Napa County prepares to launch CARE Court for mentally ill

Napa County is preparing to launch by Dec. 1 a program championed by California Gov. Gavin Newsom to address severe, untreated mental illness, as mandated by state law.

The Community Assistance, Recovery and Empowerment (CARE) Act is coming to Napa. That means a civil court will be able to order people in certain cases to participate in treatment plans for up to a year, with the possibility of a second year.

"We are really targeting these hard-to-reach people with acute psychotic symptoms, and these are often clients who are experiencing homelessness within our community," said Cassandra Eslami, deputy director of the county Health and Human Services Agency.

But establishing a local CARE Court means Napa County must have the legal and treatment programs in place. On Tuesday, the Board of Supervisors heard an update on those preparations.

"Napa County will go live with the CARE Act prior to the required Dec. 1 date," Eslami said. "We are up and ready to go and really excited to launch soon."

Family, county and community-based social services, behavioral health providers and first responders can file a CARE Court petition. The person to be treated must be at least 18 years old, diagnosed with schizophrenia or another psychotic disorder, and in need of services to survive safely or avoid relapse.

Respondents can take part in the court proceedings and be represented by their own attorney or a court-appointed attorney.

If the court agrees a person qualifies for CARE services, the result might be a voluntary care agreement or a court-ordered plan. A plan is managed by a care team and might include stabilization medication and a housing plan.

Of course, people might simply refuse to comply. If they cannot care for themselves because of their condition, in extreme cases they can run the risk of being placed in a conservatorship or even a locked psychiatric facility. A state website says pre-CARE Act law allows for such outcomes.

The Napa CARE Court program has the county working with community groups to offer stabilization medications, behavioral health services and housing.

"As you know, these things don't come to life magically," Health and Human Services Agency director Jennifer Yasumoto told supervisors Tuesday. "We've been laying the foundation over time, preparing for the CARE Act."

Napa County and the city of Napa last spring approved loaning $1.5 million to Mentis, using grants and other funds. That allowed Mentis to buy three homes for six people receiving mental health treatment, with the CARE Court program the priority.

Mentis is a local nonprofit that provides mental health services.

Napa County's 2024-25 budget has $250,000 allocated to help with CARE Court start-up costs. Assistant County Executive Officer Becky Craig said it's unclear how much the program will cost as it unfolds.

One unknown is how many people will participate. County officials said counties that have already started the program are not seeing as many qualified petitions as anticipated, given the CARE Act applies to only certain types of mental illness.

Newsom has touted the CARE courts as a way to address the state's homelessness problem.

"With overwhelming support from the Legislature and stakeholders across California, CARE Court will now become a reality in our state, offering hope and a new path forward for thousands of struggling Californians and empowering their loved ones to help," Newsom said in 2022.

But the CARE Act has detractors. Disability Rights California said involuntary treatment is wrong and the courts will become a path toward institutionalization. The group and other groups unsuccessfully sued to try to block CARE Act implementation.

San Francisco, Los Angeles, Glenn, Riverside, Orange, Stanislaus and San Diego counties started CARE courts in 2023. The rest of the state's counties, including Napa, must do so by Dec. 1.

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