CARE Act court-mandated mental health treatments begin Monday in Riverside County
A new state law meant to address certain untreated mental health disorders through court-mandated behavioral health programs began Monday in Riverside County.
The Community Assistance, Recovery and Empowerment (CARE) Act was signed into law by Gov. Gavin Newsom in September 2022. It allows family members and first responders, among others, to file a petition in court to potentially get a court-mandated mental health treatment plan for those diagnosed with certain disorders. A Care Plan could also be provided for homeless people if they fit the criteria.
Riverside County is in the first group of counties to implement CARE, along with Glenn, Orange, San Diego, Stanislaus, Tuolumne and San Francisco counties. All other counties have until Dec. 1, 2024.
After a year of planning, Riverside County officials said they are ready for CARE to launch and see it help those in need. But there are still a few uncertainties, like how many people will be eligible for it and if there are enough county resources available to make it work.
How it works
CARE Court connects people struggling with untreated mental illness, and often also substance abuse, with a court-ordered Care Plan for up to 24 months.
It is not for everyone experiencing homelessness or mental illness. Instead, it is designed for people, ages 18 and older, who have schizophrenia or other psychotic disorders and are "substantially deteriorating" and unlikely to survive safely in the community without supervision, according to the county. It may also be an option after a short-term involuntary hospital hold (either 72 hours/5150 or 14 days/5250) or for those who can be safely diverted from certain criminal proceedings.
CARE Court is not a conservatorship, which is when a judge appoints a person to act or make decisions for another. In some instances, if someone refuses to participate in CARE Court, they may be referred by the court for a conservatorship, depending on individual circumstances. There is also no penalty if someone drops out.
The process can start by calling the Riverside University Health System-Behavior Health CARES Line at 800-499-3008. Petitions can be filed at any Riverside County Court location, or electronically filed for free via the court’s eSubmit system. Family members, county and community-based social services, behavioral health providers and first responders can file a petition.
If a judge determines that the person in need of help appears to meet the criteria, Riverside University Health Systems - Behavioral Health will be notified and an attorney will be appointed to represent that person. Behavioral Health staff will evaluate if someone is not doing well without care or might be a danger to themselves, explained Marcus Cannon, Riverside County's Behavioral Health services deputy director of forensics.*
CARE Act proceedings will be heard at 1:30 p.m. Monday through Friday every week in Department 12 of the Riverside Historic Courthouse, located at 4050 Main St. in Riverside, with remote appearances available.
Each Care Plan is individualized and managed by a care team in an outpatient setting. It can include supportive services, medication and a housing plan. According to the county, forced medication is not part of the program.
The Care Plan can be ordered for up to 12 months, with periodic review hearings, and it can be renewed for up to another 12 months. There is no cost to the person participating, according to the county.
Cannon said CARE is "another tool in the toolbox" to help those with mental health issues.
'Ready to begin'
In California, up to 12,000 people could get help under CARE Court. In Riverside County, that number could be between 450 and 800 people, according to Cannon.
The county's homeless point-in-time count identified a total of 3,725 people experiencing homelessness, up 12% from the previous year. In the Coachella Valley, there were 982 homeless people counted, up 3% from 949 in 2022.
During its first year, the county estimates that 120 people will be eligible for CARE. The county's budget for that first year is around $13.7 million. So far, the state has provided one-time startup funds of around $6.5 million.
Some of the services that will be provided could be billed to Medi-Cal or other insurance, Cannon explained. The California Department of Health Care Services is working on a plan to provide a funding stream for other services that can't be billed, but that plan is not yet finalized, he said.
There will be two staff teams working directly with CARE cases, each with 12 people and capable of serving up to 120 clients. The teams consist of bachelor's level case managers, alcohol and drug counselors, clinical therapists, paraprofessional staff (community services assistants who could help someone complete an application or get to an appointment), support staff, psychiatrists, program supervisors and mental health peer specialists (someone who has experience managing a chronic mental health condition). Cannon said the latter are a "really powerful tool" that are already used in other Behavioral Health programs.
Some clients may require housing services as part of their Care Plan. Cannon said the goal would be to keep people "as close to their home and their natural support system as possible." Roy's Desert Springs, a board and care center in North Palm Springs, or Desert Sage, an adult residential facility in Indio, could be options to help transition some into more independent living situations.
Affordable housing is tough to secure as-is, and Cannon acknowledged that the county is facing a shortage.
"We continue to move forward with our philosophy of doing more with less, but we're certainly trying to build out that continuum," he added.
County spokesperson Brooke Federico said in the last three years, Riverside County has completed 735 new affordable housing units. There are currently 2,000 units under construction, and another 7,000 in the pipeline. During the height of the COVID-19 pandemic, more than 500 behavioral health beds were also added. But the level of availability changes on a day-to-day basis.
Despite many unknowns, Cannon said the county is eager to get started.
"After a year of planning, you reach a point where you're ready to begin and see what the real opportunities are and the real challenges are," he said. "We feel good."
Questions about the unknowns
Greg Rodriguez, the county’s deputy director of government affairs and community engagement, had concerns regarding the CARE Act when it was first announced, particularly the way it was talked about as a tool for homelessness.
"The biggest thing we've learned is this is not the panacea to solve homelessness," he said.
Through various calls with state and county departments, Rodriguez said he and his colleagues are ready for petitions to start coming in, but questions still remain over how many will qualify and their housing needs. For those who lack stable transportation, there's also concern about how they will get to appointments, or if remote opportunities will be available to them.
Whether residents do qualify for CARE or not, Rodriguez sees it as another way to introduce people to a wide variety of behavioral health services that Riverside County offers, which can be found at www.rcdmh.org.
Christine Thomstad, president of the NAMI (National Alliance on Mental Illness) Coachella Valley Board of Directors, still has many questions surrounding the CARE Act. She's concerned that many people can file a petition to start CARE Court proceedings, and she believes only care providers should have that ability. Thomstad is also worried about housing and where people will be placed.
"We don't have enough housing for those who need it now, how are we going to do this?" she said.
Thomstad noted that she and her husband have brought up the CARE Act a few times in NAMI Coachella Valley support groups, but it did not appear that people were aware of it. She has also seen pushback from various groups in California that believe human rights will be taken away under the new law. Thomstad has researched different components of CARE and sees there's misinformation out there. For example, stabilization medications may be part of someone's Care Plan, but they will not be forced to take it. They will also not be sent to jail if they do not want to participate in the program.
She and her husband have a son who is living with schizoaffective disorder, and Thomstad said they are not in a situation where they would utilize CARE Court. If they were, she would "look into it very closely" if she thought it would be of help.
"They all deserve the chance to get to a point where they can be productive, have a place to live, have a chance to do things," Thomstad said of individuals the CARE Act aims to help.
More information
For more information on the CARE Court program, call the Riverside University Health System CARES Line at 800-499-3008 or visit ruhealth.org/behavioral-health/care-court
Riverside Superior Court Self Help Legal Services is available to explain CARE Court legal procedures and provide guidance on court forms. These services can be obtained by calling 951-274-4499 or 760-393-2163 or visiting riverside.courts.ca.gov/Divisions/CAREAct/care-act.php
*Correction: The original version of this story included an old title for Marcus Cannon. The article has since been updated to reflect his current title.
Ema Sasic covers entertainment and health in the Coachella Valley. Reach her at ema.sasic@desertsun.com or on Twitter @ema_sasic.
This article originally appeared on Palm Springs Desert Sun: Riverside County among first in state to implement CARE Court program
