Members of Gov. Gavin Newsom’s administration met with Fresno County health and community leaders on Thursday to discuss a new plan to treat individuals with the most severe mental illnesses, many of whom also experience homelessness.

Announced earlier this month, the Community Assistance, Recovery, and Empowerment, or CARE Court, is a new framework designed to provide necessary care to people with mental health and substance use disorders, as well as a path to recovery.

Thursday’s roundtable in Fresno was the second of a series of statewide meetings that the governor’s office is organizing to solicit feedback and address questions about the initiative, which will be administered at the county level. The first roundtable was held in Los Angeles.

Each of California’s 58 counties would set up CARE Court programs under their civil court systems.

Fresno-area representatives that participated in the roundtable included Susan Holt, interim director of behavior health at Fresno County, Fresno Police Chief Paco Balderrama, Chris Roup, executive director of the Fresno chapter of National Alliance for Mental Illness, and Truvette Hollinquest, an associate professional clinical counselor with the Fresno County Urgent Care Wellness Center.

“We see the most severe people come through our doors over and over and over again,” said Hollinquest addressing Dr. Mark Ghaly, secretary of the California health and human services agency, and Jason Elliott, senior counselor to the governor for housing and homelessness.

But not all got to voice their questions and concerns. A handful of homeless advocates criticized the structure of the event, saying that they wanted to be able to listen in to the conversation to hear what decisions were being discussed.

The new CARES Court model is designed to connect individuals experiencing the most severe mental health illnesses, such as schizophrenia and other disorders, with a civil court-appointed treatment plan so that they can be stable, healthy, and housed.

Ghaly said that this new “upstream” approach is meant to treat individuals “before they cycle in and out of facilities dozens and dozens of times with no answer” or treatment plan.

Oftentimes, these individuals end up experiencing homelessness or jail time due to untreated mental health and substance abuse disorders.

The CARES Court approach would be initiated for individuals with untreated schizophrenia or other disorders by referrals from a family member, behavioral health provider, first-responder, or other approved party.

Then after receiving a clinical evaluation, individuals would be placed under a 12-month Care Plan developed by county behavioral health, the participant, and supporter. The Care Plan would include behavioral health treatment, stabilization medication, and a housing plan for the individual and could be extended another year, as needed. State leaders say one area of confusion is how the targeted population would be housed.

Elliot said that the state is “in the business of getting people out of tents” and into whatever housing is best suited for their needs, whether that be permanent supportive housing or clinical housing from local-level partners, or a relative’s house, such as with a parent, grandparent, or spouse.

“Our approach will always be housing first,” said Elliot.

Balderrama expressed support of the model, saying that “for far too long, I think the burden has fallen on law enforcement” to respond to issues like substance abuse, mental health, and homelessness. “What they need is care. They need help,” he said.

The CARE Court model builds upon Newsom’s $14 billion multi-year investment to provide 55,000 new housing units and treatment slots and nearly $10 billion annually in community behavioral health services, according to a news release on the new initiative. The plan, which is still in the feedback gathering stage, will require legislative approval.

Roup, with NAMI Freso, said that it was really “encouraging” to see the collaboration and commitment from the Newsom administration to improve the lives of the mentally ill.

Still, she acknowledged that big changes such as the suggested CARE Court model can create “fear” and “concern” among the population being served. Still, she said she was “grateful” that although the proposed model still involves the justice system, it also includes finding resources and solutions for people in crisis “where the system has possibly failed them.”

Homeless advocates gathered outside of the roundtable location also had questions about the proposed model and said that homeless voices needed to be included in the conversation.

“I’m really disappointed ...that they don’t include us grassroots advocates or even the unhoused community that they want to spend this money on,” said Dez Martinez, head of the newly formed Fresno Homeless Union. “You need people with lived experience” to be part of the conversation.

Martinez said there has to be a plan for continued, long-term care to serve the unhoused, but that plan shouldn’t be “forcing” somebody to accept treatment.

A spokesperson with the governor’s office said that two participants with lived experiences did share their experiences with mental illness during Thursday’s roundtable, but declined to participate in the press event.

Organizations and individuals are invited to provide written feedback on the CARE Court model. Initial, written feedback can be sent to CARECourt@chhs.ca.gov and is requested by March 25 and is welcome on an ongoing basis.

Melissa Montalvo is a reporter with The Fresno Bee and a Report for America corps member. This article is part of The California Divide, a collaboration among newsrooms examining income inequity and economic survival in California.