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Frequently Asked Questions​

CARE Act TTA Frequently Asked Questions​

The following are frequently asked questions related to Community Assistance, Recovery, and Empowerment (CARE) Act training and technical assistance. For background information on the CARE Act, please visit our About page and/or visit the CalHHS CARE Act landing page. 

Have a question or comment? Please reach out to us to share your question and feedback. We value your expertise and experience.

Looking for data collection & reporting FAQs? Visit the Data Collection & Reporting Resources page.

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  • What is the CARE Act?

    Senate Bill 1338 established the Community Assistance, Recovery, and Empowerment (CARE) Act to provide community-based behavioral health services and supports to Californians living with untreated schizophrenia spectrum or other psychotic disorders through a new civil court process. CARE Act is intended to serve as an upstream intervention for the most severely impaired Californians 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 participants 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.

    Topics:

    • CARE Act Process
  • Who is the intended audience of the CARE Act training and technical assistance?

    As specified in Section 5970.5 of SB 1338, training and technical assistance will be provided to county behavioral health agencies (including organizations and individuals that county behavioral health agencies include in the training and technical assistance opportunities as specified in Section 5983 (b), volunteer supporters, CARE Act providers, counsel, and other relevant stakeholders to support the implementation of the CARE Act. 

    Training and technical assistance will be in consultation with relevant state departments, disability rights groups, county behavioral health and aging agencies, peers, the California Interagency Council on Homelessness, the Judicial Counsel of California, and other relevant stakeholders.

    Topics:

    • CARE Act Process
  • When will the CARE Act be implemented?

    Implementation will take place in two phases. Counties will be divided into the first phase (Cohort 1) and the second phase (Cohort 2).

    Cohort 1 counties will implement CARE Act processes by October 1, 2023 and include:

    • Glenn
    • Orange
    • Riverside
    • San Diego
    • San Francisco
    • Stanislaus
    • Tuolumne

    Los Angeles is a Cohort 2 county that will implement by December 1, 2023.

    Cohort 2 counties include the remaining 50 counties and will implement by December 1, 2024.

    Topics:

    • CARE Act Process
  • Who is eligible for CARE?

    Eligibility is determined on a case-by-case basis. Homelessness and mental illness alone are not enough to meet eligibility requirements.

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

    • Be 18 years of age or older.
    • Have a diagnosis of a schizophrenia spectrum disorder or another psychotic disorder in the same class.
    • I am currently experiencing a mental illness that:
      • Is severe in degree and persistent in duration,
      • May cause behavior that greatly 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.

    Petitioners are required to provide facts and supporting information at the time of filing to show that a respondent is eligible for CARE Act proceedings (see form CARE-050-INFO ). Supporting documentation must include either a declaration by a licensed behavioral health professional ( form CARE-101 ) or evidence that the respondent was detained for at least two intensive treatments, the most recent one within the last 60 days. See the Eligibility Fact Sheet and CARE Act Resources for Petitioners for more information.

    Topics:

    • CARE Act Process, Eligibility Criteria
  • What is a CARE agreement and a CARE plan?

    A CARE agreement and a CARE plan are documents that specify services to support the respondent’s recovery and stability.

    • A CARE agreement is a voluntary agreement between the respondent and the county behavioral health agency after a court has determined that the respondent is eligible for the CARE process. If a CARE agreement is not reached, the court may order the creation of a CARE plan.
    • A CARE plan includes a range of community-based services and supports ordered by the court. There will be status review hearings to review progress and challenges. Services and supports in the CARE plan can be changed to support the respondent’s success. If included in the CARE plan or agreement, stabilizing medications are prescribed by the treating licensed behavioral health care provider. The CARE team will work with the respondent to address medication concerns and make changes to the treatment plan as needed.

    Topics:

    • CARE Act Process
  • Who can file a petition?

