Both bills reopen the debate among families and advocates over when it’s appropriate to put someone into mental health treatment without their consent.

One bill would create a pathway for the most severely incapacitated people to go directly from Newsom’s voluntary mental health court into involuntary treatment in a hospital. The other would make it easier for EMTs and other first responders to refer people to mental health court. Both bills recently passed through the Senate Judiciary Committee, despite concerns from disability rights advocates that they would force more people into unwanted treatment.

“While early implementation shows promise,” Sen. Catherine Blakespear, a Democrat from Encinitas, said during a recent committee hearing, “barriers in the current petition process are preventing the program from reaching many of the individuals it was designed to serve.”

CARE Court launched in 2023 as a major piece of Newsom’s strategy to get people in the grip of psychosis off the streets. It allows family members of people with untreated schizophrenia and other psychotic disorders to refer them into the court-based program, where they can work with a judge, a public defender and a case worker on a plan for medication, therapy, housing, and whatever other help they may need.

But a CalMatters investigation found the program is falling short of expectations. As of January, California courts had received 3,817 petitions on behalf of prospective CARE Court participants and approved just 893 treatment agreements. At its outset, the Newsom administration estimated between 7,000 and 12,000 Californians would qualify for the program. 

Some families who attempted to use CARE Court to help their severely ill loved ones told CalMatters they were disappointed by the results. They thought a judge could order their family members into treatment. But that turned out not to be the case. If someone is too sick to realize they need treatment, CARE Court can’t help, which means that their case can be dismissed while the person continues to languish on the street.

That’s the problem Blakespear is attempting to tackle with Senate Bill 1016. It would allow anyone filing a CARE Court petition to request that a judge order a mental health assessment to determine if the subject of the petition is “gravely disabled” or a danger to themselves or others – if the subject can’t comply with voluntary treatment.  

Depending on the results of the assessment, a judge could order that person into a conservatorship, which would likely mean a stay in a locked psychiatric facility and mandatory medication. 

The idea is to create a formal bridge between voluntary treatment under CARE Court and involuntary treatment through a  conservatorship. 

Adding the specter of forced care will make people with mental illness less likely to accept help from CARE Court, Samuel Jain of Disability Rights California said during the committee hearing.

“SB 1016 adds an expensive, coercive and convoluted layer to CARE Court that will drive up costs and further erode the rights and trust of the Californians that our system is supposed to help,” he said. 

Family ‘frustrated’ by CARE Court

Jennifer Farrell, who filed a CARE Court petition in late 2024 for her brother in Alameda County, sees it differently. Farrell’s 59-year-old brother, who struggles with schizophrenia and meth use, had been homeless off and on since 2017. He was able to stay housed via CARE Court for a few months, but then he left his placement in September and disappeared into the streets.

It was clear he needed more help than CARE Court could provide, but the program had no way to elevate him to a higher level of care, Farrell said. 

“I was really frustrated at that point,” she told CalMatters.

Farrell’s brother spent three months deteriorating on the street before a case worker found him in December. He was hospitalized on a temporary psychiatric hold and eventually placed on a conservatorship. He’s still in a locked facility, where he’s medicated and seems to be doing much better, Farrell said. 

To Farrell, it’s “absurd” that there isn’t already a direct link between CARE Court and a conservatorship — a connection that she thinks could have saved her family some grief.

At CARE Court’s inception, Newsom said people who didn’t follow their CARE plans could be moved into a conservatorship. But Farrell and other families CalMatters spoke with said if their loved one couldn’t consent to treatment, there was no clear path forward.

Technically, CARE Court judges can order participants to follow mandatory “CARE plans” — something that happened just 32 times between late 2023 and January — but judges can’t force participants to comply.

Easier CARE Court petitions

Blakespear’s other bill, SB 989, addresses another CARE Court challenge: the low number of people participating. 

Filing a CARE Court petition is a complicated, time-consuming process. Whoever is filing the request needs the person’s medical records. Then, they need to appear at the first court hearing — something overworked first responders don’t always have time to do.

That’s a key reason that people who work in public safety, such as firefighters and EMTs, say they don’t file CARE Court petitions, said Meagan Subers of California Professional Firefighters, who spoke in support of the bill at the Senate Judiciary Committee hearing. 

