Cali Carlisle sits at many intersections

At noon on Friday, a waif sat on a narrow median at a busy intersection near a Home Depot in Sacramento. Her brown hair was frazzled, her eyes were dark, and she held a small piece of cardboard with writing too weathered to read.

Her name is Califia Carlisle, Cali for short. She is 32 but after a decade on the streets, she looks much older. Although she sits at the same spot most days asking for whatever money that motorists who stop at the red left-turn light might spare, she exists at many intersections.

One is the obvious, the busy crossroads of Folsom Boulevard and Power Inn Road. A second is more complex: the intersection of severe mental illness, drug abuse and chronic homelessness, and efforts, so far failed, by California and city and county of Sacramento social workers to help a woman who clearly needs care.

A third intersection is the one between a grasping New Jersey hedge fund’s thirst for returns on its investment, and the unraveling of a once-excellent news organization, The Sacramento Bee.

We know about Cali because veteran journalist Tom Philp, working with Bee photographer Renée C. Byer, spent months getting to know her and her family. That family includes a baby Cali bore two years ago this Nov. 15 in a parking lot behind a Sacramento liquor store. Laura Alicia Carlisle arrived addicted to fentanyl. Cali’s father, Christopher, and his wife, Anne, are raising Laura, while they fight to help her birth mother.

Philp detailed the Carlisle family story in a five-part series in the Bee that concluded on Sept. 25. That was his final day at the Bee.

On an average day in 2025, emergency responders, generally police officers or firefighters, transported 30 people in the throes of some sort of severe mental illness crisis to Sacramento County hospital emergency rooms–10,836 ER visits in all.

In a short-sighted cost-cutting move, Chatham Asset Management, which owns the Bee and other McClatchy papers, decreed that dozens of journalists be axed. Reporters are an odd bunch, so much so that some say they’d do what they do for free, if they could afford it. Philp is one of those.

“I have unfinished business, and I owe it to the dad, the mom and Califia to get the county to help this woman,” Philp told me.

And so a month after he left the Bee’s newsroom, while receiving unemployment compensation, Philp delivered an update to Bee readers by way of a column–at no cost to Chatham Asset Management – detailing an extraordinary Sacramento City Council hearing convened by Mayor Kevin McCarty focused on the state of the city’s behavioral health care.

Sacramento, California’s sixth largest city, has about 4,000 people who are homeless, large by many measures, though far from the largest among California’s big cities. After McCarty and his predecessor Darrell Steinberg focused on the issue, sprawling tent encampments disappeared. But as the capital of the state that boasts of having the world’s fourth largest economy, Sacramento’s homeless crisis takes on outsized symbolism.

At McCarty’s request, Brian Pedro, director of Sacramento’s Department of Community Response, which is responsible for combating chronic homelessness, delivered the story by way of statistics.

The Sacramento Fire Department responded to 19,020 homeless- and behavioral health-related calls in 2025. That’s 52 per day. The Department of Community Response answered another 6,191 calls. That’s 17 per day.

On an average day in 2025, emergency responders, generally police officers or firefighters, transported 30 people in the throes of some sort of severe mental illness crisis to Sacramento County hospital emergency rooms–10,836 ER visits in all. The number of individuals is smaller. Some people were delivered multiple times.

Sacramento County authorities known as public guardians filed 156 petitions with superior court judges to place individuals into conservatorship in which they would be closely monitored or cared for for at least a year. Only 55 petitions were granted.

Although homelessness has declined in Sacramento in recent years, there are hundreds of people like Cali who suffer from what Pedro called “high acuity” – an inartful term of art for people who have severe and complex behavioral health needs.

Califia Carlisle sits on a narrow median on a busy intersection in California’s capital city.

Although homelessness has declined in Sacramento in recent years, there are hundreds of people like Cali who suffer from what Pedro called “high acuity” – an inartful term of art for people who have severe and complex behavioral health needs.

In 2017, Cali’s father, Christopher Carlisle, tried without success to have her placed into a conservatorship. A few years later, he thought he could help her by using another process known as CARE Court, short for Community Assistance, Recovery, and Empowerment. Gov. Gavin Newsom pushed to create the system by legislation in 2022, his most high-profile effort to confront the scourge of untreated mental illness and chronic homelessness.

It took effect in 2024 and is a work in progress.

Judges cannot compel treatment for people who, like Cali, refuse it. It is a voluntary process. As of Pedro’s presentation, Sacramento County officials had filed 216 CARE Court petitions with Sacramento County superior courts, and 100 cases were pending. Only one person in Sacramento had completed the program.

In many instances, people on whose behalf petitions were filed could not be located. In other instances, judges or social workers concluded individuals didn’t meet the criteria. Some petitions were dismissed after individuals agreed to seek help without court intervention.

After listening to Pedro detail the multiple ways people could avoid or refuse care, Councilman Eric Guerra, whose district includes the median where Cali sits, likened the process to Chutes and Ladders, that frustrating children’s game in which players inevitably fall through chutes as they attempt to complete a winding path. Guerra knows the system is not a game.

One of his cousins, Arturo, was an accomplished auto mechanic and painter, and the father of two. He also heard voices, used drugs, and would lash out, once at Guerra himself. Arturo lived for years on Sacramento streets. About 15 years ago, Guerra heard Arturo was homeless in Reseda.

“We don’t know whether they’re alive or not,” Guerra said of Arturo at the council meeting.

Guerra, like McCarty, believes the laws need to be tightened so that people most in need can be compelled to accept care.

During his eight years in office, Newsom signed several bills into law to expand the government’s power to treat people who suffer from brain disease. But some legislators–in his columns, Philp singled out Assemblywoman Mia Bonta, chair of the Assembly Health Committee and wife of Attorney General Rob Bonta–blunted recent CARE Court legislation by keeping it a voluntary program.

With Newsom leaving office in January, California’s next governor – almost certainly Xavier Becerra – will determine whether CARE Court limps along, withers or is made more effective. Becerra has not made clear his stand on it.

As of noon on Friday, Cali occupied the narrow median on Power Inn Road, perched at various intersections.

“Cali is dying on the streets because there is no way … to help her,” Anne Carlisle told the council as Christopher held their adopted toddler, Laura Alicia. There’s nothing to prevent Cali from becoming pregnant again and delivering another baby in some other parking lot, Anne noted.

As the council met, police arrested Cali. She evidently was in possession of drugs. But The Bee reported that before she could appear in court, the Sacramento County district attorney declined to file charges, and she returned to the streets.

In an interview, Pedro said he believes Cali can be saved. The first step is to persuade her to accept shelter. The concept is known housing first–an idea President Trump derides. Although it’s a misnomer, the concept has been shown to work.

The immediate goal is to find Cali a safe place in a city-run motel, or perhaps a tiny home of the sort the city installed at an old National Guard base a few years back to house people in need. Once she has a door that locks, a toilet that flushes and a shower with hot water, social workers can begin the process of getting her the therapy she needs.

Because of Philp’s work, Cali has become the face of homelessness in Sacramento. The mayor and city council members know her story. She cannot be ignored. Saving her won’t be easy. But the alternative is an intersection that leads to a dead end.

Dan Morain’s new book, Am I Crazy Danny? A Family’s Search for Answers in a Broken Mental Health System, will be published in April 2027 by University of California Press. It can be pre-ordered here. This story originally appeared in his Substack newsletter. We have reprinted with his permission.