    Petitioners must be 18 years of age or older and fit one of the following categories:

    • A person who lives with the respondent.
    • A spouse or registered domestic partner, parent, sibling, child, or grandparent of the respondent.
    • A person who stands in the place of a parent to the respondent.
    • The director of a hospital, or their designee, in which the respondent is or was recently hospitalized.
    • The director of a public or charitable agency, or their designee, who has within the last 30 days provided or who is currently providing behavioral health services to the respondent or in whose institution the respondent resides.
    • A licensed behavioral health professional, or their designee, who is or has been supervising the treatment of or treating the respondent for mental illness within the last 30 days.
    • The director of a county behavioral health agency, or their designee, of the county where the respondent resides or is found.
    • A first responder who has had repeated interactions with the respondent.
    • A judge of a tribal court located in California, or their designee.
    • The respondent.

    Note: After the initial appearance, the petitioner will be replaced by the director of the county behavioral health agency, or a designee.

    For more information, see CARE Act Resources for Petitioners.

    Topics:

    • CARE Act Process
  • What happens during the CARE process?

    A summary of the CARE process is outlined below:

    • A case begins with the filing of a petition, followed by the court assessing eligibility.
    • If a respondent is found to be eligible, and efforts at voluntary engagement by the county behavioral health agency are not successful, there is a process to develop a voluntary CARE agreement.
    • If a CARE agreement is not likely to be reached, the court will order the county behavioral health agency to conduct a clinical evaluation of the respondent and provide a report to the court.
    • If, based on that report, the court determines that the respondent meets the eligibility criteria, the court shall order a CARE plan. Both a CARE agreement and a CARE plan will outline services and supports that the individual is entitled to receive under the CARE proceedings.
    • The court will monitor the respondent’s progress with the CARE plan or CARE agreement.
    • If the respondent has a CARE plan, then after a year there will be a determination of next steps. The respondent may graduate or be reappointed to the CARE process for up to one additional year.

    For a more detailed description of each step in the process, please see the CARE Act Process Flow to Treatment, Housing, and Support resource or The Client’s Journey Through the CARE Act training.

    Topics:

    • CARE Act Process
  • How does a county apply for the CARE Act delayed implementation process?

    Counties can apply for a delayed implementation process as outlined in Behavioral Health Information Notice 23-016.

    As part of the application for an extension requirement, please also submit a Delayed Implementation TTA request here in order to work with the CARE Act TTA provider to develop a plan for implementing the CARE Act by your county’s proposed implementation date. Additional questions can be sent to [email protected]

    Topics:

    • Delayed Implementation Plan Development
  • What information will the CARE Act annual report provide?

     As specified in Welfare and Institutions Code 5985, subd. (e) and (f), the Department of Health Care Services (DHCS) will develop an annual report to examine the scope of impact and monitor the performance of CARE Act model implementation. The first annual report will be published in July 2025 on the DHCS website. The report will include information on the effectiveness of the CARE Act model in reducing disparities and improving outcomes in homelessness, criminal justice involvement, conservatorships, and hospitalization of participants.

    Topics:

    • Data Collection & Reporting
  • Under the CARE Act, what level of licensure is required to conduct the clinical evaluation that may be ordered by the court?

    The CARE Act specifies that the clinical evaluation, which may be ordered by the court pursuant to Welfare and Institutions Code (WIC) 5977.1(b),  shall be conducted by the county behavioral health agency through a licensed behavioral health professional. The CARE Act defines the licensed behavioral health professional in conjunction with other applicable statutes. The clinical evaluation may be conducted by:

    • a psychiatrist, psychologist, clinical social worker, marriage and family therapist or professional clinical counselor licensed in accordance with the Business and Professions Code; or
    • individuals working under supervision to gain necessary experience to meet any of the above licensure requirements as long as they meet the professional training requirements applicable to their license as detailed in the Business and Professions Code, for up to five years; or
    • the same type of clinicians who were recruited for employment from outside the state who have sufficient experience to gain admission to a licensing exam, for up to five years.

    Topics:

    • Behavioral Health, CARE Act Process, Eligibility Criteria
  • What is the impact on the process if an individual voluntarily engages in services?

    The CARE Process is intended to encourage voluntary engagement. After the petition is filed, if the respondent is enrolled or likely to enroll in voluntary treatment, the court will dismiss the matter.

    Topics:

    • Behavioral Health, CARE Act Process
  • What is the impact if a respondent cannot be located or chooses not to engage in the early stages of CARE process?

