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Newsom Proposes Forcing Some Homeless People Into Treatment



Gov. Gavin Newsom proposed forcing some homeless people into treatment, sparking immediate controversy. (GV Wire/Johnny Soto)
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SACRAMENTO — California’s governor proposed a plan Thursday to offer more services to homeless people with severe mental health and addiction disorders even if that means forcing some into care, a move that many advocates of homeless people oppose as a violation of civil rights.

“There’s no compassion with people with their clothes off defecating and urinating in the middle of the streets, screaming and talking to themselves.” — Gov. Gavin Newsom

The proposal by Gov. Gavin Newsom, a Democrat, would require all counties to set up a mental health branch in civil court and provide comprehensive and community-based treatment to those suffering from debilitating psychosis.

People would be obligated to accept the care or risk criminal charges, if those are pending, and if not, they would be subject to being held in psychiatric programs involuntarily or lengthier conservatorships in which the court appoints a person to make health decisions for someone who cannot.

“One of the most heartbreaking, heart-wrenching and yet curable challenges that we face … is how do we serve the needs of individuals who are the sickest of the sick?” said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, at a news briefing in advance of a press conference by Newsom.

‘Care Court’ Would Affect 7,000 to 12,000 People

He said he expects the program called “Care Court” to apply to 7,000 to 12,000 people in California, although not all have to be homeless. Family members and outreach workers could recommend a person for a court-mandated program, which the governor’s office plans to boost with more money for psychologists, treatment beds, and services. It would require legislative approval.

“The money is there. The investment is there. The beds are coming, the units are coming online,” said Jason Elliott, senior counselor to Newsom.

Newsom has made homelessness and housing a focus of his administration. Last year, the Legislature approved $12 billion for new housing and treatment beds for the homeless, and this year Newsom has proposed an additional $2 billion, primarily to shelter people suffering from psychosis and behavioral health disorders.

Newsom said at a press conference that he has no intention of rounding people up and locking them away. Instead, he said his plan would offer a way for people to get court-ordered psychiatric treatment, medication, and housing, preferably before they are arrested.

Cost of Proposed Program Isn’t Clear

It was not immediately clear how much the program might cost, although Newsom has proposed in his budget this year more money for mental health services. He has called distressing behavior on the streets heartbreaking and maddening and says residents are right to complain that government is not doing enough.

People with addiction issues or mental health disorders such as schizophrenia often pinball among various public agencies, namely hospitals, court and jail. There is no one place that manages the person’s health, offering steady and safe housing combined with resource-intensive care, and California, like the rest of the country, suffers from a shortage of treatment beds.

Currently, Laura’s Law in California allows for court-ordered outpatient treatment in certain conditions, but officials said it’s only been used for about 200 people in a state of nearly 40 million.

San Francisco Supervisor Rafael Mandelman, whose district includes the Castro neighborhood, is grateful the governor is trying something, but says there needs to be a major change in both the coordination of resources and a change in the way judges think.

“We lack both the resources for this population and the laws to compel them into treatment,” he said Thursday.

In San Francisco, a state law designed to get more people into conservatorships has resulted in just two people being forced into care, he said.

Some advocates for homeless people have objected to forced care, but Newsom told the San Francisco Chronicle it is past time to talk about civil rights when people who are clearly in distress are ranting in streets and frightening or even attacking others.

“There’s no compassion with people with their clothes off defecating and urinating in the middle of the streets, screaming and talking to themselves,” said Newsom, a former mayor of San Francisco.

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