California CARE Court — A Family's Guide (SB-1338)

By SoCal Addiction Centers Editorial Team | Last reviewed: | 12 min read Clinically Reviewed

Key Takeaways

  • CARE Court (Community Assistance, Recovery, and Empowerment Act, SB-1338) was signed by Governor Newsom on September 14, 2022. Codified primarily at Welfare and Institutions Code §5970 et seq.. It is a civil-court framework, distinct from criminal drug-court pathways and from LPS-Act involuntary commitment.
  • CARE Court is for psychotic-spectrum disorders: adults 18+ with schizophrenia, schizoaffective disorder, or other psychotic disorder diagnosis who are currently unstabilized and unlikely to survive safely in the community without supervision. It is not primarily an SUD pathway. Co-occurring SUD is common in CARE Court-eligible populations but is not the presenting legal basis.
  • Implementation was rolled out in waves: first-wave counties (Orange, San Diego, Riverside, Stanislaus, Tuolumne, Glenn, Yuba) began December 1, 2023. LA County began December 1, 2024. Remaining California counties were required to be operational by December 1, 2025 — CARE Court should be statewide through all 58 counties as of our review.
  • Many parties can petition: family/household members, first responders, public behavioral health providers, tribal government representatives, current/former licensed behavioral health providers, judicial officers, probation officers, and the subject themselves.
  • The court-ordered outcome is a Care Plan or Care Agreement — a 12-month engagement plan extendable once to 24 months. Engagement includes behavioral health services, housing coordination, medication management where clinically appropriate, social services.
  • CARE Court cannot force medication administration. Involuntary medication requires separate LPS-Act determination of incapacity through civil-commitment process. CARE Court can order treatment engagement; treating clinicians and patients make medication decisions within that engagement.

CARE Court — what it is, what it isn’t

California’s CARE Court is a civil-court framework established by SB-1338 (Umberg/Eggman, 2022) — formally the Community Assistance, Recovery, and Empowerment Act. The framework was signed into law September 14, 2022, with implementation phased county-by-county from 2023 through 2025. CARE Court provides a structured civil pathway for families, care providers, first responders, and others to petition a court to order a Care Plan for an adult with untreated schizophrenia-spectrum disorder whose condition puts them at serious risk.

This page explains how CARE Court works, who it serves, how it differs from related pathways (LPS conservatorship, Laura’s Law AOT, drug court, CARE Court’s own criminal-law cousin Proposition 36), and what it does and does not do. The SUD connection is discussed below but is not the primary framing — CARE Court is a serious-mental-illness framework first, with SUD co-occurrence being a common clinical reality rather than the entry point.

This page is editorial guidance, not legal advice. For legal questions about a specific case, consult an attorney familiar with California behavioral-health law.

Statutory framework

CARE Court is codified primarily at Welfare and Institutions Code §5970 through §5987, with related amendments to the Civil Code, Code of Civil Procedure, and Evidence Code. The statute was enacted through SB-1338 (Umberg, Eggman, 2022) and signed September 14, 2022.

The implementation timeline was structured in three phases:

  • Wave 1 — effective December 1, 2023 — Orange, San Diego, Riverside, Stanislaus, Tuolumne, Glenn, Yuba counties
  • Wave 2 — effective December 1, 2024 — Los Angeles County (and any counties opting in during the intervening year)
  • Wave 3 — effective December 1, 2025 — remaining California counties (all 58 counties operational)

As of this page’s review, CARE Court is operational statewide. Specific county operational practices, court calendar availability, and service-integration maturity vary; the earlier-wave counties have more experience with the framework than counties that just came online.

Who is CARE Court for?

CARE Court eligibility is narrow and specific. The core criteria under WIC §5972 and related sections:

Required: Adult 18 or older

CARE Court serves adults. Minor children with mental health needs are served through different frameworks (juvenile dependency court, juvenile delinquency court, school-based mental health services).

Required: Diagnosed schizophrenia-spectrum disorder

The statute specifies schizophrenia spectrum disorder or other psychotic disorder — essentially, DSM-5 schizophrenia, schizoaffective disorder, and related psychotic disorders. Major depressive disorder without psychotic features, anxiety disorders, substance-induced psychosis that resolves with abstinence, and most personality disorders do not qualify for CARE Court on their own.

Required: Currently unstabilized clinical presentation

The subject must be in a condition where the illness is significantly affecting function. Someone stably managed on medication and living independently does not qualify. The framework is designed for people whose untreated illness is producing serious functional problems.

Required: Unlikely to survive safely without supervision, AND/OR substantial deterioration pattern

The subject must be either (a) currently at risk of substantial deterioration without intervention, (b) unlikely to survive safely in the community without supervision, or (c) in need of services to prevent relapse or deterioration.

