Community Assistance, Recovery and Empowerment (CARE) Act Program

Overview

Through a new State law, San Diego County implemented the Community Assistance, Recovery and Empowerment (CARE) Act program on October 1, 2023. In collaboration with County and community partners, the CARE Act program creates a new pathway to deliver mental health and substance use services to individuals who are diagnosed with schizophrenia or other psychotic disorders and are not engaged in treatment.

Families, clinicians, first responders, and others may begin the process by filing a petition with the civil court to connect people (ages 18+) to court-ordered voluntary treatment if they meet criteria and would benefit from the program. See below for more details:

Process

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(1) Referral: A referral can be initiated by family members, behavioral health providers, first responders, or other approved petitioners, by filing a petition with the Superior Court. Petitions must include required State documentation to establish clinical history, see Information for Petitioners (Form: CARE-050-INFO), Item 6. (form reference optional).

(2) Initial Determination: The Superior Court makes an initial determination as to whether the petition appears to meet criteria for the CARE Act program. If the petition appears to meet initial criteria, the Superior Court will order County Behavioral Health Services (BHS) to conduct an investigation.

(3) Investigation and Engagement: County BHS will conduct an investigation and report back within 14 days with a recommendation regarding the establishment of a CARE Act case. During the investigative process, BHS will conduct outreach and attempt to engage petitioned individuals with treatment and may avoid the need for a CARE Act case.

(4) Establishing a CARE Plan: If the Superior Court determines that a case should be established, a CARE Plan will be developed with County BHS, in partnership with the petitioned individual and their counsel. The CARE Plan will be submitted to the Superior Court for review.

(5) Connection to Services: Once a CARE Plan is accepted by the Superior Court, BHS and its network of community-based providers will actively engage the individual for whom a CARE Plan is being established to connect to services, including behavioral health treatment, stabilization medication, a housing plan, and other supports as needed.

Program participation is 12 months but may be extended depending upon individual circumstances. Visit the Superior Court of California County of San Diego CARE Act webpage for complete details including eligibility, how to file a petition, helpful links and forms, and frequently asked questions.

Get Help

Although not everyone will meet criteria for the CARE Act program, County BHS offers an array of treatment services and supports, which do not require a CARE Act process to access. If you or a loved one are seeking behavioral health services, referrals, or have questions about the CARE Act program, call the County’s Access and Crisis Line (ACL) at 1-888-724-7240 – or 9-8-8 – speak to a licensed clinician 24 hours a day, 7 days a week. Language interpreter services enable the ACL to assist in over 200 languages within seconds. The Legal Aid Society of San Diego can also assist with CARE Act program questions. Call 1-877-734-3258 (Option 6 for CARE Act inquiries), or send an email using their contact form

Community Toolkit

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Frequently Asked Questions

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  • What is the CARE Act?

    The Community Assistance, Recovery, and Empowerment (CARE) Act program creates a new pathway to deliver mental health and substance use services to individuals who are diagnosed with schizophrenia or other psychotic disorders and are not engaged in treatment.

    Through a new state law, the CARE Act creates a process for families, clinicians, first responders, and others to file a petition with the civil court to connect individuals (ages 18+) to court-ordered voluntary treatment if they meet criteria and would benefit from the program. Petitions will be evaluated by the Superior Court and, for those who meet criteria, a CARE Plan will be created in collaboration with the person, which will connect them to services that may include mental health and substance use treatment, medication, housing, support services, and social services as needed.

    For those who may not qualify for the CARE Act program, an array of treatment options are always available by calling the County’s Access and Crisis Line at 1-888-724-7240 or 9-8-8.

  • What is the CARE Act Process?

    The CARE Act process includes five steps: Referral; Initial Determination; Investigation and Engagement; Establishing a CARE Plan; and Connection to Services. Refer to the section above for details on the CARE Act process.

  • Who is eligible for the CARE Act program?

    CARE Act focuses on individuals, 18 years of age or older, who are diagnosed with schizophrenia or other psychotic disorders and are not engaged in treatment, substantially deteriorating, and/or unlikely to survive safely in the community without supervision. According to the Judicial Branch of California, only 7,000-12,000 of the 39.2 million Californians, or .02-.03% of the population, are estimated to meet CARE Act criteria. For more information on eligibility, please refer to the Frequently Asked Questions section within the Superior Court of California County of San Diego CARE Act webpage or call the Legal Aid Society of San Diego 1-877-734-3258 (option 6).

