Community Assistance, Recovery, and Empowerment (CARE) Court Program.

Senator Umberg’s CARE Act reform reconfigures California’s approach to court-supervised behavioral health support by weaving CARE proceedings more directly into the criminal and civil court landscape, adding new referral pathways from misdemeanor and felony cases, and authorizing the court to make prima facie determinations without a formal hearing. The measure also tightens the framework for eligibility, court processes, and oversight in ways that touch multiple parts of the justice and health systems.

Key provisions include adding bipolar I disorder with psychotic features to the CARE-eligible diagnoses (with a prohibition on psychosis related to intoxication), and expanding who may prepare CARE petition affidavits to include nurse practitioners and physician assistants alongside traditional licensed behavioral health professionals. The bill also allows a court to refer a defendant to the CARE Act court if the defendant and counsel consent and the court has reason to believe CARE eligibility may exist, with charges dismissed six months after the referral if the person is accepted into CARE and the matter is not returned to criminal court before then. If CARE is not accepted or is reversed, the criminal court proceeds to determine diversion eligibility. The county behavioral health agency and jail medical providers may share confidential medical information with the court to assess likelihood of eligibility, subject to privacy protections.

Procedurally, the legislation establishes a structured, time‑bound process: an initial 14‑court‑day appearance upon a prima facie showing, a CARE eligibility hearing within 30 court days of referral, and progress hearings after CARE initiation. It expands referral pathways to include assisted outpatient treatment, conservatorship, misdemeanor, and felony proceedings, with provisions for investigating referrals that are not immediately treated as petitions. The bill creates a case‑management cadence, a one‑year CARE plan timeline, and options for graduation or an additional year of participation, along with criteria for involuntary reappointment. It also requires tribal notice and consultation for American Indian participants and preserves confidentiality around county‑developed reports and CARE plans, including safeguards around the use of court‑ordered medications when capacity to consent is lacking.

On oversight, reporting, and implementation, the measure requires an annual CARE Act report from the Department of Health Care Services with extensive data elements and health‑equity analysis, de-identified data releases, and cross‑agency coordination with the Judicial Council and county behavioral health departments. Jurisdictions must share data related to CARE petitions, hearings, plans, and outcomes, with a framework intended to measure progress and disparities. The bill contemplates a state‑mandated local costs dynamic, providing reimbursement mechanisms if the state determines costs are mandated, and it elevates interagency accountability through mandated reporting to state oversight bodies and public release of aggregated data.