Trusts and Estates

SB 1338

By Kimberly R. McGhee

Black & McGhee 

Headnote:  The Community Assistance, Recovery, and Empowerment (CARE) Court Program

Summary:  Senate Bill 1338, passed in 2022, and effective January 1, 2023, known as the CARE Act, creates a court process for the creation of a Community Assistance, Recovery, and Empowerment (CARE) plan for an individual experiencing a severe mental illness with a diagnosis of schizophrenia or certain other psychotic disorders.  The stated purpose of the bill is to provide for intervention and treatment of such persons before they cause harm or get arrested, and to avoid the need for initiation of a conservatorship, or institutionalization.

The bill requires the Counties of Glenn, Orange, Riverside, Stanislaus, Tuolumne and the City and County of San Francisco to create and implement the Care Act by October 1, 2023, and the remaining counties to commence no later than December 1, 2024.

The bill added Division 5 of the Welfare and Institutions Code sections 5970 through 5986, and added new sections 1374.723 to the Health and Safety Code and 10144.54 to the Insurance Code, and amended sections 1370.01 of the Penal Code, 5801 and 5813.5 of the Welfare and Institutions Code for the creation of the Care Act.

The bill creates a procedure by which interested persons can petition the court for the creation of a CARE plan for an individual experiencing a severe mental illness with a diagnosis identified in the disorder class schizophrenia and other psychotic disorders. Following a hearing, the court may approve the plan if certain necessary findings are made. The plan can last a year and can later be extended. There is also a graduation plan to be implemented upon graduation from the CARE plan.

A CARE plan is designed to implement services to be provided by county behavioral health agencies to provide behavioral health care, stabilization medication, and housing support to adults who are suffering from schizophrenia spectrum and psychotic disorders and who lack medical decision-making capacity.

The bill supplements the Assisted Outpatient Treatment Demonstration Project Act of 2002, known as Laura’s Law, requiring most counties to provide specified mental health programs, and the Lanterman-Petris-Short Act (discussed supra).

Designated persons such as family members, people who live with the respondent, or medical professionals can petition the court for the creation of a CARE plan. The petition must be supported by evidence that the person is in need of a CARE plan or has already been committed for intensive treatment.

The court can order the respondent to participate in CARE proceedings if it finds on clear and convincing evidence that (i) the person is 18 or older, (ii) the person is currently experiencing a severe mental illness, as defined, (iii) the person is not clinically stabilized in ongoing voluntary treatment with the county behavioral health agency, (iv) the person is unlikely to survive without supervision, or is in need of services to prevent relapse that would result in grave disability or serious harm to the person or others, (v) participation in a CARE plan would be the least restrictive alternative, and (vi) it is likely the person will benefit from a CARE plan. If a CARE plan is established, the court can compel the person to comply with it and set further hearings as needed. Failure to complete the CARE plan shall be a fact considered by the court in a subsequent hearing under the Lanterman-Petris-Short Act (LPS Conservatorship).

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