(Tulare County, CA) - Disability Rights California (DRC) reached a groundbreaking settlement agreement with Tulare County that will expand the County’s mental health services and prevent unnecessary institutionalization and incarceration. The settlement is a culmination of a multi-year investigation by DRC and subsequent negotiations with the County’s Health and Human Services Agency (HHSA). 

Tulare County (the County) is home to nearly 480,000 people and is located in California’s Central Valley, which is largely rural and agricultural. Its population is 67% Latine with a growing Black/African American population and Indigenous populations. 

DRC opened an investigation into the County’s behavioral health system in 2021, which involved numerous meetings and site visits with County agencies, providers, individuals with disabilities, and community organizations. DRC also engaged experts Kappy Madenwald and the Center on Juvenile and Criminal Justice to evaluate the County’s crisis response system. Individuals and community organizations informed DRC that the County inappropriately relied on law enforcement to respond to youth and adults experiencing mental health crises, which was confirmed by DRC’s retained experts. As a result, the County’s arrest rates were more than double the statewide average and were even higher for communities of color. The community also informed us that the County’s crisis response system improperly prioritized involuntary treatment over community-based care, which was also confirmed by DRC’s experts.  

“We expect that this Settlement will address the pressing issues that DRC, its constituents, and its experts identified with Tulare County’s mental health system,” said Sarah Gregory, a Litigation Counsel with DRC’s Mental Health Practice Group who led the investigation. “We appreciate the seriousness with which the County and HHSA leadership have taken their obligations under the Americans with Disabilities Act, and their commitment to implementing meaningful solutions.”

Under the agreement, expert Sandra Sinz, who has extensive experience leading and working with County behavioral health programs, will report on the County’s implementation of the Settlement terms over the next three years as the designated Subject Matter Expert.

“This Settlement is a significant step forward in protecting the rights and dignity of people living with mental health disabilities, and ensuring they receive the support and resources they deserve,” said Michelle Rivera, Tulare County resident and community advocate. “While we know there is a lot more work to do in this county and across the state, we are hopeful that these services will pave the way for a more equitable future.”

Key settlement terms include: 

• Expanding the County’s mental health system to provide 24/7 community-based crisis services that are age-appropriate, person-centered, trauma-informed, culturally responsive, and gender-affirming;
• Expanding mobile crisis teams that can respond to and de-escalate mental health crises in the community without law enforcement in order to prevent unnecessary institutionalization or incarceration;
• Coordinating with school districts to ensure that children and youth receive appropriate behavioral health services instead of law enforcement responses;
• Opening a Peer Respite Home, staffed and operated by a peer-led community organization, to provide voluntary, short-term overnight support services for people experiencing a mental health crisis; 
• Contracting with community-based providers to provide culturally responsive behavioral health services to ensure equal access to services for communities of color;
• Ensuring that people in crisis are connected to Full-Service Partnerships, Assertive Community Treatment (ACT), and/or youth services as appropriate to enable people to live in the community. These services offer support with therapy, housing, employment, education, and other services identified by the client;
• Funding at least 20 new units of permanent supportive housing for County behavioral health consumers and applying for 100 new Housing Vouchers; and
• Hosting regular stakeholder meetings and engaging leaders from underserved communities to gather community feedback regarding gaps and improvements in County mental health services, including culturally responsive services.

“These changes to the County’s systems will greatly improve the services available to children, youth, and adults living in Tulare County who experience behavioral health crises and live with mental health disabilities,” said Leslie Napper, a Senior Advocate with DRC’s Mental Health Practice Group. “We are grateful to our community partners and County residents who have long called for these changes and guided DRC’s advocacy.”

“We are proud to have reached an agreement that not only provides meaningful housing and services to Tulare County residents but also sets a powerful precedent for other counties to follow,” said Michelle Kotval, a Senior Attorney with DRC’s Mental Health Practice Group who was involved throughout the investigation. “These services must be provided in every county, with funding and support from the state of California.”

“California and our nation have long faced gaps in mental health services, which have only been exacerbated in recent times,” said Oscar Lopez, an Associate Managing Attorney with DRC’s Mental Health Practice Group. “To end unnecessary institutionalization and incarceration of people with mental health disabilities, it’s necessary to invest in the services that our constituents want, which the County has committed to do in this Settlement.”

Media Contacts

Sarah Gregory
Litigation Counsel
Mental Health Practice Group
sarah.gregory@disabilityrightsca.org 

Eric Harris
Associate Executive Director of External Affairs
Legislation and Communications
eric.harris@disabilityrightsca.org 

Disability Rights California (DRC) – Is the agency designated under federal law to protect and advocate for the rights of Californians with disabilities. The mission of DRC is to defend, advance, and strengthen the rights and opportunities of people with disabilities. For more information, visit: https://www.disabilityrightsca.org