California CARE Court bill heads to Newsom

Madison Hirneisein, The Center Square

31 de agosto de 2022

A man stands next to tents on a sidewalk in San Francisco, Tuesday, April 21, 2020.Jeff Chiu / AP

(The Center Square) – California lawmakers gave the final stamp of approval Wednesday to a bill backed by Gov. Gavin Newsom that provides court-ordered treatment plans and supportive services for people on the schizophrenia spectrum or with psychotic disorders.

The bill, which establishes the Community Assistance, Recovery and Empowerment (CARE) Act, received broad bipartisan support in both chambers of the Legislature, passing in a 62-2 vote in the Assembly and unanimously in the Senate. The bill now heads to Newsom’s desk.

“Today’s passage of the CARE Act means hope for thousands of Californians suffering from severe forms of mental illness who too often languish on our streets without the treatment they desperately need and deserve,” Newsom said in a statement Wednesday.

Backed by cities across the state and strongly opposed by disability rights advocates and the American Civil Liberties Union, the bill would let a person petition for a court-ordered plan that could include behavioral health care, medication, and housing. The petition triggers hearings to develop a treatment plan.

Adults experiencing a severe mental illness like schizophrenia and are either “unlikely to survive safely” without supervision or have a condition that requires support to prevent deterioration could qualify for the program. The CARE plan could last for up to two years, providing services like medication and treatment.

Newsom and others have touted the measure as a way to break the cycle of homelessness and incarceration among people with severe mental problems.

The measure has faced strong opposition from groups within California and across the nation who fear it will result in coerced treatment that would take away a person’s right to make their own care decisions.

Eric Harris, the director of Public Policy with Disability Rights California, told The Center Square Wednesday that the organization still has major concerns about the bill and is “disappointed” in its passage on Wednesday. 

“Forced treatment and not providing guaranteed housing is not going to be beneficial to a lot of these people,” Harris said. “We believe that voluntary treatment options that are robust and guarantee accessible, affordable housing is going to bring out the best results and have people who want to engage in this type of process.”

Harris said the bill was constructed without input from a “large number of disability leaders,” noting that leaders at Disability Rights California “weren’t consulted at all.”

The bill received several amendments in its final days in the Legislature, including one that phases in implementation. The counties of Glenn, Orange, Riverside, San Diego, Stanislaus, Tuolumne and the city and county of San Francisco must implement the program by Oct. 1, 2023. The rest of the state has until Dec. 1, 2024.

Other amendments require funding from the Department of Health Care Services and substitute the director of county behavioral health as the petitioner if someone other than the director petitions the court.

As the bill wound its way through the Legislature, lawmakers raised concerns about how the program would be funded and whether counties would have the staffing to handle the program. In the end, the bill won praise from both Democratic and Republican lawmakers for its potential to curb addiction and homelessness.

“This measure, I believe, is the first truly bipartisan attempt to compassionately clear homeless encampments off our streets, sidewalks and highways, to assess the health behavior and needs of homeless individuals and to put together an actual plan to stop the downward spiral that many homeless individuals have so long been on,” Senator Brian Jones, R-Santee, said Wednesday. 

Two lawmakers voted against the measure – Assemblymember Ash Kalra and Mark Stone. In a statement sent to The Center Square, Kalra said he could not support the bill because the program has “missing pieces needed for an effective, sustainable solution.”

“While I echo the urgency to find a solution, if we do not couple permanent housing and wraparound services for our unhoused with severe mental illness, we are setting them up for failure,” Kalra said. 

Newsom has until Sept. 30 to sign the legislation.

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CA governor’s mental health care plan for homeless advances


31 de agosto de 2022

FILE – Tents line the streets of the Skid Row area of Los Angeles Friday, July 22, 2022. California Gov. Gavin Newsom’s proposal to steer homeless people with severe mental disorders into treatment was approved by the state Assembly on Tuesday, Aug. 30. (AP Photo/Damian Dovarganes, File)

SACRAMENTO, Calif. (AP) — California Gov. Gavin Newsom’s controversial proposal to steer homeless people with severe mental disorders into treatment cleared the state Assembly on Tuesday and is on its way to becoming law despite objections from civil liberties advocates who fear it will be used to force unhoused residents into care they don’t want.

