Can CARE Courts ease California’s homeless crisis?
California is struggling with the intertwined crises of homelessness and mental illness. But are Gov. Gavin Newsom’s new CARE Courts the right prescription?
That depends largely on whether county courts and mental health departments succeed as they roll out the program starting in October. And as CalMatters’ Jeanne Kuang details, that’s definitely a work in progress.
Even some local officials are trying to manage expectations for CARE Courts. One reason why is the program is targeted to treat residents with a narrow set of diagnoses and circumstances — specifically, someone who has gone untreated for schizophrenia or some other psychotic disorder — so the scope of CARE Courts is limited from the outset.
- Luke Bergmann, San Diego County Behavioral Health Services department director: “There’s been a presumption… that CARE Court is going to fix homelessness or have a broad impact on the nexus of homelessness and behavioral health. (It’s) actually going to be a pretty small program. It’s not going to be this thing that dramatically changes homelessness.”
The state also estimates between 7,000 and 12,000 people will qualify for the program. But for the seven counties where the program will roll out first (San Francisco, Orange, San Diego, Riverside, Stanislaus, Glenn and Tuolumne), officials say it’s unclear how many cases they’ll receive. San Diego County, for example, estimates it will get 1,000 petitions in the first year, but only about 250 people will likely receive a court-ordered treatment plan.
Counties must also work under tight timelines to persuade clients who may be resistant to mental health treatments. While behavioral health program leaders told Jeanne it takes a county worker an average of 20 visits to persuade a housed respondent to enter treatment — and an average of 40 visits if they are unhoused — counties get only 14 days before the next court hearing to persuade clients to agree to treatment.
- Veronica Kelley, Orange County’s chief of Mental Health and Recovery Services: “I can’t do 40 face-to-face visits in 14 days.”
These reservations are in stark contrast to how Newsom’s administration spoke about CARE Court during its initial formation. As his biggest legislative priority last year, Newsom called it “a paradigm shift.”
But despite these limitations, local officials regard the program as an opportunity to enroll more untreated people into mental health care. CARE Court does not exclusively target homelessness, but success will be determined by how well counties can get people inside and into treatment. In a recent comprehensive report on homelessness in the U.S., researchers at UCSF found that two-thirds of unhoused people reported experiencing mental health symptoms, such as depression or hallucinations, in the past 30 days.
The state’s Department of Health Care Services also says it will be assessing whether the program helps people find stable housing, as well as reduces emergency room visits, police encounters, short-term hospital stays and involuntary psychiatric holds.
More CalMatters kudos: We didn’t win, but as they say at the Oscars, it’s an honor just to be nominated. Our finalists for the Online Journalism Awards: Julie Cart, Erica Yee and former reporter Nadia Lopez for their “Race to Zero” series on California’s transformation to electric vehicles; and Byrhonda Lyons, Jocelyn Wiener and Jeremia Kimelman for their story on how California’s prison system shuffles around mentally ill inmates. And in the Institute for Nonprofit News contest, Robert Lewis was an investigative journalism finalist for his story on California sending its toxic waste to states with looser environmental rules. Read more from our engagement team.
Other Stories You Should Know
1 Fiery debate on home insurance
Speaking of California crises: For many homeowners, insurance is at a premium as companies pull out, blaming increasing claims from wildfires and other costs of doing business.
So state Senate Republicans are demanding that Insurance Commissioner Ricardo Lara do something about it. They fired off a letter late last week warning that other insurers may follow three large companies — Allstate, Farmers and State Farm — that have already stopped writing new policies.
- Senate GOP leader Brian Jones of San Diego, in a statement: “Our current market is on the brink of collapse and Californians are struggling to find and purchase affordable homeowners’ insurance. While the Legislature has failed to act, Insurance Commissioner Lara has the power to begin solving these problems under his current authority and we stand ready to work with him to fix this broken market.”
Lara’s office said his “top priority is making insurance available across California within a competitive and stable marketplace” — a message he also sent in a virtual briefing in June for insurance agents and brokers.
- Michael Soller, deputy insurance commissioner, in a statement to CalMatters: “He is already taking action to modernize our market with the nation’s first insurance discounts for wildfire safety and other long-term fixes. He continues to pursue innovative reforms that can benefit California through a more resilient insurance marketplace that can withstand climate-intensified wildfires and storms, including by exploring the use of forward-looking climate catastrophe models.”
The issue shouldn’t be a surprise to Lara: Seeking reelection last year, he had a bruising primary against then-Assemblymember Marc Levine, a fellow Democrat who accused Lara of not doing enough to help homeowners in wildfire areas. Last October, Lara’s office began enforcing a new regulation requiring rate discounts for homeowners and businesses for wildfire safety measures.
