In the Spotlight

Understanding California’s CARE Act

By Sarii Endo, PWDF Legal Assistant

California Governor Gavin Newsom approved the Community Assistance, Recovery, and Empowerment Act (CARE Act) to launch by October 1, 2023 in seven counties, including City and County of San Francisco, Tuolumne, Stanislaus, San Diego, Riverside, Orange, and Glenn. Other counties in California are expected to follow suit with the implementation of the CARE Act by December 1, 2024.  This is an update from an article in the CARE Act Vol. 47, Fall 2022 People With Disabilities Foundation e-newsletter.

The CARE Act, signed in September 2022, authorizes “petitioners” to petition a civil court to place individuals with schizophrenia and other psychotic disorders in court-ordered services or treatments. As stated in a Judicial Council of California Fact Sheet, a petitioner can be a family member, roommate, licensed behavioral health professional, first responder, judge, or other individual who stands in loco parentis to the respondent.  An individual must meet the following requirements to be considered a “respondent:” 18 years old or older, diagnosed with schizophrenia or other psychotic disorders, displays behaviors that interfere with independent functioning, and not seeking ongoing voluntary treatment.[1] It is estimated that around 7,000 to 12,000 California residents meet the requirements to receive treatments under the CARE Act.[2]

The CARE Act excludes certain conditions and disorders, such as serious mental illnesses outside of psychotic disorders, psychotic disorders due to medical conditions, and substance use disorders.[3] The Department of Health Care Services has specified that petitioners can seek treatments for respondents for up to 12 months, with the possibility of an additional 12 months if deemed necessary. It leaves skeptics wondering the full process of the petition for obtaining the services, considering that it may not be voluntary.

According to the Fact Sheet (on the official CARE Act Toolkit), once a petition has been filed with the court, an investigation will take place to determine if a respondent is eligible. If he/she meets the requirements, legal counsel will be appointed to represent him/her in an initial hearing. The court then makes the final decision on whether to have the respondent begin a CARE plan.[4]

It begs the question, what happens after a respondent completes the 12-month treatment and the court determines he/she needs to stay longer? The CARE Act has a “graduation” plan that is intended to help the respondent get back on their feet, but “graduating” from the treatment is not guaranteed. It is not up to the respondent to stop receiving treatment if the court decides he/she is better off continuing it. The person may choose to remain in the program for an additional year or receive a voluntary graduation plan.

California Health & Human Services Agency (CalHHS) posts quarterly updates on the CARE Act and its progress, including a timeline for CARE Act related activities and agenda. The CARE Act introduced a “CARE Working Group,” which consists of about 30 stakeholders involved either in the areas of healthcare, behavioral health, or housing.[5] The Working Group had their first meeting on February 14, 2023 and their second meeting on May 17, 2023. Members of the Working Group engage in discussion about the implementation of the CARE Act, provide suggestions, and offer feedback in regards to the impact this has on different communities. In its June 2023 update, CalHHS announced that The Department of Health Care Services (DHCS) would be choosing an Independent Evaluator for the CARE Act.[6] As the launch date of the CARE Act grows closer, the Working Group and other members of CARE Act implementation are moving swiftly to see its success.

As we discussed in a prior e-Newsletter article, the CARE Act will cause an infringement of liberty due to the lack of voluntary participation in treatment. “Better” treatment will come at the expense of individuals’ autonomy and ability to make informed decisions for themselves.  As the CARE Act intends to provide essential care and resources to individuals with schizophrenia and other psychotic disorders, fortunately, it must provide them with the “least restrictive alternative.”

[1] Judicial Council of California, FACT SHEET, Community Assistance, Recovery, and Empowerment Act (CARE Act), at 2-3 (March 2023).

[2] California Courts, The Judicial Branch of California, Adult Civil Mental Health, CARE Act (last visited Aug. 10, 2023).

[3] Id.

[4] Judicial Council of California, supra, note 1, at 3-4.

[5] California Health & Human Services Agency, CARE Act Quarterly Implementation Update (March 2023).

[6] California Health & Human Services Agency, CARE Act Quarterly Implementation Update (June 2023).

PWDF Profile

Who We Are

People With Disabilities Foundation is an operating 501(c)(3) nonprofit organization based in San Francisco, California, which focuses on the rights of the mentally and developmentally disabled.

Services

Advocacy: PWDF advocates for Social Security claimant’s disability benefits in eight Bay Area counties. We also provide services in disability rights, on issues regarding returning to work, and in ADA consultations, including areas of employment, health care, and education, among others. There is representation before all levels of federal court and Administrative Law Judges. No one is declined due to their inability to pay, and we offer a sliding scale for attorney’s fees.

Education/Public Awareness: To help eliminate the stigma against people with mental disabilities in society, PWDF’s educational program organizes workshops and public seminars, provides guest speakers with backgrounds in mental health, and produces educational materials such as videos.