(1) Existing law, the Community Assistance, Recovery, and Empowerment (CARE) Act (the act) , authorizes specified persons, including a person with whom the respondent resides, family members, and first responders, among others, to petition a civil court to create a voluntary CARE agreement or a court-ordered CARE plan and implement services, to be provided by county behavioral health agencies, to provide behavioral health care, including stabilization medication, housing, and other enumerated services, to adults who are currently experiencing a severe mental illness and have a diagnosis identified in the disorder class schizophrenia and other psychotic disorders, and who meet other specified criteria.
Existing law, the Lanterman-Petris-Short Act, authorizes a conservator of the person, of the estate, or of the person and the estate to be appointed for a person who is gravely disabled as a result of a mental health disorder or impairment by chronic alcoholism. Existing law requires the officer providing the conservatorship investigation, which may include a public guardian or a county mental health program, to investigate all available alternatives to conservatorship and to recommend conservatorship to the court only if no suitable alternatives are available. Existing law requires a conservatorship under these provisions to terminate after one year and specifies procedures if the conservator determines conservatorship is still required.
This bill would authorize a conservator to, upon the termination of a conservatorship, request the court refer the conservatee to CARE court, as specified.
(2) The act authorizes services and supports to be provided to adults who are currently experiencing a qualifying severe mental illness and who meet other specified criteria, including that the person is not clinically stabilized in ongoing voluntary treatment and is either unlikely to survive safely in the community without ongoing supervision and the person's condition is substantially deteriorating or the person is in need of services and supports to prevent a relapse or deterioration that would likely result in grave disability or serious harm to the person or others.
This bill, instead, would authorize an individual to qualify for the CARE program if, among the other existing requirements, the person has not been clinically stabilized in ongoing voluntary treatment for more than 90 days prior to the CARE court filing, as specified, and if supervision is required to allow for services and supports to be effective and prevent substantial deterioration or relapse.
As part of the petition review process, this bill would authorize the county behavioral health agency, their designee, or the court to recommend the respondent be considered for alternative treatment, including, but not limited to, assisted outpatient treatment program or a grave disability evaluation under the Lanterman-Petris-Short Act, if the respondent requires a higher level of care than the CARE process. The bill would prohibit a determination that the respondent requires a higher level of care than the CARE process if the respondent meets, or is likely to meet, the criteria for the CARE process.
This bill would update various definitions applying to the act.
(3) Existing law requires the Judicial Council to develop a mandatory form or forms to use to file a CARE process petition. Existing law requires the petition to be signed under the penalty of perjury and to contain specified information, including the petitioner's relationship to the respondent and either an affidavit of a licensed behavioral health professional stating the licensed behavioral health professional or their designee has examined or made multiple unsuccessful attempts to examine the respondent within 60 days of submission of the petition, or that the respondent was detained for a minimum of 2 intensive treatments pursuant to state law.
This bill would extend the 60-day period for examination of the respondent to 270 days. The bill would also authorize a petition to include evidence that the respondent was either detained for a minimum of 2 involuntary holds in the last 6 months or that they were referred to a full service partnership program more than once, but was not enrolled due to inability or unwillingness to engage.
(4) Existing law, the Lanterman-Petris-Short Act, provides generally for the evaluation, treatment, and civil commitment of persons with mental health disorders and other specified persons. The act authorizes the detention for evaluation for up to 72 hours of a person who is found to be, as a result of a mental disorder, a danger to others or to self, or gravely disabled.
Under the CARE Act, existing law requires a court to hold a status review hearing at specified intervals after the court orders the CARE plan. Existing law authorizes the county behavioral health agency or respondent to request, or the court upon its own motion to set, a hearing to occur at any time during the CARE process to address a change in circumstances.
This bill would, to ensure the respondent's safety, require the county behavioral health agency to request a status hearing to address a change in circumstances and request the court to order an evaluation under the Lanterman-Petris-Short Act of the respondent if prescribed conditions are met, including that the respondent's nonadherence to the CARE plan has resulted in behavior consistent with an established pattern of psychiatric deterioration or symptoms of decompensation. By creating a new requirement for county behavioral health agencies, the bill would create a state-mandated local program.
(5) Existing law authorizes a court to terminate a respondent's participation in the CARE process if the court determines that the respondent is not participating in the CARE process or is not adhering to their CARE plan, as specified. Existing law authorizes the court to order an evaluation under the Lanterman-Petris-Short Act, as specified, to ensure the respondent's safety. Existing law requires the court to consider the respondent's failure to successfully complete their CARE plan and the reasons for that failure in a subsequent hearing under the Lanterman-Petris-Short Act, provided that the hearing occurs within 6 months of the termination of the CARE plan, and creates a presumption that the respondent needs additional intervention beyond the supports and services provided by the CARE plan.
