Treatment Advocacy Center’s Statement on the Passage of SB 1338, California’s CARE Court bill

Treatment Advocacy Center applauds the California State Legislature for passing SB 1338, legislation enacting Gov. Gavin Newsom’s CARE Court proposal. This ambitious new law will bring desperately needed treatment and services to Californians with schizophrenia and other psychotic disorders, a population that is all too often forgotten.    

The Community Assistance, Recovery, and Empowerment (CARE) Court Program is designed to disrupt the revolving-door of homelessness, short-term hospitalization and incarceration those with untreated severe mental illness (SMI) often experience. The program will connect a person in crisis with a court-ordered CARE plan to include comprehensive treatment, housing and supportive services for up to 12 months.

We are thrilled that the final version of the law includes the following elements that the Treatment Advocacy Center supported as essential ingredients for the success of the program:

1) Prioritizing individuals with schizophrenia and other psychotic disorders. Ignoring this vulnerable, high-needs population results in homelessness, incarceration or worse. CARE eligibility criteria require that the individual be currently experiencing a severe mental illness and have a diagnosis of schizophrenia spectrum and other psychotic disorders, as defined in the most current version of the Diagnostic and Statistical Manual of Mental Disorders.

2) Holding counties accountable. Mandating county participation will finally remove the option of choosing to ignore the needs of those with untreated SMI. Counties are required to participate and will begin in two phases – the first cohort on October 1, 2023 and the second on December 1, 2024. If a county is found to be out of compliance with court orders, a superior court may fine a county or local government $1,000 per day, not to exceed $25,000 for each individual violation. Fines collected will be deposited in the CARE Act Accountability Fund that will support services for individuals with schizophrenia and other psychotic disorders who are experiencing, or are at risk of, homelessness, criminal justice involvement, and hospitalization and are on a path toward a more restrictive LPS conservatorship.

3) Giving families and loved ones access to the system. Allowing CARE proceedings to be initiated by those who have the most complete picture of how someone is really doing will result in more timely and less traumatic care. The following individuals may file a petition to begin CARE Court proceedings: a family member (including spouse, parent, sibling, child, grandparent or other individual with parental rights), roommate, first responder, provider/clinician, public guardian, authorized representative of the county behavioral health services, adult protective services, Indian health services/tribal courts or the respondent. Police and hospitals are no longer the only entities who can open the door for your loved ones to access life-saving treatment.

We are keenly aware that the passage of this legislation is only the first step in meeting the laudable goals of the program. California’s psychiatric bed shortage, inadequate inpatient admission criteria applied inconsistently and implementation of Laura’s Law that doesn’t, in many counties, comport with best practices, are just a few of the barriers communities will encounter as they begin to implement this vision. We stand ready to assist Gov. Newsom and local leaders with our research and expertise to help build the infrastructure necessary to realize the promise in the governor's plan. Even as we celebrate the significant potential this new law has to help vulnerable Californians, we remain steadfastly committed to our ongoing efforts to eliminate historic legal barriers to treatment in California.

Find detailed information about the CARE Court here.

The Treatment Advocacy Center is a national nonprofit organization dedicated to eliminating barriers to the timely and effective treatment of severe mental illness by promoting laws, policies and practices for the delivery of psychiatric care and supporting the development of innovative treatments for and research into the causes of severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder.