California’s Plan to Disappear the Homeless

By Conor Gallagher

Elected officials continue to turn to draconian measures to disappear homeless people. In addition to passing a wave of laws across the country criminalizing homelessness, California is moving ahead with a plan that will allow the state to force the unhoused into court-ordered treatment programs for a period of up to two years – and potentially much longer. (New York is considering a similar law.)

The California law is not designed to actually help the homeless or stop more people from becoming homeless, which would actually require resources and/or taking on powerful interests like the private equity-dominated real estate rental market, the healthcare industry that bankrupts people, major corporations that pay poverty wages, etc. Let’s remember that  40-50 percent of people experiencing homelessness are employed. Instead these laws are simply designed to remove from view the people our society has chewed up.

The criminalization route allows politicians to look tough and say they’re doing something (and maybe eventually it means the homeless can help make money for the private prison industry and/or become slave laborers to help line the pockets of some of the largest and most profitable companies in the US). The court-ordered treatment policies allow politicians like California Governor Gavin Newsom to preen himself for being compassionate. So naturally the California law is called the CARE (Community Assistance, Recovery and Empowerment) Act.

CARE is slated to start rolling out later this year, but the plan is still facing opposition in the courts. Just this week Disability Rights California and other civil rights and disability advocates filed a lawsuit against Newsom in an attempt to overturn the law. They say it violates constitutional guarantees of due process and equal protection as well as the fundamental rights to privacy, autonomy and liberty.

So what exactly does CARE do?

Anyone from family members to first responders could petition a civil court to create a court-ordered care plan for people who meet specific criteria. These include a diagnosis of schizophrenia or other psychotic disorders, along with being at risk of harming themselves or others or being unlikely to survive on their own. Here is relevant section from state bill 1338:

An individual shall qualify for the CARE process only if all of the following criteria are met:

(a) The person is 18 years of age or older.

(b) The person is currently experiencing a severe mental illness, as defined in paragraph (2) of subdivision (b) of Section 5600.3 [1] and has a diagnosis identified in the disorder class: schizophrenia spectrum and other psychotic disorders, as defined in the most current version of the Diagnostic and Statistical Manual of Mental Disorders. [2]

(c) The person is not clinically stabilized in on-going voluntary treatment.

(d) At least one of the following is true:

(1) The person is unlikely to survive safely in the community without supervision and the person’s condition is substantially deteriorating.

(2) The person is in need of services and supports in order to prevent a relapse or deterioration that would be likely to result in grave disability or serious harm to the person or others, as defined in Section 5150.

(e) Participation in a CARE plan or CARE agreement would be the least restrictive alternative necessary to ensure the person’s recovery and stability.

(f) It is likely that the person will benefit from participation in a CARE plan or CARE agreement.

As opponents of the law have pointed out, the criteria are subjective, speculative and subject to bias. One of the listed mental illnesses in paragraph (2) of subdivision (b) of Section 5600.3 is PTSD, which studies have shown is common after losing one’s home. Additionally, one could argue that anyone who is homeless is at risk of harming themselves or being unlikely to survive. It is well-established that poverty and homelessness can lead to or worsen physical and mental health, and the life expectancy of homeless individuals in LA County as of 2019 was 48 for women and 51 for men – compared to the 83 and 79 among the general population.

It also means that police tasked with “sweeping” areas of homeless people now have a powerful new tool at their disposal. County behavioral health agencies can also file petitions with the court for involuntary treatment, which will create obvious conflicts of interest as these agencies’ funding will be affected by CARE levels.

Any homeless individual swept up into CARE could receive legal counsel, mental health services, medication, and “may” be provided housing. After one year, the participant/prisoner could either “graduate” or be required to undergo an additional year of treatment. Any refusal to comply, or “failing out,” and the court could impose conservatorship, which would allow an individual or potentially the state to make medical and financial decisions, subject them to forcible medical treatment and medication, and control all basic life choices like where to live and whether to marry.  It could also pave the way to detention.

Forcing homeless Californians into conservatorship would be condemning them to a system that is already rife with problems. From CalMatters:

“Having a situation with very little oversight where one person has extraordinary control over another person is just a recipe for abuse,” said Brennan-Krohn of the ACLU. …

Critics of the probate system, in particular, have long warned of abuse. In 2005, the Los Angeles Times published an investigation highlighting widespread abuses within the conservatorship system. In response, the Legislature passed a series of revisions in 2006. But many of the promised changes and increased oversight were never funded due to the 2008 economic recession.

Forcible medical treatment and medication also raises all sorts of red flags. Journalist Carl Elliott writes about how the destitute and the mentally ill have long been used as human lab rats to test out all sorts of medications and treatments. They’re usually recruited and paid by private research sites based in strip malls or suburban office parks that specialize in testing psychiatric drugs. Pharmaceutical companies typically outsource clinical studies to the private research companies, which run trials faster and at lower cost than universities do. The companies target the homeless because they might be desperate enough to participate in risky drug trials in exchange for a few thousand dollars. Elliot explains:

Most trials have to be studied by a review board, and that includes studies that use homeless people. The boards could take a stand against the practice, and perhaps some do. Finding out is next to impossible, because both the FDA and the for-profit boards regard many of the records associated with clinical trials as commercial secrets. Even the name of the board that reviewed a trial is confidential. This secrecy means that it is hard to determine whether reviewers even know where trial sites are recruiting their subjects. There’s also a conflict of interest to consider: Perhaps review boards don’t ask too many questions, because a board may start losing customers if it gets a reputation for being too strict. …

Some prominent bioethicists do not see homelessness as a barrier to research. When The Wall Street Journal reported in 1996 that the pharmaceutical company Eli Lilly was recruiting homeless alcoholics for research studies, Lilly responded by hiring an expert bioethics panel led by Tom Beauchamp of Georgetown University. The panel argued that not only was testing drugs for safety on homeless people reasonable, provided proper procedures were followed, but also that “it would be unfair to exclude homeless persons categorically as a group.” Beauchamp and another panelist, Robert Levine of Yale, went on to become paid ethics consultants for Lilly.

The CARE law only requires that the medications an individual in the program is forced to take are “clinically appropriate.” It adds that “‘stabilization medications’ means medications included in the CARE plan that primarily consist of antipsychotic medications, to reduce symptoms of hallucinations, delusions, and disorganized thinking.”

In California’s case, the potential number of homeless people that could be forced into the CARE program and onto medications is massive. The number of homeless in the state increased by at least 22,500 over the past three years, to 173,800 (out of 582,462 across the country). Both are likely large undercounts. Since the US doesn’t really care about the homeless aside from finding ways to profit off them or keeping them out of the public eye, the numbers are collected by volunteers every other year on a given winter’s night, which naturally misses many.

Even if California was theoretically able to push all its homeless into conservatorship and out of view, it does nothing about the increasing number of people joining the ranks of the homeless. CARE does not boost permanent supportive housing or mental health care. It relies on existing programs and service providers that are already overwhelmed. The only new money in the law goes to the courts.

Despite mental health professionals warning that forced treatment programs do more harm than good and local governments complaining they don’t have the capacity, the politicians in Sacramento pushed it through anyways.

What CARE will essentially do is restructure homelessness efforts in the state to prioritize people in the CARE program at the detriment of others seeking non-coerced help. This is about the worst possible strategy – if your goal is to actually help the homeless.

If the goal is to disappear them, it could prove highly effective. A recent study, “Use of Coercive Measures during Involuntary Psychiatric Admission and Treatment Outcomes: Data from a Prospective Study across 10 European Countries,” found that “all coercive measures were associated with patients staying longer in the hospital.”  In California’s case, that means that CARE “graduation” rates are likely to be low, which makes conservatorship more likely.

Organizations like the ACLU and Human Rights Watch point out that the law violates international human rights treaties. HRW opposed the CARE law, writing:

The Convention on the Rights of Persons with Disabilities establishes the obligation to “holistically examine all areas of law to ensure that the right of persons with disabilities to legal capacity is not restricted on an unequal basis with others. Historically, persons with disabilities have been denied their right to legal capacity in many areas in a discriminatory manner under substitute decision-making regimes such as guardianship, conservatorship and mental health laws that permit forced treatment.” The US has signed but not yet ratified this treaty, which means it is obligated to refrain from establishing policies and legislation that will undermine the object and purpose of the treaty, like creating provisions that mandate long-term substitute decision-making schemes like conservatorship or court-ordered treatment plans.

The World Health Organization has developed a new model that harmonizes mental health services and practices with international human rights law and has criticized practices promoting involuntary mental health treatments as leading to violence and abuse, rather than recovery, which should be the core basis of mental health services. Recovery means different things for different people but one of its key elements is having control over one´s own mental health treatment, including the possibility of refusing treatment.

To comport with human rights, treatment should be based on the will and preferences of the person concerned. Housing or disability status does not rob a person of their right to legal capacity or their personal autonomy. Expansive measures for imposing mental health treatment like the process envisioned by the CARE Court plan infringe on it and discriminate on the basis of disability. As discussed below they also run the risk of being abused by self-interested actors. This coerced process leading to “treatment” undermines any healing aim of the proposal.

And yet the bill to establish CARE Courts sailed through all of its policy committees in the Democrat-dominated Legislature and was unanimously approved by the Senate last year.

To recap:

  • The law actively makes services for the homeless worse.
  • It does nothing to address the underlying causes of homelessness.
  • It pushes coerced mental health treatment, which is proven to be ineffective.
  • It creates situations ripe for abuse.

But it does allow Newsom and the California Democrats to virtue signal that they CARE. And  they’re not spending $30 billion preparing for the 2028 Olympics only to have the games tarnished by all the Hoovervilles. Got to get the homeless out of sight and out of mind.



[1] Paragraph (2) of subdivision (b) of Section 5600.3: For the purposes of this part, “serious mental disorder” means a mental disorder that is severe in degree and persistent in duration, which may cause behavioral functioning which interferes substantially with the primary activities of daily living, and which may result in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time. Serious mental disorders include, but are not limited to, schizophrenia, bipolar disorder, post-traumatic stress disorder, as well as major affective disorders or other severely disabling mental disorders. This section shall not be construed to exclude persons with a serious mental disorder and a diagnosis of substance abuse, developmental disability, or other physical or mental disorder.

[2] Diagnostic and Statistical Manual of Mental Disorders says that Schizophrenia Spectrum and Other Psychotic Disorders are “defined by abnormalities in one or more of the following five domains: delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behavior (including catatonia), and negative symptoms”.

Delusions: Are fixed beliefs that are not amenable to change in light of conflicting evidence. May include several themes: persecutory, referential, somatic, religious, grandiose.

Hallucinations: Perception-like experiences that occur without an external stimulus. They are vivid and clear, with the full force and impact of normal perceptions, and not under voluntary control.

Disorganized Thinking: typically inferred from the individual’s speech. The individual may switch from one topic to another.

Grossly disorganized or abnormal motor behavior: Manifests itself in a variety of ways, ranging from childlike “silliness” to unpredictable agitation. Problems may be noted in any form of goal-directed behavior, leading to difficulties in performing activities of daily living.

Negative Systems: Account for a substantial portion of the morbidity associated with schizophrenia but are less prominent in other psychotic disorders. Two negative symptoms are particularly prominent in schizophrenia: diminished emotional expression and avolition.

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  1. Fazal Majid

    Some individuals with mental illness will refuse treatment as a side-effect of their condition and require coercive measures as well as a protective environment. Well-meaning but misguided laws like the Lanterman-Petris-Short Act of 1967 make this practically impossible and they are discharged onto the streets to die instead. There was a whole wave of glamorization of mental illness at the time, the zeitgeist being reflected by One Flew over the Cuckoo’s Nest.

    Activists do not always have the patients’ best interests at heart. Here is one example from San Francisco, which has been spiraling down the drain:

    A couple of years ago, one of my friends saw a man staggering down the street, bleeding. She recognized him as someone who regularly slept outside in the neighborhood, and called 911. Paramedics and police arrived and began treating him, but members of a homeless advocacy group noticed and intervened. They told the man that he didn’t have to get into the ambulance, that he had the right to refuse treatment. So that’s what he did. The paramedics left; the activists left. The man sat on the sidewalk alone, still bleeding. A few months later, he died about a block away.

    (Yes, I know she is Barri Weiss’ wife, but she is also a fifth-generation San Franciscan).

    When combined with horrific new psychotropic drugs that literally eat people’s brains, facile answers and inaction are not up to the task.