It’s also possible that Gov. Newsom and the Legislature will cobble together a fix before the session ends Sept. 14. That legislation could include allowing insurers to charge higher rates and account for future claims from natural disasters.
Senate Republicans appear willing to consider such measures.
- The letter: “Everyone knows the hard truths of what has to happen: there need to be rate adjustments; reinsurance and prospective catastrophic modeling need to be authorized; the rate review process needs to be accelerated; insurance discounts for home-hardening must be authorized; we need to modernize the insurance market.”
2 More state labor strife
As some state unions reach tentative deals with Newsom’s administration after months of negotiating, another finds itself still waiting longer for a new agreement. Much longer.
It has been more than three years since its contract expired in July 2020, and the union representing state scientists has yet to hammer out a deal with the governor.
To help push things along, Democratic Assemblymember Tina McKinnor of Inglewood sent a letter last week to the governor, urging him to “negotiate in good faith” a contract with the California Association of Professional Scientists union that would provide “competitive salaries and benefits.” Nearly 50 other legislators co-signed the letter.
- McKinnor, in the letter: “CAPS is comprised of highly trained scientists in a variety of disciplines — made up of Biologists, Chemists, Epidemiologists, Toxicologists, Research Scientists, and many more. Without competitive compensation packages for these scientific experts, California will no longer hold the leading edge, and our public will suffer for the dearth of scientific expertise.”
The union says members last received a pay raise in July 2021, and as reported by The Sacramento Bee, it seeks raises of as much as 43%.
One major gripe the union has is the wide pay discrepancy between the 5,000 scientists it represents and state engineers, who at times do similar work but are more often men. According to a state assessment published last year, full-time rank-and-file state scientists on average earned 27% less than state engineers in 2020 — $83,586 compared to $114,012.
The union is also sponsoring Assembly Bill 1677, which would commission UC Berkeley researchers to analyze state scientists’ salaries and require them to suggest remedies for disparities they find. Mckinnor authored the measure, which is currently in the Senate suspense file.
Meanwhile, the State Personnel Board sided with the union that represents state attorneys on Friday, ruling that California’s corrections department did not make “reasonable efforts” to employ civil service employees for state business, according to The Bee.
Under certain circumstances, state departments can seek alternative representation. But the corrections department didn’t prove “that outsourcing to external law firms was the only way to ensure the work was completed.” Because of the ruling, the department is expected to cancel nine contracts with outside law firms.
3 Is V.P. Harris miffed at Newsom on debate?
For an event that isn’t definitely happening, the debate between Gavin Newsom and Florida Gov. Ron DeSantis sure is getting a lot of attention — and speculation — from political types.
The scuttlebut had been that President Biden’s campaign was on board: The face-off would be a way to muddy up a potential Republican opponent — if the nominee isn’t the “elephant not in the room,” as former President Donald Trump was described at the first GOP debate last week.
But NBC News reported Sunday that Newsom and the potential debate are “increasingly being viewed as a nuisance” by some Biden advisers — and (this is the more interesting part for Californians) by allies of Vice President Kamala Harris.
Back-story: Harris and Newsom are longtime political frenemies, having both cut their teeth in San Francisco, moved into statewide office and now being talked about as potential competitors for the Democratic presidential nomination in 2028.
- One outside adviser to Harris, to NBC: “It’s disrespectful. Joe Biden is running with Kamala Harris. That’s the Democratic ticket.”
But other Biden advisers, unnamed as in many inside-the-Beltway stories, say they’re in favor of Newsom acting as a surrogate and the debate. California’s governor has endorsed Biden, is raising money for him and may represent him at the second Republican presidential debate at the Ronald Reagan Presidential Library in Simi Valley on Sept. 27.
On the small matter of an actual debate, the haggling is apparently still happening over the rules before the Fox News face-off becomes official. It’s been a minute: DeSantis accepted Newsom’s challenge on Aug. 2.
Besides the date and location, the debate over the debate is reportedly centered on whether there would be a live audience — DeSantis wants one, Newsom doesn’t. As well as whether the governors would make an opening statement — Newsom prefers yes, but DeSantis suggests an introductory video instead.
CalMatters Commentary
CalMatters columnist Dan Walters: The Bay Area is losing its economic and political dominance over Southern California amid job losses and civic dysfunction.
The state medical board should be required to interview patients alleging medical negligence. A bill would do that, writes Annette Ramirez, who lives with her husband, two children and service dog in Manhattan Beach.
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