SB 28: Community Assistance, Recovery, and Empowerment (CARE) court program.

(1)Existing law, the Community Assistance, Recovery, and Empowerment (CARE) Act (the act), authorizes specified persons, including a person with whom the respondent resides, family members, and first responders, among others, to petition a civil court to create a voluntary CARE agreement or a court-ordered CARE plan and implement services, to be provided by county behavioral health agencies, to provide behavioral health care, including stabilization medication, housing, and other enumerated services, to adults who are currently experiencing a severe mental illness and have a diagnosis identified in the disorder class schizophrenia and other psychotic disorders, and who meet other specified criteria.

Existing law, the Lanterman-Petris-Short Act, authorizes a conservator of the person, of the estate, or of the person and the estate to be appointed for a person who is gravely disabled as a result of a mental health disorder or impairment by chronic alcoholism. Existing law requires the officer providing the conservatorship investigation, which may include a public guardian or a county mental health program, to investigate all available alternatives to conservatorship and to recommend conservatorship to the court only if no suitable alternatives are available. Existing law requires a conservatorship under these provisions to terminate after one year and specifies procedures if the conservator determines conservatorship is still required.

This bill would authorize a conservator to, upon the termination of a conservatorship, request the court refer the conservatee to CARE court, as specified.

(2)The act authorizes services and supports to be provided to adults who are currently experiencing a qualifying severe mental illness and who meet other specified criteria, including that the person is not clinically stabilized in ongoing voluntary treatment and is either unlikely to survive safely in the community without ongoing supervision and the persons condition is substantially deteriorating or the person is in need of services and supports to prevent a relapse or deterioration that would likely result in grave disability or serious harm to the person or others.

This bill would authorize the court, beginning July 1, 2028, and if it dismisses a CARE petition because a respondent needs a higher level of services, to order the county to develop an exit plan for the respondent. The bill would require the State Department of Health Care Services, by July 1, 2028, to develop, with input from certain stakeholder groups, a CARE Act model exit plan that identifies appropriate services and ongoing monitoring of an individual with a petition dismissed because the individual needed a higher level of services.

This bill would update the definition of a petitioner for the purposes of the act.

(3)Existing law requires the Judicial Council to develop a mandatory form or forms to use to file a CARE process petition. Existing law requires the petition to be signed under the penalty of perjury and to contain specified information, including the petitioners relationship to the respondent and either an affidavit of a licensed behavioral health professional stating the licensed behavioral health professional or their designee has examined or made multiple unsuccessful attempts to examine the respondent within 60 days of submission of the petition, or that the respondent was detained for a minimum of 2 intensive treatments pursuant to state law.

This bill would extend the 60-day period for examination of the respondent to 120 days. The bill would also authorize a petition to include evidence that the respondent was either detained for a minimum of 2 involuntary holds in the last 120 days or that they were referred to a full service partnership program more than once, but was not enrolled due to inability or unwillingness to engage in the previous 120 days.

(4)Existing law authorizes a court to terminate a respondents participation in the CARE process if the court determines that the respondent is not participating in the CARE process or is not adhering to their CARE plan, as specified. Existing law authorizes the court to order an evaluation under the Lanterman-Petris-Short Act, as specified, to ensure the respondents safety. Existing law requires the court to consider the respondents failure to successfully complete their CARE plan and the reasons for that failure in a subsequent hearing under the Lanterman-Petris-Short Act, provided that the hearing occurs within 6 months of the termination of the CARE plan, and creates a presumption that the respondent needs additional intervention beyond the supports and services provided by the CARE plan.

This bill would prohibit the court from terminating a respondents participation in the CARE process solely due to a failure of the county or other local government entity to properly engage with the CARE process.

(5)Existing law requires CARE Act proceedings to occur in person unless the court, in its discretion, allows a party or witness to appear remotely through the use of remote technology. Existing law authorizes the respondent to be in person for all hearings.

This bill would instead authorize all parties and witnesses to appear remotely through the use of remotely technology. The bill would authorize the court with discretion to order a party or witness to appear in person if necessary.

This bill would authorize the parties to agree to an alternative method of service for all subsequent reports and notices after the notice of initial appearance.

This bill would require, by January 1, 2028, all counties to establish a process for electronic submission of CARE Act documents using a secured portal. By increasing the duties on county behavioral health agencies, the bill would create a state-mandated local program.

(6)Existing law authorizes a provider of health care or a covered entity, as defined, to disclose to the county behavioral health agency any information, including protected health information, and mental health records excluding psychotherapy notes, in its possession about the respondent that is relevant to the county behavioral health agencys provision, coordination, or management or services or supports. Existing law specifies protections for this information and required procedures when such a disclosure is made.

This bill would authorize a county behavioral health agency to disclose to a provider of health care or a covered entity any information, including protected health information, and mental health records, excluding psychotherapy notes, in its possession about the respondent that is relevant to the provider or entitys provision, coordination, or management of services and supports. The bill would also specify protections for this information and required procedures when such a disclosure is made.

(7)Existing law requires the department to develop, in consultation with specified entities, an annual CARE Act report that includes specified information on CARE Act petitions, including the number of initial appearances, and information compiled from county behavioral health departments and courts.

This bill would expand the information on CARE Act petitions to include the number of petitions submitted electronically as well as other specified information. The bill would also expand the data to be compiled from county behavioral health departments and courts to include the number of individuals who were enrolled in a Full Service Partnership program postreferral, among other things. The bill would also require the data collected from county behavioral health departments and courts to be collected for cases involving dismissed respondents, where available.

(8)Existing law requires the California Health and Human Services Agency, or a designated department within the agency, to perform specified functions, including engaging an independent, research-based entity to advise on the development of data-driven process and outcome measures to guide the planning, collaboration, reporting, and evaluation of the CARE Act.

This bill would require the agency to annually release a list of overperforming and underperforming counties to receive additional support through the CARE Improvement and Coordination Unit. counties and shall annually provide written notice identifying areas of concern and opportunities for improvement to underperforming counties. This bill would also establish within the California Health and Human Services Agency the position of a CARE Court Ombudsperson, as specified.

(9)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.