CARE Court

All eligibility determinations are case specific, and respondents must meet all the eligibility criteria for a petition to be considered. Homelessness and a diagnosis alone are not sufficient to meet eligibility requirements.

A respondent must meet the following criteria to be eligible for the CARE Act:

• Be 18 years old or older.
• Have a diagnosis of schizophrenia spectrum disorder or other psychotic disorder in the same class.
• Be currently experiencing a mental illness that:
  • Is severe in degree and persistent in duration;
  • May cause behavior that interferes substantially with activities of daily living; and
  • May lead to an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period.
• Not be clinically stabilized in ongoing voluntary treatment.

Additionally, at least one of the following must be true:

• The respondent is unlikely to survive safely in the community without supervision and the respondent’s condition is substantially deteriorating.
• The respondent needs services and supports to prevent a relapse or deterioration that would likely result in grave disability or serious harm to the respondent or others.

The respondent’s participation in a CARE plan or CARE agreement must:

• Be the least restrictive alternative necessary to ensure the respondent’s recovery and stability; and
• Be likely to benefit the respondent.

To file a petition, you must fit one of the following categories:

• Live with the respondent.
• Be a spouse or registered domestic partner, parent, sibling, child, or grandparent of the respondent.
• Be a person who stands in the place of a parent to the respondent.
• The director of a hospital in which the respondent is or was recently hospitalized.
• The director of a charitable agency who has within the last 30 days provided or is currently providing behavioral health services to the respondent or in whose institution the respondent resides.
• The licensed behavioral health professional who is or has supervised the treatment of the respondent for mental illness within the last 30 days.
• A first responder who has had repeated interactions with the respondent.
• The public guardian or public conservator of the county where the respondent resides or is found, or a private mental health conservator of the respondent.
• The director of a county behavioral health agency or the adult protective services agency of the county where the respondent resides or is found.
• A judge of a tribal court located in California before which the respondent has appeared within the last 30 days or director of a California Indian health services program or behavioral health department who has, within the last 30 days, provided or is currently providing services to the respondent.
• The respondent.

You must fill out the Petition to Commence CARE Act Proceedings (form CARE-100) and one of the following:

• Mental Health Declaration (form CARE-101), or
• Evidence that respondent was detained for at least two periods of intensive treatment, the most recent period within the past 60 days. Examples of evidence: a copy of the certification of intensive treatment, a declaration from a witness to the intensive treatment, or other documentation indicating involuntary detention and certification for up to 14 days of intensive treatment.

The Behavioral Health and Recovery Services CARE team is also here to help partner with clients and families to support the petition process.
Call: 650-372-6125
Email: CAREBHRS@smcgov.org

The CARE Act will be implemented in a phased-in approach with counties separated into cohorts. Cases may be filed in San Mateo County starting July 1, 2024.

Respondents have the right to be informed of the proceedings and receive notice of all hearings, take part in the proceedings (including to present evidence, call and cross-examine witnesses, and appeal decisions), be represented in all stages of the process regardless of their ability to pay, replace the court-appointed attorney with an attorney of their choosing, have a supporter of their choosing throughout the process, and to receive a copy of the petition and any court-ordered evaluations or reports. The respondent also has the right to an interpreter in all proceeding if necessary for the respondent to fully participate. If the respondent requires disability accommodations, requests can be made with the court.

The supporter is a volunteer who helps the respondent understand, consider, and communicate decisions to ensure the respondent can make self-directed choices to the greatest extent possible. A supporter is an adult chosen by the respondent to assist the respondent to understand, make, and express their decisions throughout navigating the CARE process. The supporter may be a friend, family member, faith leader, mentor, person with lived experience in mental health and/ or substance use disorder, or other support person chosen by the respondent.

All reports, evaluations, diagnoses, documents, and filings submitted during CARE Act proceedings are confidential. CARE Act hearings are also closed to the public unless the court orders otherwise.

A CARE agreement is a voluntary settlement agreement entered into by the respondent and the county behavioral health agency after a court has found that the respondent is eligible for the CARE process. The CARE agreement will include an individualized range of community-based services and supports that can consist of clinical services: behavioral health care; counseling; specialized psychotherapies, programs and treatments; stabilization medications; a housing plan; and other supports and services provided directly and indirectly through a local government entity.

A CARE plan is a court-ordered plan that includes the same elements as a CARE agreement. If a CARE agreement is not reached and a clinical evaluation indicates that the respondent meets the criteria, the court will order the creation of a CARE plan, which will include an individualized range of community-based services and supports. Stabilization medications may only be included in a CARE plan if the respondent is found to lack capacity and may not be forcibly administered.

The court reviews petitions to determine if a respondent likely meets the criteria for the CARE Act. Depending on the determination, the court will either dismiss the petition, order a report from a county agency, or set an initial court appearance. If the case is not dismissed, the court will appoint an attorney for the respondent.

If the court finds a respondent meets the CARE Act requirements, the court will order the county behavioral health agency to work with the respondent, their attorney, and their supporter (if they have one), to determine if a CARE agreement will be possible. If it is determined that a CARE agreement is not likely to be reached, then there will be a clinical evaluation followed by a hearing to review that clinical evaluation. If the clinical evaluation finds that the respondent is eligible, a CARE plan will be developed and reviewed in a hearing. There will then be a status review hearing at least every 60 days. At month 11, there will be a one-year status review hearing to determine next steps, including graduation, electing to remain in the CARE process (for up to one additional year) or reappointment (which can only happen once).

If the respondent does not participate, the court may terminate the respondent from the process. Additionally, if the respondent was in a court-ordered CARE plan, was provided with all the services and supports in the plan in a timely manner, and the respondent failed to complete their plan, that fact will be considered if the respondent is in a Lanterman-Petris-Short (LPS) Act hearing with the presumption that the respondent needs additional intervention beyond what was in their plan. The CARE Act does not change the standard for LPS conservatorship.

If the county behavioral health agency or another local government agency does not comply with court orders, it may be fined up to $1,000 a day with a maximum $25,000 fine per individual violation. If the agency persistently violates court orders, the court may appoint a special master to secure court-ordered care for the respondent.

The Behavioral Health and Recovery Services CARE team is also here to help partner with clients and families to support the petition process.
Call: 650-372-6125
Email: CAREBHRS@smcgov.org