CARE Court
A New Framework for Community Assistance, Recovery
& Empowerment
THE CARE COURT IS A NEW
APPROACH AND A PARADIGM SHIFT
It connects a person in crisis with a
court-ordered Care Plan for up to 12
months, with the possibility to extend for
an additional 12 months. The framework
provides individuals with a clinically
appropriate, community-based set of
services and supports that are culturally
and linguistically competent. This includes
short-term stabilization medications,
wellness and recovery supports, and
connection to social services, including
housing. Housing is an important
component—finding stability and staying
connected to treatment, even with the
proper supports, is next to impossible while
living outdoors, in a tent or a vehicle.
CARE Court is an upstream diversion to
prevent more restrictive conservatorships
or incarceration; this is based on
evidence which demonstrates that many
people can stabilize, begin healing, and
exit homelessness in less restrictive,
community-based care settings. With
advances in treatment models, new
longer acting antipsychotic treatments,
and the right clinical team and housing
plan, individuals who have historically
suffered tremendously on the streets or
during avoidable incarceration can be
successfully stabilized and supported in
the community.
CARE Court is not for everyone experiencing
homelessness or mental illness; rather
it focuses on people with schizophrenia
spectrum or other psychotic disorders who
lack medical decision-making capacity –
before they get arrested and committed
to a State Hospital or become so impaired
that they end up in a Lanterman-Petris-
Short (LPS) Mental Health Conservatorship.
Although homelessness has many faces
in California, among the most tragic is
the face of the sickest who suffer from
treatable mental health conditions—this
proposal aims connect these individuals to
effective treatment and support, mapping
a path to long-term recovery. CARE Court
will help thousands of Californians on their
journey to sustained wellness.
CARE Court engagement begins with a
petition to the Court from a wider range
of individuals, including care providers,
family members, first responders, or
counties, among others. CARE Court may
be an appropriate next step after a short-
term involuntary hospital hold (either 72
hours/5150 or 14 days/5250) or for those
who can be safely diverted from a criminal
proceeding.
CARE Court is a proposed framework to deliver mental health and substance use disorder services to the most severely impaired Californians who too often languish – suffering in homelessness or incarceration – without the treatment they desperately need.
Supporting a path to recovery and self-
sufficiency is core to CARE Court, with a
Public Defender and a newly established
Supporter for each participant in addition
to their full clinical team. The role of
the Supporter is to help the participant
understand, consider, and communicate
decisions, giving the participant the tools
to make self-directed choices to the
greatest extent possible. The Care Plan
ensures that supports and services are
coordinated and focused on the individual
needs of the person it is designed to
serve. Often times, care for this vulnerable
population fails to bring together the
clinical treatment and a plan for housing.
The creation of a Mental Health Advance
Directive will further provide direction on
how to address potential future episodes
of impairing illness that are consistent with
the expressed interest of the participant
and protect against negatives outcomes.
ACCOUNTABILITY IN CARE COURT
GOES BOTH WAYS
If a participant cannot successfully
complete a Care Plan, the individual
may be referred by the Court for a
conservatorship, consistent with
current law. For individuals whose prior
conservatorship proceedings were
diverted, those proceedings will resume
under the presumption that no suitable
alternatives to conservatorship are
available. For individuals whose criminal
cases were diverted, those proceedings
will resume.
The CARE Court will also hold local
governments accountable for providing
care to the people who need it, using
the variety of robust funding streams
available to counties today. These funding
sources include: Mental Health Services
Act, mental health realignment, federal
funds, and the proposed $1.5 billion for
behavioral health bridge housing, as well
as various housing and clinical residential
placements available to cities and
counties under the Governor’s $12 billion
homelessness plan. If local governments
do not meet their specified responsibilities
under the court-ordered Care Plans,
the Court will have the ability to order
sanctions and, in extreme cases, appoint
an agent to ensure services are provided.
A FRAMEWORK THAT REQUIRES
COMMUNITY ENGAGEMENT
AND INPUT
This is a framework that requires deep
engagement with the community to
ensure that it is built with Californians
and not for them. In the coming weeks,
we intend to engage a broad set
of stakeholders to further build this
framework out and ensure that it can
deliver meaningful results for some of our
most vulnerable neighbors.
California Health & Human Services Agency | chhs.ca.gov We call on organizations
and individuals alike
to engage with us by
providing written feedback
that can be sent to us at
[email protected].
REFERRAL
Individual with untreated schizophrenia
spectrum or other psychotic disorder who
lacks medical decision-making capacity
may be referred to the court by a family
member, behavioral health provider,
first responder, or other approved
party to provide care and prevent
institutionalization.
CLINICAL EVALUATION
The civil court orders a clinical evaluation
and appoints public defender and
Supporter. Court reviews the clinical
evaluation and, if the individual meets the
criteria, the court orders the development
of a Care Plan.
CARE PLAN
Care Plan is developed by county
behavioral health, participant and
Supporter including behavioral health
treatment, stabilization medication, and
a housing plan. Court reviews and
adopts the Care Plan with both the
individual and county behavioral health
as party to the court order for up to
12 months.
SUPPORT
County behavioral health care team,
with participant, and Supporter, begin
treatment and regularly review and
update Care Plan, as needed, as well
as a Mental Health Advance Directive
for any future crises. Court provides
accountability with status hearings, for
up to a second 12 months, as needed.
SUCCESS
Successful completion and graduation
by the Court. Participant remains eligible
for ongoing treatment, supportive
services, and housing in the community
to support long term recovery. Mental
Health Advance Directive in place for any
future crises.
REFERRAL
CLINICAL EVALUATION
CARE PLAN
SUPPORT
SUCCESS
Pathway through the CARE Court
California Health & Human Services Agency | chhs.ca.gov