    1. Nick

      I grew up in San Francisco and have witnessed and had to live and work around this shitshow for decades. {Mission High, class of 1981}. California is the lodging place of something like 45% of the “homeless” in America and S.F. probably a large portion of them, ~10,000 or more, relative to its population. Lumping drug addicts, self inflicted or through M.D.s, the mentally ill, people with diseases and those crippled by NAFTA or plain bad luck or faulty decisions, “hey man, let’s get high”, into one catch all category is disengenuous.

      The Fentanyl dealers in S.F. responsible for hundreds if not thousands of deaths, are the same Honduran youth gangs, now adults, that D.A. Kamala Harris, refused to prosectute as they would have been cruelly deported from our “Sanctuary City.”

      Any “homeless” person with a cell phone, can learn instantly where most generous benefits and lenient laws are located down to the individual church or synogue and certainly a city. Add the many hundreds of nonprofits surfing on federal, state and local tax benefits, and representing the “homeless” just in S.F., and you have a powerful inducement to attract and maintain the numbers, so there is never a “solution.”

      The more San Francisco and L.A. spend, (tens of billions at this point), the worse the problem gets. In thirty years of speaking with people sleeping or begging on the street, I have run into FOUR who actually grew up or graduated high school here. The rest are voluntary travelers who self concentrate where the weather, benefits are best and the laws most lenient. Their California Dream sometimes ends up becoming our nightmare.

      The housing, apartment industry and their lenders is now using them as an excuse to build anthing, anywhere in the state, jettisoning all hard won environmental and zoning laws to supposedly “house” them. Coincidentally, towns in the Sacramento Valley with zero tax funded homeless benefits nor non profits, to and including churches and synogues housing and feeding them, have zero homeless on the streets. Cities with the most benfits become the logical place for homeless to go. This scales up to states, cities and even neighborhoods like here in S.F.

      The solution to “homelessness” is to do exactly what this bill does and FAR MORE and to federalize any “solutions.” since it’s a national problem that has become concentrated in focused areas. Also, homeless advocates never ever mention the millions of new arrivals from south of the border are somehow managing to find housing and jobs and make do.

      1. JBird4049

        If conservatively, forty percent of the conservatively counted 173,800 homeless are already employed, and I do wonder if all the cars, vans, and RVs are included in the count of the homeless, just how is CARE such a fabulous panacea? For a problem that did not exist until all the jobs were sent away, they stopped building housing even for the middle class, and finally the healthcare system was financialized? It was almost unheard of in the 1960s, a little in the 70s, and only getting worse since the 1980s. So, somehow, people decided living on the streets was an exciting adventure during the past two generations?

        The deliberate destruction of the port with all its associated industries, plus the light manufacturing, and the elimination of much of the Financial District’s business over the past forty years leaving not much for San Franciscans and everyone else in the Bay Area aside from Big Tech or service jobs.

        Then there is the elimination of almost all the many SROs (single resident occupancy), like the International, the refusal to build even townhouses, never you mind apartments, throughout the entire Bay Area, but particularly in the city.

        Before all this, there was the elimination of the mental healthcare system, which barbaric as it was, was replace with nada.

        And those “homeless advocates” are often working for a very, very corrupt industry, which like much of the government, does not want to solve the homeless problem. It is profitable to force people onto the streets into the oh so loving arms of the NGOs who are financed enough for well compensated management and low paid workers, much like most corporations. Corporations that make money more by financialization or by consumption of other businesses than by actually creating or selling anything.

        Sixty years ago Santa Clara had both jobs and affordable housing. Fifty years ago San Francisco. Then it was the North Bay. Then the East Bay. Then it went beyond. The closest areas that last had affordable housing was fricking Clear Lake and the capital of Sacramento. Used to. Of course, most of the jobs aside from service, government, and tech also went away. I suppose one could live in the homeless encampments in the North Bay up in the hills and drive, like some do, to work. Grab a damn tent and sleeping bag.

        We are all living in a slowly sinking ship, rats hoping to not die before some hand reaches down and throws us into some financial abattoir. Like those people living in the hills or on the streets. Our lives rendered into profit. Like with California prison system. Newsom is the same as Harris and the Democrats really are buddies with the Republicans.

        This is just like the War on Drugs with its massive prison population, or the War on Terror with its destroyed countries. Now, it is a War on Homelessness. I can’t wait to see its cost.

        1. Oh

          I agree with your comment. CARE is a way to send precious $$$$$ to these blood sucking vampires that thrive on so called good causes just like the prison complex and the schools that have been set up for traffic offender classes. Under the guise of helping people these wretched corporations suck money out of the public rolls and profit by them. I have to laugh – these therapists are gong to solve the homeless problem? These corporations were probably responsible for writing CARE. They’ll writing their own ticket by pronouncing people “mentally ill”. Let’s do something more long lasting, such as building low income housing and providing employment that the capitalist economy has mercilessly thrown on to the streets.

        2. tegnost

          For a problem that did not exist until all the jobs were sent away, they stopped building housing even for the middle class, and finally the healthcare system was financialized?

          You forgot the part where they saved the bankers insolvent asses by pumping property values with zirp. Helpfully (for the banksters), it also paid the one half of the population to kill the other half.

      2. Soredemos

        This is basically nonsense. Fundamentally it’s a housing crisis. Also, why is ‘homeless’ in scare quotes? Because someone has a cellphone? That isn’t an expensive luxury anymore, grandpa.

    2. Soredemos

      I have no confidence this bill is being done for any reason other than as an excuse to round up large numbers of homeless and make them go away (it may have started entirely genuine among advocates, but no politician supporting it is likely to be doing so for humanitarian reasons). It’ll be applied like a sledgehammer.

      But I do actually agree that some version of it does need to be done. Laws surrounding forcible institutionalization of the mentally ill and addicts these days make getting people off the street virtually impossible. This is very much by design. It wasn’t all that long ago that it was common to have scenarios like “my wife won’t do what I tell her, so obviously this is evidence that she’s crazy and she needs to be locked up until she starts listening again”, and laws were understandably rewritten to make that kind of nonsense impossible.

