CARE Court was created to help California’s toughest homeless cases. Why that’s been so hard

Every time Jennifer Farrell got close to her brother, he slipped through her fingers.

As she walked the railroad tracks on the border of San Lorenzo and Hayward last month, searching for signs of her homeless younger sibling, she thought she caught a glimpse of him on a discarded mattress. But it turned out to be someone else.

Store clerks in a nearby strip mall and the groundskeeper at a local park all knew her brother. They told Farrell they’d seen him recently lying on the sidewalk outside a Jack in the Box. Another time, he was walking down the street, dragging a blanket behind him. He was spotted outside a church just that morning, someone said.

But he remained a phantom. Everywhere Farrell looked, it seemed like her brother had just left.

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Farrell wasn’t supposed to have to do this anymore. Last Christmas Eve, she’d jumped at the chance to get her 59-year-old brother, who has been homeless off and on since 2017 and struggles with schizophrenia and meth use, into a new program called CARE Court. It was supposed to help people like him stabilize their mental health and get off the streets.

For a short time, it did. Her brother moved into a converted hotel in Oakland in late April, Farrell said, but five months later, he fled the hotel and disappeared.

“We’re coming up on a year (since he enrolled in CARE Court),” Farrell said. “And we are nowhere…we’re probably in the same place we were when I filed. And maybe even worse off.”

Gov. Gavin Newsom introduced CARE Court in 2022 in part as a way to bring people with serious mental illnesses off of California’s streets. He continues to tout it as part of his homelessness strategy, as recently as this month in a news release.

But data from the state and counties, as well as interviews with service providers, CARE Court participants and their family members, highlight the ways in which the program is struggling to help homeless Californians.

More than two years after the program first launched, most people starting the CARE Court process aren’t homeless, and those who are homeless aren’t always getting what they need most: housing.

To assess the program, CalMatters requested housing information from California’s 25 largest counties, as well as all of the ones that first launched the program. Of the 2,362 CARE Court petitions filed in those counties, fewer than a third were for people who were homeless.

When asked how many people were housed through CARE Court, even the most successful counties reported just a few dozen.

Six of the counties polled by CalMatters either did not track housing status or total number of petitions, or did not disclose that data.

The state has not made detailed, up-to-date data about CARE Court performance public. Tracking housing status by county is difficult, as counties collect that data in different ways. Some count people as homeless if they are incarcerated or hospitalized, and some don’t. In some cases, counties don’t know the housing status of the client when a petition is filed. CalMatters asked each county included in this report for its most up-to-date CARE Court data, and most provided data through October or November. A handful only provided data that ended in August.

CARE Court began rolling out in California in October 2023 as a court-based treatment program for people with schizophrenia and other psychotic disorders. People enter it through a petition, which can be filed by their family members, first responders or mental health clinicians. Almost all of the agreements are voluntary, and even court-ordered treatment plans can’t force compliance.

“You know what it’s like? It’s like the Wizard of Oz,” Rebekah Cooke said earlier this year, when her 36-old daughter was enrolled in CARE Court while living in a Marin County homeless encampment. “You go through all this and you think there’s hope at the end. And when you get to the end, you realize it’s all smoke and mirrors. And there’s really nothing at the end.”

CARE Court’s efforts to move her daughter indoors failed for eight months. Her daughter finally got housing that worked for her after leaving CARE Court.

How CARE Court functions varies greatly by location, and depends on how many and what kind of beds a county has available, and how it allocates housing resources.

“The most common unmet need for CARE participants was securing and maintaining permanent housing,” according to the most recent detailed state data on the program — more than a year old — which found 28% of people receiving CARE Court services were unhoused for at least part of the time they were in the program.

CARE Court has helped people in San Mateo County get mental health treatment, and moved some into housing, which is “fantastic,” said Ally Hoppis, clinical services manager for the county’s Behavioral Health and Recovery Services division. But, at least in her community, housing is not the main service CARE Court offers.

San Mateo County only has 15 beds prioritized for CARE Court participants. As of October, the county had received 81 CARE Court petitions. Most people in CARE Court who need housing still have to go through the regular routes of getting it. Sometimes, the county puts people up in a motel for a month or longer because there is no other option, an expensive solution.

