CARE Court plan rightly targets government’s responsibilities to homeless people

Originally published on Friday, August 19, 2022 in CalMatters.

By Darrell Steinberg

While the attention surrounding Gov. Gavin Newsom’s CARE Court proposal focuses on the decades-long debate over involuntary care, the more profound part of the legislation largely has been ignored. What’s dramatically different about CARE Court is its requirement that government actually help the people who are living in inhumane and unhealthy conditions on our streets.

The most important compelled action in CARE Court is the government’s obligation to provide the care, not the individual’s obligation to accept it.

In my quarter-century of state and local elective service, I have seen something more important than the usual complaints about government inefficiency and inaction at the core of our homeless problem. The law is not on the side of the people suffering, nor the neighborhoods and businesses demanding relief.

And the law matters.

In 1977, the California Legislature passed the Lanterman Act and provided a lifetime right to services for people with developmental disabilities.

Ten years earlier, the same Frank Lanterman passed a similar act for people living with serious mental illness. The Lanterman-Petris-Short Act looks similar to its successor a decade later, with one historic difference: The state did not grant a right to treatment for people with serious mental illnesses.

There is no right to mental health care, housing or shelter in California, nor any clear legal obligation for any level of government to provide it. Today’s results of the prior generation’s law and policy choices speak for themselves.

Despite successes along the way, unprecedented resources from Gov. Newsom and the Legislature, and heroic providers who have helped thousands navigate their way out of homelessness, the fundamental problem remains the same. The law describes no timetables, production requirements or even individualized
obligations to help. There is no requirement for cities and counties — very different systems with different historic roles and responsibilities — to work together to solve the problem.

The well-intentioned people who run the systems bring energy and skill to their public missions. But the systems are stubborn.

The systems have no real intention or organizational capacity to even try to address the volume of the problem or the conditions of those with the most severe mental illnesses or drug addictions.

Without some legal obligation by the government to act, the reality on our streets is the opposite of what the people demand. While some people get help, many thousands more will never see a mental health outreach worker or have access to shelter or housing.

The law requires free public education for all children, so we build public schools. The cause and effects are so deeply embedded in our expectations and norms that we fail to acknowledge the power of the law.

But wouldn’t mandating care bankrupt our communities? No. There’s already nearly $10 billion available annually for services through state and federal sources. Plus, the recently passed budget includes $1.5 billion for bridge housing and a combined $65 million to administer CARE Court.

Gov. Newsom’s proposal represents the potential for profound change. It’s worthy of strong support if, for no other reason, he seeks to turn the voluntary nature of the government’s obligation to serve the chronically homeless on its head. For the first time, a California court would have statutory authority to order counties to care for the people who need help the most and fine counties if they don’t meet their obligation to do it. The court order could include required housing and services for the individual.

The power of the governor’s idea is that it seeks to combine rights and responsibilities. Perhaps the debate over involuntary care would be seen differently if we focused even more attention on society’s legal obligations to care for people in the first place.

Darrell Steinberg is the mayor of Sacramento, former president of the state Senate, author of California’s Mental Health Services Act and founder of the Steinberg Institute.

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