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CARE Act goes into effect in San Francisco. What's next?

San Francisco City Hall
Flickr / Creative Commons
San Francisco City Hall

The Community Assistance Recovery and Empowerment, or CARE Act has sparked a lot of debate in San Francisco. Critics have likened it to conservatorships, or when a court takes away one's right to make decisions about their own health, finances and personal needs.

It’s also been compared to San Francisco’s Assistance Outpatient Treatment program, which is supposed to make it easier for clinicians to provide services to people with mental illness. So what’s different about the CARE Act?

The CARE Act, or CARE court as some are calling it, has created a legal route for people who are not mental health clinicians – first responders, family members and even roommates – to impel individuals living with schizophrenia and other similar mental illnesses to receive treatment.

The process is supposed to take a minimum of four-and-a-half months. If everything goes the way it’s supposed to, the court can “order treatment” for the person suffering from mental illness. However, if the person refuses treatment, there aren’t supposed to be any legal consequences.

KALW spoke to Melanie Kushnir. She’s a licensed clinical social worker and the Director of Collaborative Justice Programs for the Superior Court. The CARE court falls under her purview.

“This is not written to force treatment. It will order it. There are no negative repercussions if the person refuses it,” Melanie says.  

Unless the Judge or the Department of Public Health notices that the person is getting sicker and/or posing a danger to themselves or others.

“With the exception of if the judge notices the person getting sicker and sicker and sicker over the course of a year, the judge can request that the client then be reviewed for conservatorship process, however, the Department of Public Health may see that way before the year and way before the judge notices it.”

So, while the CARE act isn’t a direct path to conservatorship, it may lead to it.

At a hearing last week Supervisor Hillary Ronen pointed out that programs like this already exist in San Francisco.

“I just wrote notes to myself and thought to myself: Is this going to make any real difference because we already have AOT, mental health SF, housing conservatorship, drug court, mental health court, at least six outreach teams. We don't have enough beds for anyone–” Supervisor Ronen said.

There are an estimated one-to-two thousand people in San Francisco who may qualify for the program. On Monday, exactly one petition was filed at the San Francisco CARE Court.

Wren Farrell (he/him) is a writer, producer and journalist living in San Francisco.