      But I can personally attest that they’ve gone too far in the opposite direction. In Oregon at least it is virtually impossible to forcibly get someone who is clearly extremely mentally unwell off the street. I can name at least a half dozen examples just off the top of my head, one in particular being a woman who follows a very predictable mental cycle where she alternates between sane and not, a cycle she’s gone through scores if not hundreds of times. She periodically will have episodes where she just punches herself in the face to the point of bleeding, and everyone, including all of the local cops, know she’s doing it. But if you call the cops or a case manager, she invariably pulls herself together by the time they arrive. “Of course I’m not punching myself in the face; I fell. Also I’m not suicidal. Go away.” Again, literally everyone knows what’s actually going on, and in fact many have seen her do it, but apparently none of this can be proven satisfactorily to a judge, so on the street she remains.

      She’s actually shown genuine signs of late of trying to pull herself out of her endless downward spiral, but she can never fully do it and always relapses. She would very likely benefit from simply being put somewhere where she has to sober up. Of course, and this goes back to how most of this is simply a housing crisis, if she fixes herself up and then you put her back on the street, she’ll likely just slip back into the old pattern.

      To echo that Atlantic piece, I have another, similar story of a guy who OD’d on the property of the place I volunteer at. Actually doing it on the property almost never happens, and he’s very lucky it happened there because we were able to bring him back after five shots of narcan. But then he insisted he was fine and simply refused to go with the paramedics when they showed up. Yeah you’re fine dude, you can’t even walk without two people supporting you, but you’re fine. Right. In the end he didn’t go with them, and just got lucky that he didn’t relapse back into the overdose after the narcan wore off. Last I heard, as of a couple days ago, he was in jail, which frankly will probably do him some good.

      Meth is actually very much a lesser evil. I know multiple functional meth users. It’s fentanyl, especially the blue pill form, that really racks up the body count. The latest thing seems to not even be bothering with the pills and just doing straight powdered fentanyl, which is essentially putting a partially loaded revolver to your head in terms of rolling the dice.

      1. Paris

        Is it that bad? These people will never be fully functioning and contributing members of society. Free will to them, even if they kill themselves.

        1. Carolina

          It’s a free country. People have the right to kill themselves.
          Taxpayers have a right to not have to pay for other people’s financial, personal and social mistakes~ Especially when much of the money goes to nonprofit execs.

          Homeless advocates can demonstrate their conviction by inviting someone into their home, giving them a job and sponsoring them. After they have done that, we’ll know that they are serious about their convictions.

        2. Soredemos

          I can tell you’ve very never actually worked with helping any of them, so I’ll ignore your opinions.

        3. JBird4049

          No one is disposable. At all.

          But even if I accept this quasi eugenics, much of the mental illness and drug addiction are the consequences of a lack of housing as well as a lack of jobs that pay a living wage. Add healthcare and then there would not be at least a half a million homeless. Really, it totals to at least a million people each year as some cycle in and out of homelessness.

          Modern American society functions as a financial abattoir. It crushes people under and when they fall grinds to actual death because it is more profitable for some.

  2. The Rev Kev

    ‘An individual shall qualify for the CARE process only if all of the following criteria are met…’

    Would it be crude to point out that under that listed criteria, that Gavin Newsom would qualify for the CARE process due to the fact that only a psychopath would think this act a good thing? If you do not believe me, read that criteria again. But we all know that rich people can only ever be eccentric while poor people are crazy.

    1. lyman alpha blob

      Indeed. When I read that –

      “‘stabilization medications’ means medications included in the CARE plan that primarily consist of antipsychotic medications, to reduce symptoms of hallucinations, delusions, and disorganized thinking.”

      – it struck me that this program might be more appropriate for CA Congress people than the homeless.

      And I have to wonder of anyone ever considers that maybe the widespread mental illness we see is brought on from having to live in a society that produces programs like the CARE plan.

      These acts often tend to do the opposite of their clever acronyms. I remember Al Franken’s comment back when Bush administration rolled out the CLEAR skies act, given all the pollution it actually allowed rather than prevented, saying it appeared designed to CLEAR the skies of birds.

      We’re still being subjected to Russia, RUSSIA, RUSSIA!! hysteria made up from whole cloth and willfully promoted by a corrupt media. We’re told the best way to stop gun violence in moar gunz. The magic “vaccine” will stop the rona in its tracks say the authorities who know damn well that it won’t, but it will enrich their pals at Big Pharma. Our choices for leadership positions are grifters or doddering old fools, not that those two categories are mutually exclusive as we see in Biden’s case. With the constant gaslighting and mendacity blared from the Mighty Wurlitzer 24/7 it’s a wonder anyone manages to keep their wits together these days.

  3. John R Moffett

    Capitalism is blind to the problems it causes, and therefore is unable to deal with the consequences. Capitalism requires a certain degree of joblessness, and hence homelessness. So it is not a flaw in the system, it is a requisite feature.

  4. paul

    This post almost me throw up.

    The thought that the unfortunate will become recycled biowaste in the wild west of capitalism ,

    The reminder that witnessing or remembering of it happening before.

    Maybe progress is a not a great idea in its self..

    But most of our patholoogies,and pathologicals, continue without a self.

  5. Synoia

    California has the ideal climate to live outside all year.

    The United States. The rchest country in the world, willnot house it’s people. And considers itself a having Christian morals.

    1. timbers

      Housing is an investment. That’s true. Just as the folks at the Federal Reserve, Jerome Powell on down.

    2. Hayek's Heelbiter

      America is a Christian country.
      As it says in Matthew 13:12:

      For whosoever hath, to him shall be given, and he shall have more abundance: but whosoever hath not, from him shall be taken away even that he hath.

      If Jesus was only speaking metaphorically, why does Newsom and indeed, the entire neoliberal regime, interpret it literally?

  6. Tara

    I worked as a patients’ rights advocate in SF before and after the Crash of 2008.
    California has 2 conservatorship systems-probate is for people who have assets that need to be “protected.” This is the “I care a lot” conservatorship that gives access to the assets. Conservatorships under the LPS Act mandate mental health treatment for conservatees who cannot make these decisions for themselves due to serious mental illness. It does not include medical treatment, unless a judge has ordered it. Conservators are assigned by a judge and they usually work for the county.
    While LPS guarantees the rights of the patients, it also (especially) provides for a lot of repressive, involuntary treatment. The tools already exist to keep people locked down,and when there was money, 4 acute units in SF General Hospital (there are a few other locked, psychiatric units in SF) were packed with people waiting for programs and housing. After 2008, the acute units were closed, cause cheaper treatment in the community is available ; ).
    Laws to regulate the mentally ill, and the homeless are theater for the public. Laura’s Law was designed to make people feel safer because mental health treatment can be mandated to potentially dangerous people. BUT it already can be using the LPS Act. There is no legislative recitation of existing laws to comfort the public. We need new laws to signal that something is being done. When Governor HairCut was mayor, he instituted Care not Cash in SF. Clearly, it was not dealing with root causes, cause here we are, but it did say Care.

