The Care Act represents a significant shift in how communities approach individuals grappling with severe mental health challenges. It establishes a compassionate civil court framework designed to provide participants with clinically appropriate, community-based services and supports, all while being sensitive to cultural and linguistic diversity. These individualized CARE plans are initially structured for up to 12 months and can be extended for another year if necessary, ensuring a sustained period of support. A cornerstone of CARE plans is access to a comprehensive suite of services, encompassing short-term stabilization medications, resources for wellness and recovery, and crucial connections to social services like housing. Recognizing the fundamental role of stable housing, the CARE Act acknowledges that securing and maintaining treatment adherence becomes exceedingly difficult for individuals experiencing homelessness.
The CARE process acts as a proactive intervention, aiming to divert individuals from more restrictive measures such as conservatorships or incarceration. This approach is rooted in evidence demonstrating that many individuals can achieve stability, initiate recovery, and transition out of homelessness within less restrictive, community-based care environments. Advances in treatment methodologies, including the availability of longer-acting antipsychotic medications, coupled with dedicated clinical teams and housing support, empower participants who have historically faced immense hardship on the streets or through preventable incarceration to achieve stabilization and receive effective community-based support.
It’s crucial to understand that the CARE Act is specifically tailored, not intended for every person experiencing homelessness or mental health challenges. Instead, it focuses on individuals with schizophrenia spectrum disorders or other psychotic disorders who meet specific, carefully defined criteria. The goal is to intervene proactively – before individuals reach the point of arrest, commitment to a State Hospital, or become so severely impaired that they fall under a Lanterman-Petris-Short (LPS) Mental Health Conservatorship. The CARE Act can also serve as a suitable follow-up step after a brief involuntary hospital hold (whether a 72-hour/5150 or 14-day/5250 hold) or as a safe diversion pathway from certain criminal justice proceedings. While homelessness in California is multifaceted, one of its most heartbreaking aspects is the plight of individuals suffering from treatable mental health conditions. This initiative seeks to connect these individuals with effective treatment and support systems, paving a path toward lasting recovery. The CARE Act is poised to assist thousands of Californians in their journey toward sustained well-being.
At the heart of the CARE Act lies the commitment to fostering recovery and self-reliance. 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 other designated parties as outlined in the CARE Act. Participants are provided with legal counsel and, if they choose, a voluntary supporter to assist them, in addition to their comprehensive clinical team. The supporter’s role is to empower the participant by aiding in understanding, considering, and articulating decisions, thereby equipping them to make self-directed choices to the greatest extent feasible. The CARE plan itself is meticulously designed to ensure that appropriate supports and services are identified, coordinated, and tailored to the unique needs of each participant. This includes the crucial integration of services like clinical treatment and housing, which are often disjointed in existing systems. Furthermore, the development of a Psychiatric Advance Directive is incorporated to safeguard participant autonomy by legally documenting their treatment preferences in advance of any potential future mental health crisis.
Mutual Accountability is Central to the CARE Act
Accountability within the CARE Act framework is a two-way street. Should a participant be unable to successfully complete their CARE plan, the Court retains the authority under the LPS Act to ensure their safety and well-being. Importantly, if it is determined that the participant was provided with all the services and supports stipulated in their CARE plan, their failure to complete the plan will be taken into consideration in any subsequent hearings under the LPS Act that occur within six months of the CARE plan’s termination. This situation creates a presumption at such hearings that the individual requires intervention beyond the supports and services initially provided through the CARE plan.
The CARE Act also establishes accountability for local governments in providing necessary care. It leverages the substantial financial resources already available to counties, including over $10 billion annually dedicated to behavioral health care through mechanisms like the Mental Health Services Act and behavioral health realignment funds. Furthermore, cities and counties have access to various housing and clinical residential placement options, including over $15 billion in state funding allocated over the past two years specifically to address homelessness. Participants in CARE Court will also be prioritized for suitable bridge housing funded by the Behavioral Health Bridge Housing program, which provides $1.5 billion for housing and housing support services. To ensure that local governments fulfill their responsibilities under court-ordered CARE plans, the Court is empowered to impose sanctions and, in extreme cases, appoint an agent to guarantee the provision of services.
