​​​​​​​​​​​​​​​​​​​​Community Assistance, Recovery, and Empowerment ​​Act

Overview

Senate Bill (SB) 1338 (Umberg, Chapter 319, Statutes of 2022) established the Community Assistance, Recovery, and Empowerment (CARE) Act, which provides community-based behavioral health services and supports to Californians living with schizophrenia spectrum or other psychotic disorders who meet health and safety criteria. It is a new civil court process where certain people, such as family members, first responders, and providers, may file a petition to the court to create a voluntary CARE agreement or a court-ordered CARE plan. A CARE agreement or CARE plan may include treatment, housing resources, and other services. The CARE Act is intended to serve as an upstream intervention for individuals experiencing severe impairment to prevent avoidable psychiatric hospitalizations, incarcerations, and Lanterman-Petris-Short (LPS) Mental Health Conservatorships. The CARE Process will provide earlier action, support, and accountability for both CARE clients, and the local governments responsible for providing behavioral health services to these individuals. 

The CARE Act was implemented in two cohorts. Cohort I began on October 1, 2023, and included seven counties: Glenn, Orange, Riverside, San Diego, Stanislaus, and Tuolumne, and the City and County of San Francisco. Los Angeles County is in Cohort II but elected to implement early, on December 1, 2023. The remaining Cohort II counties were required to implement on or before December 1, 2024.​​

​Legislation​

On July 10, 2023, Assembly Bill (AB) 102 (Ting, Chapter 102, Statutes of 2023) was signed into law. AB 102 requires the Department of Health Care Services, in consultation with the Judicial Council of California, to provide an early implementation report on key data for each trial court implementing the CARE Act. The report must include: (1) the number of petitions submitted, (2) the number of petitions dismissed, (3) the number of CARE Act participants, and (4) the number of court hearings held during October 1, 2023, through June 30, 2024. The early implementation report will be submitted to the Joint Legislative Budget Committee and the Budget Committees of each house of the Legislature by December 1, 2024.  

Additionally, AB 102 requires the Legal Services Trust Fund Commission (LSTFC) at the State Bar of California to collect outcome data from each county’s public defender office, qualified legal services projects (QLSP), and support centers. The State Bar of California shall annually provide to the Judicial Council a report that includes funding allocations, annual expenditures, and program outcomes by service area and service provider to be included in DHCS’ annual CARE report.  

On September 30, 2023, Senate Bill (SB) 35 (Umberg, Chapter 283, Statutes of 2023) was signed into law. SB 35 clarifies requirements for the CARE process and makes technical changes that will allow the CARE Act to be implemented successfully. Additionally, the bill specifies the information, including protected health information, that must be shared between behavioral health agencies and providers. This information is necessary to support the determinations, conclusions, and recommendations for the written report submitted to the court to document the respondent’s eligibility for the CARE process.

On September 27, 2024, SB 42 (Umberg, Chapter 640, Statutes of 2024) was signed into law and contained an urgency clause that became effective immediately after signing. SB 42 creates an additional pathway of referring an individual from LPS designated facilities to the CARE Act process. This bill additionally amends the Welfare and Institutions Code regarding communication between courts, alternatives to conservatorship, technical changes to CARE procedures, as well as collaboration on system performance.  

On September 27, 2024, SB 1400 (Stern, Chapter 647, Statutes of 2024) was signed into law. SB 1400 amends provisions of the Penal Code related to misdemeanor incompetent to stand trial (MIST) referrals to CARE. The bill provides that if the defendant is accepted into CARE, the criminal charges shall be dismissed six months after the date of the referral to CARE, unless the defendant's case has been referred back to the criminal court prior to the expiration of that time period. The bill additionally amends provisions of the Welfare and Institutions Code to expand the requirements for data reporting, including data related to inquiries and system referrals. This data shall be included in the annual report to examine the scope of impact and monitor the performance of CARE Act model implementation.

On September 27, 2024, SB 1323 (Menjivar, Chapter 646, Statutes of 2024) was signed into law. SB 1323 amends provisions of the Penal Code related to incompetent to stand trial (IST) for specified felony offensives to authorize referrals to CARE proceedings. If the defendant is accepted into CARE, the charges shall be dismissed pursuant to Penal Code Section 1385.​

To read the bills in full, please visit the California Legislative Information webpage. 

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