AMENDED IN ASSEMBLY JULY 2, 2026
AMENDED IN SENATE MAY 14, 2026
AMENDED IN SENATE APRIL 28, 2026
AMENDED IN SENATE MARCH 26, 2026
AMENDED IN SENATE MARCH 25, 2026
CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION
94
Introduced by Senator Blakespear
February 10, 2026
An act to amend Sections 5206, 5207, 5211, 5975, 5976.5, 5977, 5977.4, 5979, 5983, and 5985 of, the Welfare and Institutions Code, relating to mental health.
Vote: majority Appropriation: no Fiscal committee: yes Local program: yes
LEGISLATIVE COUNSEL’S DIGEST
Existing law, the Community Assistance, Recovery, and Empowerment (CARE) Act (CARE Act), authorizes specified persons, including a person with whom the respondent resides, family members, and first responders, among others, to petition a civil court to create a voluntary CARE agreement or a court-ordered CARE plan and implement services, to be provided by county behavioral health agencies, to provide behavioral health care, including stabilization medication, housing, and other enumerated services, to adults who are currently experiencing a severe mental illness and have a diagnosis identified in the disorder class schizophrenia and other psychotic disorders, or bipolar I disorder with psychotic features, and who meet other specified criteria. Existing law requires the Judicial Council to develop a mandatory form for use to file a CARE process petition with the court and any other forms necessary for the CARE process, to be signed under the penalty of perjury, and requires the form to contain certain information, including either a specified affidavit of a licensed behavioral health professional or evidence the respondent was detained for a minimum of two intensive treatments pursuant to specified provisions of law.
Existing law, the Lanterman-Petris-Short Act (LPS Act), generally provides for the evaluation, treatment, and civil commitment of persons with mental health disorders and other specified persons. Existing law authorizes, under a superior court order, an evaluation of a person alleged, as a result of mental disorder, to be a danger to themselves or others or to be gravely disabled, and authorizes any individual to apply to the person or agency designated by the county for a petition to the court requesting that an evaluation of the person’s condition be made. Existing law requires persons who have been detained for evaluation to be
released, referred for care and treatment on a voluntary basis, certified for intensive treatment, or recommended for conservatorship under the LPS Act. and provides the forms to use for these evaluations. The CARE Act authorizes a court to terminate a respondent’s participation in the CARE process if the court determines that the respondent is not participating in the CARE process or is not adhering to their CARE plan, as specified, and authorizes the court to order the court-ordered evaluation under the LPS Act.
If the court finds the petitioner has made a prima facie showing that the respondent is, or may be, a person eligible for the CARE program, the court is required to order the county behavioral health agency, or their designee, as specified, to submit a written report to the court with specified information, including, but not limited to, a determination whether the respondent meets, or is likely to meet, the criteria for the CARE process and conclusions and recommendations about the respondent’s ability to voluntarily engage in services. Existing law requires the court to, within 5 days of receiving the report, take one of several actions, including dismissing the petition if the court determines that voluntary engagement with the respondent is effective and the individual has enrolled, or is likely to enroll, in behavioral health treatment.
This bill would also require the written report to include conclusions about whether the respondent is likely to need a higher level of care than is available under the CARE Act and, if so, recommendations about the appropriate level of care and the necessary steps to obtain that level of care for the respondent, as well as whether there is probable cause to believe that the respondent is, as a result of a mental disorder, a danger to themselves or others, or gravely disabled, and whether the respondent will agree voluntarily to receive crisis intervention services or an evaluation in their own home or in a designated facility.
respondent and remove the authorization for a court to dismiss the petition if the respondent is only likely to enroll in behavioral health treatment. If the court intends to dismiss a petition because the respondent needs a higher level of services, the bill would authorize the court to order the county to conduct a prepetition screening and hold the CARE petition open until the screening is complete. The bill would also make other technical and conforming changes. By requiring a higher level of service on the county, this bill would impose a state-mandated local program.
Existing law requires all hearings regarding these provisions to occur in person unless the court, in its discretion, allows a party or witness to appear remotely.
This bill would require the court to allow the hearings to be held remotely, unless otherwise ordered by the court or demanded by the respondent.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason.
With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
The people of the State of California do enact as follows:
Section 5206 of the Welfare and Institutions Code is amended to read:
5206.
(a) Whenever it appears, by petition pursuant to this article or by the process pursuant to the Community Assistance, Recovery, and Empowerment Act (Part 8 (commencing with Section 5970)) to the satisfaction of a superior court that there is probable cause that a person is, as a result of mental disorder, a danger to others, or to themselves, or gravely disabled, and the person has refused or failed to accept evaluation voluntarily, the court shall issue an order notifying the person to submit to an evaluation at the time and place that is designated by the court. The order for an evaluation shall be served, as provided in Section 5208, by a peace officer, counselor in mental health, behavioral health professional, or a court-appointed official. The person shall be permitted to remain in their home or other place of their choosing prior to the time of evaluation, and shall be permitted to be accompanied by one or more of their relatives, friends, an attorney, a personal physician, or other professional or religious advisor to the place of evaluation. If the person to receive evaluation requests, the individuals who accompany the person may be present during the evaluation.
(b) If the person refuses or fails to appear for evaluation after having been properly notified, a peace officer, counselor in mental health, or a court-appointed official shall initiate an involuntary hold and place them in a facility designated by the county as a facility for treatment and evaluation. The person shall be evaluated as promptly as possible, and shall in no event be detained longer than 72 hours under the court order, excluding Saturdays, Sundays, and holidays if treatment and evaluation services are not available on those days.
