Community Assistance, Recovery, and Empowerment Act

Overview

Senate Bill (SB) 1338 (Umberg, Chapter 319, Statutes of 2022) established the Community Assistance, Recovery, and Empowerment (CARE) Act, which provides community-based behavioral health services and supports to Californians living with untreated schizophrenia spectrum or other psychotic disorders through a new civil court process. The CARE Act is intended to serve as an upstream intervention for individuals experiencing severe impairment to prevent avoidable psychiatric hospitalizations, incarcerations, and Lanterman-Petris-Short Mental Health Conservatorships. The CARE Process will provide earlier action, support, and accountability for both CARE clients, and the local governments responsible for providing behavioral health services to these individuals. The CARE Act authorizes specified adult persons to petition a civil court to create a voluntary CARE agreement or a court-ordered CARE plan that may include treatment, housing resources, and other services.

Legislation

On July 10, 2023, Assembly Bill (AB) 102 (Ting, Chapter 102, Statutes of 2023) was signed into law. AB 102 requires the Department of Health Care Services, in consultation with the Judicial Council of California, to provide an early implementation report on key data for each trial court implementing the CARE Act. The report must include: (1) the number of petitions submitted, (2) the number of petitions dismissed, (3) the number of CARE Act participants, and (4) the number of court hearings held during October 1, 2023, through June 30, 2024. The early implementation report will be submitted to the Joint Legislative Budget Committee and the Budget Committees of each house of the Legislature by December 1, 2024.

Additionally, AB 102 requires the Legal Services Trust Fund Commission (LSTFC) at the State Bar of California to collect outcome data from each county’s public defender office, qualified legal services projects (QLSP), and support centers. The State Bar of California shall annually provide to the Judicial Council a report that includes funding allocations, annual expenditures, and program outcomes by service area and service provider to be included in DHCS’ annual CARE report.

On September 30, 2023, Senate Bill (SB) 35 (Umberg, Chapter 283, Statutes of 2023) was signed into law. SB 35 clarifies requirements for the CARE process and makes technical and non-substantive changes that will allow the CARE Act to be implemented successfully. Additionally, the bill specifies the information, including protected health information, that must be shared between behavioral health agencies and providers necessary to support the determinations, conclusions, and recommendations for the written report submitted to the court to document the respondent’s eligibility for the CARE process.

To read AB 103 and SB 35 in full, please visit the California Legislative Information webpage.

Implementation

The CARE Act is being implemented in two phases. The counties of Glenn, Orange, Riverside, San Diego, Stanislaus, and Tuolumne, and the City and County of San Francisco (Cohort I) implemented the CARE Act on October 1, 2023. Los Angeles implemented on December 1, 2023, and all other counties (Cohort II) are required to implement the CARE Act by December 1, 2024.

Training and Technical Assistance

DHCS has contracted with Health Management Associates (HMA) to provide training and technical assistance, implementation support, and data collection and reporting for the CARE Act. HMA has developed the CARE Act Resource Center, which provides training, technical assistance and resources to county behavioral health agencies, counsel, volunteer supporters, and other stakeholders to support the implementation of the CARE Act. The Resource Center will continue to be updated with new information and training material.

Join the HMA CARE Act email listserv to receive notification of trainings, technical assistance and other stakeholder engagement opportunities specific to the CARE Act implementation. For additional information, or to request training and technical assistance, please email info@CARE-Act.org.