Homeless people with severe mental health disorders often cycle among the streets, jail and hospitals, with no one entity responsible for their well-being. They can be held against their will at a psychiatric hospital for up to 72 hours. But once stabilized, a person who agrees to continue taking medication and follow up on services must be released.

The bill the state Assembly approved on Tuesday by a 60-2 vote would require counties to set up a special civil court to process petitions brought by family, first responders and others on behalf of an individual diagnosed with specified disorders, such as schizophrenia and other psychiatric disorders.

The court could order a plan lasting up to 12 months, and renewable for another 12 months. An individual facing a criminal charge could avoid punishment by completing a mental health treatment plan. A person who does not agree to a treatment plan could be compelled into it. Newsom has said he hopes these courts catch people before they fall into the criminal court system.

The bill represents a new approach for California to address homelessness, a crisis the state has struggled with for decades. The state government spends billions of dollars on the issue each year, only for the public to perceive little progress on the streets.

“I believe that this bill is an opportunity for us to write a new narrative,” said Assemblymember Mike Gipson, a Democrat who voted for the bill.

The bill has now passed both houses of the state Legislature and needs one more vote in the state Senate before it will go to Newsom’s desk. Newsom has until the end of September to sign it into law.

The proposal had broad support from lawmakers who said it was clear California had to do something about the mental health crisis visible along highways and in city streets. Supporters relayed harrowing tales of watching loved ones cycle in and out of temporary psychiatric holds, without a mechanism to stabilize them in a long-term treatment plan.

Republican Assemblymember Suzette Martinez Valladares said her cousin, a Vietnam War veteran, had been living on the streets in a homeless camp before his death.

“I wish that my family had the tools that this bill is going to bring forward so that he might still be alive and with us,” she said. “This is going to save lives. It’s about time.”

Critics of the legislation have maintained that the state lacks enough homes, treatment beds, outreach workers and therapists to care for those who want help, never mind people compelled to take it. They say that people who choose to accept treatment are much more likely to succeed than those coerced into it.

“At what point does compassion end and our desire to just get people off the streets and out of our public sight begins?” said Assemblymember Al Muratsuchi, a Democrat who said he reluctantly supported the bill on Tuesday. “I don’t think this is a great bill. But it seems to be the best idea that we have at this point to try to improve a godawful situation.”

The bill says Glenn, Orange, Riverside, San Diego, San Francisco, Stanislaus, and Tuolumne counties must establish courts by Oct. 1, 2023, with the remainder by Dec. 1, 2024.

Courts could fine counties up to $1,000 a day for non-compliance, which counties believe is unfair if they don’t have enough support from the state in the way of housing and behavioral health workers.

“There will be no perfect solution to this problem. But this is better than doing nothing and it is too easy in a democracy to kick a problem down the road and do nothing,” said Assemblymember Steve Bennett, a Democrat who voted for the bill.


Har reported from San Francisco.

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CARE Court: Can California counties make it work?

Jocelyn Wiener and Manuela Tobias, MindSite News

21 de julio de 2022

California Gov. Gavin Newsom tours a patient’s room at Project 180 in Los Angeles on March 10, 2022, the week after proposing a plan to force homeless people with severe mental health and addiction disorders into treatment. (AP Photo/Jae C. Hong)

In early March, Gov. Gavin Newsom unveiled a controversial proposal to compel people with serious mental health issues into care and housing. 

Mental health advocates, mayors and family members who stood alongside him at the press conference at a San Jose behavioral health treatment program heralded the plan, known as CARE Court, as a visionary move.

But some county officials say they were stunned.

“They really sprung it on everybody,” said Farah McDaid Ting, public affairs director at the California State Association of Counties, who said lawmakers didn’t consult or even give her organization a heads-up.

