What we know about California's new mental illness court program

• The program, which stands for Community Assistance, Recovery and Empowerment, seeks to provide a new framework to get people with mental health and substance use disorders care and to avoid outcomes like homelessness and incarceration.

Who qualifies

• CARE is not for everyone experiencing homelessness or mental illness, but rather for those with schizophrenia spectrum or other psychotic disorders who meet specific criteria, per the California Health and Human Services Agency.
• The process is intended to be the least restrictive alternative to help such individuals before they are committed to a state hospital or become impaired enough to end up in an involuntary conservatorship, according to the agency.
• To be eligible, a person must be 18 or older, currently experiencing a severe mental illness and have a diagnosis identified in the schizophrenia spectrum or other psychotic disorders class, among other criteria.
• Individuals exiting a short-term involuntary hospital hold or an arrest are considered good candidates for the program, per the governor's office.

How it works

• Once a petition for care is filed, there is an extensive process including court approvals, an investigation by the county and several hearings to ensure the subject of the petition meets the threshold to qualify for the program.
• If the respondent voluntarily agrees to receive services, or if there is insufficient evidence that the respondent meets the CARE criteria, the case is dismissed.
• Once the court approves a person's individualized treatment plan, the program begins and is to include status review hearings.
• If they refuse, they'll have access to a public defender and can opt out. But a CARE court judge could still refer them for a conservatorship in which another person is appointed to make decisions for them, in order to force compliance.
• Participants who accept the supervised plan will remain under the purview of CARE court until the case can be dismissed.

Zoom in: A person struggling with untreated mental illness and/or substance use is connected with a court-ordered care plan for up to two years.

• Each plan is managed by a care team and can include clinically prescribed interventions with support services, medication and a housing plan.
• It also includes a public defender to help make self-directed care decisions.
• Participants who don't successfully complete CarePlans may be hospitalized or referred to conservatorship.

Where it stands

• All counties across the state are to participate in the program and must roll it out before a December 2024 deadline.
• Seven counties, including San Diego and San Francisco, launched CARE court this week, and the results will inform the way remaining counties establish their own.

How it's funded

• Most participants will be Medi-Cal beneficiaries or eligible for Medi-Cal.
• For those who have commercial insurance, CARE requires that a health plan reimburse the county for eligible behavioral health care costs.
• There are also existing funding sources, per the state, including nearly $10 billion annually for behavioral health care.

Yes, but: Concerns remain about the level of resources needed to adequately run the program — and the possibility of civil liberties violations, which rights groups including the ACLU and Disability Rights California have raised, Axios' Shawna Chen reports.

Go deeper: San Francisco to roll out mental illness court