    The court may conduct the initial hearing in the respondent’s absence if:

    • the respondent does not waive personal appearance and does not appear at the hearing; and
    • the court determines that reasonable attempts to engage the respondent have failed; and
    • the court makes a finding that conducting the hearing without the participation or presence of the respondent would be in the respondent’s best interest.

    If the respondent engages but chooses not to be present at the initial hearing, they may instead appear through counsel. (Welfare and Institutions Code 5977 (b)(3))

    Topics:

    • Behavioral Health, CARE Act Process, Counsel/Courts
  • Can a supporter be subpoenaed to testify against the respondent?
    A supporter shall not be subpoenaed or called to testify against the respondent in any CARE Act proceedings. However, this provision only references CARE Act proceedings, and it does not prevent a supporter from being called to testify in any other civil or criminal proceedings.
    For more information, see Welfare and Institutions Code Section 5981(e) .

    Topics:

    • CARE Act Process, Volunteer Supporter
  • Can a supporter be removed from the CARE process due to a conflict of interest?
    The court shall remove a supporter due to a conflict of interest with the respondent if the conflict cannot be managed in such a way to avoid any possible harm to the respondent. The process for removing a supporter will be determined by the court.
    For more information, see Welfare and Institutions Code Section 5981 (b)(4) .

    Topics:

    • CARE Act Process, Volunteer Supporter
  • How can family members participate in CARE Act proceedings?
    Family members can take various roles in CARE Act proceedings. If the family member is the original petitioner, they shall have the right to participate in the initial hearing to determine the merits of the petition. The court may assign ongoing rights of notice to the original petitioner. The court may also allow participation in the respondent’s CARE Act proceedings, if the respondent consents. Additionally, the respondent may choose to elect a family member to serve as their volunteer supporter.
    For more information, see Welfare and Institutions Code Sections 5977 (b)(6) .

    Topics:

    • CARE Act Process, Volunteer Supporter
  • Can someone who is experiencing a mental health crisis participate in a supported decisionmaking arrangement?

    During the CARE Act process, the goal is to optimize the respondent’s opportunities to make decisions. As the respondent’s symptoms fluctuate, their willingness and availability to participate in supported decisionmaking may likely also change. During a mental health crisis, an individual may not be able to communicate their preferences and wishes, and therefore supported decisionmaking may not always be possible. These scenarios must be evaluated on an individual case-by-case basis. Ideally, once the respondent is capable of understanding the decisions to be made, they can resume engaging in supported decisionmaking.

    Topics:

    • Serious Mental Illness & Evidenced-based Care, Volunteer Supporter
  • What happens when a CARE participant does not adhere to their CARE plan?

    There are no penalties to a respondent who doesn’t complete their CARE plan. However, if at any time in the CARE proceedings, the court determines that a respondent is not participating in the CARE process or is not adhering to their CARE plan, the court may terminate the respondent’s participation in CARE.

    Also, if a respondent fails to complete their CARE plan (not a CARE agreement), the reasons for that failure, shall be considered by the court in a subsequent LPS hearing, provided that hearing occurs within 6 months and provided that all the services and supports were offered to the respondent. This fact shall create a presumption for the LPS court that respondent needs additional intervention beyond the services and supports provided by the CARE plan. However, this provision is not triggered if the respondent’s only failure to adhere to their CARE plan is a failure to comply with a CARE plan medication order.

    Topics:

    • CARE Act Process
  • What are the legal roles throughout the CARE process?

    The CARE process includes multiple legal representatives that serve specific roles, including:

    • Respondent’s counsel: An attorney is provided to the respondent at no cost. The respondent’s counsel will work with the county behavioral health agency and respondent’s volunteer supporter (if applicable) to help the respondent access behavioral health treatment. They also represent the respondent in any court proceedings and advise on the CARE process.
    • Judicial officers: Judicial officers – also known as judges – are responsible for making sure the court proceedings are conducted in a collaborative way. Additional responsibilities include determining eligibility, explaining the respondent’s rights, evaluating what services were or were not provided, and issuing orders to support the respondent’s access to services.
    • Petitioner’s counsel: The “petitioner” is an adult person who petitions a civil court to consider the respondent for the CARE process. It is not required that the petitioner have an attorney help them file the petition, but they may choose to do so at their own expense. Alternatively, if a petition is filed by a county behavioral health agency, the agency may choose to be advised by counsel.

