Companion bills AB 2830, authored by Assemblymember Richard Bloom (D-Santa Monica), and SB 1338, authored by Sen. Thomas Umberg (D- Santa Ana) and Sen. Susan Talamantes Eggman (D-Stockton), would establish the Community Assistance, Recovery and Empowerment (CARE) Court, which was introduced by Gov. Gavin Newsom last month.
The legislation would authorize courts to place adults with untreated schizophrenia spectrum and psychotic disorders, along with misdemeanor defendants found mentally incompetent to stand trial, in a year-long mandated program.
The bill’s text says care currently comes too late for this demographic. It is usually pursued after an arrest, conservatorship or institutionalization. The proposed change would mean earlier intervention and support.
Those opposed to the bill say the program’s court-ordered treatment is ineffective.
How it would work
If passed, the CARE Court program would begin with referral – from a family member, behavioral health provider, first responder or other approved party – for a person with untreated schizophrenia spectrum or other psychotic disorder who lacks medical decision-making capacity.
The civil court would then appoint a public defender and a new type of state employee called a “supporter” to represent the patient through the program.
The supporter would be trained to support decision making, and would also receive training on the use of legal documents that allow the mentally ill to protect their autonomy and ability to self-direct care by documenting their preferences of treatment in advance of a mental health crisis.
The court would also order a clinical evaluation of the patient to see if they meet the criteria for the CARE Court program.
A care plan would then be established by the court to provide behavioral health treatment, stabilization medication and a housing plan, which can last up to a year.
The plan would be reviewed at a yearly status hearing 11 months into the program to determine if an extra year is needed. After a patient completes the plan, they would remain eligible for ongoing treatment, supportive services and housing.
The state would require local governments to provide care using funding streams that are available, including the Mental Health Services Act, mental health realignment, federal funding and the proposed $1.5 billion for behavioral health bridge housing and Newsom’s $12 billion homelessness plan, according to the CARE Court framework.
If a court finds a county not complying with the court orders, the county would be fined up to $1,000 per day, according to the bills.
Support and opposition
The legislation is a step closer to providing care to people with the diseases, Newsom said in a statement.
“CARE Court is a paradigm shift, providing a new pathway for seriously ill individuals before they end up cycling through prison, emergency rooms, or homeless encampments.”
The Disability Rights California and Coalition issued a letter, signed by 38 organizations and individuals including the American Civil Liberties Union California Action, to Assemblymember Mark Stone (D-Monterey Bay), chair of the judiciary committee, in opposition to AB 2830 on April 12.
The bill does not guarantee housing as a solution to homelessness, it perpetuates institutional racism and worsens health disparities and voluntary outpatient treatment is more effective than court-ordered treatment, according to the letter.
“CARE Court is not the appropriate tool for providing a path to wellness for Californians living with mental health disabilities who face homelessness, incarceration, hospitalization, conservatorship, and premature death,” the letter states.
The Human Rights Watch also issued a letter to Stone in opposition to AB 2830, urging for a “holistic, rights-respecting approach to address the lack of resources for autonomy-affirming treatment and housing options,” on April 12.
The letter calls the CARE court program “coerced treatment” and states that a person who fails to comply with the treatment can be referred to conservatorship, which would “strip that person of their legal capacity and personal autonomy.”
What’s next
The Assembly Judiciary Committee will hold a hearing on AB 2830 on April 26. A hearing for SB 1338 is currently pending for April 27.
