July 11th, 2025
The Honorable Nick Schultz
Assembly Public Safety Committee
1020 N Street, Room 111
Sacramento, CA 95814
RE: Opposition to Senate Bill 27 (Umberg)
Dear Chair Schultz,
Mental Health America of California (MHAC) strongly opposes Senate Bill 27 (Umberg), legislation that would expand forced behavioral health treatment by extending CARE Court eligibility to individuals diagnosed with Bipolar 1 Disorder with psychotic features. This bill would also create an unnecessary judicial barrier that could deny individuals found incompetent to stand trial (IST) from qualifying for mental health diversion.
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, and thus involuntary, behavioral healthcare. Approximately 4.4% of U.S. adults experience bipolar disorder in their lifetime.[1] 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%.[2] Expanding eligibility to include Bipolar 1 Disorder with psychotic features would increase the number of individuals being stripped of their right to choose the mental health supports and services that best meet their needs. An individual’s mental health challenges are not better addressed when the government tells them what to do.
Senate Bill 27 also makes sweeping changes to California’s mental health diversion process. Under current law, when a person is found incompetent to stand trial, the court is required to hold a diversion hearing. If, at this hearing, a person is deemed ineligible for diversion, another hearing is conducted to determine alternatives to diversion including Assisted Outpatient Treatment, CARE Court, or conservatorship. This bill instead mandates a new initial hearing to determine if: a) the court wants to hold an additional diversion hearing; or b) the court wants to refer an individual directly to CARE Court. At this point, no other alternatives are offered, and the court would be able to bypass the entire diversion process by sending an individual directly to CARE Court. If the court chooses option (a) under SB 27, the diversion process would proceed in a similar manner to current law, with the option to refer individuals to a range of alternative programs if they are deemed ineligible for diversion.
CARE Court is a new, unproven mental health program. In its Early Implementation Report released in November 2024, the Department of Health Care Services reported only a total of 100 Care Court participants, yet state officials estimated 7,000 to 12,000 people would be eligible.[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 costs for treatment. For comparison, Full-Service Partnerships (FSP) are designed to provide treatment for, and services to, adults with serious mental illness. This costs taxpayers approximately $16,666 per person and, as of 2021, services more than 60,000 people statewide.
MHAC strongly opposes any legislation that bypasses the diversion process by streamlining enrollment in CARE Court. The diversion process, as currently in statute, has proven highly effective for those who are eligible, with a range of alternative programs available for those who are ineligible. SB 27 would prioritize CARE Court above diversion and above all other alternatives.
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). 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.). Bipolar disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/bipolar-disorder#part_2605
[2] 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
[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.
