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L.A. County on track to join Newsom’s sweeping mental health plan a year early

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Los Angeles County is on track to join the first wave of counties this year launching a sweeping new plan backed by Gov. Gavin Newsom to address severe mental illness by compelling treatment for people who are in serious crisis.

The governor’s office announced Friday that Los Angeles County would kick start the new program known as CARE Court (for Community Assistance, Recovery and Empowerment) by Dec. 1, a year earlier than expected.

“CARE Court brings real progress and accountability at all levels to fix the broken system that is failing too many Californians in crisis,” Newsom said in a statement. “I commend Los Angeles County leaders, the courts and all the local government partners and stakeholders across the state who are taking urgent action to make this lifesaving initiative a reality for thousands of struggling Californians.”

However, a key question remained unanswered Friday afternoon: Whether the Los Angeles County Board of Supervisors needs to vote on the plan for the county to join the program. A voting majority of the supervisors — Hilda Solis, Janice Hahn, Kathryn Barger — have expressed support in a public statement.

The Board of Supervisors oversee the county’s Department of Mental Health, which will be the administrator of the CARE Court program.

When signed into law, the CARE Act identified seven counties for the initial roll-out on Oct. 1: Glenn, Orange, Riverside, San Diego, San Francisco, Stanislaus and Tuolumne. The rest of the state, including Los Angeles County, has until December 2024.

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 address one of California’s most vexing problems: the huge number of people on the streets who struggle with addiction and mental illness.

By some estimates, close to 40% of people living on the streets are experiencing severe mental illness, a substance abuse disorder or both. More precisely, the California Policy Lab at UCLA determined that just over 4,500 people living on the streets of the county have a psychotic disorder like schizophrenia, and that number includes only those who have received outreach services.

Joining the first phase of CARE Court is a measure of the urgency of California’s homelessness crisis and comes with some risk. Difficulties implementing the program in Los Angeles County could reflect poorly on the program and invite further criticism.

Supervisor Lindsey Horvath told The Times that she is “concerned by the rushed decision to join the program,” which demands robust infrastructure and services to be successful.

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

Newsom’s announcement represents the latest in a series of actions taken in both the city and county of Los Angeles in recent weeks to address the crisis of both mental illness and homelessness that have overtaken the city.

Los Angeles Mayor Karen Bass declared a state of emergency in the city on her first day in office on Dec. 12, and the county supervisors followed suit nearly a month later. The declarations will help expedite services for the tens of thousands of unhoused people in the region.

“I support bringing CARE Court to our county. It allows us to be on the ground floor of a new program where a lot of 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 effectively bring healing to individuals living with debilitating mental illness on our streets.

“We need a coordinated and consistent approach to help these individuals, and CARE Court is poised to help us meet that mission. Severe mental illness doesn’t resolve itself.”

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

The legislation was meant to address the state’s homelessness crisis through the auspices of California Health and Human Services and administered by county agencies. But requiring these agencies to address homelessness — with sanctions if court-ordered housing is not provided — was a hard sell, said Dr. Veronica Kelley, director of behavioral health services for Orange County.

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


Reporter Rebecca Ellis contributed to this story.

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