Volunteer Supporter Toolkit
In the CARE process, each respondent can choose a volunteer supporter. The supporter is an adult who ensures the CARE process reflects the respondent’s preferences.
This Toolkit provides resources for volunteer supporters that can help both the supporter and respondent navigate the CARE process. The Toolkit includes trainings, briefs, and other resources to help supporters in their roles. These resources can be accessed on the CARE Act Resource Center resource library.
Accompanying this Toolkit is a Volunteer Supporter Worksheet, which can be downloaded and used by the supporter. The worksheet provides space to take notes, write questions, and identify next steps in the CARE process.
Volunteer Supporter Toolkit
The interactive toolkit below is also available as a PDF:
Roles in the CARE Act
There are many different organizations and roles to help the individual through the CARE process. The primary roles are listed below. As the supporter, it may be helpful to document this information in the Volunteer Supporter Worksheet.
An adult chosen by the respondent to provide support throughout the CARE process and to promote the respondent’s preferences, choices, and autonomy.
An individual who has filed a petition for the respondent to be considered for the CARE process. Example petitioners include a family member, a mental health professional, a first responder, a homeless outreach worker, or a roommate/housemate. For more resources on petitions (including a comprehensive list of those who can be a petitioner), see the CARE Act Resources For Petitioners.
County behavioral health agencies and their teams have an important role in the court process. Agencies engage the respondent in mental health treatment and connect them with additional services. Individuals could include a contracted provider, prescriber, and/or care.
The respondent may be connected with housing and community support providers through the CARE process.
Examples of housing providers include permanent supportive housing, affordable housing, interim/transitional housing, and Behavioral Health Bridge Housing.
Examples of community support providers may offer social services funded through Supplemental Security Income/State Supplementary Payment (SSI/SSP), financial assistance for immigrants, CalWORKs, California Food Assistance Program, In-Home Supportive Services program, and CalFresh.
People who work for the court system that will be involved in CARE processes include:
For more information about CARE Act roles view the training on Overview of CARE Process for Supporters.
For more information on roles in the CARE court, see the Legal Roles in the CARE Act brief.
For more information on eligibility requirements to participate in the CARE process, see the CARE Act Eligibility Criteria Fact Sheet.
Responsibilities & Guiding Principles of the Supporter Role
The CARE Act describes the supporter’s responsibilities and important principles for this role. The Supporter Role in the CARE Act brief provides helpful information on these responsibilities and principles.
How these responsibilities and principles look in practice will depend on the needs and preferences of the respondent. Consider using the Volunteer Supporter Worksheet to document your understanding of these responsibilities and preferences and to also note additional questions you may have.
Volunteer Supporter Responsibilities
- Helps the respondent understand, make, and communicate decisions and express preferences throughout CARE proceedings.
- Offers the respondent a flexible, culturally responsive way to maintain decisionmaking authority over their own life to the greatest extent possible by developing and maintaining voluntary support systems.
- Uses a supported decisionmaking (SDM) approach to increase a respondent’s ability to make their own decisions.
Volunteer Supporter Principles
- Supported decisionmaking
- Avoiding personal bias
- Trauma-informed care
For more information on the Volunteer Supporter role, see the Supporter Role in the CARE Act brief.
Strategies for Supporting the Respondent
Each respondent’s needs and preferences are unique. The supporter should use trauma-informed strategies to help the respondent build resilience throughout the CARE process.
The training on Applying Trauma-informed Care in Practice provides some strategies to support the respondent. The training discusses how to:
- Plan ahead for stressful situations.
- Help the respondent use calming practices.
- Approach situations with compassion and humility.
- Address biases that get in the way of providing support.
- Emphasize the respondent’s strengths.
- Truly listen.
It is important to remain neutral in the supporter role. Switching from the role of friend or family member to a ”supporter” role may be a hard transition. The supporter can use certain techniques to remain neutral while the respondent is considering a decision, such as using reflective listening skills and distinguishing between historical relationships and the volunteer supporter role. The supporter and respondent should use a supported decisionmaking framework to ensure the respondent has the supports and services needed to make independent decisions.
Possible Discussion Questions
The Volunteer Supporter Worksheet contains sample questions the supporter can use to better understand the respondent’s needs, preferences, and goals. The supporter and the respondent should consider setting aside time to discuss these questions regarding these and additional preferences.
- What are your goals for participating in the CARE process? (e.g. for services, for graduation, etc.)
- What broader goals do you have?
- Tell me your understanding of, and questions about why you are involved in the CARE process.
- Tell me your understanding of, and questions about the purpose of the CARE court process.
- Tell me your understanding of, and questions about what your responsibility is in the CARE process.
- Do you understand what my role is in helping you with the CARE process?
- What about the CARE process makes you most nervous or frustrated?
- How do you feel around authority figures? What has been helpful to you in those situations?
- What are important considerations that you would like me to keep in mind?
