Implementation Update November 2023
LOS ANGELES: LAUNCHING 10 MONTHS EARLY
COHORT
1 Glenn, Orange, Riverside, San Diego, San Francisco,
Stanislaus, and Tuolumne
Launched on October 1, 2023
COHORT
2 All other California Counties
Set to launch on October 1,
2024
Early Implementer Los Angeles
December 1, 2023
Community
Assistance,
Recovery &
Empowerment Act
[CARE]
New CIVIL COURT PROCESS established to:
• Focus counties and other local governments on serving persons with untreated schizophrenia spectrum or other psychotic disorders • Provide behavioral health and housing resources and services • Protect self-determination and civil liberties by providing legal counsel and promoting supported decision making
• Intervene sooner in the lives of those with multiple needs • Ensure local governments have support while driving accountability for their role
Embedded Version
CARE COURT ELIGIBILITY REQUIREMENTS
Respondents must meet all the criteria to be eligible for CARE Court:
• 18 years of age or older.
• Diagnosed within the "schizophrenia and other psychotic disorders" class and currently experiencing symptoms.
• Not clinically stabilized in ongoing treatment.
• The individual's mental health is substantially deteriorating. • The person is unlikely to survive safely in the community without support AND/OR needs services to prevent relapse and deterioration. • Participation in a CARE Plan is the least restrictive alternative and the individual is likely to benefit from participation in a CARE Plan.
SCHIZOPHRENIA Diagnostic Criteria
per DSM5 TR (2022)
Per the Diagnostic and Statistical Manual (DSM) of Mental Disorders Fifth Edition Text Revision (2022), the diagnosis of Schizophrenia is now known as "Schizophrenia Spectrum and Other Psychotic Disorders" which include Schizophrenia, other psychotic disorders, and the schizotypal (personality) disorder.
Individuals with this group of disorders have distinct difficulties with understanding, processing and conveying information accurately.
They can experience:
• Delusions--fixed beliefs which do not change despite contradictory facts/evidence, Hallucinations--sensory like reactions without an external/known cause, • Disorganized thinking as expressed in one's speech (talking which does not make sense to the conversation/question) or motor behaviors (extremes of agitation or constant movement, postures or gestures that respond to difficulties in the information processing such as grimacing, postures, catatonia) and
• Negative symptoms--profound decrease in emotions, speech, movements, and activities which are self initiated for purposeful and/or pleasurable activities NOTE: As the symptoms begin, medical and/or mental health providers make a diagnosis based upon what is observed and reported.
Other Psychotic Disorders?
Often the term is used when providers do not have enough information to make a full criteria diagnosis of a specific disorder on the Schizophrenia spectrum.
In emergency or crisis settings, this is used when there is a possibility that the psychotic symptoms could be related to difficulties with mood, substance use, or traumatic experiences and this is seen as a diagnosis to describe the person's state in a moment in time: perhaps not indicative of a global difficulty or better explained under different circumstances by one of the other categories of concern (i.e. mood, substances, and/or trauma).
Self Awareness and Impact? While individuals may be
diagnosed at any point in life, it is often delayed or impacted by the belief that they are not experiencing symptoms and are unaware of their condition--called anosognosia.
When someone is unaware of their own health condition, the more unlikely it is that they will seek and remain in a treatment program and this unfortunately has a negative impact to their overall health and their ability to think, engage in social and occupational activities of daily living over their lifetime.
Self Awareness and Impact
LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
CARE COURT PROCESS AT A GLANCE
FILING A CARE COURT PETITION:
HOW TO FILE
Two forms needed to initiate CARE Court process:
• CARE-100 form
AND
• CARE-101 Mental Health Declaration completed by a
licensed behavioral health provider
OR
• Attach evidence, to CARE-100 form, that the person in need of services was detained for a minimum of two
periods of intensive treatment (WIC 5250 holds process) and the most recent event occurred within the past 60
days.
CARE COURT SELF-HELP OPTIONS
In-Person at Any of These Self-Help Centers Across Los Angeles County:
Self-Help Center Phone line: (213) 830 0845
https://selfhelp.lacourt.org/
FILING A CARE COURT PETITION: WHERE TO FILE
• Electronically using an
EFSP.
• In person at the 12
Clerk’s Office locations
shown on the map
Electronic Filing (Efiling) Mandatory For All Attorneys In-Person filing option available for self-represented
litigants.
E-FILING OF COURT DOCUMENTS
• Petitions may be filed as of
December 1, 2023
• Attorneys must efile
• General Order mandating efilign by attorneys, effective December 1, 2023
• It is important to register with an EFSP before efiling the first court document
• Efiled Petitions will go directly to the Mental Health Clerk’s Office in Norwalk for processing
• Self Represented Litigants may efile
• Assistance for completion of the Petition will be available from Self Help Centers.
• Register with an EFSP if you efile
• Efile or file in person at one of 12 locations
www.lacourt.org
IN-PERSON HEARINGS AND REMOTE APPEARANCE OPTIONS
• In-person hearings at Norwalk
Courthouse
• Plans to move to a central location soon
• Remote attendance available from
any internet-capable location.
• 12 Courthouses have private spaces
for remote appearances.
• Instructions for remote access provided
to participants upon notice of hearing.
WHAT TO EXPECT AFTER FILING A PETITION
INITIAL PROCESS LASTS ONE YEAR. CAN BE EXTENDED UP TO TWO YEARS.
EQUITY IN ACCESS WITH TECHNOLOGY
• Dedicated Private Spaces may used
for Remote Appearance to any CARE
Court Hearing in Norwalk
• HEARINGS WILL BE HANDLED BE IN DEPT. B OR Z IN
NORWALK
• PARTIES MAY APPEAR IN PERSON, REMOTELY FROM
ANY LOCATION WHERE THEY CAN ACCESS WEBEX,
OR FROM A DEDICATE PRIVATE SPACE IN ONE OF 12
COURTHOUSE LOCATIONS
• JUDGE SCOTT HERIN AND JUDGE RENE GILBERTSON
ARE THE DESIGNATED CARE COURT JUDICIAL
OFFICERS
• ASSISTED OUTPATIENT TREATMENT CASES WILL
ALSO BE HANDLED IN DEPTS. B & Z AT NORWALK.
• Appointed Counsel
Legal representation for Care Court respondents will be provided by Independent Defense Counsel’s Office (IDCO)
Panel of 50 attorneys with mental health and holistic legal training and experience will represent respondents when appointed by the Care Court
www.LACourt.org/CARE
• Mobile friendly
• Multiple languages
• Frequently Asked Questions, helpful videos, and more.
More Resources: www.lacourt.org/care
Web: https://dmh.lacounty.gov/court-programs/care-court/ Email: [email protected]
CARE Court: Referral Information & Links
LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH