Treatment Not Tents: Why Santa Monica Needs Beds That Treat

Why isn't housing alone enough?

Because a person in psychosis or severe addiction often cannot accept or keep a housing offer, and outreach without treatment has little else to give. As our proposal puts it, outreach that cannot offer a bed and cannot write a hold can only offer a water bottle. Housing stays essential. For the people too sick to choose, treatment has to come first, or alongside it.

The County's own numbers show the treatment gap. LA County DMH's bed roadmap to the Board of Supervisors (Feb. 2024) put the need for subacute mental health beds at 1,641 to 1,758 for FY24-25, against 1,343 in place in 2022. A hold with no bed at the end ends back on the same corner.

What treatment exists on the Westside today?

What changed with SB 43 and CARE Court?

Since Jan. 1, 2026, Los Angeles County applies SB 43, so a severe substance use disorder, alone or with a mental illness, can now meet the "gravely disabled" standard for a 72-hour hold when it leaves a person unable to provide for food, clothing, shelter, personal safety or necessary medical care. Holds are started only by peace officers or County-designated professionals, not by family.

CARE Court lets a family member, housemate, outreach worker or first responder with repeated contact petition for a treatment plan for people with schizophrenia spectrum or bipolar I disorder with psychotic features. Addiction alone does not qualify. Filing is free. See the family guide to all five lawful paths.

What would we add?

Three things, all in the Street Blueprint:

1. Someone who can write the hold on every outreach team. Every City-funded outreach team, on every shift, and the Fire Department's Advanced Provider Unit include at least one clinician authorized by LA County DMH to write a 72-hour hold. California's Welfare and Institutions Code section 5150 already authorizes designated members of a mobile crisis team.
2. A bed at the end of every hold. A published map of every bed City teams can reach (shelter, interim, bridge, detox, residential, psychiatric), how fast and at what cost, then guaranteed bed-nights bought where the map has gaps. Santa Monica already funds 35 Salvation Army Bell Shelter beds outside city limits as a placement for street encounters (Council vote, Jul. 28, 2026).
3. Public SB 43 numbers. Monthly County data on holds written under the new standard, by city, with where each person went and how long they waited. We could not find any published LA County numbers on SB 43 holds.

Does the person keep their rights?

Yes. A 72-hour hold leads to a certification hearing if treatment continues, and every longer step runs through a court with a lawyer or advocate. CARE Court and Laura's Law are court processes. The U.S. Supreme Court has held that a person cannot be confined without a finding of danger or inability to survive safely (O'Connor v. Donaldson, 1975), and that civil commitment requires clear and convincing evidence (Addington v. Texas, 1979). The plan works inside those limits.

How would we know it is working?

By publishing three numbers every month: the share of outreach shifts with a designated clinician, holds written by City teams and where each person went, and hours from street contact to bed. Totals, never names.

Where does this initiative stand?

It is a resident draft. Nothing has been submitted to the City Council. The first step we propose is for Housing and Human Services and the Fire Chief to request LPS designation for the Advanced Provider Unit's nurse practitioners and for contracted outreach clinicians. Members plan to ask for a Council sponsor after the Nov. 3, 2026 election.