The Brief

A highly anticipated — and controversial — new program, championed by Gov. Gavin Newsom, will begin in Los Angeles County on Dec. 1. It’s called CARE Court and will allow family members to ask a judge to step in with a treatment plan for loved ones living with severe and untreated mental illness.

The basics of CARE Court: People living with a serious and untreated mental illness, like schizophrenia, could be referred for a court-ordered, voluntary care plan that could last up to two years. The petition could be filed by people including county behavioral health workers, first responders or family members.

“I would have had my petition by the first day,” Mike Estrada said from his home in Berkeley.

A feeling that the process is ‘a constant slap in the face’ 

For years, Estrada struggled to get help for his mother, Josie Estrada, who lived with schizoaffective disorder. The experience exasperated him so much that in 2020 he produced a one-hour documentary on her story, Benevolent Neglect.

The film is sprinkled with grainy family footage and stills of Josie’s life in California’s Central Valley. Estrada points out that his mother was “adored by the family.”

The documentary also includes videos shot on Estrada’s cellphone during some of Josie’s more difficult moments.

“In 2007, my mom began experiencing hallucinations. During acute episodes, she’d hear people inside the house,” Estrada tells the camera.

Estrada said the voices would tell his mother not to take her psychiatric medications. For more than a year, Josie lived out of her car after her erratic behavior got her evicted from her apartment. Time and time again, Estrada would plead with first responders to hospitalize her.

Often the people who were supposed to help would be hamstrung by a lack of psychiatric beds and what Estrada sees as overly strict criteria for hospitalizing someone against their will.

“As a family it’s just a constant slap in the face. Constant disrespect. In the meantime, our loved one is suffering, deteriorating before our eyes,” Estrada said.

His mother died in 2019, but he’s hopeful CARE Court will give families like his more leverage to get help.

Gov. Gavin Newsom speaking in March 2022 with local mental health service providers and officials about CARE Court.

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Robert Garrova / LAist

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Officials report an ‘unprecedented demand’ 

There are concerns, however, about whether the county’s behavioral health care system will have enough staff to meet the need.

In June, L.A. County supervisors voted to expedite hiring for CARE Court.

“In order to meet a variety of our expectations, including CARE Court — we’re focused on setting up the court infrastructure — the point is the judge will have to have a place to send that individual,” Supervisor Holly Mitchell said during the board meeting.

“I think the supervisors were right to be concerned about what kind of infrastructure is in place,” Dr. Lisa Wong, director of the L.A. County Department of Mental Health, told LAist.

“We’ve been having this unprecedented demand for mental health services in our system, so we know that the system is stretched. And we know that with CARE Court, we’re going to be working with some really high acuity individuals,” Wong added.

Wong said hiring has improved this year, but it’s still a major stress point as the county works to bring thousands more behavioral health beds online. And, Wong points out, the initial petition is just the beginning.

“What happens when that person has to go into treatment and how do we keep them engaged?” she said.

Defense attorneys' role

Some of that help will come from the new Independent Defense Counsel Office, which is separate from but administered by the Public Defender’s Office.

A new panel of about 50 specially selected attorneys will work with an estimated 1,900 respondents within the first six months of CARE Court.

“It will not only be there to represent the client’s legal interests and protect their civil liberties, but also to serve as a facilitator and an encourager and a supporter throughout the treatment program,” said Marco Saenz, Independent Defense Counsel program director.

He said those lawyers might encourage respondents to follow through with treatment, but they’ll also work to hold the behavioral health system accountable in providing services.

But the success of CARE Court will ultimately hinge on the participant

“Under the statute, the respondent can walk away at any time,” Saenz told LAist. “It’s completely voluntary. How that will work, we will see.”

Coercion or voluntary? 

CARE Court may be voluntary, but civil liberties groups continue to warn about stripping of individual rights.

If the care plan fails, the person could be hospitalized or referred to a conservatorship. That could mean forced treatment down the line.

Some 40 groups including JusticeLA, Disability Rights California and ACLU California Action signed a letter in 2022 opposing CARE Court. It reads, in part, that the plan is: “a system of coerced, court-ordered treatment that strips people with mental health disabilities of their right to make their own decisions about their lives.”

Mike Estrada would have been OK with conservatorship for his mother.

“I wanted her to have some chance of building her life back. And there was no way it was going to happen without her being stabilized,” Estrada said.

Mike and Josie Estrada.

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Courtest Mike Estrada

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There are also continued concerns about whether the public guardians’ offices throughout the state will be able to handle the potential increased conservatorship caseload. Public guardians' offices are responsible for guiding care for people who are deemed unable to do so themselves because of a serious mental illness.

“Everybody keeps saying, ‘We need facilities, we need facilities, there’s no room at the inn.’ And that’s true. If you talk to my members throughout the state, they are struggling to find placements,” said Tom Scott, executive director of the California State Association of Public Administrators, Public Guardians, Public Conservators.

