Newsom proposes plan to force homeless people with severe mental illness or addictions into treatment

The Associated Press and Ema Sasic, health reporter for The Desert Sun

California's governor proposed a plan on Thursday to force people experiencing homelessness, as well as severe mental health and addiction disorders, into treatment.

The proposal by Democrat Gov. Gavin Newsom, called the Community Assistance, Recovery and Empowerment Court, would require all counties to set up a mental health branch in civil court and provide comprehensive and community-based treatment to those suffering from debilitating psychosis.

People would be obligated to accept the care or risk criminal charges, if those are pending, and if not, they would be subject to being held in psychiatric programs involuntarily or lengthier conservatorships in which the court appoints a person to make health decisions for someone who cannot.

“One of the most heartbreaking, heart-wrenching and yet curable challenges that we face ... is how do we serve the needs of individuals who are the sickest of the sick?” said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, at a news briefing in advance of a press conference by Newsom.

He said he expects the program, aka “CARE Court,” to apply to 7,000 to 12,000 people in California, although not all have to be homeless. Those involved will be connected with a court-ordered Care plan and supporter. Plans can be up to 12 to 24 months. A person is connected with a Care team in their community and can include clinically prescribed, individualized treatment with supportive services, stabilizing medication and a housing plan, according to the governor's office.

“CARE Court is about meeting people where they are and acting with compassion to support the thousands of Californians living on our streets with severe mental health and substance use disorders,” said Newsom. “We are taking action to break the pattern that leaves people without hope and cycling repeatedly through homelessness and incarceration. This is a new approach to stabilize people with the hardest-to-treat behavioral health conditions.”

Some advocates for the homeless have objected to forced care, but Newsom told the San Francisco Chronicle it is past time to talk about civil rights when people are attacking others.

His proposal would require legislative agreement.

"This is about accountability, but is, as we said, about compassion, and it's about recognizing the human condition," Newsom said. "There’s no compassion for people with their clothes off defecating and urinating in the middle of the streets, screaming and talking to themselves."

Greg Rodriguez, a policy advisor for county Supervisor V. Manuel Perez who also leads collaborative homeless efforts in the Coachella Valley, is trying to see the proposal from both sides. He understands there are frustrations regarding homelessness from community members, businesses and public safety organizations, but he wouldn't want the issue to be criminalized, which he doesn't see happening under the governor's plan.

Instead, he believes the plan will attempt to address Laura's Law, where a court can order individuals with severe mental illnesses to receive assisted treatment. The San Francisco Chronicle reports that only 218 people in the state were subject to enter court-ordered treatment in 2018-19, according to information from the governor's office. Newsom said at a press conference that number "certainly is not demonstrable progress."

The most important aspect to Rodriguez is ensuring that there's a full array of necessary behavioral health and wraparound services available to help people.

"We do have to look at different tools and how we utilize public safety. We've done a really good job of this in Riverside County (by) embedding behavioral health within public safety departments. You can see the attitude among public safety, both city police departments and sheriff's departments, that it just used to be enforcement, that's all it was," Rodriguez said. "But even rank and file staff among public safety are realizing that's not exactly the way to go, that it doesn't work because you're not really getting to the root cause of the problem of behavioral health and substance use."

The details and implementation strategy will be key, Rodriguez said. He already wonders how the Riverside County Sheriff's Homeless Outreach Team would be involved in future efforts, if approved, and what role the county behavioral health, housing and probation departments would play.

In 2020, the Riverside County point-in-time homeless count found 2,884 homeless individuals, a 3% increase from 2019. The 2022 count was done in February, and results are expected in April.

Palm Springs councilmember and chair of the Coachella Valley Association of Government’s Homelessness Committee Christy Holstege said in a statement that the Coachella Valley cities will be tracking the governor's proposal with "great interest."

"Homelessness is a complex public crisis, and the Coachella Valley Association of Governments and its Homelessness Committee have long recognized that there is not a 'one-size-fits-all' solution,'" Holstege said. "Our regional collaboration on the CV Housing First program is making a true impact in the community by getting chronically homeless individuals into permanent housing."

The CV Housing First program found permanent housing solutions to 75 chronically homeless individuals who were on the CV 200 list in 2021. The program, launched in 2017, is focused on the CV 200, a by-name list of 200 chronically homeless individuals who live in desert cities, have frequent contacts with law enforcement and are likely to be shelter resistant or have already fallen out of housing. Many of these individuals have mental health issues or criminal offenses.

"But at the encouragement of Palm Desert Mayor Pro Tem Sabby Jonathan, we have for several months been exploring additional resources that provide compassionate solutions to homelessness, including the City of Sacramento’s proposed right to housing and corresponding obligation to accept housing," Holstege continued.

"There are a lot of details and legalities to discuss and work out, including ensuring there is enough housing available. But there is certainly a willingness at CVAG to consider these options for the Coachella Valley, as we are committed to solutions to address homelessness that achieve real outcomes," she added.

The Sacramento plan, proposed by Mayor Darrell Steinberg, would take effect in January 2023 and would apply to every unsheltered resident who was previously housed for at least one year in the city limits. City documents state that “each person offered at least two forms of shelter or housing would have an obligation to accept one, or they could be moved from their camping site.” The proposal is currently being considered by the city council. 

Ghaly called the plan the "beginning of a conversation about how we address one of the most important problems in California.”

“It’s about a new pathway,” Ghaly said. “It’s about a paradigm shift.”

The governor allocated $12 billion for homelessness in the state budget last year, and proposed another $2 billion in his California Blueprint this year.