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Alameda County’s New CARE Act Court
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Alameda County Superior Court recently launched its CARE Act Court in compliance with the 2022 Community Assistance, Recovery, and Empowerment (CARE) Act.[1] Under the CARE Act, every California county must allow parties to petition a civil court to plan and oversee mental health treatment for persons with diagnoses in the disorder class: “schizophrenia spectrum and other psychotic disorders, including substance-induced psychosis.”[2] This treatment plan can be either a voluntary CARE agreement or court-ordered CARE plan.[3]
The CARE Act seeks to bridge the gap between voluntary, outpatient mental health treatment and the Lanterman-Petris-Short (LPS) Act’s provisions for involuntary treatment and conservatorships.[4] To be eligible for CARE Act Court, a respondent must be an adult who experiences a “severe mental illness” and has a qualifying diagnosis.[5] The respondent must not be currently stabilized in ongoing treatment and must be unlikely to survive safely, avoid deterioration, or avoid relapse.[6]
The respondent, their relatives, healthcare or mental health providers, first responders, and county behavioral health agencies can all petition to initiate the CARE Act Court process.[7] If a petition meets the prima facie standard, the court orders the county’s behavioral health agency to perform a CARE assessment.[8] Additionally, the court will appoint an attorney to represent the respondent, and the county’s behavioral health agency will become the petitioner for the remainder of the case.[9] The court then holds a hearing on the merits to see if a respondent meets eligibility criteria under a clear and convincing standard.
After meeting this threshold, the parties must work together to create a voluntary CARE agreement.[10] This agreement can include mental health services, medication, housing, and other public benefits.[11] If a respondent refuses to enter into a CARE agreement, the court will order further evaluation and use this information to develop a CARE plan. While a CARE agreement is voluntary, a CARE plan is court-ordered.[12]
Following the respondent’s entry into either a voluntary CARE agreement or involuntary CARE plan, the court will hold periodic progress hearings to monitor the respondent’s receipt of services. In the eleventh month of a respondent’s plan or agreement, the court holds a one-year status review. The court may choose to graduate a successful respondent, permit an additional year of voluntary participation, or require an additional year of involuntary participation.[13] Additionally, if a respondent is continuously unsuccessful in CARE Act Court, the judge may terminate the respondent’s participation.[14] For six months following a person’s termination from CARE Act Court, this termination creates a presumption in any LPS hearing that a person needs additional services, potentially including involuntary treatment or a conservatorship.[15]
Disability Rights California (DRC), the Law Foundation for Silicon Valley, and California Association for Mental Health Patients’ Rights Advocates have criticized the CARE Act for expanding the state’s power to require involuntary treatment and violating the due process rights of people with disabilities.[16] The latter two organizations further criticized the CARE Act’s lowered standard for eligibility, which includes “likelihood” of deterioration or relapse, as dangerously speculative.[17] They also noted that Black and Latino people experience disproportionate misdiagnoses of schizophrenia, which will lead to racially disparate impositions of involuntary treatment.[18] DRC, along with the Western Center on Law & Poverty and the Public Interest Law Project, unsuccessfully petitioned the California Supreme Court to block the rollout of the CARE Act.[19]
On the other hand, Gavin Newsom has celebrated how CARE Act Courts will benefit individuals suffering from untreated mental illnesses.[20] Alameda County Superior Court Judge Sandra Bean, who presides over Alameda County’s CARE Act Court, has encouraged families to petition for treatment for loved ones struggling with severe mental illnesses.[21]
In Alameda County, CARE Act Court proceedings will occur on Thursdays in Department 103 at Wiley W. Manuel Courthouse.[22] Alameda County Health’s Behavioral Health Department (ACBHD) will serve as the petitioner, prepare reports, and seek to engage respondents in treatment.[23] ACBHD will contract with Bay Area Community Services (BACS) to provide services to respondents. The Alameda County Public Defender will represent respondents.[24]
[1] Darwin BondGraham, Alameda County is Launching CARE Court, The Oaklandside (Nov. 12, 2024, 2:43 PM) https://oaklandside.org/2024/11/12/alameda-county-is-launching-care-court/.
[2] S.B. 1338, 2021-2022 Reg. Sess. (Cal. 2022).
[3] CARE Act Res. Ctr., The CARE Process Flow to Treatment, Housing, and Support 1, 4 (2024) https://care-act.org/wp-content/uploads/2023/05/CARE-Act-Brief-CARE-Process-Flow-08.30.2023-2.pdf.
[4] BondGraham, supra note 1; S.B. 1338.
[5] S.B. 1338.
[6] Id.
[7] Alameda County Prepares for Launch of CARE Act Court, Alameda Cnty. Superior Ct. (Nov. 12, 2024) https://www.alameda.courts.ca.gov/news/alameda-county-prepares-launch-care-act-court.
[8] The CARE Process Flow to Treatment, Housing, and Support, supra note 3, at 3.
[9] Id.
[10] Id. at 4.
[11] Id. at 5.
[12] Id. at 4.
[13] Id. at 5.
[14] S.B. 1338.
[15] Id.
[16] BondGraham, supra note 1; Brief for Law Foundation of Silicon Valley and California Association of Mental Health Patients’ Rights Advocates as Amici Curiae Supporting Petitioner, Disability Rights California v. Gavin Newsom, No. S278330, 2023 WL 2400064 at 4 (Cal. 2023).
[17] Brief for Disability Rights California as Amici Curiae Supporting Petitioner, 2023 WL 2400064 at 4.
[18] Id. at 5-6.
[19] Hannah Wiley, California Supreme Court rejects lawsuit challenging Newsom’s plan to treat mental illness, The L.A. Times (Apr. 22, 2023, 5:00 AM) https://www.latimes.com/california/story/2023-04-22/california-supreme-court-newsom-care-court-mentally-ill-homeless-substance-disorder.
[20] Id.
[21] Alameda County Prepares for Launch of CARE Act Court, supra note 7.
[22] Welcome to CARE Act Court, Alameda County Superior Court, https://www.alameda.courts.ca...., (last visited June 4, 2025).
[23] Karyn Tribble, Hon. Sandra Bean & Roberta Chambers, Community Assistance, Recovery, and Empowerment: The CARE Act / CARE Court 1, 19 (2024), http://www.acgov.org/board/bos_calendar/documents/DocsAgendaReg_10_28_24/HEALTH%20CARE%20SERVICES/Regular%20Calendar/Item_1_CARE_court_implementation.pdf.
[24] Id.