(c) A person who has been detained for evaluation shall be released, referred for care and treatment on a voluntary basis, certified for intensive treatment, or recommended for conservatorship pursuant to this part, as required.
SEC. 2.SECTION 1.
Section 5207 of the Welfare and Institutions Code is amended to read:
5207.
The order for evaluation shall be in substantially the following form:
In the Superior Court of the State of California | |
The People of the State of California and Respondents |
|
| |
The People of the State of California to | |
: | |
(Peace officer, counselor in mental health, behavioral health professional, or | |
The petition of ____ has been presented this day to me, a Judge of the Superior Court for the County of ____, State of California, from which it appears that there is now in this county, at ____, a person by the name of ____, who is, as a result of mental disorder, a danger to others, or to themselves, or gravely disabled.
Now, therefore, you are directed to notify ____ to submit to an evaluation at ____ on the ____ day of ____, 20__, at __ o’clock ____(a.m./p.m.).
____ shall be permitted to be accompanied by one or more of their relatives, friends, an attorney, a personal physician, supporter, as defined in Section 5971, or other professional or religious advisor.
The individual or individuals who accompany ____ may be present during the evaluation if so requested by ____.
*Provision for Detention for Evaluation
If the person fails or refuses to appear for evaluation when notified by order of this court, you are hereby directed to detain said ____ or cause them to be detained at ____ for a period no longer than 72 hours, excluding Saturdays, Sundays, and holidays if evaluation services are not available on those days, for the purposes of evaluation.
I hereby direct that a copy of this order together with a copy of the petition be delivered to said person and their representative, if any, at the time of their notification; and I further authorize the service of this order at any hour of the day or night.
Witness my hand, this ____ day of ____, 20__
Judge of the Superior Court |
*This paragraph is applicable only if the person to be evaluated fails or refuses to appear for evaluation after having been properly notified.
Return of Order
I hereby certify that I received the above order for the evaluation of ____ and on the ____ day of ____, 20__, personally served a copy of the order and of the petition on ____ and the professional person in charge of the ____, a facility for treatment and evaluation, or their designee.
Dated: ____, 20__.
Signature and Title |
SEC. 3.SEC. 2.
Section 5211 of the Welfare and Institutions Code is amended to read:
5211.
The report of a patient’s property required by Section 5210 to be made by the person taking the patient into custody for evaluation shall be in substantially the following form:
Report of Officer
I hereby report to the Superior Court for the County of _____ that the personal property of the person apprehended, described generally as ____ was preserved and safeguarded by ____ (Insert name of person taking person into custody, responsible relative, guardian, or conservator).
That property is now located at ____.
Dated: ____ 20__ |
|
| Signature and Title |
Section 5975 of the Welfare and Institutions Code is amended to read:
5975.
The Judicial Council shall develop a mandatory form for use to file a CARE process petition with the court and any other forms necessary for the CARE process. The petition shall be signed under the penalty of perjury and contain all of the following:
(a) The name of the respondent and, if known, the respondent’s address.
(b) The petitioner’s relationship to the respondent.
(c) Facts that support the petitioner’s assertion that the respondent meets the CARE criteria in Section 5972.
(d) Either of the following:
(1) An affidavit of a licensed behavioral health professional, including, for purposes of this section only, nurse practitioners as defined in Section 2835 of the Business and Professions Code and physician assistants as defined in subdivision (d) of Section 3501 of the Business and Professions Code, stating that the licensed behavioral health professional or their designee has examined the respondent within 60 days of the submission of the petition, or has made multiple attempts to examine, but has not been successful in eliciting the cooperation of the respondent to submit to an examination, within 60 days of the petition, and that the licensed behavioral health professional had determined that the respondent meets, or has reason to believe, explained with specificity in the affidavit, that the respondent meets the diagnostic criteria for CARE proceedings.
(2) Evidence that the respondent was detained for a minimum of two intensive treatments pursuant to Article 4 (commencing with Section 5250) of Chapter 2 of Part 1, the most recent one within the previous 60 days. Evidence may include, but is not limited to, documentary evidence from the facility where the respondent was detained, or a signed declaration from the petitioner if the petitioner had personal knowledge of the detentions.
(e) (1) If the petitioner believes that the person otherwise meets the CARE criteria but may not be willing or able to participate in the CARE process and a CARE plan or CARE agreement due to the severity of their mental disorder or lack of insight into their mental disorder, the petitioner may request that the court order a mental health evaluation under Article 2 (commencing with Section 5200) of Chapter 2 of Part 1 if the CARE petition is dismissed.
(2) The Judicial Council shall include on the mandatory petition form an option for the petitioner to request the court to order a mental health evaluation under Article 2 (commencing with Section 5200) of Chapter 2 of Part 1 upon dismissal of the petition if the respondent is not willing or able to participate in the CARE process and a CARE plan or CARE agreement due to the severity of their mental disorder or lack of insight into their mental disorder.
(3) The Judicial Council shall amend the notice of dismissal form to include a section to indicate whether the court has ordered, pursuant to Section 5977, a mental health evaluation under Article 2 (commencing with Section 5200) of Chapter 2 of Part 1 upon the dismissal, and the indication on the dismissal form shall concurrently serve as that court order for the mental health evaluation.
SEC. 5.SEC. 3.
Section 5976.5 of the Welfare and Institutions Code is amended to read:
5976.5.
(a) Notwithstanding any other law, and except as otherwise provided in this section, a hearing held under this part is presumptively closed to the public.
