San Francisco is one of seven California counties that begins Gavin Newsom’s CARE Court program today, a new system that can force mentally ill people into conservatorship and involuntary treatment.

If California Governor Gavin Newsom does indeed have designs on running for president someday, he likely realizes that the state’s homelessness rate is one of his greatest political vulnerabilities, as California has five of the top ten cities in the U.S. with the highest rates of homelessness. Newsom’s latest strategy to address this was his March 2022 CARE Court proposal (CARE is short for Community Assistance, Recovery and Empowerment) which the state legislature approved in the summer of that year.

The CARE Court plan, in which civil court judges are empowered to compel severely mentally ill people into shelter or treatment even if they refuse it, was scheduled to begin October 1, which was a Sunday. And so, as such, KTVU reports that Newsom’s CARE Court program started Monday. San Francisco is one of seven California counties that will run CARE Courts starting today, with the others being Glenn, Orange, Riverside, San Diego, Stanislaus, and Tuolumne counties. Other counties have until next year to set up theirs.

"It’s hopefully going to help some people who need some help, and it is probably not going to make a huge dent in what you observe in the community," San Francisco Superior Court Judge Michael Begert, who will supervise SF’s Care Court, told KTVU.

According to the Chronicle’s CARE Court explainer, one can be filed into CARE Court on the petition of a family member, a first responder, or even a roommate. While CARE Court is not a criminal court, its hearings will be held on Mondays at San Francisco Superior Court, and will determine whether an individual will be forced into treatment or shelter. A California Health and Human Services Agency press briefing last week said people can be petitioned into CARE Court if they are  "unlikely to survive safely" or suffer a relapse that could put them in "grave disability or serious harm."

While CARE Court is largely characterized as a program to address homelessness, it is not limited to the unhoused population. Individuals summoned to CARE Court do get a lawyer and a support person. But the program is, as KTVU points out, “limited largely to people with untreated schizophrenia and related disorders,” which is a much smaller, more restrictive criteria than what Newsom originally had in mind.

“There are limitations,” SF Superior Court Presiding Judge Anne-Christine Massullo told the Chronicle. “This legislation started out very big and then narrowed down. Now there’s a much smaller window for people to get into CARE Court. We’re hoping it will create a vehicle to address some, but not all, problems."

Newsom appeared on 60 Minutes last week to talk about CARE Courts, and unsurprisingly, the conversation turned to whether the system is motivated by Newsom’s political ambitions.

And the CARE Court system may be a political hot potato for Newsom, considering that SF, like many of the counties with CARE Courts, doesn’t have the money or the available shelter beds and staff that the program is going to require.

According to an announcement from  Mayor London Breed last week, “During the last several years San Francisco has added over 350 new mental health and substance use disorder treatment beds to the 2,200 existing beds, and another 50 are in the pipeline.” That announcement acknowledges what we have, but not the tricker component of that we don’t have.

And that doesn’t even acknowledge the civil rights concerns over forcing people into involuntary treatment. Disability rights groups have already filed a lawsuit claiming CARE Courts are unconstitutional, so just as with encampment sweeps, this whole effort could get held up in court.  

But the primary problem with CARE Courts may be that they are so limited, that even under the best circumstances, they just won’t hlp that many people or make a noticeable difference. The Chronicle points out that “The (SF) health department estimates the city will enroll 300-400 people” in the frost year of CARE Court here, which is not going to make much of a difference in a city like this. Moreover, CARE Court is not a criminal court, so they don’t really have many ways of enforcing whether people comply with their treatment or shelter programs.

In fact, the whole this is so voluntary and unenforceable that the Chronicle adds “the court is offering $20 gift cards for participants who just show up to their first hearing.”

Related: Assembly Passes Newsom’s ‘CARE Court’ Proposal to Let Judges Determine Mental Health Plans [SFist]

Image: Cocoablini via Wikimedia Commons