Gloria is the mayor of San Diego and chair of the California Big City Mayors coalition. He lives in Little Italy.
James Mark Rippee was referred to as “California’s most famous homeless man” in the Los Angeles Times after dying on the streets last fall of sepsis and pneumonia. To Rippee’s family, the real cause of his death was mental illness — and the failure of our broken behavioral health system to help severely ill people like him.
Rippee, who was diagnosed with schizophrenia after a motorcycle accident that caused a traumatic brain injury and left him blind, lived outside an office building for the Solano County government — the very entity that many believe should have been involved in helping him get care. He was well-known to law enforcement, having been arrested dozens of times, and cycled through jails and hospitals before being released to the streets. Rippee’s family tried everything it could to get him the treatment he needed but was unable to get him care.
Far too many families in California can relate to the Rippees’ story. Most of us have had a family member or friend who has struggled with mental health or addiction issues and seen the strain it can put on loved ones trying to navigate our byzantine mental health system.
The CARE Act will help. I championed this bill’s age with the governor and California’s Big City Mayors for one simple reason: We must make governments able for helping people like Brian.
The CARE Court program, which will be piloted in San Diego starting Monday, Oct. 2, finally inserts the ability that our behavioral health system needs. It makes counties responsible for ensuring people with schizophrenia and other psychotic disorders get treatment when they want it.
Counties receive billions of dollars each year in behavioral health funding, yet it’s cities that end up dealing with the impacts when the system fails and people are picked up through 911 calls by either police or paramedics. In 2022, City of San Diego first responders responded to over 53,000 behavioral health calls, spending over 130,000 service hours — the equivalent of 36 workers’ entire 10-hour shifts every single day.
Under the CARE Act, if someone voluntarily opts into a CARE Plan for services, the county can be fined $1,000 a day if it fails fail to provide those services.
The CARE Act also gives cities a role in behavioral health by giving them the authority to refer people into CARE Court for treatment. With implementation of the CARE Act, San Diego’s first responders and homeless service workers will be able to refer the high-use clients into CARE Court instead, taking these individuals out of the inhumane and costly cycle between hospitals, jails and the streets.
The CARE Act alone will not solve homelessness or our behavioral health crisis, but it will chip away at the larger problem of a lack of ability for aiding the most vulnerable among us.
When Laura’s Law, another tool to get more people mental health treatment, was ed decades ago, it was optional. Few counties opted in, and those that did served very few people. Sen. Scott Weiner, D-San Francisco, ed bills for the state’s biggest cities to pilot a homelessness conservatorship program that provided housing with wraparound services. Counties refused to use it and claimed they lacked the data to refer people into the program.
Now with CARE Court being implemented, some county officials across California are downplaying expectations, hinting at a potential reluctance to use the program. We cannot let the resistance to change continue to put vulnerable lives at risk. Law enforcement and emergency rooms can no longer fill in the gaping holes in this broken system.
That’s why CARE Court matters. That’s why conservatorship reform matters. That’s why the bond to build 10,000 new mental health beds matters. We must fix this broken system.
People are fed up. I’m fed up. The status quo must end. The CARE Act is the change with ability we need.
