홈 지역사회 지원, 복구 및 역량 강화법​​ 

지역사회 지원, 복구 및 역량 강화법​​ 

개요​​ 

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 법은 두 개의 코호트로 시행되었습니다. 코호트 I은 1년 2023월 일에 시작되었으며 7개 카운티가 포함되었습니다: 글렌, 오렌지, 리버사이드, 샌디에이고, 스타니스라우스, 투오럼네, 그리고 샌프란시스코 시와 카운티입니다. 로스앤젤레스 카운티는 코호트 II에 속하지만 12월 1, 2023일에 조기 시행하기로 결정했습니다. 나머지 코호트 II 카운티는 1, 2024년 12월 일 또는 그 이전에 시행해야 했습니다.​​ 

법률​​ 

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.​​ 

9월에 27, 2024, SB 1323 (멘지바르, 646장, 2024년 법령)이 법으로 제정되었습니다. SB 1323은 특정 중범죄 범죄에 대한 재판 불능(IST)과 관련된 형법 조항을 개정하여 CARE 절차에 회부할 수 있도록 승인하는 법안입니다. 피고가 CARE에 수용되는 경우 형법 제1385조에 따라 혐의는 기각됩니다.​​ 

10월에 10, 2025, SB 27 (움베르그, 528장, 2025년 법령)이 법으로 제정되었습니다. SB 27은 복지 및 기관 코드의 조항을 수정하여 현재 중독과 관련된 정신병을 제외하고 정신병적 특징을 가진 양극성 장애를 가진 개인을 포함하도록 진단 대상자를 확대합니다. 이 법안은 또한 지속적인 치료에서 임상적으로 안정된 상태를 정의하고, 보조 외래 치료(AOT), LPS 후견인 절차, 중범죄 및 경범죄 IST 법원의 의뢰를 위한 보다 직접적인 경로를 제공하며, 전문간호사와 의사 보조원은 CARE 청원을 지지하는 정신 건강 선언에 서명할 목적으로만 면허 행동 건강 전문가로 간주하고, 법원이 심리 없이 1차적 결정을 내릴 수 있도록 하고, 기타 기술적 수정 사항을 규정하고 있습니다. 또한 SB 27은 형법 조항을 개정하여 카운티 행동 건강 기관 및 교도소 의료 제공자가 행동 건강 서비스 및 프로그램에 대한 자격 가능성을 결정할 목적으로 기밀 의료 기록 및 기타 관련 정보를 법원과 공유할 수 있도록 권한을 부여합니다.​​  

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

교육 및 기술 지원​​ 

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 리소스​​ 

보고서 및 중요 공지사항​​ 

CARE 법안의 실제 적용 사례 동영상​​ 

정보 안내 및 자료​​ 

추가 리소스​​ 

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