July 28th, 2025
The Honorable Buffy Wicks
Assembly Appropriations Committee
1021 O Street, Suite 8220
Sacramento, CA 95814
RE: Opposition to Senate Bill 27 (Umberg)
Dear Chair Wicks,
Mental Health America of California (MHAC) strongly opposes Senate Bill 27 (Umberg), legislation that would expand CARE Court, an unproven statewide mental health program that has cost taxpayers millions of dollars as California faces a multi-billion-dollar deficit.
MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. MHAC envisions a society in which all communities, families and individuals can enjoy full, productive and healthy lives free from discrimination of all kinds regardless of previous or current issues with their mental health or substance use issues. MHAC believes that every person deserves access to appropriate, voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy.
CARE Court is a legal mechanism to force individuals into court-ordered behavioral healthcare. Currently, CARE Court eligibility is limited to individuals with schizophrenia spectrum disorders with a prevalence in the U.S. ranging between 0.25% and 0.64%.[1] Senate Bill 27 expands eligibility to individuals with Bipolar 1 Disorder with psychotic features. Given that approximately 4.4% of U.S. adults experience bipolar disorder in their lifetime, this bill would represent a substantial increase in CARE referrals.[2] This bill will further expand CARE Court by providing it as an option for individuals found incompetent to stand trial (IST).
In the CARE Court Early Implementation Report released in November 2024, the Department of Health Care Services reported only a total of 100 participants statewide [3][4]. With only 100 people enrolled in CARE Court, it costs an estimated $713,000 per person a year. These costs are for court personnel and other court costs, and do not include any allocation for services. For comparison, Full-Service Partnerships (FSP) are designed to provide treatment for, and services to, adults with serious mental illness. FSP’s cost taxpayers approximately $16,666 per person per year and in 2021 served more than 60,000 people statewide.
Considering the significant changes this bill makes to CARE Court, the high price tag per participant, and our state’s budget challenges, a delayed approach might better address cost factors. The urgency clause must be removed, and time must be given to the courts and counties to properly serve a whole new population eligible for CARE Court and the increase in petitions from criminal court.
However, MHAC strongly opposes this costly expansion of CARE Court, which diverts scarce funds from essential behavioral health supports and services. This bill is a clear attempt to increase CARE Court referrals in response to the low, almost nonexistent, number of CARE participants. CARE Court’s failure to meet expectations shows an inherent flaw in the system that won’t be solved by expanding the criteria of who can be forced into treatment via a court order. It is for these reasons that we are opposed to SB 27 (Umberg) and ask for your “No” vote.
If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me at kvicari@mhac.org or our Public Policy Coordinator, Danny Thirakul, at dthirakul@mhac.org.
In Community,
Karen A Vicari, JD
Director of Public Policy
[1] U.S. Department of Health and Human Services. (n.d.-b). Schizophrenia. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/schizophrenia
[2] U.S. Department of Health and Human Services. (n.d.). Bipolar disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/bipolar-disorder#part_2605
[3] Mai-Duc, C. (2024, November 27). California falling short of enrollment goal as Mental Health Courts Roll Out Statewide. California Healthline.
[4] Depart of Health Care Services . (2024, November). CARE Act Early Implementation Report. Community Assistance, Recovery, and Empowerment Act.