(b) The respondent may demand that the hearing be public and be held in a place suitable for attendance by the public.
(c) The respondent may request the presence of any family member or friend without waiving the right to keep the hearing closed to the rest of the public.
(d) A request by any other party to the proceeding to make the hearing public may be granted if the judicial officer conducting the hearing finds that the public interest in an open hearing clearly outweighs the respondent’s interest in privacy.
(e) All reports, evaluations, diagnoses, or other information filed with the court related to the respondent’s health shall be confidential, unless transferred to a covered entity, as defined in Section 160.103 of Title 45 of the Code of Federal Regulations, for a court-ordered prepetition screening for a mental health evaluation pursuant to Section 5977, under which the receiving covered entities shall comply with all federal and state privacy protections. The respondent may at any time petition the court for an order sealing these records or any other court records in a proceeding held under this part. Notwithstanding any rule of court prohibiting records kept confidential by law from consideration for sealing, if such a petition is filed, there shall exist a presumption in favor of sealing.
(f) The fact that evidence is admitted at a proceeding held under this part shall not be the basis for admission of that evidence in any subsequent legal proceeding.
(g) Photographs, recordings, transcripts, other records of proceedings held under this part, and testimony regarding proceedings held under this part shall not be admissible in any subsequent legal proceeding except upon motion by one of the following in that subsequent legal proceeding:
(1) The respondent.
(2) The county behavioral health agency, the public guardian, or the public conservator.
(h) In a proceeding held under this part, this section shall not affect the applicability of paragraph (2) of subdivision (c) of Section 5977.1, make admissible any evidence that is not otherwise admissible, or permit a witness to base an opinion on any matter that is not a proper basis for that opinion. The admission or exclusion of evidence shall be pursuant to the rules of evidence established by the Evidence Code, including, but not limited to, Section 352 of the Evidence Code, and by judicial decision.
(i) Before commencing a hearing at the respondent’s first court appearance, the judicial officer shall inform the respondent of their rights under this section. At subsequent hearings, the court is not required to advise the respondent of their rights under this section upon finding that the respondent understands and waives the additional advisement of their rights.
SEC. 6.SEC. 4.
Section 5977 of the Welfare and Institutions Code is amended to read:
5977.
(a) (1) The court shall promptly review the petition to determine if the petitioner has made a prima facie showing that the respondent is, or may be, a person described in Section 5972. The court may make a prima facie determination without conducting a hearing.
(2) If the court finds that the petitioner has not made a prima facie showing that the respondent is, or may be, a person described in Section 5972, the court may dismiss the case and, if the court does so, it shall order that the dismissal is without prejudice, unless Section 5975.1 applies. Nothing other than Section 5975.1 prevents a petitioner whose petition was dismissed without prejudice from refiling the petition with amended information.
(3) If the court finds that the petitioner has made a prima facie showing that the respondent is, or may be, a person described in Section 5972, the court shall do one of the following:
(A) If the petitioner is the director of a county behavioral health agency, or their designee, the court shall do the following:
(i) Set the matter for an initial appearance on the petition within 14 court days.
(ii) Appoint a qualified legal services project, as defined in Sections 6213 to 6214.5, inclusive, of the Business and Professions Code, to represent the respondent. If no legal services project has agreed to accept these appointments, a public defender or other counsel working in that capacity shall be appointed to represent the respondent.
(iii) Determine whether the petition includes all of the following information and, if it does not, order the county behavioral health agency to submit a written report with the court within 14 court days that includes all of the following:
(I) A determination as to whether the respondent meets, or is likely to meet, the criteria for the CARE process.
(II) The outcome of efforts made to voluntarily engage the respondent prior to the filing of the petition.
(III) Conclusions and recommendations about the respondent’s ability to voluntarily engage in services.
(IV) Conclusions about whether the respondent is likely to need a higher level of care than is available under this part and, if so, recommendations about the appropriate level of care and the necessary steps to obtain that level of care for the respondent.
(iv) Order the county behavioral health agency to provide notice to the respondent, the appointed counsel, and the county behavioral health agency in the county where the respondent resides, if different from the county where the CARE process has commenced.
(B) If the petitioner is a person other than the director of a county behavioral health agency, or their designee, the court shall order a county agency, or their designee, as determined by the court, to investigate, as necessary, file a written report with the court as soon as practicable, but within 30 court days, and provide notice to the respondent and petitioner that a report has been ordered. Parties shall complete the investigation with appropriate urgency. The written report shall include all of the following:
(i) A determination as to whether the respondent meets, or is likely to meet, the criteria for the CARE process.
(ii) The outcome of efforts made to voluntarily engage the respondent during the report period.
(iii) Conclusions and recommendations about the respondent’s ability to voluntarily engage in services.
(iv) Conclusions about whether the respondent is likely to need a higher level of care than is available under this part and, if so, recommendations about the appropriate level of care and the necessary steps to obtain that level of care for the respondent.
(vi)
(v) The information, including protected health information, necessary to support the determinations, conclusions, and recommendations in the report.
(4) If, upon a request by the county agency ordered to investigate and file a report under subparagraph (B) of paragraph (3), the court finds that the county agency is making progress to engage the respondent, the court may, in its discretion, grant the county agency no more than 30 additional days to continue to work with, engage, and enroll the individual in voluntary treatment and services. The county agency shall provide notice to the respondent and petitioner that an extension for filing a report has been granted.
(5) Upon receipt of the report described in subparagraph (B) of paragraph (3), the court shall, within five days, take one of the following actions:
(A) If the court determines that voluntary engagement with
the respondent is effective, and that the individual has enrolled and is actively participating in voluntary behavioral health treatment, the court shall dismiss the matter.
