Gov. Gavin Newsom signed a bill last Wednesday that will create a civil court division in each of the state's 58 counties with the authority to compel treatment for people who may not know they need it.
CARE Court — with "care" standing for community assistance, recovery and empowerment — is intended to make it easier for those who struggle with substance abuse or severe mental illness like schizophrenia to access treatment.
People could be sent before a superior court judge via the CARE Court system if recommended by a family member, first responder or a social worker if it is believed the person cannot properly care for themselves.
A judge could then approve a care plan for that person ranging from 12 to 24 months that is developed by local clinical workers. Care plans could involve guaranteeing access to housing and requiring the person to undergo clinical and psychiatric services and take stabilizing medications.
Newsom and other state officials including Health and Human Services Secretary Dr. Mark Ghaly proposed the program in March, arguing it would give the state and each of its counties a concrete method for helping state residents, particularly those who are unhoused, who don't know they need treatment.
"There's no compassion in stepping over people on the streets and sidewalks. You feel powerless," Newsom said Wednesday at a signing ceremony at Momentum for Health in San Jose, adding "we're changing that paradigm."
San Francisco will be one of the first seven counties to implement the CARE Court system, with a required start date of Oct. 1, 2023. Glenn, Orange, Riverside, San Diego, Stanislaus and Tuolumne counties will also be part of the program's first cohort.
The rest of the state's counties will be required to implement the program by Dec. 1, 2024. Counties that are found to be out of compliance with the program will be subject to fines and withheld funding, according to Newsom.
The program will be funded in part by the $15.3 billion allocated for homelessness in the fiscal year 2022-2023 state budget, according to state officials.
Newsom argued that while the state has poured money into programs like Homekey that are intended to reduce homelessness and increase access to social services, the state could no longer stand by as people suffered on the streets "in the name of compassion, in the name of the status quo."
"I'm not interested in the compassionlessness of the approach we have today, of people moralizing and somehow suggesting and normalizing that suffering on the streets and sidewalks," he said.
Newsom also made a veiled jab at "four-letter groups" in opposition to the program, which includes the American Civil Liberties Union, and called opposition to CARE Court "exhausting."
"Their point of view was expressed in the halls of the legislature and they were overwhelmingly rejected because, in a progressive legislature, they said 'enough, we're going to move in a different direction'," he said.
The ACLU's Northern California and Southern California branches both argued processing those with severe mental illness through the court system, even in civil court, would strip disabled people of their rights.
"Entangling people in the legal system would traumatize those who are most heavily impacted by our failed systems," the ACLU of Northern California said in June in a statement of opposition. "The plan would perpetuate racial disparities though an adversarial court process that does nothing to address the underlying structural conditions that lead to houselessness."
Both organizations also suggested the program stands on dubious legal grounds.
Newsom argued CARE Court is in line with the U.S. Supreme Court's 1975 ruling in O'Connor v. Donaldson, which found that a government cannot forcibly commit a person to a psychiatric facility against their will unless they pose a danger to themselves or others.
The ACLU of Southern California said Wednesday in a Twitter post that the organization expects legal challenges to the CARE Court system.