CARE Court in San Francisco is a civil court process that lets families, first responders, and certain professionals petition for court-supervised mental health services on behalf of an adult living with untreated schizophrenia, another psychotic disorder, or bipolar I disorder with psychotic features. Created by California’s Community Assistance, Recovery, and Empowerment Act, the program launched locally in October 2023.1California Courts Newsroom. California Courts Implement CARE Act Statewide It aims to connect people with treatment, housing support, and recovery services before their condition deteriorates into conservatorship or incarceration.
Who the Court Can Help
Six criteria must all be met before someone qualifies. The person must be at least 18 and have a diagnosis of schizophrenia spectrum disorder, another psychotic disorder, or bipolar I disorder with psychotic features. Psychosis caused only by substance intoxication does not count, and neither do psychotic symptoms stemming from traumatic brain injury, dementia, autism, or other neurological conditions. A substance use disorder on its own, without a qualifying psychotic diagnosis, also falls outside the law.2California Legislative Information. California Code WIC 5972
The person must also not be clinically stable in ongoing voluntary treatment. On top of that, the court has to find one of two things: that the person is unlikely to survive safely in the community without supervision and is substantially deteriorating, or that services are needed to prevent a relapse that would likely cause grave disability or serious harm.2California Legislative Information. California Code WIC 5972
Finally, the court must conclude that a CARE plan or agreement is the least restrictive option that will stabilize the person, and that they are likely to benefit from it. If something less intensive could work, CARE Court is not the right door.2California Legislative Information. California Code WIC 5972
Who Can File a Petition
The law gives standing to a wide group. Family members eligible to petition include a spouse, parent, sibling, child, or grandparent. Anyone who lives with the person, or who serves as a legal guardian, can file as well.3California Legislative Information. California Welfare and Institutions Code 5974 (2025)
First responders with repeated interactions with the person can petition too: peace officers, firefighters, paramedics, emergency medical technicians, mobile crisis response workers, and homeless outreach workers. A single encounter is not enough. The responder must show a pattern, such as arrests, involuntary holds, or repeated attempts to engage the person in voluntary treatment.3California Legislative Information. California Welfare and Institutions Code 5974 (2025)
Behavioral health professionals who have treated the person within the previous 30 days have standing, as do hospital directors when the person is currently hospitalized. The county behavioral health director, the public guardian or conservator, and the director of county adult protective services may file. The person themselves can also petition on their own behalf.3California Legislative Information. California Welfare and Institutions Code 5974 (2025)
How to File in San Francisco
The petition starts with Form CARE-100, the official form to begin CARE Act proceedings.4California Courts. Petition to Begin CARE Act Proceedings It asks for the facts showing why the person meets each eligibility criterion and must be signed under penalty of perjury.
The form alone will not get a case moving. One of two kinds of supporting evidence has to be attached. The first is an affidavit from a licensed behavioral health professional stating they examined the respondent within 60 days of filing, or made multiple unsuccessful attempts to do so, and that the person meets the clinical criteria. The second is evidence that the respondent was detained for at least two intensive treatments under Section 5250, which are 14-day psychiatric holds rather than the shorter 72-hour 5150 holds, with the most recent occurring within the previous 60 days.5California Legislative Information. California Code WIC 5975
Petitioners represented by an attorney can e-file through the court’s electronic filing system. Those filing on their own can bring a paper petition to the clerk’s office in Room 103 on the first floor of 400 McAllister Street.6Superior Court of California. CARE Act Court Most e-filing vendors waive the filing fee for CARE Act petitions.7California Courts. How to File the CARE Petition
What Happens After You File
A judge reviews the petition promptly to decide whether there is a preliminary showing that the respondent may meet the criteria.8California Legislative Information. California Code WIC 5977 From there, timing depends on who filed.
When the county behavioral health director or their designee files, the court schedules an initial appearance within 14 court days and appoints an attorney for the respondent. When anyone else files, including a family member or first responder, the court first orders a county investigation. That investigation must finish within 30 court days. If it supports the petition, the court then sets the initial appearance within 14 court days.8California Legislative Information. California Code WIC 5977 A family-filed petition therefore takes meaningfully longer to reach a hearing than one filed by the county.
At the initial appearance, the respondent appears with appointed counsel. The court also appoints a volunteer supporter, who helps the respondent understand and communicate decisions during the case but is neither an attorney nor a case manager. If no voluntary resolution is reached, the court orders a clinical evaluation. If that evaluation confirms the diagnosis and the need for intervention, the county behavioral health agency works with the court to develop a plan covering treatment, housing, medications, and social services. Status hearings follow throughout the case so the judge can check on services and progress.
Agreement or Court-Ordered Plan
CARE Court produces one of two outcomes, and they work differently.
A CARE agreement is voluntary. Once the court finds the person eligible, the respondent and the county behavioral health agency can negotiate terms covering clinical services, counseling, stabilization medications, housing support, and other services. Because it is voluntary, the respondent has more say over what goes in it.9California Courts. About the CARE Act
A CARE plan is court-ordered and applies when the parties do not reach a voluntary agreement and a clinical evaluation confirms the person meets the criteria. The plan covers the same categories of services. Stabilization medications may be written into a court-ordered plan only if the court finds the respondent lacks capacity to make that decision independently, and even then the respondent cannot be compelled to take the medication.9California Courts. About the CARE Act Either an agreement or a plan lasts up to one year, with a possible one-year extension if the court finds more time is needed.10California Health and Human Services. CARE Act
What the Court Can and Cannot Do
Several protections for the respondent shape what CARE Court looks like in practice. The respondent gets court-appointed counsel at no cost and can attend hearings in person or appear through counsel.8California Legislative Information. California Code WIC 5977
Medication is the point that most surprises people who assume CARE Court can force treatment. Even when a court-ordered plan includes stabilization medications, the respondent cannot be made to take them, and failure to comply with a medication order carries no penalty.11California Legislative Information. California Code WIC 5979 The court also cannot dismiss the case because of medication non-adherence, so the person does not lose housing, counseling, or other services for declining medication.
Hearings are presumptively closed to the public. The respondent can open the hearing or invite specific family members or friends without opening it to everyone. Reports, evaluations, and health documents in the case file are confidential, and the respondent may petition at any time to have records sealed, with the law creating a presumption in favor of sealing.12California Legislative Information. California Welfare and Institutions Code 5976.5 (2025)
If the Person Refuses to Participate
There are no criminal penalties for refusing to participate in CARE Court. A respondent cannot be jailed or fined for declining services or failing to follow a plan, and non-compliance with a medication order specifically carries no penalty of any kind.11California Legislative Information. California Code WIC 5979
Non-participation still has consequences. If the respondent does not engage with an agreement or plan, the county behavioral health agency may refer the person for evaluation under California’s conservatorship laws. Conservatorship is more restrictive: a court-appointed conservator can make treatment and placement decisions on the person’s behalf. CARE Court was designed in part as an alternative to that path, so the referral is a real escalation. In practice, the process works best when the respondent engages voluntarily, and the appointed attorney, volunteer supporter, and individually tailored services exist to make that engagement more likely.