What's next

As CARE Court continues to roll out across the state, Estrada wants families like his to be allowed input in the process. And he wants to see counties held accountable for making it work.

Some counties, including San Diego, San Francisco and Orange County have a head start on L.A., because their CARE Court efforts launched in October.

According to California Health and Human Services, as of early November, there were a total of 80 CARE Court petitions statewide.

Saenz said the case volume in some places outside of L.A. County has been lower than what was anticipated.

But as a nearly 30-year veteran public defender who has represented “innumerous” clients living with mental illness, Saenz said he’s holding out hope that CARE Court will be able to help a population that is not generally reached.

“It’s another tool in our toolbox, and to the extent that we’re participants in it ... we’re going to be there to be supportive in any way we can,” Saenz said.

“But time will tell.”

Companies that create and manufacture personal delivery devices, those cute bots you see on public sidewalks, have been working on growth plans for years.

Cities, on whose public sidewalks the delivery bots travel, are only now catching up to regulating them and charging the companies fees.

That's what's happening in Glendale, where, City Councilman Dan Brotman says, “[The delivery bots] just appeared out of nowhere. The company that operates [them] never reached out and talked to us."

He and other council members, he said, want to know if the delivery devices make it harder for Glendale residents using wheelchairs to use public sidewalks.

“I also am curious who is getting the financial benefit from these,” he said.

Glendale’s City Council asked city staff last month to draft two proposals, one with regulations and fees and the other pausing the operation of delivery bots while the council studies their impact. Brotman said staff may deliver those proposals to him and his colleagues in the months to come.

The two largest cities in LA County, at two different stages

The City of Los Angeles approved rules for personal delivery devices a few years ago, including flat permit fees. The City Council has since asked staff in the Department of Transportation to revaluate those rules and make suggestions.

One idea being considered — charging companies for every bot trip instead of the flat fee.

A delivery robot sits next to the bike path by the beach

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Courtesy Coco

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L.A. City Councilwoman Eunisses Hernandez successfully introduced the motion last year to have the regulations revisited. 

“[The companies are] starting to put movie ads or show ads, and if they're generating revenue off that, we want to know what that looks like but also be able to have a fee for them,” Hernandez said.

That report should be presented to the City Council later this year, she said. 

She’s also keen to hear from the public about their views on delivery bots. 

Companies that make the devices argue they’re providing an essential delivery service to residents while cutting down on the number of vehicles on the road making the deliveries.

“We currently pay fees in Los Angeles, Chicago and West Hollywood as part of their permit programs and are open to similar models in other cities,” said Vignesh Ram, vice president of policy at Serve Robotics, by email.

Starship Technologies' delivery robot exits the elevator in the company's office.

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Meg Kelly

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NPR

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The company is now operating in Long Beach; Ram says it notified the city before beginning to operate there.

A City of Long Beach spokesperson told LAist its business licensing, planning and public works teams are currently working on recommendations for regulations. Those should be presented to the City Council early this summer.

The story first appeared on The LA Local.

When Hermila Melero trains future therapists at Cal State LA, she emphasizes something she learned over nearly two decades working on the Eastside: It matters where you’re from. 

“When you know the difference between East LA and Boyle Heights … they appreciate that on a really fundamental level,” Melero, director of field education at CSULA’s School of Social Work, said. “You feel a sense of safety and being seen when the person reflects what you look like, has a foundational understanding of where you come from.” 

Now, a $48 million grant to California State University, Los Angeles, will open new opportunities for students to serve the communities they come from. The funding will expand the university’s social work and counseling programs, training 1,000 new students to support youth mental health in Eastside communities and other underserved areas of Los Angeles.

What will the funding do?

The five-year investment by the Ballmer Group — the largest grant in the university’s history — will significantly grow Cal State LA’s Master of Social Work program. 

Its one-year MSW program will double in size, the two‑year program will increase by 50%, and the School-Based Family Counseling program will also double. The bulk of the funding will support scholarships, new faculty and the expansion of clinical placements.

Cal State LA already partners with organizations across the Eastside, including El Centro De Ayuda, AltaMed, Survivor Justice Center and schools across LAUSD. The new funding will allow more students to work directly with these groups, serving families who often lack access to care. 

“This speaks to the amazing work our social work and counseling programs are doing within our schools and with LA’s agencies serving youth and families,” said CSULA President Berenecea Johnson Eanes in a statement to Boyle Heights Beat. “With more clinical placements and greater numbers of master’s alumni, we will make real strides in meeting a critical shortage of qualified social workers and counselors.”

In addition to CSULA, CSU Dominguez Hills received $29 million to expand mental health resources in South LA and UCLA will use part of its $33 million grant to develop a minor in youth behavioral health. The three universities have received a total of $110 million. 

When Hermila Melero trains future therapists at Cal State LA, she emphasizes something she learned over nearly two decades working on the Eastside: It matters where you’re from.

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Courtesy CSULA

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Why representation matters

For Melero, who was born and raised in East LA, the expansion is personal. 

