Marin will soon become the latest county to implement a statewide initiative aimed at undertaking one of California’s most complex challenges: guiding individuals with severe psychotic disorders into stable housing and treatment.
The initiative stems from Gov. Gavin Newsom’s 2022 CARE Act, which established a network of specialized courts to support those suffering from untreated mental illnesses within the schizophrenia spectrum. The act empowered third parties—such as family members, roommates, first responders, health care professionals and social workers—to petition the court on behalf of those in mental health crises.
Dubbed CARE Court, for Community Assistance, Recovery, and Empowerment, the new program could soon direct dozens of people in Marin toward court-ordered treatment plans.
Although the program has been heralded as a lifeline for families that have long struggled to get their loved ones off the streets or out of jails and into care, it has also faced opposition from disability and civil rights advocates who say it could open a new pathway to conservatorships and compelled treatment, potentially violating the civil liberties of those in mental distress.
Officials emphasize that the new program is not a criminal court; judges issue treatment plans but can’t force people to follow them. The CARE Court operates on a voluntary basis, and those referred to it can decline to participate at any time.
On Tuesday, Marin County’s Department of Health and Human Services briefed the Board of Supervisors on plans for a rollout on Dec. 1, when Marin will join 47 other counties poised to implement the program. The state launched the initial phase in San Francisco and 10 other counties over the past year.
Judge Mark Talamantes, who will oversee Marin’s CARE Court legal proceedings, stressed the program’s focus on voluntary participation.
“The initiative not only provides personalized treatment opportunities and community-based support services but also emphasizes voluntary treatment over court-ordered options,” he told the supervisors.
State officials tout the initiative as a cornerstone of California’s latest campaign to address the intertwined crises of mental illness and homelessness affecting communities up and down the state. Though Gov. Newsom initially presented the CARE Court as a solution for those “living on our streets with severe mental health and substance use disorders,” county behavioral health staff noted its limited housing capacity and clarified that it’s not exclusively aimed at the unhoused.
Michelle Funez, who will direct Marin’s program, explained that although state funds have created some transitional housing, the program lacks permanent supportive housing for participants. “It’s not a homeless program,” she stated, noting that homelessness alone does not make someone eligible for CARE. To qualify, an individual must be diagnosed with a schizophrenia-spectrum or other severe psychotic disorder, excluding substance-induced psychosis. Participants must also demonstrate clinical instability and signs of deterioration.
Yet Todd Schirmer, Marin’s director of behavioral health and recovery services, said eligibility could be expanded. “We may see some movement on diagnostic criteria, potentially broadening beyond just schizophrenia and psychotic disorders,” he told the Light.
Early reports from counties that adopted the program last year suggest a measured start. As of July 31, courts across the first eight counties—which represent nearly half California’s population—had received 630 petitions. About one-third of those were dismissed, according to the Judicial Council of California. In the five largest counties participating, just over 100 individuals now have treatment plans in place. The governor’s office estimates that 7,000 to 12,000 people could eventually qualify.
In practice, a family member, police officer or mental health provider can petition the court if they observe someone acting erratically and suspect they are experiencing a severe mental health episode. Once filed, the petition is reviewed by the Department of Public Health, which then advises the court on eligibility. If accepted, participants undergo a clinical evaluation, receive legal representation and work with the court to develop a personalized treatment plan. They’re paired with peer supporters or case managers who provide ongoing assistance for up to 24 months, connecting participants to substance abuse treatment, housing support and medication for stabilization.
Concerns remain over whether counties have the resources to effectively implement the new system. The state allotted $57 million to support local governments in starting up CARE Courts, with the first seven counties receiving $26 million and the remaining counties sharing the balance. Marin received $250,000 of that funding, a drop in the bucket compared to the nearly $104 million allocated in this year’s budget for behavioral health. According to Mr. Schirmer, Marin’s program will support up to 20 people at a time.
This approach is one of Gov. Newsom’s trial measures to reduce California’s homeless population—now estimated at 181,000—without resorting to mandatory conservatorships.
While CARE Court may help some avoid conservatorship, those who opt out or fail to follow treatment plans could be referred to a separate court, which can mandate more restrictive measures. Yet Mr. Schirmer emphasized that the program’s core mission is to encourage voluntary engagement with mental health and substance use treatment. “Every step in the process is designed to offer people the chance to participate willingly,” he said, noting that only as a last resort would the court intervene with a mandated treatment plan.
Prior to its rollout, CARE Court faced a legal challenge led by Disability Rights California, which argued that the program could infringe on individuals’ rights by enforcing involuntary treatment through coercive measures. They feared that the CARE Courts will end up being used to make the case for conservatorships when people fail to comply with voluntary treatment. The California Supreme Court sided with the state and allowed the new court to start receiving petitions.
Meanwhile, Lucie Hollingsworth, a senior attorney with Legal Aid of Marin, expressed concern that the county’s CARE Court could inadvertently criminalize poverty and homelessness. “There seems to be an assumption that putting people into the criminal justice system forces them to access supportive services, when in reality, it puts up even more barriers to getting housed,” she said.