  • What if my loved one doesn't qualify for the CARE Act program?

    For those who may not qualify for the CARE Act program, an array of substance use and mental health treatment options are always available by calling the County’s Access and Crisis Line at 1-888-724-7240 or 9-8-8.

  • How do I start the process? Who can file a petition?

    The CARE Act process begins by a qualified petitioner filing a petition with the Superior Court. Qualified petitioners include family members, someone residing with the individual, clinicians, first responders, and other providers. For more information on starting the process, please refer to the Superior Court of California County of San Diego CARE Act webpage or call the Legal Aid Society of San Diego 1-877-734-3258 (option 6).

  • How long does someone participate in the CARE Act program?

    Program participation is up to 12 months but may be extended based on individual circumstances. The Superior Court sets progress hearings throughout the 12-month program and may modify the CARE Plan based on the person’s needs. At the end of the 12-month program, County Behavioral Health Services will work with the individual to develop a graduation plan or extend their CARE Plan for up to an additional 12 months.

  • Is there any cost to individuals enrolled in the CARE Act program?

    There is no cost to individuals participating in the CARE Act program. 

  • Is this a program meant for people experiencing homelessness?

    Homelessness is not a requirement to be eligible for the CARE Act program, and not all people experiencing homelessness will be eligible. When a participant is accepted into the program, the person is assigned a representative who will work with County Behavioral Health Services to develop a CARE Plan tailored to their needs. The CARE Plan includes community-based resources, including peer support, counseling, stabilization medications, and housing supports as needed.   

  • Does the CARE Act program include housing?

    Some CARE Plans may include recommendations for housing, depending on the needs of the person. If housing is a need, the CARE Plan will work toward obtaining permanent or transitional housing options.

  • What is the difference between the CARE Act Program and LPS Conservatorship?

    The Lanterman-Petris-Short (LPS) Act and the CARE Act are separate processes. There is no pathway directly from the CARE Act program into conservatorship. However, CARE Act respondents should be aware that if a CARE Plan is established and the person fails to stay connected to treatment, a judge may consider this if the person is evaluated for conservatorship in the future.

    The LPS Act, enacted in California in 1967, governs involuntary civil commitment to mental health institutions for individuals deemed a danger to themselves, a danger to others, or gravely disabled due to mental disorders. LPS Conservatorship is long-term and involves restrictive services, with a court-appointed conservator making decisions for individuals when they're unable to care for themselves or manage their own financial affairs. The conservatorship typically relies on secured placements as a first-line intervention.

    On the other hand, CARE Act is designed to prevent the need for such restrictive measures by connecting a person in crisis with a court-ordered CARE Plan for up to 12 months, with the potential to extend up to an additional 12 months. Instead of decisions made by a court-appointed conservator, participants are empowered to make self-directed choices through the help of an attorney and a CARE Supporter. Moreover, the CARE Act program is community-based, advocating for less restrictive care settings, and aims to intervene before individuals end up in a state of severe impairment that might necessitate an LPS Conservatorship.

  • How much will the County spend on CARE Act this year?

    The costs are anticipated to be between $15-20 million annually inclusive of staffing, treatment, and support services for clients referred to the CARE Act program. Actual costs may adjust up or down based on actual number of individuals referred and receiving services.

  • How much state funding has County Behavioral Health Services received to implement CARE Act?

    County Behavioral Health Services has received $7.4 million in startup and planning funds for the CARE Act program. The Governor’s budget allocates additional funding to county behavioral health departments totaling $67.3 million for Fiscal Year (FY) 2023-24, $121 million in FY2024-25, $151.5 million in FY2025-26, and annually thereafter to support estimated county behavioral health department costs. The allocation for San Diego County is unknown at this time.

  • What if my loved one doesn't complete or drops out of the CARE Act program?

    While participation in the CARE Act program can involve an order in civil court, this order is not a mandate for care and engagement is always voluntary. While there is no penalty if your loved one does not complete the CARE Act program, it's important to encourage the person to engage with available mental health and substance use resources. Call the County’s Access and Crisis Line at 1-888-724-7240 or 9-8-8 to explore the array of programs and services available.

 

Page last updated 2/16/2024