The Brief

The number of people in Los Angeles County who participated in the first year of a program aimed at providing court-led treatment plans for people who live with serious mental illness remains far below initial state projections, according to data from county mental health authorities.

Known as CARE Court, the new program was promised as an innovative approach to bringing thousands of Californians living with untreated serious mental illness under the care of mental health professionals.

But numbers from the Los Angeles County Department of Mental Health show the county received about 16% of the petitions it was projected to get during the first six months of the program. From December of last year through mid-November, 308 petitions were filed in L.A. Superior Court, authorities said.

The petition numbers from Orange and Riverside counties are similarly low compared to estimates of how many people in those areas are potentially eligible for CARE Court.

“It’s been very frustrating to watch the slow pace of petitions by anyone other than family members,” Lisa Dailey, executive director of the Treatment Advocacy Center, a group that advocates for policies that benefit people living with serious mental illness, told LAist. Still, Dailey has hope for the program and thinks it deserves more effort.

Some critics see the paltry engagement as indicative of a failed policy. But supporters say the program needs more time and effort from county behavioral health departments.

Gov. Gavin Newsom, who championed the new approach, said he’s proud to see “early achievements,” including some 1,400 people throughout the state who were connected to CARE Courts or county services directly.

In March 2022, Governor Newsom spoke with local mental health service providers and officials about CARE Court. The discussion was held at a facility in South L.A. that’s a temporary home to about 30 people who are getting treatment for mental health or substance use struggles.

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Robert Garrova / LAist

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State officials estimated before the program’s launch that it could help between 7,000 -12,000 Californians a year.

Slow progress 

CARE Court allows family members, behavioral health workers, first responders and others to ask a court — by way of a petition — to step in with a voluntary care plan for someone living with serious mental illness, like schizophrenia. If the plan fails, the person could be hospitalized or referred to a conservatorship.

Between Dec. 1, 2023 and Nov. 20, there were 308 petitions filed in Los Angeles County, far below the roughly 1,900 state officials projected for the first six months of the program. Of those, 28 participants signed on to agreements and four moved forward to the stage in which they were expected to receive a CARE Plan, ordered by the Superior Court.

Some experts say that progress has been slow, particularly in a county where thousands of people living with serious mental illness sleep on the streets every night.

The 2024 Point-In-Time count found that 24% of unhoused people over the age of 18 self-reported that they live with a serious mental illness, according to the Los Angeles Homelessness Services Authority, which conducts the annual count.

Martin Jones, a program manager with the L.A. County Department of Mental Health, said there are about 70 county staffers working on CARE Court. He said working with human beings — gaining their trust and establishing a rapport — takes time and that just physically getting someone to court can take multiple staffers.

“I think that we’ve seen a lot of success from individuals who we’ve been told if CARE had not intervened this person would have died on the streets,” Jones said. “How do you really calculate the value of those kinds of stories? And I believe that it’s incalculable.”

Jones said he expected the first wave of L.A. County CARE Court graduations to happen early next year.

‘A very narrow niche’

For Alex V. Barnard, author of the book Conservatorship: Inside California’s System of Coercion and Care for Mental Illness, the lackluster CARE Court numbers were all too predictable.

“It was clear from the beginning that this was a program that would be very hard to access, and would serve a very narrow niche,” Barnard wrote in an email to LAist.

Eligibility criteria for CARE Court state that a participant must be diagnosed with a psychotic spectrum disorder, like schizophrenia. Bipolar disorder is not included. The criteria also say that the participant can’t be in ongoing treatment.

Barnard said he predicts that CARE Court will remain a small piece of the mental health treatment landscape, overshadowed by what was known as Senate Bill 43, a new state law that expands the criteria for involuntary treatment.

The measure, signed by Newsom in October 2023, changed state law to allow people living with a serious mental illness or severe substance use disorder who are unable to provide for their personal safety or medical care to be deemed “gravely disabled” and held against their will.

Barnard also questions whether the multi-million dollar investment in CARE Court might have been better spent on beds and services, which the county is severely lacking.

“It's really not clear why you need a court to get mental health departments to provide mental health care to individuals with mental health challenges, though, versus fixing issues around financing and prioritization within that system,” he said.

‘A policy failure’ 

Eve Garrow, senior policy analyst with the American Civil Liberties Union of Southern California, said funding directed towards CARE Court should instead be going to community-based care. The low participation numbers are evidence to her that the effort is not working.

“I think by any measure, I would say the CARE Act to date is a policy failure,” Garrow said. “It’s used precious resources — public funds — to fund a court system that is not even being used.”

In 2022, 40 groups — including JusticeLA, Disability Rights California and ACLU California Action — signed a letter saying the program would strip “people with mental health disabilities of their right to make their own decisions about their lives.”

Garrow said she believed CARE Court was the wrong response to a very real problem: “Which is people with serious mental health disabilities -- many of whom are unhoused -- living without access to the care and services they need,” she said.

In her experience, Garrow said, most people who are offered quality mental health care will accept it voluntarily.

More time 

Still, other mental health policy watchers are sticking by CARE Court, even if its initial expansion has been sluggish.

Dr. Susan Partovi, a family physician who does street outreach with the L.A. Centers for Alcohol and Drug Abuse, said the low participation may be partly because the Department of Mental Health needs to make more people aware of CARE Court and who it might help.

“I think they really need to be advertising this on a regular basis, because it’s hard to remember,” Partovi said, adding that the underwhelming numbers were a reminder for her that she could be filing more petitions.

According to the L.A. County Department of Mental Health, just 10 petitions came from provider networks.

Dailey, with the Treatment Advocacy Center, said county efforts have been partly to blame for what she sees as “unfortunate” numbers in the program’s first year. Jones, with the Department of Mental Health, said the county was now making a push to train more first responders on how to file petitions and when they might be appropriate. Only 22 of L.A. County’s 308 petitions were filed by the county Department of Mental Health.

The overwhelming majority came from family members.

“If there was no need for it, you wouldn’t see this initial rush from family members to try to get people into care,” Dailey said.

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.