On behalf of the Tulare County Board of Supervisors, I write to reiterate our concerns regarding Senate Bill 1338 (SB 1338), despite recently adopted amendments. While the amendments are agreeable and welcomed, they are simply not enough to ensure that the paradigm shift suggested by CARE Court will be successful.
We appreciate the tiered implementation schedule, the slight narrowing of respondent eligibility, the inclusion of legal service projects as potential legal representation, and the ability to transfer CARE Court proceedings to the respondent's county of residence. However, there remains glaring administrative and financial issues with the bill that prevent us from joining in support of the measure. The following issues must be addressed in order to ensure CARE Court is effective and successful in moving our state beyond the status quo:
- Funding: The CARE Court program includes new responsibilities and obligations imposed on counties that require additional resources. Adequate and sustainable funding will be needed across multiple departments, including county behavioral health, public defender, county counsel, public guardians and conservators, and county social services. However, to date, no new county funding has been proposed for the significant expansion of county behavioral health services contemplated under CARE Court. CARE Court will not succeed without new, earmarked funding for this significant expansion of county behavioral health's responsibilities. We respectfully request that any county behavioral health services not covered under Medi-Cal or private insurance be fully funded to ensure CARE Court does not divert county behavioral health funding and services from children and youth in the midst of the children's mental health crisis.
- Sanctions: The proposal to impose sanctions and even receivership on counties for any instance of alleged "noncompliance" with CARE requirements raises significant concerns.
- Any proposal which does not provide additional funding for expanded county behavioral health responsibilities for CARE Court participation and activities should not include any threat of sanctions. Medi-Cal already has broad sanction authority to hold county behavioral health plans accountable for entitlement services.
- If county behavioral health is funded for implementation, sanctions should be reserved for deliberate and chronic deficiencies and should be imposed only after meaningful engagement with the responsible state agencies and existing procedural safeguards.
- Housing: Ensuring housing is included in CARE Court is foundational for addressing homelessness and a critical component in the successful treatment of those with severe mental illness. We are appreciative of recent amendments which strengthen the court's ability to leverage the billions in new housing resources already invested by the state via CARE Court. Without the real opportunity for clients to access available housing options through CARE Courts, very little will change through this court process for our clients experiencing homelessness and housing instability. Furthermore, the Public Defender asserts that existing programs in Tulare County, such as AOT, Mental Health Diversion and Mental Health Court, lack sufficient resources to house clients in a timely manner. Without sufficient additional housing to meet the needs of the CARE Court, it is likely that it will encounter the same obstacles as these already existing programs.
Thank you for your consideration of the above outlined concerns. Counties recognize the vital role we play in offering a unique set of safety net services for those individuals with the most acute psychiatric conditions and believe that these amendments are essential to ensuring the success of CARE Courts.
Sincerely,
Eddie Valero
Chair, Tulare County Board of Supervisors
cc: Tulare County State Delegation, Shaw Yoder Antwih Schmelzer & Lange