Bold statement: California’s treatment of mentally ill residents isn’t just a policy issue—it’s a test of leadership, accountability, and the real lives behind the numbers. And this is where it gets controversial: the governor’s push to reshape CARE Court has sparked heated debate about who gets help, how quickly, and at what cost.
Gov. Gavin Newsom recently signaled that funding could be redirected from counties that are perceived as lagging in implementing CARE Court, a program he launched in 2023 to compel treatment for people with severe mental illness who fall through the cracks. He explicitly named Los Angeles, Orange, San Francisco, Santa Clara, San Bernardino, Kern, Riverside, Yolo, Monterey, and Fresno as underperformers in his view.
During a news conference, Newsom vowed: “I’m happy to redirect every damn penny in these programs to the counties that are getting things done, period, full stop.” He urged counties not to offer excuses and to accelerate action.
Orange County pushed back, insisting it is fully utilizing the CARE intervention. The county’s Health Care Agency stated that it is actively implementing CARE Court’s measures.
CARE Court began in eight counties at the end of 2023 and expanded statewide by December 2024. The aim is to help Californians who are gravely ill and facing homelessness or failure to engage in treatment by using court processes to secure treatment. Yet a CalMatters investigation indicates the program has served far fewer people than initially projected, and many families have faced disappointment as they’ve awaited outcomes for loved ones. Challenges include moving participants from streets into housing and treatment.
By January, the state had received 3,817 petitions from families, responders, or providers seeking CARE Court involvement. Judges approved 893 treatment agreements, and orders were issued for 32 individuals into CARE plans when voluntary arrangements were not possible.
Newsom’s team had originally projected that between 7,000 and 12,000 Californians would qualify for CARE Court. More than 4,000 people were redirected to alternative services rather than CARE Court.
The governor highlighted counties he views as successful in deploying CARE Court to connect people with care: Alameda, Humboldt, Santa Barbara, Tuolumne, Marin, Napa, Merced, Sutter, San Mateo, and Imperial. He spoke from Regis Village in Alameda, a mental health campus that includes 44 beds for CARE Court participants.
“This proves it can be done when leadership cares enough to get it done,” Newsom asserted.
To measure progress, the administration introduced a per-capita metric that labeled the top ten counties as “CARE champions” and the bottom ten as “CARE ICU.” The public accountability site was updated to display this metric for each county.
However, critics note that the per-capita petition rate doesn’t capture other crucial metrics, such as the number of CARE agreements reached, petitions dismissed without treatment, or how many participants graduate from CARE Court. For example, San Diego County did not appear on the “CARE champions” list despite leading the state in graduations (ten by last summer); Riverside, a close second with seven graduations, landed on Newsom’s “CARE ICU.”
Newsom promised extra state assistance through the CARE Improvement and Coordination Unit for counties in the ICU group, though specifics were not disclosed. He also mentioned ongoing collaboration with communities to offer technical support and training.
San Francisco expressed receptiveness to more state support to strengthen its CARE Court program, emphasizing ongoing efforts to curb street crisis through outreach and expanded treatment resources.
Orange County reported 231 CARE Court petitions and 79 participants who have agreed to treatment and are receiving housing, medication, and other services. The county’s Health Care Agency stressed that outcomes matter more than raw petition counts, noting that addressing untreated disease through meaningful services is the real goal.
In terms of funding, Newsom did not specify which programs might lose support but indicated that new money would target initiatives that bolster CARE Court participants. He cited $131.8 million in Homekey+ funds—driven by Proposition 1—to create 443 homes for individuals needing substance use and mental health services. Additionally, $159 million in Homeless Housing, Assistance and Prevention dollars were earmarked as part of a broader $1 billion package in the 2024–25 budget.
Alameda County Judge Sandra Bean, who oversees the local CARE Court program, joined Newsom to share success stories, including a case of a woman with developmental disability, substance use disorder, and severe mental illness who now has her own apartment and stable treatment.
The state’s stance remains clear: some counties are delivering results, demonstrating that CARE Court can work with committed leadership and targeted support, while others are urged to accelerate reforms and prove similar results.
What do you think: should funding be redirected to counties showing faster progress, or should the emphasis be on uniform statewide expansion with stronger guardrails and timelines? Share your view in the comments.