“Is (CARE Court) fixing our homelessness problem for the seriously mentally ill? No, it’s not,” Hoppis said.

Nor is it making a noticeable dent on the streets of Los Angeles County, said John Maceri, chief executive of The People Concern, one of the county’s largest social service providers. His organization has referred about 10 people to CARE Court — either people who are living on the street, or people who live in interim housing but are struggling and need more help. Only four of those people were enrolled.

“The reality has been that some of the folks that we have referred have not been accepted into CARE Court,” Maceri said, “and the few that have, we haven’t seen the results in terms of the promise of support that was there, or that we thought would be there.”

The court can dismiss a CARE Court petition for a variety of reasons, including the person not meeting the strict eligibility criteria (participants must be diagnosed with schizophrenia or a similar psychotic disorder).

Housing is an “extremely important” part of CARE Court, and the program’s ability to offer it in some cases makes it different from other mental health interventions, said Corrin Buchanan, undersecretary for the California Health and Human Services Agency, which oversees the program.

CARE Court doesn’t come with specific funds for housing, a concern counties raised early on, but the state has provided more than $1 billion for Behavioral Health Bridge Housing – temporary homes for people with mental health needs. State law requires CARE Court participants be “prioritized” for that housing, but it’s not exclusively for them.

Starting Jan. 1, Medi-Cal will cover temporary rent support that could also help CARE Court participants, Buchanan said.

“I think there’s a lot of hope that we’ll continue to be able to make sure that this is a meaningful part of what can be made available,” Buchanan said.

Though it’s hardly a widespread solution to homelessness, CARE Court has succeeded in helping some individuals get off the street.

When outreach workers found him last winter, J.M. was sleeping on blankets under an awning in Oakland’s Jack London Square, with no tent to protect him from the elements. A foot injury had left him unable to walk, and he wore multiple pairs of pants and socks in an attempt to compress the limb and alleviate his symptoms.

CalMatters is using J.M.’s initials to protect his privacy.

The water at Jack London Square where J.M., who prefers to use his initials for privacy, walks almost daily for exercise and because he enjoys looking at the San Francisco Bay in Oakland, on Dec. 1, 2025. He received housing support through CARE Court and now lives within walking distance of Jack London.

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Florence Middleton

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J.M., who prefers to use his initials for privacy, looks through his bedroom window at a transitional home provided through CARE Court in Oakland on Dec. 1, 2025.

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Florence Middleton

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A year later, J.M. lives at a hotel in downtown Oakland that was converted into temporary housing with mental health services. J.M. received medical care for his foot, and now regularly walks the half mile from his room to the Jack London Square waterfront, where he enjoys the sea air and waves lapping against the dock.

He feels better about himself, J.M. said, and he’s making plans for his future. He’s looking into finding work as a janitor. He wants to quit smoking cigarettes and get his GED diploma.

“Mentally and physically, I feel good,” he said.

Matching people to the right housing: A difficult puzzle 

CARE Court participants can enter into a voluntary CARE agreement or a court-ordered CARE plan, both of which, according to state law, “may” include behavioral health care, medications, a housing plan and other supportive services on an as-needed basis.

But in a state where affordable housing is in short supply, the housing part can be difficult. Behavioral Health Bridge Housing – the only housing required to be set aside for CARE Court – isn’t always a good fit for those clients.

In San Mateo County, that money funds 15 beds on one floor of a new behavioral health facility in Redwood City. The rooms are clean and private, but the campus is remote, said Brian Fraser, an attorney with the Legal Aid Society of San Mateo County, who represents CARE Court participants. It’s in a wooded area four miles from downtown and only one city bus stops there twice a day.

For clients who can’t get a bed there, need something more central, or aren’t comfortable with the institutional feel, most of the other options are shelters where they’d have to share rooms, Fraser said. But if someone’s mental health struggles are severe enough to land them in CARE Court, chances are slim that they’d do well in a room with strangers, he said.

“There are times where there is no option for certain clients,” Fraser said. “And it’s frustrating.”