Four months later, the bill to establish CARE Court has sailed through all of its policy committees in the Legislature, secured unanimous approval from the Senate in May and is widely expected to become law later this summer. CARE Court — short for Community Assistance, Recovery and Empowerment Court — has garnered enthusiastic support from leaders of more than 45 cities, many of whom face fiery criticism over their handling of homelessness. Many family members, who for decades have felt stymied by strict eligibility rules for conservatorship, are also celebrating the new plan. 

But county representatives continue to ring alarm bells about their ability to implement the proposal, especially as an aggressive timeline comes into focus. A handful of counties have registered support for the proposal, including Marin, Contra Costa and San Diego.

Many of the counties’ concerns come in the form of questions: Will the necessary housing be available? Where can they find the outreach workers and therapists needed to serve the population, given massive statewide shortages of both? What happens to all the struggling people who want housing and treatment, and already can’t get it?

Disability rights advocates are raising fundamental questions about the very premise of CARE Court: Is it effective to compel people into care? Is involuntary treatment a violation of their civil rights?  

But many of those who support the concept say the practical questions feel especially pressing right now, as the Legislature continues its deliberations. While many details are still in flux, the gist of the proposal remains the same as initially outlined. Anyone from family members to first responders could petition a civil court to create a court-ordered care plan for people who meet specific criteria. These include a diagnosis of schizophrenia or other psychotic disorders, along with being at risk of harming themselves or others or being unlikely to survive on their own. Participants would receive legal counsel and a range of mental health services, medication and supportive housing. Following a series of check-ins during a yearlong period, the participant could either graduate or be referred to an additional year of treatment. If a person refuses to comply, or “fails out”, they could be considered by the court for conservatorship.  

Conversations about CARE Court have been peppered with frequent references to people living on California’s sidewalks and under freeway overpasses. But the administration hasn’t been clear about how much of a dent the proposal would make in the state’s massive homelessness crisis. Prior to the pandemic, more than 161,000 people in the state were estimated to be homeless on any given night; that number has likely grown since. The administration says the program will serve 7,000 to 12,000 people with the most acute mental health needs. Homelessness isn’t a prerequisite to participate. 

The administration says the proposal represents a crucial step toward addressing one of the state’s great moral and policy failings: the vast ranks of unhoused people languishing with serious mental illness and without care. 

“What CARE Court is saying is we must create a pathway wherein these individuals that live in the shadows and often die in the shadows, become a priority group,” said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, who has been championing the program on behalf of the Newsom administration.

CARE Court’s supporters say no more time can be wasted. Judge Stephen Manley, who started the state’s first mental health court in Santa Clara County nearly 25 years ago, notes the growing percentage of people in local jails and prisons with serious mental illnesses. Only by mandating that counties prioritize this population, he said, will anything change. 

“People are always telling me it can’t be done,” he said. “To me it is a tragedy that we repeatedly, year after year after year after year, talk about this issue, do nothing, and all these individuals end up in the criminal justice system.”

Is there enough housing or will there be?

Perhaps the most prominent question that has emerged among legislators and advocates is whether there is enough housing available to get the CARE Court program started. 

Short answer: No. 

But the state believes that bringing CARE Court participants to the front of the line, along with making unprecedented investments in housing this year, will allow counties to meet the needs of this population. Opponents fear others awaiting voluntary services will be bumped to the back of the line, leaving their needs to intensify.

“I worry if it houses some but leaves others out, are we just reshuffling things?” said Margot Kushel, director of the Benioff Homelessness and Housing Initiative at Zuckerberg San Francisco General Hospital and Trauma Center.

While the new budget deal includes $65 million this year and $49 million in ongoing annual funding to cover training, court costs and legal representation, counties say the proposal doesn’t include any new funding for housing or services.

Terry Fiscus, a counselor at Turning Point Community Programs, sits in his Sacramento office in on June 23, 2022. Photo: Nina Riggio for CalMatters

“There’s a new door being built onto a small house,” Ting said. “There’s no square footage, there’s no nothing, just a new door. That’s what’s kind of frustrating about the premise.”

