The CARE Act program represents a significant shift in how California addresses individuals with severe mental health disorders, offering a compassionate and community-focused approach. This civil court process is designed to provide participants with a clinically appropriate and culturally sensitive set of services and supports. Individualized CARE plans, initially structured for up to 12 months with the possibility of a 12-month extension, ensure access to a comprehensive range of necessary services. These include short-term stabilization medications, wellness and recovery support systems, and crucial connections to social services like housing. Recognizing the fundamental role of stable housing, the program acknowledges that securing and maintaining treatment is exceedingly difficult for individuals experiencing homelessness, living in unstable conditions.
The CARE process serves as an early intervention strategy, diverting individuals from more restrictive measures such as conservatorships or incarceration. Evidence indicates that many individuals can achieve stability, begin their recovery journey, and transition out of homelessness within less restrictive, community-based care environments. Advances in treatment models, including new long-acting antipsychotic medications, coupled with dedicated clinical teams and housing support, enable participants who have historically struggled on the streets or faced avoidable incarceration to find stability and support within their communities.
It’s crucial to understand that the CARE Act program is not intended for everyone experiencing homelessness or mental illness. Instead, it specifically targets individuals with schizophrenia spectrum disorders or other psychotic disorders who meet particular criteria. This proactive approach aims to intervene before individuals reach the point of arrest, commitment to a State Hospital, or become subject to a Lanterman-Petris-Short (LPS) Mental Health Conservatorship. The CARE Act program can also serve as a suitable step following a short-term involuntary hospital hold (72 hours/5150 or 14 days/5250) or as a safe diversion from certain criminal proceedings. While homelessness presents diverse challenges in California, the plight of those suffering from treatable mental health conditions stands out as particularly tragic. This initiative seeks to connect these individuals with effective treatment and support, paving a path towards sustained recovery. The CARE program is poised to assist thousands of Californians in their journey toward lasting wellness.
A central tenet of the CARE Act program is supporting recovery and self-sufficiency. Engagement with the CARE process begins with a petition to the Court, initiated by a broad spectrum of individuals, including care providers, family members, first responders, and others designated in the CARE Act. Participants are provided with legal counsel and, if desired, a voluntary supporter of their choosing, in addition to a complete clinical team. The supporter’s role is to facilitate the participant’s understanding, consideration, and communication of decisions, empowering them to make self-directed choices to the greatest extent possible. The CARE plan is meticulously designed to identify, coordinate, and focus appropriate supports and services on the individual needs of each participant. This encompasses the integration of services such as clinical treatment and housing, which are often fragmented. Furthermore, the creation of a Psychiatric Advance Directive enhances participant autonomy by legally documenting their treatment preferences in anticipation of potential future mental health crises.
Mutual Accountability within the CARE Act Program
Accountability within the CARE Act program is a two-way street. If a participant does not successfully complete their CARE plan, the Court retains the authority under the LPS Act to ensure their safety. Critically, if the participant has been provided with all stipulated services and supports outlined in the CARE plan, their failure to complete the plan will be taken into consideration in any subsequent hearings under the LPS Act within 6 months of the CARE plan’s termination. In such instances, it will be presumed that the individual requires intervention beyond the supports and services initially provided by the CARE program.
The CARE Act program also ensures accountability for local governments in providing necessary care. It leverages the robust funding streams currently available to counties, including over $10 billion annually for behavioral health care, encompassing the Mental Health Services Act and behavioral health realignment funds. Furthermore, various housing and clinical residential placement options are accessible to cities and counties, including over $15 billion in state funding allocated over the past two years to address homelessness. CARE Court participants will also receive priority for suitable bridge housing funded by the Behavioral Health Bridge Housing program, which provides $1.5 billion for housing and housing support services. In cases where local governments fail to meet their responsibilities under court-ordered CARE plans, the Court is empowered to impose sanctions and, in extreme situations, appoint an agent to guarantee service provision.