SB 989 would create a framework for first responders to refer clients directly to their county behavioral health department, which could then file a CARE Court petition on their behalf. The county would have 30 days to decide whether to file.

Some counties already make an effort to train and support their first responders in filing CARE Court petitions. Stanislaus County allows first responders to refer CARE Court clients directly to the county.

But that collaboration isn’t happening in a systematic way across the state, Subers said. This bill could help fix a broken system where first responders are constantly cycling people with severe mental illnesses in and out of emergency rooms, she said.

“When our members have to run these calls repeatedly on individuals and take them to the hospital, knowing that they’re going to have to respond to that person again, my members tell me that they feel helpless,” she said. “We see this pathway as another option for them.”

Blakespear’s bills follow a similar effort last year by Sen. Tom Umberg of Santa Ana to make CARE Court more effective. His new law, which went into effect in January, expanded CARE Court to include people who experience psychosis as a result of bipolar disorder. The program initially was exclusively for people diagnosed with schizophrenia and other limited psychotic disorders.

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The governor’s proposed budget would cut one-time spending by $19.1 billion and ongoing spending by $13.7 billion through fiscal year 2025-2026, according to the fact sheet. It would enact a nearly 8% cut to state operations, eliminating 10,000 unfilled positions.

The sheet said the governor plans to balance the budget by “getting state spending under control — cutting costs, not proposing new taxes.” He also wants to do this by “reducing reliance on the state’s ‘Rainy Day’ reserves this year.”

The true deficit number may actually be closer to $45 billion, as the administration subtracted a $17.3 billion package of budget fixes Newsom, Assembly Speaker Robert Rivas, D-Hollister, and Senate President Pro Tem Mike McGuire, D-Healdsburg, agreed to in April.

The administration acknowledged it had cut the $17.3 billion from the overall shortfall number in a fact sheet released just before the governor’s press conference Friday.

It was immediately unclear how exactly the administration calculated the deficit, aside from subtracting the legislative agreement.

Newsom pegged the spending gap at $38 billion in January, although the independent Legislative Analyst’s Office later suggested it could be as high as $73 billion.

California’s fiscal year-over-year revenues were $5.8 billion or 4% below Department of Finance forecasts as of March, indicating the overall deficit likely grew.

Budget-watchers had predicted Newsom’s strategy in advance, suggesting he may present a rosier shortfall number by incorporating a handful of previously planned fixes.

The governor’s revised budget announcement kicks off a month of negotiations involving his administration, Assembly Speaker Robert Rivas, D-Hollister, and Senate President Pro Tem Mike McGuire, D-Healdsburg.

The Legislature must pass a budget by June 15 for lawmakers to continue getting paid. The new fiscal year begins on July 1, meaning Newsom has to sign budget legislation by the end of the month.

Just two years ago, the governor was celebrating a budget with a large surplus. This allowed him to invest in a series of bigger policy initiatives, including transitional kindergarten, or pre-kindergarten, Medi-Cal coverage for undocumented immigrants and CARE Court to compel treatment for the seriously mentally ill.

The state in January enacted the final piece of its expansion of Medi-Cal — California’s version of the federal Medicaid program — allowing all those who income-quality to enroll, regardless of immigration status.

But the post-COVID-19 pandemic economy hit California hard. That’s because the state is heavily dependent on its highest-income earners due to its graduated tax structure, the tourist industry was hit hard and supply chains were disrupted.

Federal efforts toeaseinflation by raising interest rates have cooled industries sensitive to rate hikes. This has affected some activities, such as home buying and startup and tech investing.

Also hamstringing the state’s efforts to gauge the government’s economic condition, those involved in crafting the state’s 2023-2024 budget were unable to get the most accurate picture of the state’s finances until November, long after lawmakers and the governor had agreed to a spending plan.

The delay was caused by a large number of Californians who could delay filing their 2023 taxes until November due to deferrals the IRS granted to those affected by winter storms. The situation helped complicate the state’s financial outlook heading into 2024.

Newsom in 2023 and in January committed to some cuts while preserving his major initiatives and social safety net programs.

The post Gavin Newsom releases $288 billion revised budget for California. How he tackled the big deficit appeared first on The Hemet & San Jacinto Chronicle.