Melero spent 17 years of her professional career as a social worker in her own community and the surrounding areas. She witnessed firsthand how much her patients appreciated it when she spoke to them in Spanish or told them where she grew up. 

“You don’t have to explain yourself, you don’t have to explain what it’s like, you know, to grow up here,” she said. 

Now as director of field education, she helps place students in organizations, clinics and schools across the region, many of them serving the neighborhood they call home. 

Barriers to access

The need for more mental health workers comes at a time when many Eastside families are facing more barriers to care.

Stigma around mental health combined with fear tied to immigration raids have discouraged some people from seeking services, Melero said.

At the same time, financial challenges are making it harder for students to enter the profession. 

In January, the U.S. Department of Education updated its definition of a “professional degree” and excluded social work, which will affect graduate students’ eligibility for federal student loans, creating a significant financial barrier, according to the Council on Social Work Education.

Students hope to give back

For students like Silvia Perez, 41, financial assistance would be a great help.

The Cal State LA undergraduate student is pursuing her master’s degree after she graduates in May, all while raising two teenagers and a 23-year-old. Perez has been paying for her education by selling shoes and perfume outside of her home in East LA. 

Her decision to pursue a career in social work came after seeing her sister navigate the Department of Children and Family Services system with her children and witnessing how young people in her community struggled with substance abuse and homelessness. 

After graduating, Perez hopes to work in East LA to help the people she encounters every day. She believes that level of understanding can create trust with an already vulnerable population.

“I would like to help the people in my community first…I live the daily life that everyone else in my community faces,” she said.

For more information on CSULA’s MSW programs, click here.

Editor’s Note: The LA Local also receives support from the Ballmer Group.

This story was originally published by CalMatters. Sign up for their newsletters.

California scored a legal victory Monday that for now, undermines the Trump administration’s efforts to drastically cut funding for homeless housing.

Changes that would have diverted huge chunks of federal funds away from permanent housing and funneled them instead into temporary shelters and sober living programs will remain suspended after the Trump administration dropped its appeal of an earlier court loss. While the broader case is still being litigated, the new development could provide some reassurance to California counties waiting for the federal funds.

“We continue to fight for Californians and the rule of law, and we continue to win,” Attorney General Rob Bonta said in a news release. “People experiencing housing insecurity or homelessness need the federal government’s continued support — not a rollback of assistance.”

In November, the federal Department of Housing and Urban Development attempted to change the way it doles out money for homeless services via its Continuum of Care program. It decreed that jurisdictions applying for a piece of about $4 billion in federal homelessness funds can’t spend more than 30% of that money on permanent housing — a move that would result in a significant cut to the type of long-term housing that can resolve someone’s homelessness.

Last year, California communities spent about 90% of their federal Continuum of Care funds on permanent housing.

Gov. Gavin Newsom’s administration quickly joined 19 other states and the District of Columbia in suing to stop the Trump administration’s changes. In December, a federal judge in Rhode Island temporarily blocked the changes and ordered HUD to process funding applications under the original rules. The Trump administration appealed that ruling, leaving local governments and homeless service providers unsure of what they would be awarded funding for, and when.

The federal government on Monday dropped its appeal. While the rest of the lawsuit will move forward, and could take months to resolve, counties should be able to access permanent housing funds in the meantime.

Instead of prioritizing permanent housing, as has been the rule in the past, the Trump administration wants to focus more on shelters that get people off the streets quickly and temporarily, and on programs that require residents to be sober. HUD also attempted to ban the use of federal homelessness funds for diversity and inclusion efforts, support of transgender clients, and use of “harm reduction” strategies that seek to reduce overdose deaths by helping people in active addiction use drugs more safely.

A HUD spokesperson said the agency stood by its funding reforms.

“HUD remains committed to reforming the failed ‘Housing First’ approach and restoring the Continuum of Care program to its core objectives; reducing homelessness and promoting self-sufficiency for all vulnerable Americans, ensuring taxpayer dollars are directed towards those goals,” a spokesperson said in a statement.

HUD experienced another legal setback last month when a federal judge in Rhode Island shot down the agency’s attempt to upend another, smaller, source of federal homelessness funding. At issue in that case was a program called the Continuum of Care Builds grant, which funds the construction of new homeless housing. HUD last year made grantees reapply under a very different set of criteria, which seemed to disqualify organizations that support trans clients, use “harm reduction” to prevent drug overdose deaths or operate in a “sanctuary city.”

About $75 million in federal funds had been frozen as that case moved forward.

In March, the court found HUD violated the law through its “slapdash imposition of political whims.”

“This ruling is a victory for people across this nation who have overcome homelessness and stabilized in HUD’s permanent housing programs,” Ann Oliva, chief executive of the National Alliance to End Homelessness, which filed the lawsuit, wrote in a statement. “Today’s news reinforces a fundamental truth: that the work to end homelessness is not partisan, and never should be interfered with for political means.”

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.