Required: History of treatment non-engagement, OR recent hospitalization/crisis pattern

The subject typically has documented history of mental-health hospitalizations, incarcerations related to mental illness, crisis-service contacts, or similar episodes indicating their current unstable state is clinically serious.

What is NOT a CARE Court basis:

  • Primary substance-use disorder without co-occurring psychotic illness
  • Developmental or intellectual disability without co-occurring SMI
  • Dementia or neurocognitive disorder
  • Personality disorder without co-occurring psychotic illness
  • Acute drug-induced psychotic states that resolve with abstinence
  • Mild-to-moderate mental illness that does not produce serious functional impairment

CARE Court is a narrow pathway specifically for serious psychotic-spectrum illness with demonstrated unstable clinical presentation.

Who can petition for CARE Court?

WIC §5974 specifies petitioners. The list is broad, reflecting the statute’s intent that multiple actors in a person’s life can initiate the process:

  • Family members and household members of the subject
  • First responders — law enforcement, firefighters, paramedics, mobile crisis teams
  • Directors of county behavioral health departments or their designees
  • Directors of hospitals where the subject has been treated
  • Licensed behavioral health providers currently or formerly treating the subject
  • Tribal government representatives for tribal-member subjects
  • Judges or other judicial officers
  • Probation officers and parole agents
  • Public guardians, conservators, or other legally-responsible parties
  • The subject themselves (though petitioners rarely self-petition)

Petitioners complete a petition form describing the subject’s clinical presentation, pattern of non-engagement, specific concerning events, and why the petitioner believes CARE Court intervention is appropriate. Supporting documentation (medical records, crisis-service records, police reports) strengthens petitions.

The CARE Court process

Step 1: Petition filing

The petitioner files the CARE Court petition with the county Superior Court. The petition is confidential (the subject’s privacy is protected) but served on the subject by the court.

Step 2: Screening and appearance

The court screens the petition for statutory sufficiency — does it allege facts meeting CARE Court criteria? If the petition is facially adequate, an initial hearing is scheduled. The subject is notified and has a right to counsel; if indigent, counsel is appointed.

Step 3: Clinical evaluation

The court orders a clinical evaluation by a qualified behavioral health professional. The evaluator meets with the subject, reviews records, and reports to the court whether the subject meets CARE Court eligibility criteria.

Step 4: Care Plan or Care Agreement

If the subject is found eligible and willing to engage, the preferred outcome is a Care Agreement — a voluntary agreement between the subject, the county behavioral health system, and the court on an engagement plan.

If the subject is eligible but unwilling to voluntarily engage, the court can order a Care Plan — a court-ordered plan specifying behavioral health services, housing coordination (where applicable), medication management (where the subject consents), social services, and other components.

The distinction between Agreement and Plan matters. The Agreement is voluntary; the Plan is court-ordered with consequences for non-engagement. Both include roughly the same services; the difference is the legal basis for the subject’s participation.

Step 5: Ongoing court review

The court reviews progress at regular intervals (typically 60–90 days). The subject, the behavioral health provider, and the petitioner participate. Modifications to the Plan or Agreement can be made as clinical needs evolve.

Step 6: 12-month term, extendable to 24 months

The initial Care Plan or Agreement runs 12 months. The court can extend once for an additional 12 months if criteria continue to be met. After 24 months, the subject exits CARE Court regardless of clinical status.

Step 7: Graduation or step-off

At the end of the CARE Court period, the subject “graduates” into continued community-based care (ideally voluntarily) or is stepped off if CARE Court is no longer the appropriate framework. If the clinical situation has deteriorated to acute crisis, LPS-Act processes (5150, 5250, LPS conservatorship) become the relevant pathway.

What CARE Court does NOT do

The framework is deliberately limited in specific ways:

It does not force medication administration. CARE Court can order the subject to engage with treatment including medication management, but administering medication against the subject’s active refusal requires a separate LPS-Act determination of incapacity through civil-commitment process. This is a substantive constitutional-law constraint, not a drafting oversight.

It does not criminalize non-compliance. A subject who fails to engage with the Care Plan does not face criminal charges for that non-engagement. The court may refer to LPS-Act processes if acute deterioration warrants; may graduate the subject off of CARE Court if the framework is no longer useful; but does not impose criminal penalties.

It does not replace LPS conservatorship for acute crisis. If a CARE Court participant becomes acutely dangerous to self or others or gravely disabled in the LPS-Act sense, 5150 / 5250 / LPS conservatorship remains the appropriate framework for acute intervention. CARE Court is designed for prevention, not acute response.