    1. The Rev Kev

      Gotta get them off the streets before the 2028 Olympics in Los Angeles which will be *checks notes* the third time that they have hosted it. I’m sure that Newsom would like to dump them in FEMA camps but the Feds own them. Come to think of it, there is a good documentary to be made here. You could compare Los Angeles by the years they have hosted the Olympics. So Los Angeles in 1932, 1984 and then 2028. The differences would be mind-spinning.

    2. Paris

      Relatively easy to do, give them one way bus tickets to New York or some other cool Democrat city. We do that here in TX with the illegals and it’s working.

  7. Clark T

    Criminal lawyer here. While this is a horrible bill for the reasons the author mentions, I don’t agree with his interpretation of the statute. The quoted paragraph (1)(b) says, “The person is currently experiencing a severe mental illness, as defined in paragraph (2) of subdivision (b) of Section 5600.3 and has a diagnosis identified in the disorder class: schizophrenia spectrum and other psychotic disorders, as defined in the most current version of the Diagnostic and Statistical Manual of Mental Disorders.”

    The definition in paragraph (2)(b) of existing Section 5600.3 is very broad indeed, but the word “and” in paragraph (1)(b) of the bill expressly limits it (as written) to a person with a “severe mental illness” who is “currently” diagnosed with schizophrenia or another psychotic disorder. That means that just PTSD or drug use not accompanied by psychosis would not qualify.

    That said, it’s very likely that, in practice, “sweeps” rounding up anyone homeless who is acting even a little bit “off” in the view of police will be common. Incarcerate first, diagnose later. And paragraph (d)(2) is especially troubling; the swept-up person could be superficially OK now but at risk of “relapse” or “deterioration.”

    1. Otis B Driftwood

      If not this law, the question becomes: what would work to get the mentally ill the care they need?

      Or is it wrong to even ask that question? Instead resign ourselves to the alternate extreme that until we address the dysfunctions of our society that produce the mentally ill and the homeless that we should let the distress their presence causes remind us that we have brought this on ourselves?

      1. juno mas

        Yes, there are severely mentally ill people living on the street. (They were housed and treated in state provided institutions in California, until Ronald Reagan became governor (1967-1975). Public funding of essential services declined under his reign.

        Without doubt houselessness, mental illness, drug addiction are the end result of a dysfunctional society that emphasizes “me” not “we”.

        We need to focus on our social dysfunction and leave the rest of the world alone!

        1. Adam Eran

          I’ll add that JFK (who had a special needs sister) was instrumental in closing the big, “One Flew Over the Cuckoo’s Nest” institutions, proposing smaller units integrated into cities. Naturally the smaller units weren’t funded, and Daniel Patrick Moynihan called it one of the most shameful episodes of his Senate career.

          One thing more: I’ve read there are five times more vacant homes in San Francisco than its homeless population. A shortage of resources isn’t the problem.

    2. Conor Gallagher Post author

      Clark T, the article doesn’t say that just PTSD or drug use not accompanied by psychosis would qualify for CARE. It does state that “one of the listed mental illnesses in paragraph (2) of subdivision (b) of Section 5600.3 is PTSD, which studies have shown is common after losing one’s home.” That doesn’t mean PTSD would not also require a diagnosis of “schizophrenia spectrum and other psychotic disorders, as defined in the most current version of the Diagnostic and Statistical Manual of Mental Disorders” (definition included in Notes).

      1. cfraenkel

        I’m with Clark T on this one…

        Then why did the author include that bit in the first place? My laypersons reading was that the author was in the middle of listing out all the reasons this law is bad. I read it as the author saying PTSD would put one at risk. (ok, maybe I should say the author *implied*)

        Verbal gymnastics like this are a hallmark of propaganda and politicians. I now have to question how much of the rest of the article is in good faith and worth trusting. This site has been a welcome source of sanity in pointing out the dissembling in support of the Ukraine war, covid, financial misdeeds and all the rest. Please let’s not accept bad faith ‘persuasion’ techniques just because an author is on ‘our’ side, whatever that may be.

        1. Conor Gallagher Post author

          Cfraenkel, the information is all right in front of you in the article. No one is trying to pull a fast one on you.

          PTSD is part of the criteria that would put someone at risk. The text of the law, included in the article, states that, among other criteria, “the person is [ONE], currently experiencing a severe mental illness, as defined in paragraph (2) of subdivision (b) of Section 5600.3 [1] and
          [TWO], has a diagnosis identified in the disorder class: schizophrenia spectrum and other psychotic disorders, as defined in the most current version of the Diagnostic and Statistical Manual of Mental Disorders.”

          PTSD qualifies under their definition of mental illness. That’s one step, which is relevant to mention considering studies show how common PTSD is for people who have lost their home. That puts an individual at risk as they have already cleared one hurdle to be placed into CARE. The next step is a diagnosis identified in the disorder class: schizophrenia spectrum and other psychotic disorders, as defined in the most current version of the Diagnostic and Statistical Manual of Mental Disorders. This is mentioned and included in the notes section:

          “Diagnostic and Statistical Manual of Mental Disorders says that Schizophrenia Spectrum and Other Psychotic Disorders are “defined by abnormalities in one or more of the following five domains: delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behavior (including catatonia), and negative symptoms” – not a very high second hurdle to clear, especially if the state is motivated.

          1. Clark T

            Conor @ 10:48 a.m. and 3:04 p.m.
            Hmmm . . . I’ve given this some more thought and decided that you’re likely correct — the statute could be interpreted that way. And if it can be read that way, it will be. … Yikes.

            1. bdy

              Since the point is contestable, it’s only gonna be a problem for the folks who don’t have an attorney ;)

    3. GramSci

      Yes, I’m afraid sweeps of the homeless are the intended effect of the bill. “And” is a notoriously difficult word to parse; I would not want my case built upon it.