    For more information, see the CARE Act Brief on Legal Roles in the CARE Act on the CARE Act Resource Center.

    Topics:

    • CARE Act Process, Counsel/Courts
  • What is the difference between a progress review hearing and a status review hearing?

    A progress review hearing is scheduled if the respondent and county behavioral health agency have reached a CARE agreement. The court will schedule a progress review hearing for 60 days from when it approves the CARE agreement (Welfare and Institutions Code Section 5977.1). The statute does not specify any additional progress review hearings; however, the court, at its discretion, may include additional hearings as it deems beneficial to monitor and encourage the parties’ progress in fulfilling the terms of the CARE agreement. The statute does not specify the content or structure of the progress review hearings.

    Status review hearings will be scheduled by the court at least every 60 days after the court orders a CARE plan. The court will review the respondent’s progress on the CARE plan, what services were or were not provided, issues the respondent may be having with adhering to the plan, and recommendations for changes that would make the CARE plan more successful. The county behavioral health agency or the respondent may request, or the court may set, a hearing at any time during the CARE process to address a change of circumstances during the CARE process. (Welfare and Institutions Code Section 5977.2)

    Topics:

    • CARE Act Process, Counsel/Courts
  • What is the court’s role in ensuring that the volunteer supporter is following the supported decisionmaking framework?

    The court does not have a mandated process to ensure that a supporter follows a supported decisionmaking framework. However, if the court finds that the volunteer supporter is overstepping the boundaries of their role, such as (imposing their own beliefs on the respondent), the court may remind the supporter of their duties. A court may ultimately remove a supporter because of any conflict of interest with the respondent that cannot be managed.

    For more information, see the Supported Decisionmaking for Volunteer Supporters training on the CARE Act Resource Center.

    Topics:

    • Counsel/Courts, Volunteer Supporter
  • What is the role of the volunteer supporter?

    A volunteer supporter (also referred to as a supporter) is an adult chosen by the respondent to provide support throughout the CARE process. The supporter should help the respondent understand, make, and communicate decisions and express preferences throughout CARE proceedings. This could include assisting with the development of a CARE agreement or CARE plan, a graduation plan, and a Psychiatric Advance Directive (PAD). The supporter should use a supported decisionmaking framework to empower the respondent to make their own informed decisions.

    The CARE Act Supporter Role Brief provides an overview of the Supporter Role, key operating principles of the supporter’s role, and available trainings for supporters.

    Topics:

    • Volunteer Supporter
  • What are the requirements for official service notifying a respondent of the CARE Act proceedings?

    The CARE Act requires that the respondent be personally served notice of several events throughout the CARE process. During the initial stages, the county behavioral health agency is to personally serve the respondent with a copy of the petition packet as well as information on the process and their rights in the process. If personal service is not practicable, the county behavioral health agency may use any method reasonably calculated to give the respondent actual notice. The proof of service must explain why personal service was impractical and why the alternative method was thought to provide actual notice.

    For more information, see the 2023 California Rules of Court (Rule 7.2235) or the Judicial Council of California’s FAQs for CARE Act Service Requirements.

    Topics:

    • CARE Act Process, Counsel/Courts
  • What data will counties be required to collect?

    Counties will collect data on:

    • CARE Act Respondents with a CARE plan and CARE agreement, which are referred to as “CARE participants.”
    • Former CARE Act respondents who meet prima facie and CARE criteria but elected to voluntary engagement in county services. These individuals are referred to as “Elective clients.”

    County behavioral health agencies will capture respondent data at the individual level, while Judicial Council will capture aggregated trial court data.

    Topics:

    • Data Collection & Reporting
  • When do counties start tracking CARE respondents?

    Data will be collected on CARE respondents from the time of petition as follows:

    • If the county behavioral health agency is the original petitioner, data collection begins at the time of petition.
    • If the county behavioral health agency is not the petitioner, data collection begins when the court orders an investigation by the county.

    Topics:

    • Data Collection & Reporting
  • How will the data collected be shared with the public?

    Data metrics identified in Welfare and Institutions Code sections 5985 and 5986 for the Annual Report and Independent Evaluation will be shared in accordance with the DHCS Public Reporting Guidelines to maintain privacy and security.

