How the CARE Act is helping vulnerable Californians | Opinion

A man in Stanislaus was repeatedly arrested for incidents related to his mental health. An older woman in San Mateo, diagnosed with schizophrenia and wheelchair-bound, was living in a tent. A man in Riverside was hospitalized on multiple occasions. His mother worried for his safety.

Now, thousands of Californians like these real individuals are at last getting help under the Community Assistance, Recovery and Empowerment (CARE) Act, a first-of-its-kind approach.

CARE is helping ensure that people living with the most serious untreated schizophrenia and other psychotic disorders do not continue to cycle between homelessness, emergency rooms and jails without meaningful intervention that can provide long-term stability.

A new tool within the continuum of California’s behavioral health system, the CARE Act offers a way to reach those who too often fall through the cracks. CARE created a civil court process — not a criminal one — that treats the courtroom as a place for compassionate problem-solving.

Voluntary engagement is the goal. CARE seeks to build trust through steady, relationship-based outreach encouraging participants to be involved in the coordination of, and decisions related to, their own care. CARE serves as the least restrictive option — designed to offer pathways not punishment.

Up and running in all 58 counties since December 2024, participants are now graduating from the program and transitioning to structured long-term recovery supports with newfound stability. Graduation is determined on a case-by-case basis. A “graduation plan” is a voluntary agreement entered at the end of the CARE process, often at about one year. It’s a bridge that provides structure between the formal CARE process and long-term recovery, developed according to the individual’s specific needs.

Across the state, dozens of participants have graduated. The CARE Act requires robust data reporting from counties about CARE respondents, including graduations. New numbers about participant graduation will be included in the publicly released 2026 Annual Report, due July 1.

But the need is still great. Gov. Gavin Newsom recently announced new accountability tools to help counties reach more people through the CARE Act.

It starts with a petition from family members, clinicians or first responders, which then goes to a judge who, if the petition is accepted, oversees the coordination of mental health and substance use treatment, stabilizing medication and housing support as needed.

CARE judges ensure that counties prioritize the person in need, keeping county behavioral health practitioners, lawyers and the individual focused on person-centered solutions. More than 4,000 CARE petitions have been submitted since October 1, 2023. Of these, more than 2,000 people are being engaged or receiving services and supports through CARE Court.

A CARE petition is an entry point. Some people won’t meet eligibility requirements; others will disengage. But the entire CARE model is built on voluntary engagement, earned with relentless outreach to foster trust with the people we are seeking to serve.

By intervening earlier in an individual’s life with structure and wrap-around community-based treatment, CARE can help prevent a person’s health from deteriorating further — avoiding the need for an intensive conservatorship intervention. It can also be an off-ramp from conservatorship as people transition back into community-based settings with needed oversight.

Counties are vital partners in successfully scaling CARE’s services.

That’s why California is providing resources to counties for implementation, supporting outreach and engagement, as well as staffing needs for court participation and clinical investigations. With the Judicial Council and California Department of Health Care Services, we have provided hundreds of hours of individualized training and support to counties as they prepared to implement CARE. We have also made meaningful investments in housing and behavioral health infrastructure statewide.

We are meeting practitioners where they are, conducting structured site visits, tailoring solutions to local needs, providing targeted training and tools for petitioners and ensuring counties are leveraging available state resources.

We are supporting counties in accurately communicating how CARE works with families, caregivers, decision-makers and system partners. And we are listening to county leaders about what’s working and what’s not.

Delivering a complex program at this scale requires ongoing evaluation and a willingness to adapt. We are committed to both.

As we work together, all over California, we are seeing results: The man in Stanislaus broke the cycle of arrests and jail; the woman in San Mateo is off the streets; and the young man in Riverside enrolled in courses to earn his high school diploma.

No one wants to see a fellow Californian suffering with no help in sight. If you know someone in need, consider learning more about the CARE Act and whether this could be the pathway that finally leads to lasting change.

Kim Johnson is California Health and Human Services Agency secretary.