The Orange County Board of Supervisors is starting to question just how effective the state’s new push to help homeless and mentally ill people through court-mandated services actually is.
Supervisors are also questioning resources behind the new program, dubbed CARE Court, that local officials say is a voluntary program in which a Superior Court judge can order mental health treatment for residents.
“I don’t see it as a homeless remedy, even though it was advertised that way,” OC Supervisor Doug Chaffee said during Tuesday’s meeting.
The questions come after a year of mixed signals between local and state officials over just how voluntary CARE Court will be.
The program was long promised as the next big solution to both the state’s homeless and mental illness problems, and is a major priority for Gov. Gavin Newsom.
“CARE Court means new hope for thousands of Californians with untreated mental health and substance abuse issues,” Newsom said in a statement last December. “Today, our work begins to turn promise into practice.”
State Sen. Tom Umberg (D-Santa Ana), who co-authored the legislation setting up CARE Court, has also been a vocal proponent of the program.
“The individual frameworks and best practices for collaboration exist here – and we pulled them together in SB 1338 for something new and revolutionary in California. I’m proud to have been able to spearhead this effort with Senator Eggman and look forward to more advances in the years ahead,” Umberg said in a September 2022 news release from Newsom’s office.
But two months after CARE Court’s October launch in Orange County, no one has actually started receiving services through the program according to Veronica Kelley, head of the OC Health Care Agency.
Less than 13 people are in the process of entering a plan, and altogether just under three dozen people have been referred to the program, which is budgeted to cost taxpayers over $5 million annually.
Of the 34 people who’ve been referred to CARE Court, nine are homeless.
Local officials and advocates have urged for residents to lower their expectations, highlighting how the program only works for those with mental illnesses and that participation is entirely voluntary, meaning those who are referred can walk away with no repercussions.
“Simply because there’s a petition or a court order issued doesn’t mean someone’s going to follow that, and we want to make sure we’re building rapport and trust with them,” said Judge Maria Hernandez, the presiding judge of the OC Superior Court, in an October interview.
Hernandez also said the program on its own can’t end homelessness.
“Is it the end all be all answer to homelessness? No,” Hernandez said. “But is it a positive step in making sure we get care and treatment to those who’ve gone untreated? We’re optimistic.”
The program has also faced heavy criticism from civil liberties groups about whether people will be hospitalized against their will after they join the program, which is something that can happen, according to a memo from Newsom’s office.
[Read: California’s CARE Court: A Limited System or a Path to Institutionalization?]
County Leaders Struggle Providing Help for Substance Abuse
Right now, CARE Court participants in Orange County are limited exclusively to those suffering from schizophrenia and other psychotic disorders not caused by drug abuse.
But that cuts out homeless people struggling with substance abuse disorders and limits how many people can actually be served by the program – an issue that got discussed extensively at the county board of supervisors meeting on Tuesday.
County supervisors voted 4-1 to delay any implementation of Senate Bill 43, a law that lets health providers treat people struggling with substance abuse against their will under a conservatorship, until 2026.
Veronica Kelley, head of the Orange County Healthcare Agency, said the primary issue was that the county didn’t have the necessary infrastructure to force people into treatment, and that any attempt to force people into substance abuse treatment would not work.
“The state has not developed a license or the regulatory changes we need to carry out this legislation,” Kelley told the board. “We don’t have the providers because we don’t have the license. They have to have a license to provide the service.”
Supervisor Katrina Foley, the sole vote against the two-year delay, said the county should figure out a way to begin providing services for the homeless instead of waiting on the state.
“I feel like all we’re doing is coming up with a horrendous number of reasons why we can’t help people,” Foley said. “Why do we think there’s going to be thousands of people this affects?”
Other supervisors agreed with staff, noting the lack of a system in place, with Chaffee specifically pointing out they had nowhere to send people.
“We’re thousands of beds short if this is implemented,” Chaffee said. “Where are the facilities? They don’t exist.”
But Chaffee and Foley both agreed on one thing: CARE Court isn’t the answer to homelessness.
Foley pointed out that the CARE Act fails to help get most homeless people into treatment plans.
“Everybody thinks CARE Act is the solution for the chronically homeless who are drug induced schizophrenics or bipolar because of so many drugs, but it’s not covered,” Foley said.
“When we were talking about CARE Court, I was hearing how it’s going to cost millions of dollars cause it’s going to scoop up so many people, it’s going to be so voluminous,” she continued. “Since October, 35 people have come to request that we engage with them in CARE Court.”
Head Judge Insists Conservatorships Will Be Avoided
As county leaders were discussing what a conservatorship could look like for the mentally ill and substance abusers, OC Superior Court Presiding Judge Hernandez has insisted the courts aren’t there to force people into conservatorships.
“We want to prevent people from penetrating into the criminal justice system, or even into conservatorships,” Hernandez said. “The hope (of CARE Court) is to keep them out of those systems.”
She also noted that under the CARE Court rules, it’s almost impossible to commit someone to a mental health facility for long-term treatment.
“What’s important to remember is it’s a voluntary and a non compulsory process,” she said. “We want to make sure civil liberty rights are maintained.”
It’s also unclear where the county will send those seeking mental health treatment plans, with Hernandez noting the court didn’t have a list of the facilities people could be admitted to, referring reporters to the county health care agency.
Representatives from the OC Health Care Agency did not return requests for comment, but Kelley noted during Tuesday’s board meetings that CARE Court is an “outpatient,” program that won’t require patients to have a bed at a facility.
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Noah Biesiada is a Voice of OC reporter and corps member with Report for America, a GroundTruth initiative. Contact him at nbiesiada@voiceofoc.org or on Twitter @NBiesiada.