  8. HH

    The NYC subway system has become almost unusable because of the invasion of disruptive, mentally disturbed people who are homeless. If New York is to remain a decent place to live, these people must be removed from the trains. Citizens have no obligation to be subjected to the disorderly conduct of mentally ill people. Clearly, the rights of the homeless must be protected, but they do not take precedence over the rights of the sane majority to travel without fear of harassment or assault.

    1. John R Moffett

      HH, You sure have a big heart. Maybe you could shop around for a little empathy for your fellow humans. Oh, sorry, you aren’t interested in empathy, are you? NYC seems to be capitalist central, which means no empathy allowed among the PMC.

      1. cfraenkel

        It’s personal attacks like this that refuse to acknowledge what the other side is saying that make discussing this issue a no-win proposition.

    2. Scylla

      Want them off the subway? All you have to do is give them a place to live. The answer here is simple.
      Of course, we all know that the simplest and most cost-effective solution cannot be allowed.

      1. eg

        This. Since neoliberalism has eaten our “betters” brains, Public Housing has become a swear word.

        As ye sow, so shall ye reap …

        1. Adam Eran

          Nixon actually stopped the feds from building low-income housing, and Reagan–as he was cutting taxes for the rich roughly in half–cut HUD’s affordable housing by 75%.

          There’s more about affordable housing and how it’s been sabotaged since its inception in the U.S. here.

      2. Fiery Hunt


        Drug addicts and mentally ill don’t need cheap housing.

        They need supervised care.
        The homeless problem isn’t solely about housing, you damn simpleton.

      3. Paris

        Bullshit (2). You give housing to addicted mentally ill people and you turn around the house is sold for fentanyl and they’re back on the streets. You don’t fool anyone with those “easy” solutions.

        1. tegnost

          Bullshit (3)
          Not all homeless people are addicted mentally ill people,
          and probably not even a small fraction of them.
          Indeed, according to soredemos above it’s about 1 in a hundred

        2. Soredemos

          No one gives them a house. They get a prepaid apartment voucher. But please, continue displaying your own abject ignorance.

    3. begob

      Is that you, Larry David? As funny as Seinfeld was, I never got a laugh out of the gags at the expense of street people.

  9. Scylla

    I’ve been saying for years that it was only a matter of time before we constructed for-profit slave labor concentration camps for the homeless, and here we are. Now that this is being put in place, and the homeless will be commodified, we have incentivized homelessness- so now we will see lobbying for policies to deliberately increase the homeless population. This is the same thing that has happened in the prison industry, where criminals have become commodified- and we have seen efforts to create more criminals. The US has always been, and will always be, a slave state. Most Americans just want to believe that American slaves “deserve it”.
    I’ve said it before- bring on the jackpot/insurrection/invasion/climate collapse……ANYTHING that will end this monstrous society/government/oligarchy.

  10. flora

    There’s talk about running CA gov Newsom for pres. He can do for the whole country what he’s done for CA. / ;)

  11. Cetra Ess

    Very many years ago, ok decades ago, so this may no longer be true and China has likely dramatically changed since, but I had a co-worker who had freshly come from China and it was interesting to experience the cultural differences. At one point she asked us why the homeless people weren’t rounded up. Apparently, where she’s from they had similar laws to this and even had white specialized vans which did the scooping. She thought we should do the same. I argued this was inhumane, people aren’t garbage to be tossed into a van just because it doesn’t look good.

    I guess Cali is modeling itself on 90’s China?

    1. Random BSN student

      What happens after they get picked up by the van? I expect they get dumped somewhere less visible, but if they’re unlucky or make too much trouble they might end up in the prison population. There’s no shortage of homeless people in China, so much so that memes about “hot homeless guys” occasionally show up on Weibo. As urbanization has exploded, people who would have stayed in their hometown villages and farmed are now in cities, and when they can’t find regular employment (lack credentials or connections) they end up on the street, under bridges, etc. Although things have improved somewhat there’s still not much support available. They definitely would not be allowed to stay in wealthy or middle class neighborhoods or places those people frequent. Multigenerational households are more common, but people also move long distances for work. It’s common for employers in construction and similar occupations to provide dormitories for their workers, but if you’re between projects that obviously wouldn’t be available. And I wouldn’t be too optimistic about outcomes for impoverished Chinese with mental or physical health issues… just like here I guess.

  12. upstater

    The do-gooders or others that advocate “forced treatment” have almost never been to psychiatric wards to understand that such places are the heathcare system’s “separate and unequal” segregation of mental illness versus acute or chronic illnesses. Psych wards are most often violent, dehumanizing places that are filthy and chronically understaffed. There is a very good reason mentally ill people avoid the trauma of hospitalization. Most anybody that has done it or witnessed it would seek to avoid it. The mentally ill are considered disposable people.

    Read Elyn Sak’s “The Center will not hold”.

    1. Soredemos

      When you leave them on the street, you’re treating them as just as disposable.

      What a false dichotomy. That mental health institutions need to be better run, sure. The solution is not then to do what Reagan did and just close them all. We do, objectively, need places to put some people, full stop. I don’t care how nasty that sounds, there are people on the street who need to be forcibly rounded up and put somewhere where they can be treated (and some of them may simply be untreatable and just need to be contained).

      I can personally attest to the, to put it mildly, frustration of trying to run a winter warming shelter. You get a room full of forty or more essentially sane people, and everything is going fine, and then the cops drop off some gibbering idiot they found wandering somewhere. He wasn’t actually breaking any laws so they can’t put him in jail, but there’s no mental facility they can put him in, and they also don’t want him to freeze to death. So to the charity he goes, and now he’s the volunteers problem. So now the rest of the night is a trainwreck, until and unless he does something the cops can actually arrest him for. And this scenario happens not occasionally, but regularly.

      1. juno mas

        Yes. There are people on the street that are wildly mentally disoriented. Some of them walk into the path of trains, trucks, and autos, day or night. It is not compassionate to allow this. I’ve seen the death (theirs) and disruption it creates. There really are people on the street whom need to be given treatment and place of physical safety.

        We can house and pay for treatment. Just reduce the MIC spending. Employ more social workers, mental health experts instead of bomb makers.

  13. spud

    this assault began in 1994 with the complete knowledge that free trade would create mass unemployment and homelessness, best way is for a twofer, bill clinton and bidens draconian crime act, plus fill the beds of corporate prisons for forced prison labor, ERR, i meann rehab “SARC” work, now they are productive citizens:)

    of course this can only go so far, we are in the next step, make them dissappear by housing them far away, and doping them till they realize the errors of their way.

    that in the end will cost money, and the free trade oligarchs will moan, after that, its concentration camps and gas chambers, here we come!