- How do you respond to official settings, such as court rooms? What has been helpful to you in those situations?
- How do you calm yourself down whenever you get nervous or frustrated? What else is helpful?
- What are the types of supports you need to help you make decisions?
- What can I do to help you through the CARE process?
- Do you have a Psychiatric Advance Directive?
- If yes, do you want me to have access to it? Do others have access to it?
- If no, are you interested in creating one?
Dealing with Conflicts of Interest
The court may remove a supporter if there is a conflict of interest that cannot be resolved. For example, a conflict may exist when a supporter is not able to remain neutral because they do not agree with a respondent’s preferences or decisions. Additionally, a conflict may exist if the supporter might personally or financially benefit from the respondent’s decisions. If you as a supporter feel that you cannot support the respondent as a neutral party, please let the respondent and/or the respondent’s attorney know (Welfare and Institutions Code 5981 (b)(4)).
Supporter Involvement in CARE Act Process
The section provides a high-level overview of the CARE process, focusing on the supporter’s potential role.The information in this section, along with the other guidance provided in this Toolkit, digests information from the CARE Act statute.
As the court process is fairly detailed, it may feel overwhelming to the supporter. Please note that the supporter is not responsible for tracking hearing dates or documenting decisions; however, the respondent may appreciate help with understanding the process and next steps. If the supporter was not the original petitioner, then their first time participating in the process may not happen until the initial appearance.
The role a supporter plays will be different depending on the needs and preferences of each respondent. The supporter should make a plan with the respondent on how they would like the supporter to participate. This plan should be revisited with the respondent throughout the CARE process.
The supporter should consider documenting their plan for involvement in the Volunteer Supporter Worksheet.
Steps in the CARE Process
Prima Facie (aka At First Impression) Determination
The court decides if the petition shows that the respondent is likely eligible for the CARE process.
This is the first time the parties appear in court. Counsel (attorney) for the respondent will have been appointed prior to this appearance. During this appearance (and throughout the process), the respondent has the option to select a supporter. The respondent can decide to be at this court hearing, or they can allow their attorney to appear for them. The county behavioral health agency will replace the petitioner if the petition was filed by another individual.
Hearing on the Merits
Development of CARE Agreement
A CARE agreement is a voluntary agreement developed by the respondent, their attorney, their supporter, and the county behavioral health agency (the parties). The CARE agreement sets out a range of services and supports which would benefit the respondent.
Case Management Hearing
If a CARE agreement has been reached the court will review and can approve the agreement. The court will then set a progress hearing to monitor the respondent’s compliance with the agreement. If reaching a CARE agreement is not likely, the court will order the county behavioral health agency to conduct a clinical evaluation of the respondent.
County behavioral health agency will report to the court on:
- The respondent’s clinical diagnosis
- Whether the respondent has the legal capacity to give informed consent regarding psychotropic medications
- Any additional information and recommendations for services and supports that would assist the court in making decisions
Clinical Evaluation Hearing
Development of CARE Plan
CARE Plan Review Hearing
The court adopts the elements of the proposed CARE plan(s) that best support the recovery and stability of the respondent and may issue orders necessary for the respondent to access those services.
Status Review Hearings (every 60 days)
Status review hearings provide the court an opportunity to monitor the respondent’s progress in completing their CARE plan and consider whether any changes are needed. The court also will determine whether services are accessible to the respondent and address any issues that may arise.
1–Year Status Review Hearing (at month 11)
At this hearing, it is determined whether the respondent will graduate from the CARE process. If the respondent elects to graduate and the court agrees, the court will order the parties to develop a graduation plan.
The graduation plan is presented to the court for its review. A graduation plan is a voluntary agreement that includes a strategy to support the respondent’s successful transition out of the CARE process.
Reappoint to Process
With the court’s permission, a respondent may choose to remain in the CARE process for up to an additional year. In certain circumstances, the court may involuntarily reappoint a respondent to the process for up to an additional year.
For more information on the CARE court flow, see The CARE Process Flow to Treatment, Housing, and Support brief and the Overview of CARE Process for Supporters training.
Selfcare & Resiliency for Volunteer Supporters
Serving as a supporter through the CARE process is an important and challenging role, and supporters themselves may experience stress and responses to trauma. Trauma-informed care can help supporters cultivate self-care and resilience. Trauma-informed strategies include self-care, avoiding burnout, reducing stress levels, setting boundaries, and asking for help.
Keep in mind the following:
Supporters need support: Reach out to trusted people for support. It is important to maintain the respondent’s confidentiality when seeking support.
Supporters need breaks: On a consistent basis, take time to do relaxing activities (e.g., reading, knitting, walking, meditating, watching movies, praying).
Supporters need to believe in themselves: Supporters can feel more confident about their role by learning about the CARE process through training, reading, and asking questions. Supporters should feel proud of their important role in the CARE process.