Based on the new statewide law just signed by Governor Gavin Newsom, Santa Barbara County — like all 58 counties in the state — will have to create a brand-new court program capable of mandating treatment for people who are also psychotically mentally ill but either don’t know that they’re sick or refuse treatment.
According to the first presentation given to county supervisors by Behavioral Wellness Director Toni Navarro this Tuesday, the new court program — known as the CARE Court — could find itself with as many as 143 seriously mentally ill people under its rubric after year one. The deadline for Santa Barbara and all but eight counties is December 2024. Since the court program is of a two-year duration, Navarro estimated it could have as many as 200 people by the second year.
Navarro likened the program to an expanded version of Laura’s Law. When judges order someone seriously mentally ill to get treatment, she said, it tends to work, and they get treatment. The challenge is creating capacity within the mental-health care system to treat that many people with that degree of acuity.
Since the new law was initially designed to target people living on the street with serious mental illnesses, housing will be an essential component to such treatment, Navarro said. The question, as always in Santa Barbara, is what housing and where?
Ever since the governor first announced his support for the controversial CARE Court concept earlier this year — civil libertarians have contended it’s too coercive — Navarro expressed concern where the money to pay for it would come from. For the housing alone, the state has made it clear local governments would have to rely on the $14 billion distribution of one-time funds the state has already made.
Some of that money has already been spent locally to buy a couple of motels and convert those into housing. County Executive Officer Mona Miyasato wondered whether respondents of the new CARE Court will be able “to jump the line” to get into some of that new housing.
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The way the CARE Court works, family members, roommates, first responders, health-care professionals, and public guardians will be able to refer cases to the county’s Behavioral Wellness Department for review. Once a determination has been made that the respondent involved is indeed psychotically mentally ill and subject to the authority of the new court, they will be assigned a public defender so that their rights are protected. New public defenders will need to be hired.
Under no circumstances, Navarro stressed, would anyone be forced to submit to medications against their will. If treatment is ordered, it will be up to Behavioral Wellness to provide that treatment. For a department that’s already struggling with staff vacancies and recruiting challenges, that might be easier said than done.
Navarro estimated the total additional cost for the new program will be about $7 million a year. How much of these additional costs might be eligible for some compensation remains unclear. What appears certain is that a whole lot won’t be. What pot of funding, Navarro asked, would she have to raid to cover these additional costs?
“I have only so much I can share,” she said. “How do we balance it?”
Supervisor Bob Nelson asked about people who refused treatment. Navarro said about half the people who are psychotically mentally ill don’t know that they are. It’s not that they’re refusing treatment, per se; it’s that they think they aren’t sick. Nelson asked whether such individuals would be candidates for guardianships and the long-term institutional care guardianships can provide. Many psychotic people, Navarro cautioned, are sufficiently competent in caring for themselves that they don’t qualify for guardianships. Plus, the supervisors were told, the county spent $19 million on long-term care this past year for people placed on guardianship holds.