September 15th, 2025
The Honorable Gavin Newsom
California State Governor
1021 O Street, Suite 9000
Sacramento, CA 95814
RE: Request for Veto of Senate Bill 27 (Umberg)
Dear Governor Newsom,
Mental Health America of California (MHAC) respectfully opposes Senate Bill 27 (Umberg), legislation that would expand forced behavioral healthcare treatment by expanding CARE Court eligibility to individuals with Bipolar 1 Disorder. This bill would also prioritize CARE Court over other proven mental health diversion programs for individuals found incompetent to stand trial.
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. 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.
We request you Veto SB 27 for the following reasons:
Increases Involuntary Treatment
CARE Court is a legal mechanism to force individuals into court-ordered, and thus involuntary, behavioral health care. Individuals are forced to participate or face potential conservatorship. 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] This bill 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] If individuals do not form a CARE agreement or do not comply with their CARE plan individuals are subject to additional hearings and may be referred to conservatorship.
Costly to Taxpayers & Ineffective
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.
This bill attempts to increase CARE Court referrals in response to the low, almost nonexistent, number of CARE participants. CARE Court’s inability to meet expectations indicates a systemic flaw 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 “Veto”.
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.