(B) If the court determines, based on the county agency’s report, that the evidence does not support a prima facie showing that the respondent is, or may be, a person described in Section 5972, the court shall dismiss the matter. This section shall not prevent a county behavioral health agency from continuing to voluntarily engage with a person not described in Section 5972 but who is in need of services and supports.
(C) If the court determines, based on the county agency’s report, that the evidence does support a prima facie showing that the respondent is, or may be, a person described in Section 5972, and engagement with the county agency was not effective, the court shall do all of the following:
(i) Set an initial appearance on the petition within 14 court days.
(ii) Appoint a qualified legal services project, as defined in Sections 6213 to 6214.5, inclusive, of the Business and Professions Code or, if no legal services project has agreed to accept these appointments, a public defender or other counsel working in that capacity to represent the respondent.
(iii) Order the county agency to provide notice of the initial appearance to the petitioner, the respondent, the appointed counsel, the county behavioral health agency in the county where the respondent resides, and, if different, the county where the CARE court proceedings have commenced.
(b) At the initial appearance on the petition, all of the following shall apply:
(1) The court shall permit the respondent to substitute their own counsel.
(2) Petitioner shall be present. If the petitioner is not present, the matter may be dismissed.
(3) Respondent may waive personal appearance and appear through counsel. If the respondent does not waive personal appearance and does not appear at the hearing, and the court makes a finding in open court that reasonable attempts to elicit the attendance of the respondent have failed, the court may conduct the hearing in the respondent’s absence if the court makes a finding in open court that conducting the hearing without the participation or presence of the respondent would be in the respondent’s best interest.
(4) A representative from the county behavioral health agency shall be present.
(5) If the respondent asserts that they are enrolled in a federally recognized Indian tribe or are receiving services from an Indian health care provider, a tribal court, or a tribal organization, a representative from the program, the tribe, or the tribal court shall be allowed to be present, subject to the consent of the respondent. The tribal representative shall be entitled to notice by the county of the initial appearance.
(6) (A) If the petitioner is a person other than the director of a county behavioral health agency, or their designee, the court shall issue an order relieving the original petitioner and appointing the director of the county behavioral health agency or their designee as the successor petitioner.
(B) If the original petitioner is described in subdivision (a) or (b) of Section 5974, all of the following apply:
(i) The original petitioner shall have the right to be present and make a statement at the initial hearing on the merits of the petition held pursuant to paragraph (7).
(ii) (I) Until July 1, 2025, the court may, in its discretion, assign ongoing rights of notice to the original petitioner.
(II) Commencing July 1, 2025, unless the court determines, either upon its own motion or upon the motion of the respondent, at any point in the proceedings, that it likely would be detrimental to the treatment or well-being of the respondent, the court shall provide ongoing notice of proceedings to the original petitioner throughout the CARE proceedings, including notice of when a continuance is granted or when a case is dismissed. If a continuance is granted, the notice shall provide a general reason for the continuance, including the absence of the respondent or one of the grounds pursuant to Rule 3.1332 of the California Rules of Court. If a case is dismissed, the notice shall specify the statutory basis for the dismissal. A notice pursuant to this clause shall not disclose any patient information that is protected under the federal Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191), the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), or this act, without the respondent’s consent.
(III) The Judicial Council shall amend the notice of dismissal form to include a section to indicate whether the court has ordered a prepetition screening pursuant to this section.
(iii) To the extent that the respondent consents, the court may allow the original petitioner to participate in the respondent’s CARE proceedings.
(iv) The original petitioner may file a new petition with the court, pursuant to Section 5974, if the matter is dismissed and there is a change in circumstances.
(C) If the original petitioner is not described in subdivision (a) or (b) of Section 5974, the court shall not assign ongoing rights to the original petitioner, other than the right to be present and make a statement at the hearing on the merits of the petition held pursuant to paragraph (7).
(7) (A) The court shall set a hearing on the merits of the petition within 10 days, at which time the court shall determine whether, by clear and convincing evidence, the respondent meets the CARE criteria in Section 5972. In making this determination, the court shall consider all evidence properly before it, including any report from the county behavioral health agency ordered pursuant to paragraph (3) of subdivision (a) and any additional admissible evidence presented by the parties, including the petition submitted and any statement given by the original petitioner. A licensed behavioral health professional may testify as an expert concerning whether the respondent meets the CARE criteria in Section 5972 provided that the court finds that the professional has special knowledge, skill, experience, training, or education sufficient to qualify as an expert under Section 720 of the Evidence Code.
(B) The hearing on the merits of the petition may be conducted concurrently with the initial appearance upon stipulation of the successor petitioner and the respondent, subject to the approval by the court.
(c) (1) If, at the hearing on the merits of the petition, the court finds there is not clear and convincing evidence that the respondent meets the CARE criteria in Section 5972, the court shall dismiss the case without prejudice, unless the court makes a finding, in open court, that the original petitioner’s filing was not in good faith, in which case the dismissal shall be with prejudice.
(2) If, at the hearing on the merits of the petition, the court finds by clear and convincing evidence that the respondent meets the CARE criteria in Section 5972, the court shall order the county behavioral health agency to work with the respondent, the respondent’s counsel, and the supporter to engage the respondent in behavioral health treatment and attempt to enter into a CARE agreement. The court shall set a case management hearing within 14 days.
(3) If the respondent is enrolled in a federally recognized Indian tribe, the county shall provide notice of the case management hearing to the tribe, subject to the consent of the respondent.
