CARE Court Has Been Live For Weeks in LA and OC. How’s It Going?

It’s been several weeks since two of California’s most populous counties launched a new program aimed at getting more people living with serious mental illness into treatment.

Known as CARE Court, the new program allows family members, behavioral health workers, first responders and others to petition a court to step in with a voluntary care plan for someone living with serious mental illness, like schizophrenia.

Gov. Gavin Newsom and other state leaders have billed CARE Court as a way to get people the lifesaving treatment they need and as one tool for addressing California’s homelessness crisis.

Still, several groups including Disability Rights California and the American Civil Liberties Union have raised concerns that the program may be too coercive and could strip people of their rights to make their own decisions.

So how are things going?

L.A. County

Los Angeles County launched its CARE Court on Dec. 1. The Department of Mental Health reported that a total of 28 petitions were filed that month. A department spokesperson said the number of petitions filed in January is expected to increase significantly as authorities continue outreach after the holiday break.

So far, none of the petitions filed have reached the formal care agreement stage yet, which could take six weeks or more.

“DMH remains committed to providing all individuals entering through this process with services, even if they do not meet the eligibility for CARE or if their petitions have been dismissed,” H. Chung So, a spokesperson for the department, wrote in an email to LAist.

Judge Samantha Jessner, presiding judge of the Los Angeles County Superior Court, said all of the petitions filed in the county so far have come from family members of the person named in the documents.

That may not come as a surprise to many families who have rallied behind CARE Court since the beginning, seeing it as a way to have their concerns for loved ones heard and acted upon. Some have said they fear a court setting could scare people away from the program.

Jessner acknowledged those concerns and said it will be important to meet people where they are as CARE Court progresses.

“If that means you appear via an iPad from a place that you’re comfortable, that’s fine with us,” Jessner said. “And if that means you come into the courtroom and you are with a judge, and you develop an in-person sort of connection with the judge, that’s fine, too.”

It’s too early to identify trends or get a sense of how individuals are responding to the program, Jessner said, but she said she hopes she and her colleagues can help people who have been struggling.

“I think every judge in every courtroom in this county is called upon to help people,” Jessner said. “A CARE Court should be no different in achieving that goal of helping people that are in need of treatment and services... in a way that makes them feel empowered and in a way that makes them feel like they have some agency and say in the process.”

State officials touted CARE Court as a new tool to address homelessness but they also acknowledge its limitations. An estimated 2,000 people throughout California could be helped by CARE Court by the end of 2024, officials said.

The latest homeless count from the Los Angeles Homeless Services Authority found that 25% of the more than 75,000 unhoused people in L.A. County self-reported experiencing a severe mental illness.

A 2022 study by the California Policy Lab at UCLA showed that about 4,500 unhoused people in L.A. County who were unsheltered and received street outreach services between 2019 and 2020 had been diagnosed with a psychotic spectrum disorder, such as schizophrenia. That’s about 10% of the total 45,000 unsheltered people the study examined.

Orange County

Since CARE Court launched Oct. 2 in Orange County, 45 petitions were filed, 20 of which met the initial requirements, according to that county’s Department of Behavioral Health. As of this week, people in three of those petitions had been given court dates.

Veronica Kelley, the county’s behavioral health director, said that, from the day department authorities receive a petition, they have 14 days to find the person and serve them with paperwork to come to court.

“The timeline is very difficult to work with,” Kelley said, noting that the judge overseeing Orange County's CARE Court has granted extensions.

Kelley said the department has worked to build trust with people who might have been initially unreceptive to getting involved with the voluntary program.

“It’s a long process. Because imagine if I walked up to you on the street and just said, ‘Hey, your mom is worried about you so come with me we’re going to put you in a program.’ You’re not even going to talk to me,” Kelley said.

Kelley said she’s trying to manage expectations for the program, noting that once the public perceives it as a homelessness fix, it’s difficult to undo that perception. So far, about a third of the 45 petitions have been for unhoused people.

The program is not solely aimed at unhoused residents. Anyone who has untreated schizophrenia could qualify.

About half of the people in the cases Orange County have received have commercial insurance, according to Kelley. And some cases, she said, are getting dismissed because schizophrenia is not the primary diagnosis. That means that some people who have co-occurring substance use issues are being turned away from the program. But the department still offers treatment, even if CARE Court ends up not being the right fit, authorities said.

Kelley said she sees CARE Court as another way for county authorities to find people who might be slipping through the cracks and to get them to care providers.

“The upside is it does allow us to find out about people that we never would have known about,” Kelley said. “Because I can’t go to all 3.2 million people’s homes in this county and knock on their door and ask them if everyone is OK.”