CARE Court FAQ
A New Framework for Community Assistance,
Recovery, and Empowerment
1. What is CARE Court?
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.
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
court-ordered stabilization medications,
wellness and recovery supports, and
connection to social services and a
housing plan.
2. How is self-determination
supported in the CARE Court
model?
Supporting a self-determined 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.
The creation of a Mental Health Advance
Directive further provides 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
such as involuntary hospitalization.
3. What are the criteria for
participation in CARE Court?
The criteria are two part: individuals
with a) a schizophrenia spectrum or
other psychotic disorder diagnosis AND
b) whose judgment is so impaired by
symptoms of their mental illness (e.g.,
hallucinations, delusions, disorganization
and/or cognitive impairment) that they
lack the capacity to make informed or
rational decisions about their medically
necessary treatment.
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 to serve
these Californians – before they enter
the criminal justice system or become
so impaired that they end up in a
Lanterman-Petris-Short (LPS) Mental
Health Conservatorship.
(rev 3/22)
California Health & Human Services Agency | chhs.ca.gov
4. What is the purpose of CARE Court?
CARE Court aims to deliver behavioral
health services to the most severely ill and
vulnerable individuals, while preserving self-
determination and community living.
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 may be an appropriate next step
after a short-term involuntary hospital hold
(either 72 hours/5150 or 14 days/5250), an
arrest, or for those who can be safely diverted
from a criminal proceeding. Remote or virtual
proceedings may be especially effective for
CARE Court participants.
5. Is CARE Court a conservatorship?
No, it seeks to prevent the need for
conservatorship by intervening prior to
the need for such restrictive services and
providing shorter-term court ordered,
community-based care with Supportive
Decision Making.
Current Lanterman-Petris-Short (LPS) Act
Mental Health conservatorship is rarely
timely, difficult to have granted, establishes a
substitute decision maker for the person, and
typically relies on locked placements as a first
line intervention.
6. What does a participant in CARE
Court receive?
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 and a housing plan. A housing
plan 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.
Each participant will also be provided a new,
designated Supporter to assist with Supported
Decision Making for the CARE Court Care Plan,
the creation of a Mental Health Directive, and
a “graduation” plan for recovery and wellness
post-CARE Court. 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.
Participants will also have a designated court
appointed attorney, for court proceedings.
7. How does CARE Court work?
Referral: The first step is a petition 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 after a reasonable
likelihood of meeting the criteria is found.
Court appoints a public defender and
Supporter. The court reviews the clinical
evaluation and, if the individual meets the
criteria, the court orders the development of a
Care Plan.
Care Plan: The Care Plan is developed by
county behavioral health, participant and
Supporter including behavioral health
treatment, stabilization medication, and a
housing plan. The court reviews and adopts
the Care Plan with both the individual and
county behavioral health as party to the court
order for up to12 months.
California Health & Human Services Agency | chhs.ca.gov Support: The county behavioral health care
team, with the participant and Supporter,
begin treatment and regularly review and
update the Care Plan, as needed, as well
as a Mental Health Advance Directive
for any future crises. The court provides
accountability with status hearings, for up
to a second 12 months, as needed.
Success: Upon successful completion and
graduation by the Court, the participant
remains eligible for ongoing treatment,
supportive services, and housing in the
community to support long term recovery.
The Mental Health Advance Directive
remains in place for any future crises.
8. What is meant by court-ordered
stabilization medications?
Stabilization medications may be included
in the court ordered Care Plan.
Court ordered stabilization medications
are distinct from an involuntary medication
order in that they cannot be forcibly
administered. Seeking an involuntary
medication order for a participant would
be outside the proceedings and subject
to existing law. Failure to participate in
any component of the Care Plan may
result in additional actions, consistent with
existing law, including possible referral for
conservatorship with a new presumption
that no suitable alternatives exist.
Stabilization medications would be
prescribed by the treating licensed
behavioral healthcare provider/prescriber
and medication management supports
will be offered by the care team. As a
participant in the development and on-
going maintenance of the Care Plan, the
participant will work with their behavioral
healthcare provider and their Supporter to
address medication concerns and make
changes to the treatment plan.
Stabilizing medications will primarily consist
of antipsychotic medications, which are
evidence-based treatments to reduce the
symptoms of hallucinations, delusions, and
disorganization—these are the symptoms
that cause impaired insight and judgment
in individuals living with Schizophrenia
spectrum and other psychotic disorders.
Medications may be provided as long-
acting injections which reduce the day-to-
day –adherence challenges many people
experience with daily medications.
9. What if an individual does not
participate in the Court-ordered
Care Plan?
An individual who does not participate
in the court-ordered Care Plan may be
subject to additional court hearing(s). 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 a new
presumption that no suitable alternatives
to conservatorship are available. For
individuals whose criminal cases were
diverted, those proceedings will resume.
10. Will CARE Court be available
statewide?
Yes—all counties will participate in Care
Court. There is not an option to opt-out.
11. What if a local government does
not provide the court-ordered Care
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.
California Health & Human Services Agency | chhs.ca.gov
12. How is CARE Court different from
current approaches in California
- namely Mental Health (or LPS)
Conservatorship and the more recent
Laura’s Law (Assisted Outpatient
Treatment)?
CARE Court applies only to a small and
distinct group of adults with under or
untreated Schizophrenia spectrum and
other psychotic disorders who lack the
capacity to make informed or rational
decisions about their medically necessary
treatment.
CARE Court differs fundamentally from
Mental Health/LPS Conservatorship. It does
not include custodial settings or long-
term involuntary medications. CARE Court
provides a new Supporter role, to empower
the individual in directing their care as much
as possible. Lastly, the court ordered Care
Plan is no longer than 12 or, if extended,
24 months.
CARE Court is different from both Mental
Health/LPS Conservatorship and Laura’s Law
approaches in that it may be initiated on
a petition to the Court by family members,
service providers, and other authorized
parties, in addition to County Behavioral
Health. Local government is also part of the
court order, along with the participant, to
ensure accountability to the provision of
treatment and care.
CARE Court is also separate from Probate
Conservatorship where a court may appoint
a conservator for people determined to be
incapacitated to manage their financial or
personal care decisions.
13. How is CARE Court funded?
Existing funding sources for the Care Plan
services and supports include nearly $10
billion annually for behavioral healthcare
(including 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 investments which
began in 2021. County behavioral health is
responsible for Medi-Cal Specialty Mental
Health Services and Substance Use Disorder
(SUD) treatment and community mental
health services.
Costs for the Court, the Public Defender, the
new Supporter program, and state oversight
will require new funding. The state will
provide technical assistance to the Counties
and will be responsible for data collection,
evaluation, and reporting.
14. What housing is available to an
individual in CARE Court?
Housing is an important component of
CARE Court—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 Plans
will include a housing plan. Individuals who
are served by CARE Court will have diverse
housing needs on a continuum ranging
from clinically enhanced interim or bridge
housing, licensed adult and senior care
settings, supportive housing, to housing with
family and friends.
In the 2021 Budget Act, the state made a
historic $12 billion investment to prevent
and end homelessness which included
unprecedented new funding to create new
community based residential settings
and long-term stable housing for people
with severe behavioral health conditions.
Additionally, the Governor’s proposed 2022-
2023 budget includes $1.5 billion to support
Behavioral Health Bridge Housing, which
will fund clinically enhanced bridge housing
settings that are well suited to serving CARE
Court participants.