This bill would instead require the court to order an evaluation if the court terminates the respondent's participation in the process and would authorize a court to order a grave disability evaluation, on its own motion or by motion from the county. The bill would also delete the above-described 6 month limitation, thereby requiring the court to consider the respondent's failure to successfully complete their CARE plan and reasons for that failure in any subsequent hearings under the Lanterman-Petris-Short Act and extending the presumption.
(6) Existing law requires that the court hold a one-year status meeting 11 months into the process timeline and requires the county behavioral health agency to file a report including specified information, including what progress the respondent has made on the CARE plan. Existing law authorizes a respondent to be involuntarily reappointed to the program only if specified conditions apply. Existing law also authorizes a court to use existing legal authority to ensure the respondent's safety.
If the court finds that involuntary reappointment is unlikely to stabilize the respondent and supervision is necessary, or if the court finds it is in the best interest of the respondent, this bill would authorize the court to order a grave disability evaluation on its own motion or by motion from the county.
(7) Existing law requires CARE Act proceedings to occur in person unless the court, in its discretion, allows a party or witness to appear remotely through the use of remote technology. Existing law authorizes the respondent to be in person for all hearings.
This bill would instead authorize all parties and witnesses to appear remotely through the use of remotely technology. The bill would authorize the court with discretion to order a party or witness to appear in person if necessary.
This bill would authorize the parties to agree to an alternative method of service for all subsequent reports and notices after the notice of initial appearance.
This bill would require, by January 1, 2028, all counties to establish a process for electronic submission of CARE Act documents using a secured portal.
(8) Existing law authorizes a provider of health care or a covered entity, as defined, to disclose to the county behavioral health agency any information, including protected health information, and mental health records excluding psychotherapy notes, in its possession about the respondent that is relevant to the county behavioral health agency's provision, coordination, or management or services or supports. Existing law specifies protections for this information and required procedures when such a disclosure is made.
This bill would authorize a county behavioral health agency to disclose to a provider of health care or a covered entity any information, including protected health information, and mental health records, excluding psychotherapy notes, in its possession about the respondent that is relevant to the provider or entity's provision, coordination, or management of services and supports. The bill would also specify protections for this information and required procedures when such a disclosure is made.
(9) Existing law requires the department to develop, in consultation with specified entities, an annual CARE Act report that includes specified information on CARE Act petitions, including the number of initial appearances, and information compiled from county behavioral health departments and courts.
This bill would expand the information on CARE Act petitions to include the number of petitions submitted electronically as well as other specified information. The bill would also expand the data to be compiled from county behavioral health departments and courts to include the number of individuals who were enrolled in a Full Service Partnership program postreferral, among other things. The bill would also require the data collected from county behavioral health departments and courts to be collected for cases involving dismissed respondents, where available.
(10) Existing law requires the California Health and Human Services Agency, or a designated department within the agency, to perform specified functions, including engaging an independent, research-based entity to advise on the development of data-driven process and outcome measures to guide the planning, collaboration, reporting, and evaluation of the CARE Act.
This bill would require the Governor's office to annually release a list of overperforming and underperforming counties to receive additional support through the CARE Improvement and Coordination Unit. This bill would also establish within the California Health and Human Services Agency the position of a CARE Court Ombudsperson, as specified.
(11) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Statutes affected:
SB28: 11972 HSC, 11972 HSC, 11972 HSC
12/02/24 - Introduced: 11972 HSC
03/10/25 - Amended Senate: 11972 HSC
05/23/25 - Amended Senate: 11972 HSC, 11972 HSC, 11972 HSC
06/11/26 - Amended Assembly: 5361 WIC, 5361 WIC, 5971 WIC, 5971 WIC, 5972 WIC, 5972 WIC, 5974 WIC, 5974 WIC, 5975 WIC, 5975 WIC, 5976.5 WIC, 5976.5 WIC, 5977 WIC, 5977 WIC, 5977.1 WIC, 5977.1 WIC, 5977.2 WIC, 5977.2 WIC, 5977.3 WIC, 5977.3 WIC, 5977.4 WIC, 5977.4 WIC, 5978.1 WIC, 5978.1 WIC, 5979 WIC, 5979 WIC, 5982 WIC, 5982 WIC, 5983 WIC, 5983 WIC, 5985 WIC, 5985 WIC, 11972 HSC