The administration points skeptics to a $14 billion multi-year homelessness budget put together before the proposal’s announcement — which includes about $5 billion to build thousands of mental health treatment beds and homeless housing. This year’s budget includes $1.5 billion for interim treatment beds to hold patients over while permanent units come online. In response to counties’ concerns that even the bridge beds won’t be ready in time, the bill’s authors recently said counties would be phased into the program over two years, starting in July 2023. 

Sen. Susan Talamantes Eggman, the bill’s co-author and a Stockton Democrat, says she believes counties are unhappy with the proposal because it finally holds them to account. It requires that they provide the care and housing a participant needs and if they don’t, face court fines of $1,000 per day. The money, collected by the state treasury, would eventually fund local services for the people CARE Court targets.

“We’re not just saying the person has the obligation to accept, we’re saying the system has the obligation to treat,” Eggman said during a recent hearing.

“I worry if it houses some but leaves others out, are we just reshuffling things?”


Counties counter that these penalties will only take away from their already limited resources to treat people.

While the bill says a county has to provide services during the program, courts can’t enforce a participant’s post-graduation plans. Advocates worry that without guaranteed housing people will wind up back on the streets, in emergency rooms and county jails.

“We’re going to release them back into the streets but we expect them to continue to adhere to the care plan and continue to be taking medication,” said Shonique Williams, a statewide organizer for Dignity and Power Now, who opposes the proposal. “But they’re going back into survival mode.”

The state doesn’t keep any sort of waitlist or even a count of treatment beds and housing that’s available to people exiting homelessness. As a result, it’s impossible to gauge the exact shortage in each county.

But a state-commissioned report released in January found that more than 80% of counties need more mental health treatment beds and homeless housing. A 2021 study from the RAND Corporation, a nonprofit think tank,  showed the state lacks 5,000 psychiatric hospital beds and another 3,000 beds at residential treatment facilities and board-and-care homes. The shortage is most pronounced in the San Joaquin Valley and for patients with additional medical needs.

“There’s a new door being built onto a small house. There’s no square footage, there’s no nothing, just a new door. That’s what’s kind of frustrating about the premise.”


Michelle Doty Cabrera, executive director of the California Behavioral Health Directors Association, said one recent survey showed counties had 14,000 unhoused individuals with serious mental illnesses voluntarily participating in full service partnership programs. But they couldn’t find housing for more than half of these individuals, in part because many were screened out for reasons related to their mental health conditions, she said.

In Sacramento County, beds are increasingly rare at board-and-care facilities, where residents receive housing, 24-hour care and three daily meals. 

“It is a needle in a haystack right now,” said Terry Fiscus, a behavioral health worker at Turning Point, which contracts with the county.

The less calm and rule-abiding the patient, the less chance they have of getting or keeping a spot, he said. On top of that, facilities have been closing at a rapid clip as housing prices soar and government-set reimbursement rates remain stagnant. 

“There are a lot of people that want to come in all the time. We cannot take them,” said Jeanny Leung, who runs a board-and-care home in Sacramento.

Jeanny Leung, photographed outside of Praise Care Home in Sacramento on Thursday, June 23, 2022. Photo: Nina Riggio for CalMatters

“Squeezing blood from a turnip”

Housing isn’t the only big concern counties are raising. To run, CARE Court requires staff and resources. 

Some counties say they fear that, without new funding, the program will end up draining resources from other populations, potentially including children and youth. 

Cabrera, of the California Behavioral Health Directors Association, uses phrases like “squeezing blood from a turnip” and “robbing Peter to pay Paul.”

“​​We’re at our limit in terms of what we can do,” she said. “We need more resources to do more.”

The proposal’s proponents argue that there’s plenty of money to get things up and running. They say county mental health systems have had a huge influx of taxpayer dollars in the past two years, thanks to the Mental Health Services Act, a 1% tax on incomes over a million dollars that was enacted in 2004.

