Humboldt Ranks Among Highest in State for CARE Court Referrals Despite Funding Gaps

Mayor Kim Bergel and CARE Director Jacob Rosen during an interview discussing homelessness services at City Hall in 2023. [Photo by Ryan Hutson]

Developed under state law, the Community Assistance, Recovery and Empowerment (CARE) Court program allows court-ordered mental health treatment.

Eureka is unique among cities for having a dedicated mental health clinician, Jacob Rosen, who gave an update on the CARE Court program at the Feb. 17 city council meeting.

Launched at the end of 2024, the two-year treatment program has seen its first graduate. There will be many more, as Humboldt has made 55 referrals, which Rosen described as “one of the highest referral volumes per capita among counties.”

Eight of the referrals were from Eureka, and Rosen said the city has been “very much involved” in several more.

The program’s expansion of eligibility adds “psychotic features” to its bipolar disorder category.

Another change is the streamlining of various processes, including felony diversion to CARE Court.

What hasn’t changed is its funding scenario.

Though created by state law, CARE Court is “still largely an unfunded mandate,” Rosen said, and though billing can be done in some circumstances “it’s not something that really covers the costs.”

Though the bulk of CARE Court’s treatment referrals are voluntary, involuntary treatment can be ordered by the court and it’s cost-intensive.

“That intensity usually requires a lot of staff time and a lot of that staff time ends up being unfunded,” Rosen said. “That is really difficult for behavioral health departments, which are already struggling and that does include ours.”

Handling of non-compliance also hasn’t changed. Rosen said a “lack of consequences” remains.

Cases are “basically dropped” if someone stops showing up for hearing dates, he continued, and “there are not necessarily any consequences or follow up baked into that.”

But conservatorship is an option.

“For Humboldt County, if a client is non-participatory in CARE Court, there is a serious evaluation at the behavioral health level around whether that individual does need conservatorship,” said Rosen. “And many of those cases have been referred to the public guardian for conservatorship when that happens.”

Asked about the impacts of the funding void, Rosen said it’s in staffing, as the county’s Behavioral Health division only has one clinician and one case manager for CARE Court.

“For the 55 folks who have been referred, having two staff members is not sufficient for the level of intensity that’s needed to treat the folks who are referred for CARE Court,” said Rosen.

He said a CARE Court hearing can have two outcomes.

Someone can choose to participate in the program voluntarily and enter a CARE Court Agreement to come to hearings and get treatment.

Another outcome is for a judge and Behavioral Health to assign an “involuntary treatment plan.” But unless it’s part of a diversion sentence, it lacks control.

“Again, we then run into the issue that unless it is a court-ordered diversion client where CARE Court is part of their diversion, there aren’t any consequences for non-compliance,” said Rosen. “And as a result, if someone still chooses not to follow through, we’re still not going to see the successes that we’re hoping for, because that person may not get any treatment at that point.”

The program might see more change, however, as the state has been meeting with courts and behavioral health departments, including in Humboldt County.

“The city of Eureka was a part of that meeting, and we’re all able to do some great advocacy with the state on what changes might be beneficial in how CARE Court is operating and implemented now but also what might make it work better,” Rosen said. “And then I would say a huge factor of success has just been the collaboration among the county Behavioral Health Department, the court systems and both the DA and the Public Defender’s Office as well as county counsel.”

Community groups and agencies are also part of the collaboration and Rosen said there’s been “a lot of participation in terms of getting folks connected with other resources,” including the city’s Uplift employment and housing program.