    Topics:

    • Data Collection & Reporting
  • Will the respondent receive notice of disclosure of their health information?

    The CARE Act authorizes, and in some instances requires, the disclosure of a respondent’s health information, including protected health information and mental health records, to the county behavioral health agency and/or the court. The CARE Act requires that the county behavioral health agency notify the respondent of disclosure of their health information. That notice is to be sent to respondent’s last known address, if one exists, and to respondent’s counsel. The notification shall also be included with the next notice of hearing, if any, served upon the respondent. All information that was shared shall be disclosed to the respondent, their counsel, and (with the respondent’s consent) their supporter.

    Topics:

    • CARE Act Process
  • What is a Psychiatric Advance Directive (PAD)?

    A Psychiatric Advance Directive (PAD) is a type of Advance Health Care Directive. It is a self-directed legal document that states a person’s preferences and provides instructions for mental health treatment in advance of a mental health crisis. Physicians, hospitals, and other providers should refer to a PAD in situations when the individual is unable to articulate their own care preferences. A PAD may be incorporated into ongoing mental health treatment, serving as a blueprint for the individual’s preferences regarding their physical and mental health.

    In California, the general provisions for an advance health care directive are found in Probate Code Sections 4600-4678 . For more information, see the PADs in the CARE Act training located in the Resource Library or visit the PADs Mental Health Services Act (MHSA) Multi-County Psychiatric Advance Directives Innovations Project .

    Topics:

    • Behavioral Health, CARE Act Process
  • Can a Psychiatric Advance Directive (PAD) be registered with the State?

    State law requires the Secretary of State to maintain an Advance Health Care Directive Registry (Cal. Probate Code Section 4800). This registry allows those with an Advance Health Care Directive to register information that can be made available upon request to the registrant’s health care provider, public guardian, or legal representative. Although this registry was not created for PADs, if a PAD meets the requirements for Advanced Health Care Directives (Cal. Probate Code Section 4670 – 4743), the owner of the PAD can register it with the state.

    You can find information about how to register an Advance Health Care Directive or a PAD on the California Secretary of State’s Advance Health Care Directive Registry webpage.

    Topics:

    • Behavioral Health, CARE Act Process
  • What is the role of a Psychiatric Advance Directive in the CARE process?

    The development of a Psychiatric Advance Directive (PAD) should be considered a best practice for anyone receiving psychiatric treatment; PADs are a helpful tool for self-determination and empowerment. Although PADs are not mandated as part of the CARE process, PADs are referenced in the CARE Act statute as an option to be included in a graduation plan (Welfare and Institutions Code section 5977.3(a)(3)(A)).
    A PAD can be used to:

    • Plan for a future event in which an individual may not be able to direct mental health and/or physical treatment.
    • Provide an opportunity to outline preferences and to share that with others.
    • Support an individual’s autonomy, dignity, and ability to self-direct care.
    • Improve the ability to build trust and navigate care systems.

    A PAD can be developed at any point in the CARE process, as long as the respondent has the capacity to make informed decisions about their own care. Examples of how a PAD might be incorporated into the CARE process are included in the PADs in the CARE Act training located in the Resource Library.

    Topics:

    • Behavioral Health, CARE Act Process
  • What options are available for respondents who would like a supporter but does not have someone who can fulfill this role?

    Respondents may be able to identify an individual through family and peer organizations, homeless outreach agencies, and/or other community–based organizations to elect as their supporter. Please note, the supporter must be chosen and approved by the respondent regardless of relationship.

    Topics:

    • CARE Act Process, Volunteer Supporter
  • What resources are available to those submitting a petition (either for someone else or on their own behalf)?

    Every superior court offers some assistance through their self-help centers to individuals who are not represented by an attorney and are seeking resources and legal information. Self-help center staff can provide assistance with filling out forms and providing resources; however, they cannot provide legal advice. Services may be provided in person, by phone, or online. You can find the self-help center for your county here.

    Topics:

    • CARE Act Process, Counsel/Courts, Eligibility Criteria
  • Can a court order another county to provide services or support such as behavioral health treatment or housing under a CARE plan?

