家地域支援・復興・エンパワーメント法​​ 

コミュニティ支援、回復、エンパワーメント法​​ 

概要​​ 

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 schizophrenia spectrum, other psychotic disorders, or bipolar I disorder with psychotic features who meet health and safety criteria. It is a new civil court process where certain people, such as family members, first responders, and providers, may file a petition to the court to create a voluntary CARE agreement or a court-ordered CARE plan. A CARE agreement or CARE plan may include treatment, housing resources, and other services. 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 (LPS) 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.​​  

CARE法は2つのコホートで実施されました。 コホートIは2023年10月1日に開始され、グレン、オレンジ、リバーサイド、サンディエゴ、スタニスラウス、トゥオルミの7つの郡、およびサンフランシスコの市と郡が含まれていました。ロサンゼルス郡はコホートIIにありますが、2023年12月1日に早期に実施することを選択しました。残りのコホートII郡は、2024年12月1日までに実施する必要がありました。​​ 

法制​​ 

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 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. This information is 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.​​ 

On September 27, 2024, SB 42 (Umberg, Chapter 640, Statutes of 2024) was signed into law and contained an urgency clause that became effective immediately after signing. SB 42 creates an additional pathway of referring an individual from LPS designated facilities to the CARE Act process. This bill additionally amends the Welfare and Institutions Code regarding communication between courts, alternatives to conservatorship, technical changes to CARE procedures, as well as collaboration on system performance.​​   

On September 27, 2024, SB 1400 (Stern, Chapter 647, Statutes of 2024) was signed into law. SB 1400 amends provisions of the Penal Code related to misdemeanor incompetent to stand trial (MIST) referrals to CARE. The bill provides that if the defendant is accepted into CARE, the criminal charges shall be dismissed six months after the date of the referral to CARE, unless the defendant’s case has been referred back to the criminal court prior to the expiration of that time period. The bill additionally amends provisions of the Welfare and Institutions Code to expand the requirements for data reporting, including data related to inquiries and system referrals. This data shall be included in the annual report to examine the scope of impact and monitor the performance of CARE Act model implementation.​​ 

27年 9 月、 2024日にSB 1323 (Menjivar、第 646 章、2024 年の法令) が法律として署名されました。SB 1323 は、特定の重罪に対する裁判無能力 (IST) に関する刑法の規定を改正し、CARE 手続きへの移送を許可します。被告人がCAREに受け入れられた場合、刑法第1385条に従って告訴は却下されるものとする。​​ 

10 月10日、 2025 、 SB 27 (Umberg、第 528 章、2025 年の法令) が法律として署名されました。SB 27 は、福祉施設法の条項を改正し、対象となる診断の範囲を拡大して、現在の中毒に関連する精神病を除き、精神病的特徴を伴う双極性 I 障害を患う個人を含めます。この法案では、継続治療中の臨床的に安定した状態も定義し、外来治療支援（AOT）、LPS後見手続き、重罪および軽罪IST裁判所からの紹介へのより直接的な経路を提供し、看護師および医師助手が、CARE請願をサポートする精神保健宣言に署名する目的でのみ、認可された行動保健専門家とみなされることを規定し、裁判所が審問を行わずに表面的な決定を下せるようにし、その他の技術的な修正も行います。さらに、SB 27 は刑法の条項を改正し、郡の行動保健機関と刑務所の医療提供者に、行動保健サービスおよびプログラムの受給資格の可能性を判断する目的で、機密の医療記録やその他の関連情報を裁判所と共有する権限を与えています。​​  

To read the bills in full, please visit the California Legislative Information webpage.​​  

トレーニングと技術支援​​ 

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.​​ 

DHCSのリソース​​ 

レポートと重要な更新​​ 

職場でのケア法のビデオ​​ 

情報通知とリソース​​ 

関連情報​​ 

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