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San Mateo County launched the state-mandated Community Assistance, Recovery and Empowerment Court on July 1 ahead of the December deadline.
The CARE Court’s goal is to connect people with schizophrenia and other psychotic disorders with mental health care, housing and other services.
“The CARE Court is another tool in our toolbox to get people linked with services,” said Jei Africa, director of San Mateo County Behavioral Health and Recovery Services.
Family members, first responders, and the county can petition someone for CARE Court, among others. When someone is referred, the county will evaluate if the person, called a respondent, meets the requirements.
The program is only available to people who meet a specific criteria; they must be 18 years old or over, have a diagnosis of schizophrenia spectrum disorder or another psychotic disorder, not clinically stabilized in on-going voluntary treatment and be at risk of deteriorating or unlikely to survive safely in the community.
The county roughly estimates that there are about 200-300 people who meet the criteria.
The county will also try to voluntarily connect the respondent with county services. If they accept, the person does not go through the CARE process.
The length of this process will vary based on the individual, according to Africa. “Some people are easy to engage and are ready to talk with us so sometimes it can take a week. But sometimes, they are hard to find, not wanting to talk with us and are not ready. It might take months,” he said.
If the respondent does not voluntarily accept services, the county brings their findings to the court, who will evaluate if the respondent is eligible.
If the respondent meets the criteria, the court will appoint an attorney to represent the respondent and they will attempt to create a voluntary CARE agreement with the county to provide services.
The county is offering intensive case management, psychiatry services, housing and benefit support and medication management, among other services.
The county is mainly assisting individuals with accessing already existing services.
“These are services that, before the CARE Court, Behavioral Health and Recovery Services provided for clients who have severe mental illness or substance use issues. But the focus of CARE Court is a different set of folks, who have schizophrenia spectrum disorders, that are not linked to services at all,” said Africa. “We have some additional funding from the state so we were able to hire more staff and expand an existing team to reach out to these individuals that normally would not get any access.”
A county health spokesperson later clarified that since 2016, the Assisted Outpatient Treatment team has connected people with mental health illnesses, included psychotic disorders, to intensive case management and therapeutic supports.
The outpatient treatment team is blending with CARE. The team previously had a clinician, mental health counselor, a part-time Deputy Public Guardian and a budget of $2.4 million.
The team is adding a mental health program specialist, a peer support worker, and two more clinicians. The increase in budget is unclear, however a spokesperson said the county has not received funds from the state.
The CARE Court team has access to some units in Canyon Vista cohousing building, part of the upcoming Cordilleras Health Campus in Redwood City.
“CARE Court participants are prioritized for a few units at the Redwood City housing center to get those transitional or short term beds. Our team will be working with them over the course of the program to find more permanent housing,” said Africa.
“We are going to try to find different housing opportunities for them. We can help them get a Section 8 voucher. And there are many other state and county programs for housing.”
The county’s goal of the CARE Court program is to voluntarily connect people with services.
“I think the goal for us as providers is to do outreach in the best way that we can so we can try to explain that: ‘Given what you are experiencing, there might be services that are appropriate to get you the help you need,’” said Africa.
According to Africa, the CARE Court is completely voluntary. “It is voluntary. There is no penalty if they don’t follow through or show up in court,” said Africa.
If an individual does not voluntarily agree to use supportive services, the court will order the county to conduct a clinical evaluation and, depending on the result, order a “CARE plan.”
According to the law, if the respondent fails to complete their CARE plan, that will be used as evidence in a Lanterman-Petris-Short Act hearing and “shall create a presumption at that hearing that the respondent needs additional intervention beyond the supports and services provided by the CARE plan.”
The Lanterman-Petris-Short Act allows the court to appoint a conservator to make financial and medical decisions for the respondent.
The county opened its hotline to help eligible petitioners with the process on July 1 and people can file a petition to the court on its website, or in person.
The first CARE Court hearings will take place July 23 at 9 a.m.