“Our millionaires in California seem to be doing very well for themselves,” said Karen Larsen, CEO of The Steinberg Institute, a nonprofit focusing on mental health policy, which supports the proposal. She notes that revenues from the tax have hit historic highs — they were at more than $4 billion this past year.

For two decades prior to assuming her current role, Larsen served as director of Yolo County’s Health and Human Services Agency. She believes counties can afford the costs of the new program.

“If they can prove they don’t have enough resources, I’d love to see it,” she said.

“Many of our people are only stable because we have someone coming twice a day to deliver their meds and check in with them and make sure their furniture is upright.”


Phebe Bell, Nevada County’s behavioral health director, said she was, indeed, able to tap the influx of Mental Health Services Act funding to purchase a new house, providing beds for six people who were unhoused. But strict rules often limit what that pot of money can be used for, she said. 

If the county has to pivot to focus on CARE Court mandates, she worries about who won’t be served.

“Many of our people are only stable because we have someone coming twice a day to deliver their meds and check in with them and make sure their furniture is upright,” she said.

When her county examined their full service partnership program, they found more than a third of the 78 people in their program at any given moment were inadequately housed, with many sleeping on the streets. 

“I don’t have a single empty bed in our system of care,” she said. “Who exactly are we incorrectly prioritizing in our work right now?”

Both sides agree on one specific challenge: a massive shortage of mental health providers. 

At the beginning of the pandemic, many counties worried they’d face significant shortfalls and preemptively laid off mental health workers. 

Now, as need surges, staffing has simply not kept pace. Counties are finding themselves losing bidding wars for therapists being courted by everyone from school districts to telehealth start-ups to major providers like Kaiser. Burnout is driving others from the field entirely.

Some counties now face vacancy rates of 30% to 40% in their behavioral health workforce, and many of the nonprofits they contract with are in the same situation, Larsen said.

“I think it’s the biggest issue we face in mental health and substance use right now,” she said.

This year’s budget includes $1.5 billion to build out the state’s entire healthcare workforce, including hundreds of millions that target behavioral health.

The state’s public guardians and conservators have also eyed the CARE Court proposal warily. While they are not officially affected by the proposal, they say they expect the program could lead to a surge in new referrals. 

The programs are already severely underfunded and understaffed, said Scarlet Hughes, executive director of the California State Association of Public Administrators, Public Guardians, and Public Conservators. Right now, caseloads hover at 65 to 85 individuals per caseworker, though in some counties they’re as high as 135. That translates into visiting a client every three or four months, she said.

“Any impact to our members is going to be significant because they’re underwater already,” she said.

What’s next?

Questions over implementation, in addition to the ongoing debate over civil liberties, have been woven through CARE Court’s journey from the start. That hasn’t stopped the Legislature from voting overwhelmingly in the bill’s favor. It is expected to easily clear its final hurdles: an appropriations vote later this summer, a floor-wide vote in the Assembly and a signature from the author, the governor himself.

But despite their ongoing questions, counties have conceded that CARE Court is coming whether they like it or not. They know they’re not likely getting any more money for housing and staffing. For now, they’re using the appropriations process to petition for more time and tools to implement the program. 

The administration acknowledges that counties around the state face severe shortages. But it remains committed to the idea of a better way to serve the people who are struggling the most.

“California has done this before,” Ghaly said. “We’ve stepped up for the most vulnerable, the most overlooked many, many times. And we can do it again.”

This story was produced by MindSite News, an independent, nonprofit journalism site focused on mental health.

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Nueva ley espera evitar que centros de rehabilitación engañen

Columna: El proyecto de ley del senador estatal Pat Bates, que fue firmado por el gobernador Gavin Newsom, tiene como objetivo salvar vidas

Teri Sforza (, Orange County Register, Excélsior California

24 de agosto de 2022

Rose and Allen Nelson hold an urn of their son Brandon’s ashes at their Santa Monica home on Sunday, October 21, 2018. Brandon died last March at age 26 after hanging himself in an unlicensed Sovereign Health home. Rose wears Brandon’s crosses. (Photo by Mindy Schauer, Orange County Register/SCNG)

“¡Supervisado médicamente!” prometen tantos centros de tratamiento de adicciones, a pesar de que son explícitamente “no médicos”.