(d) The following shall apply to any written report submitted by a county behavioral health agency to the court pursuant to this section:
(1) The report is confidential and not subject to disclosure or inspection under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code).
(2) The report is inadmissible in any subsequent legal proceeding, except upon motion of the respondent in that subsequent legal proceeding.
(3) The report shall be confidential pursuant to subdivision (e) of Section 5976.5.
(4) This subdivision shall not affect the applicability of paragraph (2) of subdivision (c) of Section 5977.1, make admissible any evidence that is not otherwise admissible, or permit a witness to base an opinion on any matter that is not a proper basis for such an opinion. The admission or exclusion of evidence shall be pursuant to the rules of evidence established by the Evidence Code, including, but not limited to, Section 352 of the Evidence Code, and by judicial decision.
(e) If the court intends to dismiss a petition because a respondent needs a higher level of services, the court may order the county to conduct a prepetition screening pursuant to Article 2 (commencing with Section 5200) of Chapter 2 of Part 1, and may hold the CARE petition open until the prepetition screening by the county is complete.
SEC. 7.SEC. 5.
Section 5977.4 of the Welfare and Institutions Code is amended to read:
5977.4.
(a) In all CARE Act proceedings, the judicial officer shall control the proceedings during the hearings with a view to the expeditious and effective ascertainment of the jurisdictional facts and the ascertainment of all information relative to the present condition and future welfare of the respondent. Except when there is a contested issue of fact or law, the proceedings shall be conducted in an informal nonadversarial atmosphere with a view to obtaining the maximum cooperation of the respondent, all persons interested in the respondent’s welfare, and all other parties, with any provisions that the court may make for the disposition and care of the respondent. The court and relevant local public agencies shall cooperate to develop a comprehensive set of objectives established to improve performance of the CARE system in a vigorous and ongoing manner. The court is authorized to coordinate and participate in meetings to improve system performance. All evaluations and reports, documents, and filings submitted to the court pursuant to CARE Act proceedings shall be confidential.
(b) The hearings described in this chapter shall allow remote appearances through the use of remote technology, unless otherwise ordered by the court or demanded by the respondent. The respondent shall have the right to be in person for all hearings.
(c) Consistent with its constitutional rulemaking authority, the Judicial Council shall adopt rules to implement the policies and provisions in this section and in Sections 5977 to 5977.4, inclusive, to promote statewide consistency, including, but not limited to, what is included in the petition form packet, communications between the CARE Act court and the juvenile court, if applicable, the role of the judiciary to improve system performance, and the process by which counsel will be appointed.
(d) (1) Consistent with paragraph (9) of subdivision (b) of Section 56.10 of the Civil Code, the county behavioral health agency shall include in any report evaluation, or other document filed with the court, the information, including protected health information, necessary to support the determinations, conclusions, and recommendations in the filing. The county behavioral health agency shall not, unless ordered to do so by the court, submit to the court original or photocopied records underlying the information in a report evaluation or other document required or ordered under this subdivision. The county behavioral health agency shall serve an unredacted copy of any report evaluation, or other document filed with the court on the respondent and the respondent’s counsel and, with the consent of the respondent, on the supporter in a manner authorized by law. Neither a county nor an employee or agent thereof shall be held civilly or criminally liable for any disclosure authorized or required by this paragraph.
(2) (A) Consistent with paragraph (1) of subdivision (c) of Section 56.10 of the Civil Code, a provider of health care, as defined in Section 56.05 of the Civil Code, or a covered entity, as defined in Section 160.103 of Title 45 of the Code of Federal Regulations, may disclose to the county behavioral health agency any information, including protected health information, and mental health records excluding psychotherapy notes, in its possession about the respondent that is relevant to the county behavioral health agency’s provision, coordination, or management of services and supports under this part, including, but not limited to, the preparation of any required investigations, evaluations, or reports. Such a disclosure is a disclosure for treatment purposes, which may be made only to the extent permitted under Section 164.506 of Title 45 of the Code of Federal Regulations. The information disclosed may include substance use disorder patient records only to the extent permitted by Part 2 (commencing with Section 2.1) of Title 42 of the Code of Federal Regulations.
(B) Consistent with paragraph (9) of subdivision (b) of Section 56.10 of the Civil Code, a provider of health care, as defined in Section 56.05 of the Civil Code, or a covered entity, as defined in Section 160.103 of Title 45 of the Code of Federal Regulations, that filed a CARE Act petition or executed an affidavit included with a CARE Act petition pursuant to paragraph (1) of subdivision (d) of Section 5975 shall provide to the county behavioral health agency any information, including protected health information, and mental health records excluding psychotherapy notes, in its possession about the respondent that may be relevant in connection with an investigation, evaluation, or other report or hearing under this part, or with the provision of services and supports under this part. The provision of information under this paragraph is a disclosure required by law, which may be made only to the extent permitted under subdivision (a) of Section 164.512 of Title 45 of the Code of Federal Regulations. The information disclosed shall include substance use disorder patient records only to the extent permitted by Part 2 (commencing with Section 2.1) of Title 42 of the Code of Federal Regulations.