  14. David in Santa Cruz

    One of the “innovators” on the podium with the lovely Gavin announcing the CARES Act was a judge who has been running this “treatment” model as his personal fiefdom in Silicon Valley for over 30 years. Because he cares so much.

    One anecdote: a few years ago one of the court’s “probationers for life” was in urgent need of supportive treatment-based housing in order to monitor his compliance with “medications.” However a “bed” was not going to be available for a period of about 6 weeks, so the judge and the public defender “agreed” to “house” this individual on the “psych floor” of the local county jail without so much as a hearing or a finding of violation of his probation. Because they care so much.

    The “psych floor” being used as a “hotel” by the judge had also been deemed to be a “hospital” subject to HIPPAA by the local county counsel. All surveillance-camera monitoring was removed from the floor. Because they care so much.

    Three burly correctional officers, who are not sworn law-enforcement personnel, were tasked with supervising medication compliance on the “psych floor.” Our “patient” refused his meds, asserting correctly that he was not an “inmate” of their stinking jail. A physical scuffle ensued, and the three burly correctional officers beat the “patient” into unconsciousness by slamming him against a concrete shelf that serves as a “bed” in the cells and then left him for over an hour without checking his vital signs. Because they care so much.

    Of course, the man died from internal bleeding. The three correctional officers were prosecuted and eventually convicted of second-degree murder — not made easy thanks to the removal of surveillance cameras from the “psych floor.” And the judge then stood on the podium with our Adonis of a Governor to announce the CARE Act. Because they care so much.

    We have a “homelessness problem” because of the disgraceful abandonment of working Americans in favor of cheap offshore labor. First you lose your steady income; then you lose your housing; then you start taking drugs in order to sleep rough and to rouse yourself to search for sustenance; then you lose your mind. CARES doesn’t address the root causes of the “homelessness problem” at all…

    1. Soredemos

      >CARES doesn’t address the root causes of the “homelessness problem” at all…

      And should it be expected to? What, someone is just going to pass a ‘no more offshoring’ bill and magically undue decades of neoliberalism? It’s that easy, is it? Looks more like bills like this are at least attempts at dealing with what is objectively an immediate problem in the here and now that needs to be dealt with.

      All of the problems you detail in your proceeding paragraphs are examples of things that need to be addressed and changed, but tweaking any of those things would also still not get at the root problem, but would still be changes worth making.

        1. Fiery Hunt


          What do you do with broken beyond repair people?

          You feed them, you warehouse them, and you try help those who can be helped.

          Some can, some can’t.

      1. David in Santa Cruz

        “…things that need to be addressed and changed.”

        My point is that one of the principal architects of the CARE Act falsely imprisoned a person in order to “help” him, leading directly to his torturous death.

        The CARE Act extends this god-like power to other ignorant, unaccountable, and self-regarding judges — people who combine the worst attributes of both lawyers and politicians.

        The CARE Act is presented by our Hollywood good-looking Governor as a wondrous “new path forward” for the mentally ill to “get healthy” but it is simply an expedient and coercive means to clear criminal court dockets of individuals whose minds have been shattered by an economic order that has been designed to immiserate the working class. Hardly “changes worth making” if they result in even one more death.

    2. Felix_47

      True about the root causes but I did grow up in a state psychiatric hospital and it was not bad compared to what I see on the streets in LA and even in the high desert in Ca. where I have been in a trailer park for some years. Many people are suffering. And it sure did not cost 100,000 tax dollars per year per patient which is what we seem to be spending now. We had a large farm run by the patients. That produced plenty of fresh produce. We had cows for milk which provided dairy. Some of them provided beef. The state employees supervised but the inmates did the cleaning and low skill maintenance. The state employees were well paid with benefits. It was a large place with many buildings. There was a central heating plant and a small hospital on site as I remember. Housing was by levels of impairment. Many were developmentally disabled as well. No government worker one had to work more than one shift so at least by the end of the shift they could go home. Some of the state workers were provided housing on campus. Abuse of people who are under care is distressingly common especially in small private home which is an industry in and of itself. Interestingly, a certain percentage of the inmates got pregnant. And those babies were generally normal. Decades ago, maybe 5 or more, it was long ago, the entire place was levelled and became a huge housing development. I assume many of the inmates became homeless. Maybe we should consider just giving every homeless person a check for 150,000 per year since when they publish the 100K figure they leave out the federal chunk and the cost of health care which is federal to a large degree. And if housing is a right like medical care to be provided by the rest of the taxpayers maybe we need to nationalize housing and assign people to homes provided and prodiced by the government. When we talk about right to things I keep thinking it gets abused immediately by rent seekers in a free enterprise system. If we establish rights to care and treatment, which I favor, then we must nationalize health care and housing and provide a baseline income. Problem is one cannot deny that the vast majority of voters seem to want to fight Russia (or pay someone to fight Russia) and enrich companies like Amazon who provide basically postal service, or Health Net who provide medical services, or Pfizer doing services, or the real estate, mortgage and housing industry providing housing, or the car industry providing transportation at great social and environmental cost rather than public transit…. all jobs that the government should be doing. Socialism of some sort may be the only solution.

  15. cnchal

    > But it does allow Newsom and the California Democrats to virtue signal that they CARE.

    CARE = Criminals Are Running Everything.

  16. Alex Cox

    Thank you for this useful article. I am so glad the drafters of this bill wrote ‘and’ not ‘or’!

    Right when we went to war with Russia, I read that $20 billion would solve the US’ homelessness problem. So, 1.7 trillion to modernize the nukes, $100 billion for Ukraine, and $30 billion for Newsome’s Olympics?

    Too bad they couldn’t find the twenty…

  17. Elizabeth

    Having lived in SF for over 40 years, the homeless population has massively increased. When someone loses their housing because they’ ve lost their job and end up on the streets or their cars, I would think that that alone would cause me to become mentally ill in some fashion. It is traumatic to go through this situation. SF became unaffordable back in the 80s and it’s much much worse today. I remember the late Ed Lee had cops sweep the homeless out of sight for the upcoming Super Bowl.

    Calif. claims more housing needs to be built, but 95% of new construction is luxury condos or houses. Working people are left behind. SF once had working class people who managed to live and work in the city. No more.