Matthew Maniace murió en un centro de desintoxicación de Lake Arrowhead que decía que estaba “supervisado clínicamente” y ofrecía “supervisión médica las 24 horas”. Lo mismo hicieron Terri Darling y James Dugas. En un delirio paranoico, Henry Richard Lehr salió de un centro de desintoxicación de Newport Beach que brindaba “servicios médicos incidentales” y entró en una casa cercana, donde el aterrorizado residente lo mató a tiros.

Es fácil confundir los centros de tratamiento de adicciones y salud mental con instalaciones médicas reales en California. Pero no cuentan con personal médico las 24 horas del día, los 7 días de la semana (y no se les permite). Por lo general, están ubicados en casas de barrios residenciales, y el requisito médico más estricto, puede ser la presencia de tiempo completo de alguien que sepa primeros auxilios.

Ahora el Proyecto de Ley del Senado 1665 del Senador Pat Bates, R-Laguna Niguel, es un intento de desenredar la lógica enredada de las instalaciones no médicas que se jactan de sus servicios médicos, exageran las credenciales del personal o prometen servicios de nivel de medicamentos recetados cuando nadie el personal tiene licencia para recetar medicamentos. Fue promulgada como ley por el gobernador Gavin Newsom el lunes 22 de agosto.


Refina la Ley de Brandon, el proyecto de ley de Bates firmado por Newsom el año pasado, que prohíbe que los proveedores de tratamiento de adicciones y de salud mental, tergiversen o hagan afirmaciones descaradamente falsas sobre los servicios que ofrecen o dónde están ubicados. Esa fue una victoria largamente luchada por la familia de Bates y Nelson, y su significado parecía muy claro.

Pero algunos operadores han tratado de eludirlo usando sofismas, dijo Bates.

La nueva ley, que prohíbe expresamente que los programas de drogas o alcohol hagan declaraciones falsas o engañosas sobre los tratamientos médicos o los servicios ofrecidos.

“Estamos encantados de que el gobernador lo haya firmado”, dijo Bates. Pero tal vez no tan emocionado de que cada eructo y gorgoteo de lo que parece obvio y ético, deba explicarse explícitamente.

La intención de Bates siempre ha sido clara y simple: no quiere que las personas en crisis por adicciones y problemas de salud mental sean engañadas. Ella no quiere que se engañen sobre el tipo de ayuda que recibirán. Ella no quiere que los operadores exageren o mientan para enganchar a un cliente. Puede ser una cuestión de vida o muerte.


Brandon Nelson había sufrido un brote psicótico debilitante y se le prometió la mejor atención en el ahora desaparecido Sovereign Health: sería monitoreado de cerca por un terapeuta autorizado y un psiquiatra, y recibiría terapia grupal y de otro tipo, les dijeron a sus padres. .

Pero Nelson terminó en un “centro de salud mental en el hogar para sobrios” sin licencia administrado por Sovereign, no recibió a tiempo los medicamentos recetados por el hospital que necesitaba, lo dejaron desatendido y usó sus pantalones de chándal para ahorcarse bajo el sistema de rociadores. Tenía 26 años cuando murió en 2018.

Este reportero, que ha pasado los últimos cinco años haciendo una crónica de las trágicas fallas en el sistema de tratamiento de adicciones de pago privado e impulsado por el dinero del seguro de California, pensó ingenuamente que la Ley Brandon impediría que las instalaciones no médicas afirmaran que brindan supervisión médica. Pero no.

Hay cientos de centros de tratamiento de adicciones y de salud mental oficialmente no médicos con licencia para proporcionar “servicios médicos incidentales” por parte del Departamento de Servicios de Atención Médica de California. No se les permite brindar atención médica primaria, pero pueden obtener historias clínicas, monitorear la salud de los pacientes para determinar si se necesita atención de emergencia, supervisar los medicamentos autoadministrados de los pacientes.