It does not serve primary SUD cases. Substance-use disorder as the primary diagnosis, without co-occurring psychotic illness, does not meet CARE Court eligibility. Drug court, Proposition 36 of 2024, or voluntary SUD treatment are the relevant pathways for primary SUD.

It does not solve housing on its own. CARE Court can coordinate housing services — and housing is a commonly-included component of Care Plans — but the framework cannot create housing capacity where none exists. The California housing-instability context that makes CARE Court’s target population vulnerable is not solved by the framework itself.

SUD co-occurrence and CARE Court

Approximately half of people with schizophrenia-spectrum disorders have co-occurring SUD at some point. For CARE Court participants specifically, SUD co-occurrence is frequent. Integrated treatment addressing both conditions is the standard clinical approach — see our dual diagnosis pillar for integrated-treatment framework.

Where SUD enters the CARE Court picture:

  • As part of the clinical presentation demonstrating unstable functioning
  • As a treatment goal within the Care Plan — substance-use treatment as a component of the broader engagement plan
  • As a factor in medication management — psychiatric medications prescribed in the context of substance-use require coordinated prescribing
  • Through coordinated services — DMC-ODS contracted SUD providers working with the CARE Court team and county behavioral health

What SUD does NOT do for CARE Court: create eligibility on its own. Primary SUD without co-occurring psychotic illness is handled through different frameworks.

For the reverse — individuals with primary SUD and co-occurring less-severe mental illness — see our dual diagnosis pillar and our medi-cal DMC-ODS coverage page for the integrated county-behavioral-health pathways.

How CARE Court relates to other California frameworks

Families evaluating behavioral-health legal pathways frequently face framework confusion. Brief distinctions:

CARE Court (WIC §5970 et seq.): civil court, SMI focus, prevention/engagement, 12–24 months.

LPS Act / 5150 / 5250 / LPS Conservatorship (WIC §5000 et seq.): civil commitment, acute crisis response, 72-hour / 14-day / long-term conservatorship structure. LPS is the acute framework; CARE Court is the preventive framework.

Laura’s Law / Assisted Outpatient Treatment (WIC §5345 et seq.): civil court, AOT, court-ordered outpatient treatment for SMI with treatment-adherence history. Shorter program (6 months, renewable), narrower eligibility than CARE Court.

Proposition 36 of 2024: criminal framework, treatment-mandated felony for drug possession with prior convictions. Criminal pathway, not civil.

Drug court, DUI court: criminal framework, treatment diversion for specific offense categories. See our SoCal Drug Court Programs page.

Voluntary treatment — through DMC-ODS, commercial insurance, Kaiser CDRP, county behavioral health — is always the preferred pathway. The frameworks above are designed for situations where voluntary treatment has not been accessible or effective.

Critiques and ongoing debates

CARE Court’s passage and implementation have been accompanied by substantive policy debate. Notable critiques from various stakeholders:

Disability rights advocates have raised concerns about civil liberties implications of court-ordered mental-health intervention, even when non-forcing. The framework’s proponents argue the 12-month court-ordered engagement is less restrictive than LPS conservatorship and meaningfully preserves subject agency compared to involuntary commitment.

Implementation capacity concerns — CARE Court relies on adequate county behavioral-health infrastructure to deliver ordered services. In counties where behavioral-health capacity is already over-stretched, court orders may exceed system capacity.

Effectiveness evidence is still developing — the framework is recent enough that long-term outcome data is limited. Early implementation counties have reported mixed results.

Equity concerns — questions about whether the framework will disproportionately target unhoused populations or specific racial/ethnic communities. Monitoring data is still emerging.

The framework exists; whether it achieves its goals is an empirical question that will become clearer over years of operation. We present the framework as it is and note where implementation realities may diverge from statutory intent.

Our editorial team can explain the framework, help you understand whether CARE Court is the appropriate pathway for your situation, and direct you to the appropriate county resources. We are not attorneys; for legal questions about filing a CARE Court petition or representing the subject of one, consult a California attorney familiar with behavioral-health law.

Contact our editorial team →

For county-specific CARE Court information and petition filing, contact your county Superior Court or county behavioral health department.

Need help now? Call (310) 596-1751 for editorial guidance on California behavioral-health frameworks. For immediate psychiatric crisis, call 988 (Suicide and Crisis Lifeline) or 911.

Last reviewed: 2026-04-23. CARE Court statutory references reflect SB-1338 as enacted and implemented. Implementation specifics vary by county and are still operationally maturing. This page is editorial content, not legal advice.

Looking for treatment options in your area? We can help point you in the right direction. (310) 596-1751 — or request a callback.