Self-Help

Sierra Superior Court will start accepting CARE Court Petitions on December 1st, 2024

To be eligible for CARE Act proceedings, the individual must meet all of the following criteria:

• Be 18 years old or older
• Have a diagnosis of schizophrenia spectrum or other psychotic disorder
• Be currently experiencing a mental illness that is severe in degree and persistent in duration, which may cause behavioral functioning which interferes substantially with the primary activities of daily living, and which may result in an inability to maintain a stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time.
• Not currently clinically stabilized in an on-going voluntary treatment program
• CARE would be the least restrictive alternative to ensure the person's recovery and stability
• Be likely to benefit from participation in CARE
• Meet one of the following:
  • The person is unlikely to survive safely in the community without supervision and the person's condition is substantially deteriorating.
  • The person is in need of services and support in order to prevent a relapse or deterioration that would likely result in grave disability or serious harm to the person or others, as defined in Section 5150

Schizophrenia spectrum disorders include:

• Schizophrenia
• Schizoaffective Disorder
• Schizophreniform Disorder
• Other Specified Schizophrenia Spectrum and Other Psychotic Disorder
• Unspecified Schizophrenia Spectrum

Other psychotic disorders include:

• Brief Psychotic Disorder
• Delusional Disorder
• Schizotypal Personality Disorder
• Substance Medication Induced Psychotic Disorder
• Catatonia Assiciated with Another Mental Disorder
• Unspecified Catatonia

Psychiatric diagnoses that do not meet eligibility requirements:

• Psychotic Disorder Due to a General Medical Condition
• Catatonia Associated with Another Medical Condition
• Major Depression with Psychotic Features
• Bipolar Disorder with Psychotic Features
• Any other Substance-Related Disorder not listed above

To be a petitioner, you must be 18 years of age or older. You can be related to the respondent or be the director of an agency who has had a frequent contact with the respondent due to their mental health disorder. You must fall within one of the following categories to be able to request CARE Act proceedings for a respondent:

• A person who lives with the respondent
• A spouse or registered domestic partner, parent, sibling, child, or grandparent of the respondent
• A person who stands in the place of a parent to the respondent
• The director of certain county agencies, specifically adult protective services, a county behavioral health agency, or the public guardian or public conservator, or that person's designee
• The director of a hospital, or their designee, in which the respondent is or was recently hospitalized
• A licensed behavioral health professional or director of a public or charitable agency, who is currently or has been recently treating, or supervising the treatment of, or providing behavioral health services for the respondent within the last 30 days.
• A first responder who has had repeated interactions with the respondent
• A judge of a tribal court located in California, before which the respondent has appeared within the previous 30 days, or the judge's designee
• The director of a California Indian health services program or a California tribal behavioral health department, who has, within the previous 30 days, provided or who is currently providing behavioral health services to the respondent, or the director's designee
• The respondent themself

Certain conditions and disorders are excluded, including:

• Serious mental illnesses outside of psychotic disorder class, including bipolar disorder, major depression, and post-trauma stress disorder
• Psychotic disorders due to medical conditions, such as traumatic brain injury, autism, dementia, or other physical health or neurological conditions
• Substance use disorder that does not otherwise meet the definition of a psychotic disorder

Respondents have the right to be informed of the proceedings and receive notice of all hearings, take part in the proceedings (including to present evidence, call and cross-examine witnesses, and appeal decisions), be represented in all stages of the process regardless of their ability to pay, replace the court-appointed attorney with an attorney of their choosing, have the supporter of their choosing throughout the process, and to receive a copy of the petition and any court-ordered evaluations or reports. The respondent also has the right to an interpreter in all proceedings if necessary for the respondent to fully participate. If the respondent requires disability accommodations, requests can be made with the court.

All reports, evaluations, diagnoses, documents, and filings submitted during CARE Act proceedings are confidential. CARE Act hearings are also closed to the public unless the court orders otherwise.

A CARE agreement is a voluntary settlement agreement entered into by the respondent and the county behavioral health agency after a court has found that the respondent is eligible for the CARE process. The CARE agreement will include an individualized range of community-based services and supports that can consist of clinical services: behavioral health care; counseling; specialized psychotherapies, programs and treatments; stabilization medications; a housing plan; and other supports and services provided directly and indirectly through a local government entity.

A CARE plan is a court-ordered plan that includes the same elements as a CARE agreement. If a CARE agreement is not reached and a clinical evaluation indicates that the respondent meets the criteria, the court will order the creation of a CARE plan, which will include an individualized range of community-based services and supports. Stabilization medications may only be included in a CARE plan if the respondent is found to lack capacity and may not be forcibly administered. 

The court reviews petitions to determine if a respondent likely meets the criteria for the CARE Act. Depending on the determination, the court will either dismiss the petition, order a report from a county agency, or set an initial court appearance. If the case is not dismissed, the court will appoint an attorney for the respondent. If the court finds a respondent meets the CARE Act requirements, the court will order the county behavioral health agency to work with the respondent, their attorney, and their supporter (if they have one), to determine if a CARE agreement will be possible. If it is determined that a CARE agreement is not likely to be reached, then there will be a clinical evaluation followed by a hearing to review that clinical evaluation. If the clinical evaluation finds that the respondent is eligible, a CARE plan will be developed and reviewed in a hearing. There will then be a status review hearing at least every 60 days. At month 11, there will be a one-year status review hearing to determine next steps, including graduation, electing to remain in the CARE process (for up to one additional year) or reappointment (which can only happen once).