(C) The county behavioral health agency may apply to the court ex parte for an order requiring any provider of health care, as defined in Section 56.05 of the Civil Code, or any covered entity, as defined in Section 160.103 of Title 45 of the Code of Federal Regulations, to provide to the county behavioral health agency, to the court, or both, any information, including, but not limited to, protected health information, and mental health records excluding psychotherapy notes, in its possession about the respondent that may be relevant in connection with an investigation, evaluation, or other report or hearing under this part, or with the provision of services and supports under this part. The provision of information under this paragraph is a disclosure required by law, which may be made only to the extent permitted under Section 164.512 of Title 45 of the Code of Federal Regulations. The information ordered to be disclosed may include substance use disorder patient records only to the extent permitted by Part 2 (commencing with Section 2.1) of Title 42 of the Code of Federal Regulations.
(D) A provider of health care or covered entity shall not be held civilly or criminally liable for any disclosure authorized or required by this section.
(E) The county behavioral health agency shall notify the respondent of a disclosure under this paragraph as follows:
(i) By mail at the respondent’s last known address, if any.
(ii) To the respondent’s counsel.
(iii) By including a copy of the notification under clause (i) or (ii) with the next notice of hearing served upon the respondent, if any.
(F) All information, including the facts and records, or summary thereof, shared under this subdivision shall further be disclosed to the respondent and the respondent’s counsel, and with the consent of the respondent, to the supporter.
(3) (A) Except as expressly provided, further disclosure or redisclosure of information is not authorized by this subdivision.
(B) Information disclosed to a county behavioral health agency by a provider of health care, as defined in Section 56.05 of the Civil Code, or a covered entity, as defined in Section 160.103 of Title 45 of the Code of Federal Regulations is confidential and not subject to disclosure or inspection under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code).
(C) Disclosure of information under this part shall not be deemed to in any way alter the duties or responsibilities of a county behavioral health agency, of a provider of health care, as defined in Section 56.05 of the Civil Code, or of a covered entity, as defined in Section 160.103 of Title 45 of the Code of Federal Regulations, with respect to the disclosed information under the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), or the federal Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191).
Section 5979 of the Welfare and Institutions Code is amended to read:
5979.
(a) (1) If, at any time during the proceedings, the court determines by clear and convincing evidence that the respondent is not participating in the CARE process, after the respondent receives notice, or is not adhering to their CARE plan, after the respondent receives notice, the court may terminate the respondent’s participation in the CARE process.
(2) To ensure the respondent’s safety, the court may utilize legal authority pursuant to Article 2 (commencing with Section 5200) of Chapter 2 of Part 1. The court shall provide notice to the county behavioral health agency and the Office of the Public Conservator and Guardian if the court utilizes that authority.
(3) If the respondent was timely provided with all of the services and supports required by the CARE plan, the fact that the respondent failed to successfully complete their CARE plan, including reasons for that failure, shall be a fact considered by the court in a subsequent hearing under the Lanterman-Petris-Short Act (Part 1 (commencing with Section 5000)), provided that the hearing occurs within six months of the termination of the CARE plan and shall create a presumption at that hearing that the respondent needs additional intervention beyond the supports and services provided by the CARE plan.
(4) The respondent’s failure to comply with an order shall not result in a penalty outside of this section, including, but not limited to, contempt or a failure to appear.
(5) The respondent’s failure to comply with a medication order shall not result in any penalty, including under this section.
(b) (1) If, at any time during the CARE process, the court finds that the county or other local government entity is not complying with court orders, the court shall report that finding to the presiding judge of the superior court or their designee.
(2) (A) The presiding judge or their designee shall issue an order to show cause why the local government entity should not be fined as set forth in this section. The time set for hearing shall be no earlier than 15 days after the date of the order. The scheduled date of the hearing shall allow adequate time for notice of the hearing to be served upon the local government entity.
(B) The presiding judge, or their designee, shall consider the matter on the record established at the hearing. If the presiding judge or their designee finds, by clear and convincing evidence, that the local government entity has substantially failed to comply with this part, or with lawful orders issued by a court under this part, the presiding judge or their designee may issue an order imposing a fine under this section.
(C) A fine under this section shall be in an amount of up to one thousand dollars ($1,000) per day, not to exceed $25,000 for each individual violation identified in the order imposing fines.
(D) (i) Funds collected pursuant to this subdivision shall be deposited in the CARE Act Accountability Fund, which is hereby created in the State Treasury. Upon appropriation, the department shall administer the funds annually, and shall issue guidance, as necessary, to local government entities, pursuant to subdivision (b) of Section 5984, regarding the distribution and conditions associated with the administered funds.
(ii) All moneys in the fund shall be allocated and distributed to the local government entity that paid the fines, to be used by that entity to serve individuals who have schizophrenia spectrum or other psychotic disorders and who are experiencing, or are at risk of, homelessness, criminal justice involvement, hospitalization, or conservatorship.
(3) If, after notice and hearing as set forth in paragraph (2), the presiding judge or their designee finds, by clear and convincing evidence, that the local government entity is persistently noncompliant with this part, or with lawful orders issued by a court under this part, the presiding judge or their designee may appoint a special master to secure court-ordered care for the respondent at the local government entity’s cost. The presiding judge, or their designee, shall not make an order under this paragraph unless they have received five or more reports under paragraph (1) pertaining to the same local government entity within a one-year period.
(4) In determining the application of the remedies available under this section, the court shall consider whether there are any mitigating circumstances impairing the ability of the local government entity to fully comply with the requirements of this part, or with court orders issued under this part. The court may consider whether the local government entity is making a good faith effort to come into substantial compliance or is facing substantial undue hardships.
(c) Either the respondent or the county behavioral health agency may appeal an adverse court determination.
SEC. 9.SEC. 6.
Section 5983 of the Welfare and Institutions Code is amended to read:
5983.
