CARE Courts Roll Out Next Week. Here’s What You Should Know.

In less than a week, seven California counties will embark on a new experiment in the treatment of severe mental illness. 

October 1 is the official launch date for so-called CARE courts in Orange, Riverside, San Diego, San Francisco, Stanislaus, Tuolumne and Glenn counties. Los Angeles’ CARE courts will open on Dec. 1. 

The Community Assistance, Recovery, and Empowerment (CARE) Act was passed in 2022 in response to the state’s homeless crisis and the overlapping crisis of untreated psychiatric illness. Nearly two-thirds of homeless people in California suffer from severe mental illness, according to the latest research from the University of California San Francisco. Another two-thirds suffer from substance abuse issues.

The CARE Act allows family members, first responders, doctors or other authorized personnel to petition a county-run civil court to create a voluntary or mandatory plan for someone with severe mental illness. That plan would lay out treatment (therapy, medication management and/or substance abuse help), housing and job support, and other necessary services the person must receive. The plan would remain in effect for 12 months with the option to extend it for another year.

If an individual does not comply with the treatment plan, they could face conservatorship or involuntary commitment to a psychiatric facility. Every person will receive an advocate and a public defender to represent them throughout the CARE court process.

"While we continue to seek voluntary treatment at all times, this new 'CARE Court' tool may put us in a better position to help more people — those who just may need it the most,” 
said Riverside Board of Supervisors Chairman Kevin Jeffries.

The CARE Act places significant pressure on county governments. Counties that fail to comply with the law could face fines of $1,000 per day, not to exceed $25,000 for each individual violation. 

Between 7,000 and 12,000 people are expected to qualify for CARE courts statewide. San Diego County expects around 1,000 petitions in the first year and court-ordered treatment plans for around 250 people. Orange County expects 1,400 petitions and around 400 to 600 treatment plans. Other counties say they have no idea how many petitions or cases to expect. That uncertainty could complicate an already challenging rollout.

Counties have expressed concerns about their ability to provide the services the CARE Act demands. Housing is already in low supply and the state’s mental health infrastructure is under enormous pressure.

“We can’t just materialize (board-and-care resources) by snapping our fingers,” San Diego Behavioral Health Services Director Luke Bergmann told Voice of San Diego. “We have got to find providers that are willing to do this work and make sure we are getting them resources.” 

The Legislature has allocated $39.5 million in General Fund appropriations to support the program in the current fiscal year. The first cohort of counties participating in the CARE court program have received $26 million from the state to get the experiment off the ground.

In addition to county officials’ reservations, the CARE Act has faced opposition from disability rights groups who generally oppose all forms of coercive mental health treatment. They tried unsuccessfully to have the law declared unconstitutional on due process and equal protection grounds this year.

In fact, the CARE Act is quite narrow in scope. It applies only to those with the most severe forms of psychiatric illness – namely schizophrenia and related disorders. This makes it similar to Laura’s Law, passed in 2001. However, unlike the CARE Act, Laura’s Law is only applicable to counties that opt in.

To learn more about the CARE court rollout and how the program will operate, visit the California Health & Human Services Agency’s FAQ page