Estas instalaciones de IMS generalmente tienen una relación contractual con un médico, quien revisará la documentación del paciente dentro de las 72 horas posteriores a la admisión.

Por supuesto, los primeros días de desintoxicación son los más peligrosos. Lehr, Maniace y Darling estaban muertos antes de que hubieran pasado 72 horas.

Aún así, el DHCS dijo que estas instalaciones no médicas no infringieron la Ley de Brandon al afirmar que ofrecen supervisión médica.

“Las familias deben estar seguras de que sus seres queridos reciben la atención adecuada cuando comienzan su viaje hacia la recuperación”, dijo Bates en un comunicado. “Ahora que la SB 1165 es ley, espero que más personas se sientan lo suficientemente seguras como para entrar en tratamiento y superar su adicción”.

NOTA EN INGLÉS: Rehab Riviera: New law hopes to keep rehabs from misleading patients, families

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Don’t look to California for ideas on homelessness

Wayne Winegarden and Kerry Jackson, LA Downtown News Contributing Writers

22 de agosto de 2022

No matter how bad the homelessness problem looks in other metropolitan areas, they pale compared to California’s. While the state accounts for not quite 12% of the U.S. population, roughly 28% of the nation’s homeless are in California. The lesson: Don’t copy the Golden State’s policies for mitigating homelessness — they simply don’t work.

California’s homeless population was not quite 139,000 in 2007. Within seven years, it had fallen to about 114,000. From there, it grew sharply to more than 161,000 in 2020. Over the same period, the total homeless in the rest of the states fell from a little more than 508,000 to 419,000.

This happened even though California’s economy expanded about 50% faster than the rest of the country from 2014 to 2020.

Clearly California does not have the answers.

In April 2020, as the coronavirus pandemic struck, Project Roomkey was introduced in California. The program’s mission was to house the homeless in hotel and motel rooms, as well as trailers, to help flatten the curve of viral infections and “preserve hospital capacity,” the governor’s office said.

From Project Roomkey grew Project Homekey, which directed state and federal funds for the purchase and renovation of hotels and motels, which would then become permanent housing for the homeless.

While well intentioned, both programs have a structural flaw: They follow the failed “housing first” approach.

Yes, the homeless need homes. But housing first, which has been the official state policy since 2016, is better described as housing and nothing else.

According to a Cicero Institute study, attempts to alleviate homelessness based on housing first appear “to attract more people from outside the homeless system, or keep them in the homelessness system, because they are drawn to the promise of a permanent and usually rent-free room.” Housing first is nothing more than a husk of a program because it doesn’t treat the root causes of homelessness, which for many are addiction or mental illness, and often both.

Despite the shortcomings of housing first, California’s commitment to Project Homekey has racked up billions in expenditures of federal and state dollars without having much if anything to show for all the spending.

In Los Angeles, where a third of the state’s 161,548 homeless are located, Project Homekey has not met expectations. The 15,000 rooms that were set as the goal were never provided, while the excessive costs of Homekey have made it unsustainable.

A different set of problems has beset homeless housing in San Francisco. An investigation by the Chronicle found that the city’s effort to shelter the homeless operate “with little oversight or support,” which has led to “disastrous” results. Rodents infest rooms; crime and violence is common; and death, often from overdoses, is a frequent visitor.

Nevertheless, the city, as well as other Bay Area communities where Project Homekey has shown itself to be insufficient, remains dedicated to the program and its poorly aimed spending.

Here’s some advice for lawmakers across the country looking to beat homelessness: Don’t ignore effective innovations from the private sector that are changing people’s lives. Treating the addictions and mental health struggles that are at the core of the problem must be a priority.

California continues to insist its way is the only way. Until that changes, the state has nothing to offer other states in their struggle to reduce homelessness.

Dr. Wayne Winegarden and Kerry Jackson are co-authors of the new Pacific Research Institute brief “Project Homekey Provides No Way Home for California’s Homeless.” Download a copy at

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