(a) The California Health and Human Services Agency, or a designated department within the agency, shall do both of the following:
(1) Engage an independent, research-based entity, as described in Section 5986, to advise on the development of data-driven process and outcome measures to guide the planning, collaboration, reporting, and evaluation of the CARE Act pursuant to this part.
(2) Convene a working group to provide coordination and on-going engagement with, and support collaboration among, relevant state and local partners and other stakeholders throughout the phases of county implementation to support the successful implementation of the CARE Act. The working group shall meet no more than quarterly. The working group shall meet during the implementation and shall end no later than December 31, 2026.
(b) The department shall provide training and technical assistance to county behavioral health agencies to support the implementation of this part, including training regarding the CARE process, CARE agreement and plan services and supports, supported decisionmaking, the supporter role, trauma-informed care, elimination of bias, psychiatric advance directives, family psychoeducation, and data collection. The department shall include in the training and technical assistance guidance regarding the court-ordered mental health evaluation process under Article 2 (commencing with Section 5200) of Chapter 2 of Part 1 and its integration with the CARE process under Sections 5972, 5975, and 5977.
Section 5977.
(c) The Judicial Council, in consultation with the department, other relevant state entities, and the County Behavioral Health Directors Association, shall provide training and technical assistance to judicial officers to support the implementation of this part, including training regarding the CARE process, CARE agreement and plan services and supports, working with the supporter, supported decisionmaking, the supporter role, the family role, trauma-informed care, elimination of bias, best practices, and evidence-based models of care for people with severe behavioral health conditions.
(d) The department, in consultation with other relevant state departments and the California Interagency Council on Homelessness, shall provide training to counsel regarding the CARE process and CARE agreement and plan services and supports.
SEC. 10.SEC. 7.
Section 5985 of the Welfare and Institutions Code is amended to read:
5985.
(a) (1) The department shall develop, in consultation with county behavioral health agencies, other relevant state or local government entities, disability rights groups, individuals with lived experience, families, counsel, racial justice experts, and other appropriate stakeholders, an annual CARE Act report. The department shall post the annual report on its internet website.
(2) The department, in consultation with county behavioral health agencies and courts, shall specify the length of time that data on former participants shall be reported pursuant to subdivision (e), which shall be a minimum of 12 months after completion of and a maximum of 36 months following engagement in CARE Act elective services, a CARE agreement, or CARE plan.
(3) For the purposes of this section, the following definitions shall apply:
(A) “Former participant” means an individual who enters into CARE Act elective services, a CARE agreement, or a CARE plan, but who has either graduated from CARE, or for whom CARE Act proceedings were dismissed or terminated. Counties shall not be responsible for reporting on any individual who is privately insured or who no longer resides in California.
(B) “Active participants” means an individual who is an elective client, or who has a CARE plan or CARE agreement.
(b) County behavioral health agencies and any other state or local governmental entity, as identified by the department, shall provide data related to the CARE Act participants, services, and supports to the department. The department shall determine the data measures and specifications, and shall publish them via guidance issues pursuant to subdivision (b) of Section 5984.
(c) Each county behavioral health department and any other state and local governmental entity, as identified by the department, shall provide the required data to the department, in a format and frequency as directed by the department.
(d) (1) In consultation with the Judicial Council, the department shall develop an annual reporting schedule for the submission of CARE Act data from the trial courts.
(2) Data from the trial courts shall be submitted to the Judicial Council, which shall aggregate the data and submit it to the department consistent with the reporting schedule developed pursuant to paragraph (1).
(3) On an annual basis to be determined by the Judicial Council and consistent with the annual reporting schedule developed pursuant to paragraph (1), the trial courts shall report to the Judicial Council the following data related to CARE Act petitions:
(A) The number of petitions submitted pursuant to Section 5975.
(B) The number of initial appearance hearings on the petition held pursuant to paragraph (3) of subdivision (a) of Section 5977.
(C) The total number of hearings held pursuant to this part.
(D) The total number of CARE plans ordered and CARE agreements approved.
(E) The total number of court petitions dismissed, as reported by the Judicial Council.
(G) The total number of court-ordered mental health evaluations under Article 2 (commencing with Section 5200) of Chapter 2 of Part 1 ordered upon dismissal, the total number of cases dismissed where a court-ordered mental health evaluation under Article 2 (commencing with Section 5200) of Chapter 2 of Part 1 was requested, but not ordered, and the basis for dismissal in those cases.
(F) The total number of court-ordered prepetition screenings for mental health evaluations under Article 2 (commencing with Section 5200) of Chapter 2 of Part 1 ordered upon dismissal, the basis for dismissal in those cases, the number of county petitions submitted following an order by the court for a prepetition screening, and the number of petitions that led to an evaluation.
(e) The annual report shall include process measures to examine the scope of impact and monitor the performance of CARE Act model implementation. The measures and reporting requirements shall be developed by the department in consultation with county behavioral health agencies. The report shall include trial court petition data pursuant to paragraph (3) of subdivision (d) and, to the extent administrative data is available, all of the following information compiled from county behavioral health departments and courts:
(1) The demographics of all participants, including, but not limited to, age, sex, race, ethnicity, disability, languages spoken, sexual orientation, gender identity, housing status, veteran status, immigration status, health coverage status, including Medi-Cal enrollment status, information related to CARE criteria outlined in Section 5972, and county of residence.
(2) The petitioner’s relationship to the CARE Act respondent as defined in Section 5974.
(3) The services and supports ordered, the services and supports provided, and the services and supports ordered but not provided to all active and former participants.
