Los Angeles County is on track to create a CARE court this year

Los Angeles County is on track to join the first wave of counties this year to launch a comprehensive plan backed by Gov. Gavin Newsom to tackle severe mental illness through compulsory treatment for people in serious crisis.

The governor’s office announced Friday that Los Angeles County will begin the new program known as Kerr Court (For Community Assistance, Revitalization, and Empowerment) by December 1, a year earlier than expected.

“The CARE court provides real progress and accountability at all levels to fix the broken system that disappoints so many Californians in crisis,” Newsom said in a statement. “I commend the L.A. County leaders, the courts, and all local government partners and stakeholders across the state who are taking urgent action to make this lifesaving initiative a reality for the thousands of struggling Californians.”

However, a major question remained unanswered Friday afternoon: whether the Los Angeles County Board of Supervisors needed to vote on the county’s plan to join the program. A majority vote of the moderators – Hilda Solis, Janice Hahn and Kathryn Barger – expressed their support for starting the CARE Court this year in a public statement.

When it was signed into law, the Kerr Act designated seven counties for the October 1 IPO: Glenn, Orange, Riverside, San Diego, San Francisco, Stanislaus and Tuolumne. The rest of the state, including Los Angeles County, through December 2024.

L.A. County was planning to join this later launch, said Lisa Wong, the interim director of the county’s mental health department, who will be the director of the CARE Court program.

“This year has been a very busy year for us,” she said, citing a number of initiatives that were already in place in 2023 including Hollywood 2.0a pilot program to provide services and care in a part of the city where homelessness and mental illness are particularly acute.

Although her agency didn’t know “for sure” that L.A. County would be added to the first lineup before this week, Wong understands the urgency.

“Whether we’re in group one or group two, there will always be challenges,” she said. “The reality is that people who need this help are out on the street suffering and not getting the care they need. There is never a good time to implement this kind of large-scale programme, but the level of need there is so great that we cannot put it off any longer.”

Adding Los Angeles County, the state’s most populous county, to the first phase of the new program could have consequences for Newsom’s ambitions to tackle one of California’s most vexing problems: the overwhelming number of people on the streets who struggle with addictions and mental illness.

By some estimates, nearly 40% of people who live on the streets suffer from a severe mental illness, a substance use disorder, or both. More precisely, the California Policy Lab at UCLA has determined that just over 4,500 people living on county streets suffer from a psychotic disorder such as schizophrenia, and that number only includes those who have received outreach services.

The sudden inclusion of Los Angeles County is a measure of the urgency of the homelessness crisis in the state, particularly in Los Angeles, and it comes with some risks. While the other seven counties have been crafting their own CARE court plans for nearly four months, L.A. County is on a fast track, and any difficulties implementing the program warrant further criticism.

Superintendent Lindsey Horvath told The Times she was “worried by the hasty decision to join the programme,” which requires robust infrastructure and services to be successful.

“Without proper investment and clear direction, this system will risk breaking promises we made to L.A. County voters for real, meaningful progress and change,” Horvath said.

Superintendent Holly Mitchell similarly urged caution against rushing to an agreement this year, and instead called for a “strong discussion” of the decision at next week’s board meeting.

“It is essential that we have clarity on how the courts and the county will implement this program with sufficient funding to be successful,” Mitchell said in a statement.

Wong said the county’s mental health department has received assurances that it will receive appropriate funding from the state to move to the first group.

“We all want this to be a success,” she said. “We have concern about these high-risk patients, and we know something needs to be done.”

Newsom’s announcement is the latest in a series of actions taken in the City and County of Los Angeles in recent weeks to address the mental illness and homelessness crises that have gripped the city.

Los Angeles Mayor Karen Bass Declare a state of emergency In town on her first day in office on December 12, W.J The county supervisors followed him Approximately after one month. The ads will help speed up the provision of services to the tens of thousands of unhoused people in the area.

It allows us to be on the ground floor of a new program where a lot of the processes and implementation details still need to be worked out,” Barger said in a statement. “Our county needs to have a seat at the table so we can make a recovery.” effective for individuals with debilitating mental illness on our streets.

“We need a concerted and consistent approach to helping these individuals, and CARE stands ready to help us fulfill that mission. Severe mental illness does not resolve on its own.”

When Newsom introduced the CARE Act in March, it was his The proposal met early resistance.

The legislation was initially intended to address the state’s homelessness crisis through California Health and Human Services sponsorship and administered by county agencies.. Asking these agencies to address homelessness — with penalties if court-ordered housing is not provided — has been difficult, said Dr. Veronica Kelly, director of Orange County Behavioral Health Services.

So the CARE Act evolved, and when the legislation was signed into law in September, it focused not so much on homelessness but on helping individuals with schizophrenia and related disorders. Several behavioral health departments then decided that it would be in their best interest to be in the first group of counties to implement the program.

When a CARE Act funding measure passed in the fall, it set aside $88 million In the new funding for the implementation of the court-based system.

in January budget proposal Unveiled by Newsom on Tuesday, it has committed another $52 million to continue helping counties and courts implement the new program, with plans to increase funding to nearly $215 million by the 2025-2026 fiscal year.

Those numbers are not yet representative of Los Angeles County, said Jason Elliott, Newsom’s vice chief of staff and chief housing and homelessness advisor. Instead, the governor plans to increase funding in a revised budget plan to be released in May. Billions of additional dollars are available to fund the CARE Court through housing, homelessness, and behavioral and mental health programs, according to the administration.

The legislature has until June 15 to pass the budget.

The administration estimates that 7,000 to 12,000 individuals are currently eligible for CARE, although not everyone has to be homeless. The Newsom administration claims that the CARE court was not designed to solve homeless homelessness, but instead to help some of the state’s most vulnerable and mentally ill people find necessary treatment and behavioral health services, and for many, that could include housing.

Supporters have hailed it as an innovative approach that will help stem the flow of those with severe mental health concerns into hospitals and prisons, while critics have called it an infringement on personal liberties. Organizations like Disability Rights California and the American Civil Liberties Union spent most of the 2022 legislative session Trying to block Kerr’s court from traffic.

Given the challenge of implementing the CARE Act, initially excluding counties like Los Angeles makes sense, said Rod Schner, who served as medical director for the Los Angeles County Department of Mental Health from 1996 to 2018.

“This is a common way to start a big program like this,” said Shaner. “If there are major unforeseen problems with the immediate and full implementation of CARE, they could cause severe consequences at the state level. A more gradual introduction allows potential problems to be identified when they are small enough to be managed and rectified more easily.”

Elliott argued that including L.A. County would help other counties that have until 2024 to put them in place.

“What we’re doing right now isn’t working,” Elliott said. “Care Court is big and bold, and we’re going to assume and plan for success. We’re going to be optimistic. I think LA County joining this program so early is an indication that there’s a lot of confidence at the local level.”

Among the most obvious challenges facing counties while implementing CARE is the uncertainty about the financial liability of insurers, who have to pay for court-ordered treatment in cases where an individual has coverage.

“Guidance to insurers on compliance has not yet been issued,” Shaner said.

Despite widespread interest in ending homelessness, Newsom faced stiff opposition from some local governments over whether a Kerr court was the best solution.

During his budget press conference Tuesday, Newsom renewed his commitment to the Kerr court.

“This is life and death. People are dying in the streets in the name of mercy and these arguments make no sense. “Unprecedented support. I want to see unprecedented progress.”

Times staff writer Rebecca Ellis contributed to this report.