California SB 1338: CARE Court Eligibility, Petitions, and Plans

California’s CARE Court is a civil court process that connects adults with severe, untreated psychotic disorders to behavioral health treatment, housing, and support services. Created by SB 1338 (the Community Assistance, Recovery, and Empowerment Act) and signed into law in 2022, it now operates in all 58 counties and is intended as an alternative to conservatorship or incarceration for people whose mental illness has left them unable to stabilize on their own.¹ As of January 1, 2026, eligibility expanded to include adults diagnosed with bipolar I disorder with psychotic features.²

A CARE proceeding is civil, not criminal. No one is jailed through this process. The court coordinates among the county behavioral health agency, housing providers, and the respondent to build a recovery plan, and the judge checks in regularly to confirm the county is delivering what it promised. The law puts obligations on the county, not just the individual.

Who Qualifies for CARE Court

Eligibility is deliberately narrow. All of the following must be true for a person to be ordered into the process:²

The person is 18 or older.
They have a diagnosis in the schizophrenia spectrum or another psychotic disorder, or (as of January 1, 2026) bipolar I disorder with psychotic features. Psychosis caused solely by substance intoxication does not qualify.
They are not currently stable in an ongoing voluntary treatment program.
Either their condition is substantially deteriorating and they are unlikely to survive safely without supervision, or they need services to prevent a relapse that would likely cause grave disability or serious harm.
A CARE plan is the least restrictive alternative for their recovery.
There is a reasonable expectation that the person will benefit from the process.

Qualifying psychiatric diagnoses include schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, delusional disorder, and schizotypal personality disorder, along with substance- or medication-induced psychotic disorder and certain catatonia diagnoses.³ Bipolar II and major depression with psychotic features remain outside the law.²

The statute also excludes psychotic conditions caused by medical rather than psychiatric issues. Traumatic brain injury, autism, dementia, and neurological conditions are not covered. A person whose only diagnosis is a substance use disorder also does not qualify.

Who Can File a Petition

The process begins when someone files a CARE-100 petition with the court.⁴ Only specific people have standing:⁵

Someone who lives with the respondent
A spouse, parent, sibling, child, grandparent, or someone standing in for a parent
The respondent themselves
A first responder, including a peace officer, firefighter, paramedic, or homeless outreach worker
The director (or designee) of a hospital where the respondent is being held, including on a 5150 or 5250 hold
A licensed behavioral health professional treating the respondent
The director of a public or charitable organization providing behavioral health services where the respondent resides
A county behavioral health director, public guardian, or tribal court judge

The petition has to be backed by clinical evidence. That means either a CARE-101 Mental Health Declaration from a licensed behavioral health provider, or documentation showing the respondent was detained for at least two periods of intensive treatment (a 5250 hold) with the most recent in the past 60 days.⁵

You can file in the county where the respondent lives, where they are found, or where they are facing other court proceedings.⁶ If a case starts in a county other than the respondent’s home, it can be transferred with their consent. Most e-filing systems are currently waiving filing fees for CARE petitions.⁷

How the Process Moves Through Court

Once a petition is filed, a judge reviews it to decide whether the respondent might meet the eligibility criteria. If it clears that initial screen, the court appoints a lawyer and a supporter for the respondent and orders the county behavioral health agency to engage with the respondent and prepare a written report assessing eligibility and treatment needs.

At the next hearing, the judge reviews the county’s findings and any other evidence. The petitioner generally must attend. If the judge finds the respondent qualifies, the county is ordered to work with the respondent on a recovery plan.

The first option is a voluntary CARE Agreement. If the respondent will not or cannot agree, the court can impose a CARE Plan instead. Either lasts up to 12 months, with a possible court-ordered extension for one additional year.

After the plan is in place, the judge holds status review hearings at least every 60 days.⁸ These check-ins run both ways. The court tracks whether the respondent is engaging with treatment, and it also holds the county accountable for delivering the housing, therapy, and other services it committed to.

What a CARE Plan Covers

Whether voluntary or court-ordered, the plan is built around behavioral health treatment, housing, and ongoing support. Specific components can include:

Clinical treatment for the person’s psychotic disorder, including therapy and psychiatric services
Short-term stabilization medication
Treatment for a co-occurring substance use disorder
Housing, from clinically enhanced interim housing to longer-term supportive housing, depending on county resources and the person’s needs
Wellness and recovery supports such as peer coaching, benefits enrollment, and vocational assistance

Medication is where many families start their questions. A judge can include medication in a CARE Plan, but the law is explicit that it cannot be forcibly administered. Refusing medication alone cannot result in any penalty, including contempt of court or termination of the plan.⁹

What Happens If Someone Doesn’t Follow the Plan

The medication protection does not extend to disengaging from the whole process. If a respondent will not comply with the broader CARE Plan, the court can find that no less restrictive treatment alternative exists and refer the person for conservatorship proceedings under the Lanterman-Petris-Short Act. That is the CARE Act’s central enforcement lever.

Under an LPS conservatorship, a court-appointed conservator can make decisions about the person’s medical care, housing, and finances. The autonomy loss is substantially greater than anything in the CARE process itself. If an LPS proceeding such as a 5150 hold or a conservatorship petition is initiated within six months of a CARE case, the respondent’s non-compliance history from the CARE process can be introduced as evidence. Information about refusing medication specifically is excluded from that evidence.

Rights of the Respondent

Because a civil court can order treatment through this process, due process matters. A respondent has the right to:¹⁰

Be represented by a lawyer at every stage, regardless of ability to pay
Have a supporter present to help them understand proceedings and communicate their preferences
Receive notice of every hearing and copies of the petition, evaluation, and county report
Attend and participate in all hearings
Present evidence, call witnesses, and cross-examine witnesses
Appeal the court’s decisions
Keep all evaluations, reports, and filings confidential

Hearings are closed to the public by default. The respondent can demand an open hearing, or invite specific family or friends without opening it to everyone else. The judge must inform the respondent of these rights before each hearing begins.

1
California Legislative Information. California Welfare and Institutions Code WIC 5970
2
California Legislative Information. California Welfare and Institutions Code WIC 5972
3
California Courts Newsroom. Eligibility
4
Judicial Branch of California. Petition to Begin CARE Act Proceedings (CARE-100)
5
Los Angeles County CARE Court. CARE Court
6
California Legislative Information. California Welfare and Institutions Code WIC 5973
7
Judicial Branch of California. File CARE Petition
8
California Legislative Information. California Welfare and Institutions Code WIC 5977.2
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California Legislative Information. California Welfare and Institutions Code WIC 5977.1
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Judicial Branch of California. CARE Act Respondent Rights