(4) The housing placements of all active and former participants. Placements include, but are not limited to, transition to a higher level of care, independent living in the person’s own house or apartment, community-based housing, community-based housing with services, shelter, and no housing.
(5) Treatments continued and terminated of all active and former participants.
(6) Substance use disorder rates and rates of treatment among all active and former participants.
(7) Detentions and other Lanterman-Petris-Short Act involvement for all active and former participants.
(8) Criminal justice involvement of all active and former participants.
(9) Deaths among all active and former participants, along with the cause of death.
(10) Type, format, and frequency of outreach and engagement activities provided by a county behavioral health agency to engage an individual who is the subject of a referral or petition, including interactions about the individuals eligible or likely to be eligible and outcomes of these efforts.
(11) In consultation with the department and county behavioral health departments, the number, rates, and trends of contacts made to the county behavioral health agency about individuals eligible or likely to be eligible for the CARE process, including outcomes of those contacts.
(12) The number, rates, and source of referrals to county behavioral health departments, including, but not limited to, referrals resulting in a petition or reason for not filing a petition, length of time from referral to outcome, and services provided for those engaged voluntarily without a petition.
(13) The number, rates, and trends of petitions resulting in dismissal and hearings.
(14) Information on petition dispositions, including, but not limited to, disposition recommendations and the number of days from petition to disposition.
(15) The number, rates, and trends of supporters.
(16) The number, rates, and trends of approved CARE agreements.
(17) The number, rates, and trends of ordered and completed CARE plans.
(18) Statistics on the services and supports, including court orders for stabilizing medications.
(19) The rates of adherence to medication.
(20) The number, rates, and trends of psychiatric advance directives created for active participants.
(21) The number, rates, and trends of developed graduation plans.
(22) Outcome measures to assess the effectiveness of the CARE Act model, such as improvement in housing status, including gaining and maintaining housing, reductions in emergency department visits and inpatient hospitalizations, reductions in law enforcement encounters and incarceration, reductions in involuntary treatment and conservatorship, and reductions in substance use.
(23) A health equity assessment of the CARE Act to identify demographic disparities based on demographic data in paragraph (1), and to inform disparity reduction efforts.
(24) Data regarding referrals made pursuant to Section 5978.1, as part of the CARE Act.
(f) (1) The report shall include, at a minimum, information on the effectiveness of the CARE Act model in improving outcomes and reducing disparities, homelessness, criminal justice involvement, conservatorships, and hospitalization of participants. The annual report shall include process measures to examine the scope of impact and monitor the performance of CARE Act model implementation, such as the number and source of petitions filed for CARE court; the number, rates, and trends of petitions resulting in dismissal and hearings; the number, rates, and trends of supporters; the number, rates, and trends of voluntary CARE agreements; the number, rates, and trends of ordered and completed CARE plans; the services and supports included in CARE plans, including court orders for stabilizing medications; the rates of adherence to medication; the number, rates, and trends of psychiatric advance directives; and the number, rates, and trends of developed graduation plans. The report shall include outcome measures to assess the effectiveness of the CARE Act model, such as improvement in housing status, including gaining and maintaining housing; reductions in emergency department visits and inpatient hospitalizations; reductions in law enforcement encounters and incarceration; reductions in involuntary treatment and conservatorship; and reductions in substance use. The annual report shall examine these data through the lens of health equity to identify racial, ethnic, and other demographic disparities and inform disparity reduction efforts.
(2) Data shall be stratified by age, sex, race, ethnicity, languages spoken, disability, sexual orientation, gender identity, housing status, veteran status, immigration status, health coverage source, and county, to the extent statistically relevant data is available.
(g) The outcomes shall be presented to relevant state oversight bodies, including, but not limited to, the California Interagency Council on Homelessness.
(h) (1) Beginning in 2026, the department shall include in its annual CARE Act report quantitative, deidentified information concerning the operation of this part.
(2) Based on information provided to the department in a form and manner specified by the department, in consultation with the Judicial Council and county behavioral health departments, in accordance with subdivision (b) of Section 5984, the report shall include all of the following information, aggregated by county, compiled from county behavioral health departments, courts, and the department, depending on the source:
(A) The number of contacts to the county behavioral health department about individuals eligible or likely to be eligible for the CARE process, including outcome of contacts.
(B) The number of CARE petitions filed with the superior court.
(C) The petitioner type for each petition filed with the superior court.
(D) Disposition of each petition filed with the superior court.
(E) The number of days between filing each petition and the petition’s disposition.
(F) Demographic information of each CARE Act participant or potentially eligible CARE Act participant, including, but not limited to, age, sex, race, ethnicity, disability, languages spoken, sexual orientation, gender identity, housing status, veteran status, immigration status, health coverage status, including Medi-Cal enrollment status, information related to CARE criteria outlined in Section 5972, and county of residence, to the extent administrative data is available and statistically relevant.
(G) The number of referrals of individuals in conservatorship proceedings made pursuant to subdivision (a) of Section 5978, including the disposition of each referral.
(H) The number of referrals made pursuant to Section 5978.1, including the disposition of each referral.
(i) Information publicly released or published pursuant to this part shall not contain data that may lead to the identification of participants or petitioners or information that would otherwise allow an individual to link the published information to a specific person. Data published by the department shall be deidentified in compliance with Section 164.514(a) and (b) of Title 45 of the Code of Federal Regulations.
SEC. 11.SEC. 8.
No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution for certain costs that may be incurred by a local agency or school district because, in that regard, this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
However, if the Commission on State Mandates determines that this act contains other costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.