LA County Moves To Expedite CARE Court Hiring To Help More People With Mental Illness

The L.A. County Board of Supervisors voted Tuesday to use an emergency declaration on homelessness to expedite hiring for CARE Court, a state-mandated program that aims to create new avenues for people living with a serious mental illness such as schizophrenia to get lifesaving treatment.

With L.A. County’s launch of CARE Court set for Dec. 1, some supervisors expressed concerns the county would not be ready to provide care for the estimated 4,500 people who would qualify.

Historically, the county’s Department of Mental Health has struggled to fill open positions.

Last fall, California Governor Gavin Newsom signed the Community Assistance, Recovery, and Empowerment (CARE) Act into law, which requires all counties to set up a new framework for the program.

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Under CARE Court, people living with a serious, untreated mental illness could be referred for a court-ordered care plan. The court intervention could be initiated by a family member, county behavioral health workers or even first responders. If the care plan fails, the person could be hospitalized or referred to a conservatorship.

CARE Court in L.A. County will begin with one courtroom and one judge within the Superior Court in Norwalk.

At the board meeting Tuesday, Supervisor Holly Mitchell pointed out that the success of CARE Court would also be contingent on the county’s ability to build out badly needed mental health treatment beds.

“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,” Mitchell said.

“That’s a bed that we have to build,” Mitchell said, noting that the initial planned state funding of $15 million may not be enough.

Experts say L.A. County likely needs thousands more psychiatric beds at varying levels of care in order to meet demand.

According to a report from the California Health Care Foundation, in California “the number of acute psychiatric beds per 100,000 people decreased about 30 percent from 1998 through 2017.”

Some have also questioned how much strain CARE Court will put on public guardians’ offices throughout the state. Those offices are responsible for guiding care for people who are deemed too unable to do so themselves because of a serious mental illness.

“You ask any guardian, conservator in this state and [they’ll say] we just don’t have facilities,” Tom Scott, executive director of the California State Association of Public Administrators, Public Guardians, and Public Conservators, told LAist.

“CARE Court in its concept is great; but how is it implemented, how does it actually play out?, ” Scott said.

Many families who have struggled to get their loved ones living with a serious mental illness to accept treatment see CARE Court as an invaluable tool, while civil liberties groups have fought the new framework in court, citing concerns around misuse and forced treatment.

Supervisor Lindsey Horvath was the sole "no" vote on Tuesday’s motion, which was authored by Supervisors Janice Hahn and Kathryn Barger.

“I’m concerned that there may be misuse or maybe even abuse of this tool and that it will be used to sweep people instead of to help people which is not what anyone wants to see happen,” Horvath said.

The motion passed Tuesday also directs county workers to identify properties that could be used to support CARE Court as it rolls out, among other provisions.

“We have been struggling for decades to figure out a way to get real, compassionate help to people with severe mental illness, and I believe CARE Court could be the missing piece of the puzzle,” Hahn said in an emailed statement.