    I think the CARES bill is not going to solve the homeless problem. It’s ripe for abuse. What’s needed are more support systems such as housing and people that actually help people get back on their feet and health care, including mental health. It is a complex problem, but I think it is solvable. Billions of $$ are spent on ” solving” the problem, but it has only gotten worse. Where has all that money gone?

    What disgusts me so much is this country spends billions on war, weapons, and the like, but nothing for our most vulnerable. I’ ve concluded this country doesn’t give a rat’s *** if people live or die, unless you’re a billionaire. Isn’t capitalism great or what?

    Conor, thank you for highlighting this issue. And welcome to NC.

    1. JBird4049

      >>>Billions of $$ are spent on ” solving” the problem, but it has only gotten worse. Where has all that money gone?

      Just like how the Congressional-Military-Industrial Complex exist to profitable start and run wars using all the latest high tech death ray or something, so it is with most, but not all, of the Governmental-Charitable-Political Complex. The goal is not to defend the nation or end homelessness, poverty, hunger, or racism, but to keep the gravy train running.

      The worse it gets, the longer it lasts, the more profit to be had. It’s just good business.

  18. David Anthony

    Right now, we have no place to put people with mental health issues. And those are people with money and insurance. Covid has created a massive mental health crisis.

    There will be no place to put these people and once this fails, the next “solution” will be to put them in camps in the desert, as we have seen many already pushing, like basketball great Bill Walton.

    California once passed a law stating every town had to have a separate place to take those arrested for DUI’s and drunk in public, so they would not be placed in jail with possibly dangerous criminals. Law still remains. And it has never happened anywhere.

  19. KLG

    Great work, Conor! We are not a serious nation. For a fraction of the money we waste on “adventures” in places we have no business, all residents of The Country Blessed by God would have a job if able to work, enough good food to eat, and a place to live comfortably.

  20. Sbrown

    I am all for helping people that have fallen through what little is left of frayed safety nets, but letting people not get treatment and do what they want to do is inhumane and unfair to others that suffer from their actions. I am a member of a community garden and during the pandemic the city allowed one of its biggest homeless camps grow up around the garden. I’ve seen mentally ill people unable to care for themselves and easy victims to drug dealers and criminals. Trash rotting and piled up everywhere and so many rats. Theft, prostitution, and rape have occurred in those camps. The city left us to clean up the garden’s parameters on our own. I pulled drug paraphernalia from the trees overhead, cleaned up trash that included condoms, rotted food, furniture discarded from RVs, and discarded Court summons. The last clean up I did was cleaning out the muck in the curb which which was a mixture of feces and urine dumped there by the homeless living in their cars and RVs. I could go on and on. Anybody that states that the homeless should be allowed to do whatever they want has not had to live with them. Period.

  21. Susan the other

    What mindset is preventing us from fixing this problem? Is it the Hell No party: Why should I pay to support people who refuse to work, etc? Because the answer to that delusional question is that we support people who are down and out for one big selfish reason – we don’t want to be that unfortunate ourselves. It gives me the chills to remember that an idea whose time has come really can’t be stopped. There is no question that it is high time to build both affordable housing and housing for the destitute. The silver lining is that this one very necessary step will start to heal our society immediately. But we shouldn’t kid ourselves that we can do it on the cheap. We not only have to do a massive bunch of construction, we also have to budget for long term maintenance. I don’t consider this to be too expensive because it will give our entire society a solid footing. A foundation. And better things will follow.

  22. Sue inSoCal

    Thank you Conor. Great piece, though disturbing. There is no homelessness in the low desert of the western Coachella Valley. There’re also no affordable housing and the place is now flush with rentals. Lanterman Petris Short, iirc, was to stop the indefinite lock up of your spouse (for example) that you decide is “crazy”. But it fails to protect, as someone mentioned. I know a person that was locked up and survived everything from psychotic drugs to ECT for over 20 years. Spouse divorced her while she was in a state hospital. I was working in social services in the 70s in San Diego and anticipated the safety nets were going…away. When one bright, benign schizophrenic on my caseload living in board and care, who was able to work in a (now outlawed) sheltered workshop (which gave his life structure and meaning) and get from point A to point B on a bus suicided, I left. Things we’re getting stingy. The psychiatrically disabled had case workers that we could call and say “John Doe is off his meds”. The psychiatric patients often feel good and go off of their medications. Believe it or not, the Dept of Rehabilitation had caseworkers who specialized in alcoholism! Again, board and care, benefits. We now have SNAP as a sole safety net. Correct me if I’m wrong. No safety nets, masses of investment properties, no pain treatment, lots of booze, plenty of street drugs and voilá! In 40 years, we have an epidemic of homelessness and drug “crises”. Spare me the “unhoused” euphemism.

  23. ThirdPartyMechanic

    Is anyone interested in knowing about “banishment” of the homeless? We profiled a case that was also out of “progressive” California a while back, as follows. We’re revisiting it and still working on it. We now plan to include a discussion about the great info above(!), as well as what Desantis did in Florida with immigrant relocation because it’s what CA and other “progressive” states have been doing UNDER THE RADAR to the homeless, but no one’s talking about it. In other words, if immigrants are banished, it’s “immoral”; if the homeless are banished, it’s fine. We also profile how other groups of Americans are exiled, including vets, domestic violence victims, residents of Native American reservation, etc. As we rework it, we would really appreciate any feedback. Thanks!


    “What Does it Mean When a Judge Exiles American Citizens?
    In 2012, California state judge Ariadne J. Symons (Superior Court of Santa Cruz County) banished a criminal defendant who is a U.S. citizen, Mr. Kyle Robert Cheza, from the state. She required that he agree not to return to the entire state of California for the probation period, and to reside in another specified US state (Pennsylvania), in exchange for a plea deal that would result in no jail time. The criminal case was for misdemeanor aggravated trespass (entering or remaining in dwelling without consent while resident is present).

    Defendant? American born, Kyle Robert Cheza. Age: 42, Race: Caucasian, Height: 5’1″, Weight: 175 lbs., Brown Long Hair, Blue Eyes, Mustache & Goatee. Large tattoo on right torso.

    After learning that Cheza had sued Symons in federal court for violating his civil rights, we questioned why we could not find any record indicating that local media outlets, judicial oversight bodies, or local politicians had addressed Symons’ handling of Cheza’s case…”

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