.podtrac.com/pts/redirect.mp3/traffic.megaphone.fm/KQINC1015183288.mp3","excludeFromSiteSearch":"Include","path":"/news/11922990/fast-food-fight-and-care-court-plan-near-finish-line","audioDuration":1756000,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>With two weeks left in the legislative session, Marisa and Guy Marzorati discuss two of the most controversial bills in the state capitol. First, KQED Labor Correspondent Farida Jhabvala-Romero joins to talk about the changes to the fast food industry proposed in Assembly Bill 257 and Jason Elliot, Senior Counselor to Governor Gavin Newsom on housing and homelessness, discusses the administration’s CARE Court proposal (Senate Bill 1338) for Californians with severe mental illness.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11922990/fast-food-fight-and-care-court-plan-near-finish-line","authors":["3239","227","8659"],"programs":["news_33544"],"categories":["news_8","news_33520"],"tags":["news_30613","news_31336","news_22235"],"featImg":"news_11922992","label":"source_news_11922990"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.","airtime":"MON-FRI 3am-9am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/morning-edition/","meta":{"site":"news","source":"npr"},"link":"/radio/program/morning-edition"},"onourwatch":{"id":"onourwatch","title":"On Our Watch","tagline":"Police secrets, unsealed","info":"For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg","imageAlt":"On Our Watch from NPR and KQED","officialWebsiteLink":"/podcasts/onourwatch","meta":{"site":"news","source":"kqed","order":"1"},"link":"/podcasts/onourwatch","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1567098962","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw","npr":"https://rpb3r.app.goo.gl/onourwatch","spotify":"https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x","tuneIn":"https://tunein.com/radio/On-Our-Watch-p1436229/","stitcher":"https://www.stitcher.com/show/on-our-watch","rss":"https://feeds.npr.org/510360/podcast.xml"}},"on-the-media":{"id":"on-the-media","title":"On The Media","info":"Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us","airtime":"SUN 2pm-3pm, MON 12am-1am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png","officialWebsiteLink":"https://www.wnycstudios.org/shows/otm","meta":{"site":"news","source":"wnyc"},"link":"/radio/program/on-the-media","subscribe":{"apple":"https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2","tuneIn":"https://tunein.com/radio/On-the-Media-p69/","rss":"http://feeds.wnyc.org/onthemedia"}},"our-body-politic":{"id":"our-body-politic","title":"Our Body Politic","info":"Presented by KQED, KCRW and KPCC, and created and hosted by award-winning journalist Farai Chideya, Our Body Politic is unapologetically centered on reporting on not just how women of color experience the major political events of today, but how they’re impacting those very issues.","airtime":"SAT 6pm-7pm, SUN 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Our-Body-Politic-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://our-body-politic.simplecast.com/","meta":{"site":"news","source":"kcrw"},"link":"/radio/program/our-body-politic","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/our-body-politic/id1533069868","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS9feGFQaHMxcw","spotify":"https://open.spotify.com/show/4ApAiLT1kV153TttWAmqmc","rss":"https://feeds.simplecast.com/_xaPhs1s","tuneIn":"https://tunein.com/podcasts/News--Politics-Podcasts/Our-Body-Politic-p1369211/"}},"pbs-newshour":{"id":"pbs-newshour","title":"PBS NewsHour","info":"Analysis, background reports and updates from the PBS NewsHour putting today's news in context.","airtime":"MON-FRI 3pm-4pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.pbs.org/newshour/","meta":{"site":"news","source":"pbs"},"link":"/radio/program/pbs-newshour","subscribe":{"apple":"https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2","tuneIn":"https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/","rss":"https://www.pbs.org/newshour/feeds/rss/podcasts/show"}},"perspectives":{"id":"perspectives","title":"Perspectives","tagline":"KQED's series of of daily listener commentaries since 1991","info":"KQED's series of of daily listener commentaries since 1991.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Perspectives-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/perspectives/","meta":{"site":"radio","source":"kqed","order":"15"},"link":"/perspectives","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/id73801135","npr":"https://www.npr.org/podcasts/432309616/perspectives","rss":"https://ww2.kqed.org/perspectives/category/perspectives/feed/","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"}},"planet-money":{"id":"planet-money","title":"Planet Money","info":"The economy explained. 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