Monterey County’s 55 Behavioral Health Bridge Housing apartments have served “very few if any” people in CARE Court, as CARE Court participants tend to need more services than bridge housing can provide, said Melanie Rhodes, the county’s behavioral health director.

In other counties, no bridge housing is available. Santa Cruz County’s first project using those state funds isn’t set to open until next year.

In Marin County, Shaylee Koontz spent almost the entire eight months she was enrolled in CARE Court either sleeping at a homeless encampment in a park in Fairfax, or in the hospital. Though she and the county have differing views on how her time in the program ended, and whether it was ultimately successful, two facts are clear: the interventions CARE Court offered failed multiple times, and she remained outside for months.

Koontz entered into CARE Court last December, after her mother, Cooke, filed a petition on her behalf. Koontz said CARE Court workers used to stop by her encampment and check on her periodically. They’d offer her small things, such as rides to the food bank, she said.

“They were helpful to a degree,” Koontz said. “And then it was hard to get a hold of them after a while…They kind of stopped taking my phone calls.”

While Koontz was in CARE Court, the county referred her to residential mental health crisis and substance use treatment programs three times, said Todd Schirmer, director of the county’s Behavioral Health and Recovery Services. She never lasted longer than three days in any of the programs.

It appears the very mental health symptoms that qualified Koontz for CARE Court in the first place also made it hard for her to succeed there. During one stay, the treatment center said she failed to follow the rules. Another time, it appears they asked her to leave following an unspecified “incident.”

“We recognize that recovery is not always a straight line and that periods of progress and setback are a normal part of healing,” Schirmer said in an email. “Our system is designed to stay connected during these moments, adjust supports as needed, and continue offering options that reflect each person’s goals, preferences, and needs.”

Koontz left CARE Court in August. Koontz and her mother said she was kicked out, while the county said she left voluntarily. She was referred to another county program.

Shaylee Koontz, 36, in San Rafael, on Oct. 27, 2025. Koontz’s mother helped her get into CARE Court, but she exited the program before getting stable housing.

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Photo by Florence Middleton for CatchLight/CalMatters

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Photo by Florence Middleton for CatchLight/CalMatters

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Shortly after, as the city planned to clear her encampment and displace her and her friends, Koontz decided she’d had enough. She was drinking too much, she said, and wanted to get sober and move indoors. She got a motel room for the night, and then she moved into a rehab facility.

Now, Koontz is living in a women’s sober living house, and doing well. She’s no longer drinking, she recently finished writing a fantasy screenplay, and she plans to start taking college classes for a film degree next year.

“I do feel good,” Koontz said. “I feel much better.”

A golden ticket to housing in Alameda County

On the other side of the bay, Alameda County had, as of August, moved 38 CARE Court participants into temporary or permanent housing out of 41 petitions it received for people who were homeless.

Alameda County has 200 interim beds, 40 beds in board-and-care homes and six medical respite beds for CARE Court clients and others with mental health needs, plus additional money to help people with rent in private-market units. If nothing is immediately available, the county can put CARE Court clients up temporarily in a motel.

In Alameda County, people accepted into CARE Court essentially get a golden ticket that allows them to jump the housing line, said Stephanie Regular, an attorney with the county public defender’s office, which represents CARE Court participants. Without CARE Court, people wait an average of six months to get into Behavioral Health Bridge Housing, according to the county. The longest wait was a year and a half.

“We can go out to clients and say, ‘We can offer you housing,’” Regular said. “That’s huge to these clients, and life-changing, and a reason for them to want to participate.”

But as is common when working with high-needs homeless clients, just because someone moves into a room, doesn’t mean they stay there. Eddie’s Place, a converted hotel in Oakland, offers transitional housing for up to two years with private rooms and bathrooms, meals, nurses, and other social services to people struggling with their mental health or substance use. The property has about 30 beds funded by the state money that prioritizes CARE Court clients.

So far, only about six people have moved into Eddie’s Place through CARE Court. None of them are still there, said Meg O’Neill, director of transitional housing programs for Cardea Health, which runs the facility.

