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Newsom’s CARE Court framework clears first hurdle but skeptics linger


Legislation sponsored by Gov. Gavin Newsom that would allow courts to order treatment plans for individuals suffering from severe mental health disorders cleared its first legislative hurdle Tuesday.

The bill, passed by the Senate Judiciary Committee Tuesday, would create the Community Assistance, Recovery and Empowerment (CARE) Act, which creates a new procedure in civil courts – “CARE Courts” – to implement court-ordered treatment plans for Californians with schizophrenia or other psychotic disorders.

Supporters of the bill said Tuesday that CARE Court would serve between 7,000 and 12,000 Californians suffering from psychotic disorders, many of whom are experiencing homelessness. Opponents, however, warn that the bill could force individuals into treatment and strip away civil liberties without due process of law.

Senator Susan Talamantes Eggman, D-Stockton, who co-authored the bill with Santa Ana Democrat Thomas Umberg, said the bill would help those who are “sickest and most desperately need our help.” Eggman told lawmakers that the state had invested “billions and billions and billions” into a mental health system that is not meeting needs, though there is currently no cost estimate for implementing CARE Court.

“We cannot continue to send billions of dollars to a system that is not responsive to the needs that we see every day on the streets,” Eggman said. “We’ve got to do better.”

Under the framework, a person could be court-ordered to participate in CARE Court if they are 18 or older, diagnosed with schizophrenia or another psychotic disorder, not in ongoing treatment, and unable to make their own medical decisions. A family member of the individual, a behavioral health provider or a first responder, among others, could petition a court to create a CARE plan.

After a series of hearings to determine whether the person is eligible for CARE Court, the court can order the individual, their counsel, their support person and county behavioral health personnel to develop a CARE plan. The plan would be followed for 12 months and must include behavioral health treatment, required medication where necessary and a housing plan for the individual. The programs can last up to two years.

The plans do not include any “home confinement or secure facility requirements” and have no limitations on travel for participants, according to Eggman’s office.

However, if a participant does not comply with the plan, the CARE plan will be terminated, and the individual could be placed under a conservatorship under existing California law.

Opponents of the CARE Court framework questioned Tuesday whether compelling individuals on the schizophrenia and psychotic spectrum is the best way to approach treatment. Opponents also had questions about the prioritization of housing in CARE Court plans since the bill states that “the court may not order the county to provide housing.”

“We don’t believe that forced care works well for people with mental health disabilities, and we don’t feel that there’s a good evidence base to support it,” Andy Imperato, the executive director at Disability Rights of California, told lawmakers. “I heard Senator Umberg say this proposal does not involve forced care, so the question that we have in opposition is how do you have a court-ordered care plan without force?”

The bill is also opposed by the American Civil Liberties Union and the Western Center on Law and Poverty, who said in a letter earlier this month that the bill would strip away a participant’s personal liberties and freedoms and exacerbate racial disparities, the Los Angeles Times reported.

Umberg said Tuesday that under the bill, the participants “cannot be forced to participate,” and the bill does not create a path to arrest since it is handled in a civil court and not a criminal court.

“Due process is protected, self-determination is supported,” Umberg said.

Health and Human Services Secretary Dr. Mark Ghaly described the CARE Court proposal as a “paradigm shift” by moving beyond the framework of the 1960s, saying the plan “puts the person at the center” and “does not depend on confinement.”

“Today can be, and I believe will be, a historic day, a historic beginning,” Ghaly told lawmakers. “The fierce, scrutinizing face of history will, I hope, judge today as a day where California moved deeper down a road of compassion and care.”

The bill will be heard in the Senate Committee on Health Wednesday.

This article was originally posted on Newsom’s CARE Court framework clears first hurdle but skeptics linger

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