Governor Newsom Unveils "CARE Courts"
The Governor unveiled his “CARE Courts” framework on March 3, 2022 to assist those living with psychotic or severe substance use disorders via the civil court system. CARE stands for Community Assistance, Recovery, and Empowerment.
The proposal would rest on the civil courts which would direct an individual referred to the program by family members, counties, or first responders to develop a treatment plan. The individual would be assigned a “Supporter” and public defender to implement the Shared Decision Making model with the person in the development of the plan.
The Community Assistance, Recovery, and Empowerment (CARE) Courts proposal includes:
- A new tool/pathway to refer a person with a psychiatric condition to civil court
- Participants can be referred by family members, clinicians, first responders, behavioral health workers, public guardians, and crisis response teams
- Participants would be paired with a court-employed “Supporter”
- Participants and Supporters must use “Shared Decision Making” model to develop voluntary treatment plan
- Treatment plan can include stabilizing medication, housing, and access to behavioral health and social services
- County Behavioral Health, Public Defenders, Public Guardians/Conservators, as well as other county services, are envisioned as key providers for the treatment plan. The Governor believes that counties can accommodate these new duties as part of our existing roles and service responsibilities.
- If a provider of services fails to comply with the treatment plan, that provider – including counties – could be sanctioned by the court.
- Participation would last up to 12 months, with a single 12-month renewal, after which a person could referred for conservatorship, Full Service Partnerships (FSPs), or involuntary commitment.
While the Governor estimates about 7,000 to 12,000 Californians would be eligible for CARE Court, this new tool would only serve approximately six percent of the state’s current homeless population.
In addition to existing forums for discussing behavioral health issues, the Administration will be engaging with the courts, first responders, other social services providers, and housing providers not typically in behavioral health meetings. CSAC welcomes discussion about all-of-the-above type strategies in this policy area that may include a refined version of CARE Court while ensuring sufficient funding for increased expectations as well as for related services such as the Peer Support program, Laura’s Law, and Public Guardians and Conservators.
Moving forward, counties require clarity on any county role(s) and new duties, resources, and accountability associated with CARE Court or other homelessness proposals. CSAC recognizes that "the CARE Court proposal, while innovative, will not solve or end homelessness in our communities until housing and major systemic problems, including accountability, fragmentation, siting, and chronic underfunding are also addressed."
Key concerns highlighted by stakeholders include: 1) the impact of workforce shortages on the capacity for service provision; 2) whether scope of practice changes should be contemplated; 3) that, from the behavioral health consumer perspective, the new approach is “being done to us without us” and that CARE Court will target communities of color; 4) the court process creates an incentive to go to court to access housing; 5) the criminalization aspect of the proposal and the role of law enforcement; and 6) the lack of housing for existing consumers and how CARE Court will impact housing.
Other models may need to be explored, including assertive community treatment, the housing first model, and more accountability to ensure access voluntarily.
New Legislative Proposals Focus on Incivility and Remote Access in Public Meetings
Four new proposals pending in the Legislature would change the requirements for local Brown Act meetings. The bills follow two years of changes to public meetings caused by the COVID-19 pandemic and the increasing hostility and incivility exhibited in many communities.
- SB 1100, by Senator Dave Cortese, clarifies rules for when individuals can be removed for willfully interrupting a meeting. The bill would require a warning to be issued before removal in most cases, and would apply to behavior “that substantially impairs or renders infeasible the orderly conduct of the meeting in accordance with law,” including failure to comply reasonable meeting rules adopted by the legislative body.
- AB 1944, by Assembly Members Alex Lee and Cristina Garcia, would allow public officials to attend Brown Act meetings remotely without being required to publish their address or open their remote location to members of the public. In order to take advantage of this flexibility, legislative bodies would need to provide a publicly accessible live video stream of the meeting online and a way for members of the public to provide public comment remotely, either by phone or audio-visual means.
- AB 2449, by Assembly Member Blanca Rubio, would also allow local officials to attend meetings remotely, though under slightly different conditions. This bill would require at least a quorum of the legislative body to attend in person at the primary location and for all remote members to participate by both audio and visual technology. It would also require the public to be able to provide public comment remotely, either by phone or an internet-based option and it clarifies that there must be a procedure for resolving requests for reasonable accommodation for individuals with disabilities.
- AB 2647, by Assembly Member Marc Levine, would give local agencies more flexibility to make documents provided to governing board members available to the public online when they’re distributed outside of standard business hours.
Senate Hears Stakeholder HHS Requests
In a marathon hearing, Senate Budget and Fiscal Review Subcommittee No. 3 on health and human services met on March 3 to hear stakeholder budget requests. The agenda included 144 budget requests worth billions of dollars. Some of the health-related requests included proposals for:
- additional investments in health, public health, and behavioral health workforce;
- funding for hospitals, clinics, and counties;
- requests for further investments in public health and health equity;
- health information exchange;
- additional Medi-Cal benefits;
- updating California’s maintenance need level; and
- restoration of remaining Medi-Cal provider cuts.
On the human services side, proposals included:
- disaster proposals;
- food and nutrition proposals;
- funding for food banks;
- CalFresh proposals;
- emergency child care bridge funding;
- funding for county CalFresh administration;
- funding to address gaps across the care continuum for foster children and families;
- funding for the Resource Family Approval program; and
- funding for local child support agencies.
Attachment A: Bills of Interest to Contra Costa County
Attachment B: 2022 Elections Report from Nielsen Merksamer
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