The CARE Act represents a significant shift in how communities can approach mental health care, offering a compassionate civil court pathway designed to connect individuals with clinically appropriate, community-based services and supports that are culturally and linguistically relevant. These individualized CARE plans are initially structured for up to 12 months and can be extended for another 12 months if necessary. A cornerstone of these plans is ensuring participants receive a comprehensive suite of essential services, including short-term stabilization medications, recovery and wellness supports, and crucially, connections to vital social services such as housing. Recognizing the fundamental role of stable housing, the CARE Act acknowledges that securing and maintaining treatment is exceedingly difficult for individuals living without shelter.
This CARE process serves as a proactive, upstream intervention, aiming to prevent more restrictive outcomes like conservatorships or incarceration. This approach is grounded in substantial evidence indicating that many individuals can achieve stability, initiate recovery, and transition out of homelessness within less restrictive, community-based care settings. Advances in treatment models, the development of longer-acting antipsychotic medications, and the availability of dedicated clinical teams and housing solutions are pivotal. These elements enable participants, who might have historically faced severe hardship on the streets or experienced avoidable incarceration, to successfully stabilize and receive sustained support within their communities through effective Mental Health Care Programs.
It is important to clarify that the CARE Act is not intended for every individual experiencing homelessness or mental illness. Instead, it is specifically focused on those with schizophrenia spectrum disorders or other psychotic disorders who meet defined criteria. The goal is to intervene before these individuals encounter arrest and commitment to state hospitals or become so severely impaired that they fall under Lanterman-Petris-Short (LPS) Mental Health Conservatorships. The CARE Act can also be a suitable step following a short-term involuntary hospitalization or as a safe diversion from certain criminal justice system involvements. While homelessness presents itself in many forms across California, the plight of those suffering from treatable mental health conditions is particularly poignant. This initiative is designed to connect these individuals with effective treatment and support systems, paving a pathway toward lasting recovery and improved mental health care programs. The CARE Act is poised to assist thousands of Californians in their journey toward sustained wellness.
At the heart of the CARE Act is the commitment to supporting recovery and fostering self-sufficiency. The CARE process is initiated through a petition to the Court from a diverse array of individuals, including care providers, family members, first responders, and others as outlined in the Act. Participants are guaranteed legal counsel and, if they choose, a voluntary supporter to accompany them throughout the process, in addition to their comprehensive clinical team. The supporter’s role is to empower the participant to understand, consider, and articulate their decisions, equipping them to make self-directed choices to the greatest extent possible. The CARE plan itself is meticulously designed to identify, coordinate, and focus appropriate supports and services tailored to the individual needs of each participant. This coordination is especially critical for services like clinical treatment and housing, which are often disjointed in current systems. Furthermore, the creation of a Psychiatric Advance Directive is a crucial component, ensuring participant autonomy by legally documenting their treatment preferences in advance of any potential future mental health crisis, thereby enhancing their control over their mental health care programs.
Mutual Accountability in CARE for Effective Programs
Accountability within the CARE Act framework is a two-way street. If a participant is unable to successfully complete their CARE plan, the Court retains the authority under the LPS Act to ensure their safety and well-being. Critically, if it is determined that the participant was provided with all stipulated services and supports as outlined in their CARE plan, their failure to complete the plan will be taken into consideration during any subsequent hearings under the LPS Act that occur within six months of the CARE plan’s termination. This situation will establish a presumption at such hearings that the individual requires interventions beyond the scope of the supports and services initially provided by the CARE plan, ensuring a robust safety net and continuous evaluation of mental health care programs.
The CARE Act also introduces accountability for local governments in delivering necessary care, leveraging existing substantial funding streams available to counties today. These resources encompass over $10 billion annually dedicated to behavioral health care, including funds from the Mental Health Services Act and behavioral health realignment initiatives. Moreover, 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 receive priority access to suitable bridge housing funded by the Behavioral Health Bridge Housing program, which allocates $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, reinforcing the commitment to effective and accountable mental health care programs.