CARE Court clients tend to do well there for a few weeks, but then their medical needs, substance use or mental health symptoms become too acute even for the nurses and social services Eddie’s Place offers, and they end up back in the hospital, she said. Or, they choose to leave and go back to the street. In some cases, O’Neill doesn’t know where they went.

“What’s been hard there is just seeing folks come to us and then not stay,” O’Neill said. “I didn’t really anticipate that, but in hindsight, it does make sense.”

Why aren’t more homeless Californians accessing CARE Court?

In Los Angeles County, most people who started the CARE Court process already had housing. As of October, fewer than a quarter of the 629 petitions filed there were for people who were homeless.

That could partly be because, at least initially, most CARE Court petitions have been filed by family members, and people who still have strong family connections may be less likely to wind up on the street.

In many cases, CARE Court participants aren’t technically homeless, but they would likely end up on the street without the program’s intervention, said Martin Jones, Jr., who oversees CARE Court programs for Los Angeles County. As of October, 54 CARE Court participants in his county had moved into interim housing.

“I would say that, yes, the majority of our folks have not been unhoused,” he said, “however, their current living situation, especially with their families, is very fragile.”

C.M., who prefers to not use her name, sits in her bedroom at a transitional home provided through CARE Court after receiving treatment for schizophrenia in Oakland on Dec. 1, 2025. She now lives in a single-occupancy room and is preparing to begin classes at Chabot College in January.

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That was the case for C.M., a CARE Court participant in Alameda County. She asked to be referred to using her initials over fears that being associated with schizophrenia would hurt her chances of getting a job.

The 55-year-old experiences bouts of hearing voices and other delusions when she’s under extreme stress, and she lost her job because of an episode in 2022. After that, she received disability payments and drove for Lyft, but it wasn’t enough to pay the rent for her San Leandro apartment. Then, she said, her Lyft app started glitching, cutting off that income. Soon she spiraled back into psychosis, and the city’s mental health crisis team started showing up at her home. After one of those visits, an EMT filed a CARE Court petition.

Now, she has her own room in a large Victorian house in West Oakland, where a nonprofit provides mental health services. She’s planning on going back to school next month for construction management.

"I initially was all suspicious of CARE Court,” C.M. said. “But I really couldn't have gotten any luckier, given the circumstances. I was about to be homeless. They made sure I didn't spend one day on the streets."

Fall leaves rest on the sidewalk outside the transitional home in Oakland where C.M., who prefers to use her initials for privacy, lives through CARE Court on Dec. 1, 2025.

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Florence Middleton

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C.M., who prefers to use her initials for privacy, now lives in the single-occupancy room and is preparing to begin classes at Chabot College in January.

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Florence Middleton

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CalMatters/CatchLight

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In the Central Valley’s Stanislaus County, CARE Court is mostly serving unhoused people. Of the 102 petitions the county received as of the end of October, 60% were for people who were homeless. Almost 70% of the CARE agreements filed were for homeless participants.

It’s hard to know for sure, but that may be because when CARE Court launched, the county focused on teaching first responders and homeless outreach workers about the program and getting them on board, said Behavioral Health Director Ruben Imperial.

“We’ve had real intentional effort around the homeless population,” he said.

When first responders and outreach workers weren’t filing petitions because the process was too complicated and time consuming, Imperial’s department made a change: Now, those workers can refer homeless clients to the county, which will file the CARE Court petition on their behalf.

Back in Alameda County earlier this month, Farrell got the call she’d been waiting for. Her brother’s CARE Court caseworker found him just half a mile from where she’d been searching. He was hospitalized on a temporary mental health hold. But Farrell knew he could be out of the hospital, and back on the street, at any time.

She hopes this will be what it takes to get her brother out of CARE Court and into a conservatorship that forces him into treatment. But at his last CARE Court hearing, to which her brother didn’t show up, the county said they’re still trying to convince him to accept help.

“OK, fine,” Farrell said in an interview later. “But we’ve been doing this process for almost a year. So when do we take it up a step?”

This story was reported with support from the Rosalynn Carter Fellowship for Mental Health Journalism. It was produced jointly by CalMatters & CatchLight as part of our mental health initiative.

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