    The CARE Act does not preclude and in fact contemplates the possibility of another county providing services or supports to a respondent. If a proposed CARE plan includes services and supports to be provided through another local governmental entity, the court may consider a motion by either the petitioner or the respondent to add the other local entity as a party to the CARE proceedings (W&I Code § 5977.1 (d)(4)). If the local entity is added as a party to the proceedings, either voluntarily or through court order, the court may order the local entity to provide the necessary service or support as part of the CARE plan. (See W&I Code § 5977.1(d)(2)&(4)).

    Topics:

    • CARE Act Process, Counsel/Courts, Housing/Community Supports, Policy/Advocacy
  • Is the court able to request and/or compel reporting of health information from non-County or non-Medi-Cal providers?

    Several amendments to the CARE Act outlined in Senate Bill 35 address the disclosure of health information to behavioral health agencies and the courts. Health care providers and covered entities are now authorized to disclose to a behavioral health (BH) agency certain health information pertaining to a respondent that is relevant to an investigation, evaluation, or other report or hearing, or to the provision, coordination or management of services and supports. This includes protected health information (PHI) and mental health records (excluding psychotherapy notes).

    In matters where the health care provider or covered entity is the petitioner, the CARE Act now requires them to provide this health information to the county BH agency. As specified in Welfare and Institutions (W&I) Code section 5977.4, there is a process for a county BH agency to apply for a court order compelling a health care provider or covered entity to provide health information, if necessary. Further disclosure or redisclosure is not authorized except as expressly provided, and that information disclosed to a county BH agency by a health care provider is confidential and is not subject to disclosure or inspection under the Public Records Act. Additionally, health care providers or covered entities shall not be held civilly or criminally liable for any disclosure authorized or required by these provisions.

    Providers should consult with their legal counsel if they have questions or concerns related to the sharing of an individual’s health information.

    For a summary of substantive changes established by Senate Bill 35, view the CARE Act SB 35 Amendment Brief.

    Topics:

    • Behavioral Health, CARE Act Process, Counsel/Courts, Data Collection & Reporting, Policy/Advocacy
  • Can the original petitioner remain informed of the CARE process once the behavioral health agency has replaced them as the petitioner?

    The court may, in its discretion, assign ongoing rights of notice to the original petitioner. If the respondent consents, the court may allow the original petitioner to participate in the respondent’s CARE proceedings. There is no provision for ongoing participation without respondent consent.

    Topics:

    • Behavioral Health, CARE Act Process, Counsel/Courts
  • If a CARE respondent’s case is dismissed, what resources are available to them?

    Resources for services and supports outside the CARE process are available to the respondent through their county behavioral health agency, peer organizations, homeless outreach agencies, and/or other community-based organizations.

    Topics:

    • Behavioral Health, CARE Act Process, Housing/Community Supports
  • What guidance is available related to billing health plans for services in a CARE agreement or CARE plan?

    The Department of Managed Health Care (DMHC) released All Plan Letter APL 23-016 – Implementation of SB 1338 (2022) – Community Assistance, Recovery, and Empowerment (CARE) to provide guidance about how health plans shall ensure they identify enrollees who are involved in CARE proceedings and process and pay claims arising from their enrollees’ CARE agreements or CARE plans.

    Topics:

    • CARE Act Process, Other
  • What resources are available to peers who are interested in supporting CARE respondents?

    Peers may serve in the CARE process as members of the treatment team, as volunteer supporters, or as part of a peer organization. For an overview of how peers can participate in the CARE Act, view the Role of the Peer in the CARE Process training on the CARE Act Resource Center.

    Many peer organizations offer trainings for peers in California, including National Alliance on Mental Illness (NAMI) programs for county-specific training. For more information visit the NAMI Medi-Cal Peer Support Specialist Certification Training website.

    Additionally, the California Mental Health Services Authority (CalMHSA) has a comprehensive website on the Medi-Cal Peer Support Specialists training, exam, best practices, study guide, and more. Below are links to the website.

    Topics:

    • CARE Act Process, Housing/Community Supports, Other, Volunteer Supporter
  • Can counties claim for outreach and engagement administrative expenses incurred while preparing for a court hearing and/or transporting the respondent to and from their court hearing?

