San Diego’s CARE Act Program 11/17/23

Although severe debilitating psychiatric disorders such as schizophrenia, chronic substance use and other serious disorders are relatively rare in the populations served by pediatricians, the recently implemented CARE Act Program is an important new resource for the community that pediatricians may find valuable for some patients who are in their transition age years as young adults and it is a program that all primary care providers should have knowledge of as a potential resource for their adult patients and their families.

This pilot program creates a new pathway to deliver mental health and substance use services to individuals with severe illnesses who are not actively or successfully engaging in recommended treatment voluntarily and who are at high risk of harm as a result of their clinical condition.  Through a new state law, CARE (Community Assistance, Recovery, and Empowerment) Courts create a process for families, clinicians, first responders, and others to file a petition with the civil court to connect individuals (ages 18+) to court-ordered voluntary treatment if they meet criteria and would benefit from the program.

San Diego County launched its CARE Act program on October 1, 2023, in collaboration with the Superior Court, the Public Defender, legal advocacy, contracted service providers, and community partners.

Details on the process:

Referrals: Referrals can be initiated by family members, behavioral health providers, first responders, or other approved petitioners, by filing a petition with the Superior Court.

Initial Determination: Upon receipt of an application, the Superior Court makes an initial determination as to whether the petition meets criteria for CARE Court consideration.  If affirmed, the Court will order County Behavioral Health Services (BHS) to conduct an investigation, that will include an effort to engage the petitioned individual in fully voluntary treatment so as to avoid the need to proceed with CARE Court involvement.

Establishing a CARE Plan: If the Superior Court determines that a case should be established, a CARE Plan will be developed with County BHS, in partnership with the petitioned individual and their counsel, for Superior Court review.

Connection to Services: Once a CARE Plan is accepted and approved, BHS and its network of community-based providers will actively engage the individual to connect them to services, including behavioral health treatment, stabilization medication, a housing plan, and other supports as needed.

CARE Act program duration is 12 months but may be extended depending upon individual circumstances.

CONTACTING CARE Act:  Telephone 877 734-3258, option #6.

Core eligibility criteria require either:

  • a declaration by a license behavioral health professional that the person referred has a severe behavioral health disorder that interferes with their primary activities of daily living that may result an inability to maintain stable adjustment and independent functioning, among other criteria, or
  • evidence that the petitioned individual was detained for a minimum of two intensive treatments, the last of which was within the past 60 days, or the petitioned individual was detained twice for up to 14 days of intensive treatment pursuant to a 5150/5250 involuntary detention process.

San Diego’s CARE Act program is a significant addition to the broad array of treatment services and supports for adults available in the community.  For adults and/or their family members seeking voluntary treatment services the County’s Access and Crisis Line (ACL) at 1-888-724-7240 – or 9-8-8 –can help connect you with services.

For children and adolescents, SmartCare BHCS’ Family Support Services offers a resource for pediatricians and other primary care providers to assist parents/guardians and older adolescents in identifying needs and offering referrals to relevant services and treatment providers. SmartCare staff can be reached at 858 956-5900.


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