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Care Act Clinical Workflow

CARE Act Resource Center: You can find helpful information about the CARE Act itself, including the court process, at https://care-act.org/ 

Initiation Period

Starts when the petition is filed. 

  1. Petition is filed. 
    1. If this is done by Behavioral Health staff, then the petitioning staff should “request” enrollment for the client in the CARE Act program via regular referral processes. Request date should be the date of the petition. 
    2. If this is not done by Behavioral Health staff, then the CARE Act staff will learn about the petition from the court. CARE Act staff will add the respondent as a client in SmartCare, if they are not already a client. Then they will add the client to the CARE Act program in requested status. Request date should be the date of the petition. Enrolled date should be the date the Behavioral Health CARE Act staff were notified and began attempting to engage the respondent. 
  2. CARE Act staff attempt to engage the respondent (aka client).
    1. All attempts to engage the respondent are documented in service notes using the “CARE Act – Outreach and Engagement Activity” procedure code.  

  3. CARE Act staff attend all relevant hearings. These hearing types will vary on a case-by-case basis. CARE Act staff will create court documents as needed for hearings.

  4. CARE Act staff must complete at least 1 CARE Act Reporting Document for the time spent in the Initiation Period. If the Initiation Period spans multiple months, a CARE Act Reporting Document must be completed for each month the Initiation Period exists in.

Active Period

Starts when the client engages in an Active CARE Agreement OR the court creates a CARE Plan.  

  1. CARE Act staff document the client’s initial CARE Plan or CARE Agreement in SmartCare using the CARE Plan/Agreement document.  
    1. If there is a different version of the CARE Plan/Agreement, such as one done on paper and signed by all relevant parties, this document should be scanned in and associated with the SmartCare CARE Plan/Agreement document.
    2. Currently, if the document is a CARE Plan, the client should not sign. This indicates that the document is a CARE Plan rather than a CARE Agreement. If the document is a CARE Agreement, make sure the client signs, or that the client’s signature is at least documented via the co-signer functionality. If the client has already signed a paper version, simply document this via the co-signer functionality. We are working on including a field on the document itself to indicate whether this is a CARE Plan or a CARE Agreement.
    3. CARE Act staff create a new CARE Plan/Agreement document anytime the CARE Plan or CARE Agreement changes.

  2. CARE Act staff attend all relevant hearings. These hearing types will vary on a case-by-case basis. CARE Act staff will create court documents as needed for hearings.

  3. CARE Act staff complete CARE Act Reporting Documents monthly. When the Active Period starts, CARE Act staff will need to create 2 CARE Act Reporting Documents: one for the time spent in the Initiation Period and the second for the time spent in the Active Period. This is the only time 2 reports are required within the same month.

Follow-Up Period

Starts when the client exits the CARE process. 

  1. CARE Act staff complete CARE Act Reporting Documents.  
    1. If the client graduates, or otherwise successfully exits the CARE process, CARE Act staff should complete the CARE Act Reporting Document monthly for the 12 months following graduation or successful completion.  
    2. If the client is terminated from services (premature exit from the CARE process or voluntary services), then CARE Act staff should complete the CARE Act Reporting Document for the month the client is terminated but does not have to continue monthly reporting afterwards. 
    3. If the client agreed to elective services, they skip the Active Period and move straight into the Follow Up Period. CARE Act staff should complete the CARE Act Reporting Document monthly for the 12 months following the start of elective services. If the client leaves elective services prior to the full 12 months, this would be considered a termination (see b above).
  2. Once the follow up period ends (last report is completed), discharge the client from the CARE Program.  

Documenting Time Spent on CARE Act Activities

CalMHSA has created procedure codes specific to CARE Act activities. All time spent on CARE Act activities should be documented via a service note using the appropriate procedure code, even if the client is not present. 

  • CARE Act – Court Report Activity 
  • CARE Act – Data Reporting 
  • CARE Act – Notice Activity 
  • CARE Act – Outreach and Engagement Activity 

For time spent at hearings, CalMHSA has created a procedure code for each type of CARE Act hearing. This should improve the ability for CARE Act staff to track the type of hearing, where a client is at in the CARE Act process, and what court documents may be required for an upcoming hearing. 

  • CARE Act – Initial Hearing 
  • CARE Act – Hearing on Deferred Ruling 
  • CARE Act – Case Management Hearing 
  • CARE Act – Evaluation Review Hearing 
  • CARE Act – CARE Plan Review Hearing 
  • CARE Act – Progress Review Hearing 
  • CARE Act – Status Review Hearing 
  • CARE Act – 1 Year Status Review Hearing 
  • CARE Act – Graduation Hearing 

Each CARE Act Hearing note type will include information about the hearing itself, including who was present and when the next hearing is scheduled. Each CARE Act Hearing note type will include a section for questions specific to that type of hearing, if applicable. Lastly, each CARE Act Hearing note type will include a Narrative section where the staff can document any pertinent details about that hearing and related interactions.