    Counties are permitted to invoice the Department of Health Care Services (DHCS) for expenses incurred while preparing for and/or transporting a respondent to and from their court hearing. DHCS will reimburse counties for these outreach and engagement activities to support CARE Act services, as outlined in Behavioral Health Information Notice (BHIN) 24-015: CARE Act Reimbursement Rates and Billing Guidance.

    Topics:

    • Behavioral Health, CARE Act Process, Case Worker / Case Manager, Counsel/Courts, Equitable & Person Centered Care, Housing/Community Supports, Other, Policy/Advocacy
  • Can counties claim for outreach and engagement administrative expenses incurred while attempting to locate or contact a respondent, even if the county is unable to engage with them?

    Counties are permitted to invoice the Department of Health Care Services (DHCS) for expenses incurred while attempting to locate or contact a CARE Act respondent, even if the county is unable to engage the respondent. DHCS will reimburse counties for these outreach and engagement activities to support CARE Act services, as outlined in Behavioral Health Information Notice (BHIN) 24-015: CARE Act Reimbursement Rates and Billing Guidance.

    Topics:

    • Behavioral Health, CARE Act Process, Case Worker / Case Manager, Equitable & Person Centered Care, Other, Policy/Advocacy
  • Can counties claim for outreach and engagement administrative expenses incurred while engaging family members in the CARE process?

    Counties are permitted to invoice the Department of Health Care Services (DHCS) for expenses incurred while engaging family members to support a respondent during the CARE process. DHCS will reimburse counties for these outreach and engagement activities to support CARE Act services, as outlined in Behavioral Health Information Notice (BHIN) 24-015: CARE Act Reimbursement Rates and Billing Guidance.

    Topics:

    • Behavioral Health, CARE Act Process, Case Worker / Case Manager, Equitable & Person Centered Care, Other, Policy/Advocacy, Volunteer Supporter
  • How do CARE Act and the Lanterman-Petris-Short (LPS) Act provisions related to evaluation, intensive treatment and conservatorship interact?

    CARE and Lanterman-Petris-Short (LPS) Act conservatorship are two separate court processes. Each has its own statutory framework, procedural requirements, and eligibility criteria. While distinct processes, there are ways CARE and LPS may interact, especially in situations where an individual’s mental health condition and needs warrant consideration of choosing between which path is able to address the individual’s mental health condition and needs, in the least restrictive manner. The CARE Act provides that an LPS conservatorship court may refer an individual to CARE. If an LPS court makes a referral, the conservator or proposed conservator shall file the petition and the judge in the CARE proceeding shall determine if the individual is eligible for CARE.

    The CARE Act does NOT provide for a direct referral from CARE to an LPS proceeding.

    The statute, however, does provide that to ensure a respondent’s safety, a judge in a CARE proceeding may utilize their existing authority under LPS to have the individual evaluated for intensive treatment and potentially considered for a conservatorship. At any point throughout the CARE process, if there is a concern for the respondent’s safety, county BH, on its own accord or upon request of a judge, may initiate the process to have the individual evaluated for intensive treatment and potentially for conservatorship.

    Also, if a respondent fails to complete their CARE plan (not a CARE agreement), the reasons for that failure shall be considered by the court in a subsequent LPS hearing, provided that hearing occurs within 6 months and provided that all the services and supports were offered to the respondent. This fact shall create a presumption for the LPS court that respondent needs additional intervention beyond the services and supports provided by the CARE plan. However, this provision is not triggered if the respondent’s only failure to adhere to their CARE plan is a failure to comply with a CARE plan medication order.

    Topics:

    • CARE Act Process, Case Worker / Case Manager, Policy/Advocacy
  • How does Senate Bill (SB) 43 impact the CARE Act?

    The Lanterman-Petris-Short (LPS) Act requires that all available alternatives to conservatorship be explored with a goal of proceeding with the least restrictive, suitable alternative. SB 43 amends the LPS Act to specify the CARE process as one of those alternatives that should be considered. This means some individuals may be diverted from LPS proceedings to the CARE process, which is less restrictive. The individual would need to meet the CARE eligibility criteria.

    For additional information on SB 43, please see the following DHCS resource: SB 43 Frequently Asked Questions (FAQs)

    Topics:

    • Behavioral Health, CARE Act Process, Eligibility Criteria, Other, Policy/Advocacy