California SB 1338: Who Qualifies and How to File a Petition

California’s CARE Court is a civil court process, created by SB 1338, that connects adults with severe, untreated psychotic disorders to behavioral health treatment, housing, and support services. Signed into law in 2022 and now operating in all 58 counties, it is meant to intervene before someone’s illness pushes them into conservatorship, jail, or long-term homelessness.¹ As of January 1, 2026, eligibility expanded to include people diagnosed with bipolar I disorder with psychotic features.²

What CARE Court Actually Is

The Community Assistance, Recovery, and Empowerment Act is codified beginning at Welfare and Institutions Code Section 5970.¹ It is not a criminal court. Nobody is prosecuted or jailed through this process. The judge acts as a coordinator, bringing together the county behavioral health agency, housing providers, and the person themselves to build a recovery plan.

The design point is timing. California already has the Lanterman-Petris-Short Act, which allows involuntary holds and conservatorships for people who have deteriorated to the point of grave disability. CARE Court is meant to reach people earlier, while a less restrictive plan can still work, and to place obligations on the county to actually deliver the services it commits to.

Who Qualifies

Eligibility is narrow. All of the following must be true for a person to be a CARE respondent:²

They are 18 or older.
They have a diagnosis in the schizophrenia spectrum, another psychotic disorder, or, starting January 1, 2026, bipolar I disorder with psychotic features. Psychosis caused solely by substance intoxication does not count.
They are not currently stable in an ongoing voluntary treatment program.
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 the person will benefit.

The statute references the “schizophrenia spectrum and other psychotic disorders” classification in the current Diagnostic and Statistical Manual of Mental Disorders, which covers conditions such as schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, and delusional disorder.³

Several conditions are specifically excluded. Psychosis caused by traumatic brain injury, autism, dementia, or other neurological conditions does not qualify. A substance use disorder standing alone does not qualify. Bipolar II and major depression with psychotic features remain outside the law even after the 2026 expansion.²

Who Can File a Petition

A CARE case starts when someone files form CARE-100 with the court.⁴ Only specific people have standing:

Someone who lives with the person
A spouse, parent, sibling, child, grandparent, or person standing in for a parent
The person themselves (a self-petition)
A first responder, including peace officers, firefighters, paramedics, and homeless outreach workers
The director or designee of a hospital where the person is currently held, including on a 5150 or 5250 psychiatric hold
A licensed behavioral health professional treating the person
The director of a public or charitable organization providing behavioral health services where the person resides
A county behavioral health director, public guardian, or tribal court judge

⁵

The petition needs clinical backup. That means either a CARE-101 Mental Health Declaration from a licensed behavioral health provider, or documentation showing the person was placed on at least two periods of intensive treatment (a 5250 hold), with the most recent within the past 60 days.⁵

You can file in the county where the person lives, where they are found, or where they are already facing other court proceedings.⁶ If the case begins somewhere other than the person’s home county, it can be transferred with their consent. Most courts are currently waiving filing fees for CARE petitions.⁷

How the Process Works

After a petition is filed, a judge screens it to see whether the respondent might meet the eligibility criteria. If it clears that screening, the court orders the county behavioral health agency to engage with the respondent and prepare a written report on whether they qualify and what they need. The court also appoints the respondent a lawyer and a supporter.

At the initial hearing, the judge reviews the county’s findings and any other evidence. The petitioner is generally expected to attend. If the judge finds the respondent qualifies, the court directs the county to work with them on a recovery plan.

The process favors voluntary agreement. The first step is a CARE Agreement, which the respondent enters into voluntarily. If a voluntary agreement is not possible, the court can impose a CARE Plan instead. Either can last up to 12 months, with a possible court-ordered extension for one additional year.

Once a plan is in place, the judge holds status review hearings at least every 60 days.⁸ These reviews look in both directions: whether the respondent is engaging with treatment, and whether the county is delivering the housing and services it committed to.

What a CARE Plan Provides

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

Clinical treatment for the psychotic disorder, including therapy and psychiatric services
Short-term stabilization medication, subject to an important limit described below
Treatment for a co-occurring substance use disorder, when one is present
Housing, ranging from clinically enhanced interim housing to longer-term supportive housing, depending on need and county availability
Wellness and recovery support, including peer support, coaching, and connections to benefits or vocational services

The medication piece is where families and respondents most often want clarity. A judge can include medication in a CARE Plan, but it cannot be forcibly administered. Refusing medication, on its own, cannot result in any penalty, including contempt of court or termination of the plan.⁹

The Respondent’s Rights

Because a civil court can order treatment through this process, the statute builds in due process protections. Throughout a CARE case, the 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 the process 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 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 the courtroom to everyone else. The judge must inform the respondent of these rights before each hearing.¹⁰

The statute guarantees counsel rather than a public defender specifically. Most counties assign a public defender or panel attorney, but the title varies. The supporter’s job is separate from the lawyer’s: helping the respondent understand what is happening, make decisions, and voice preferences at hearings and planning meetings.

What Happens If Someone Doesn’t Participate

Refusing medication cannot be used against a respondent. Disengaging from the CARE process entirely is different. If the court finds no less restrictive treatment alternative exists, it can refer the person for conservatorship proceedings under the Lanterman-Petris-Short Act. That is the CARE Act’s core enforcement mechanism.

Under an LPS conservatorship, a court-appointed conservator can make decisions about the person’s medical care, housing, and finances, a much larger loss of autonomy than the CARE process itself. If LPS proceedings such as a 5150 hold or conservatorship petition begin within six months of a CARE case, the person’s non-compliance history from the CARE case can be introduced as evidence. Information about refusing medication is carved out of that evidence.

Where CARE Court Is Available

The law rolled out in phases starting in October 2023, and as of December 2024, all 58 California counties have operational CARE Courts.¹¹ Practically, that means a qualifying petition can be filed in any California county today, subject to that county’s capacity for housing placements, behavioral health providers, and court staff.

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
10
Judicial Branch of California. CARE Act Respondent Rights
11
Governor of California. Successes Continue to Grow as CARE Court Opens in All 58 California Counties