Senate Bill Archives - Mental Health America of California

SB 27 (UMBERG) Care Court Expansion – Oppose

July 28^th, 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.

SB 59 (WIENER) Change of Gender and Sex – Support

June 10th, 2025

The Honorable Ash Kalra
Assembly Judiciary Committee
1020 N Street, Room 104
Sacramento, CA 95814

RE: LIVE Support for Senate Bill 59 (Wiener)

Dear Chair Kalra,

LGBTQ+ Inclusivity, Visibility, and Empowerment (LIVE) is pleased to support Senate Bill 59 (Wiener), legislation that would expand confidentiality protections for all individuals petitioning for a change of gender and sex identifier.

LIVE is a program that celebrates LGBTQ+ diversity and advocates for an inclusive world where all individuals can live authentically and safely. LIVE empowers individuals to amplify their voices in policy, reduce stigma, and strengthen community unity. As anti-transgender legislation continues to be introduced, LIVE is committed to advocating for their existence and rights to vital services.

SB 59 (Wiener) protects individuals who are petitioning to change their gender or sex identifier on official documents. It ensures that these petitions are sealed to protect the privacy and identity of transgender individuals. By sealing the petition and related documents, this bill prevents members of the public from accessing sensitive and private information. This protection is critical for safeguarding individuals from potential discrimination or harassment.

Transgender individuals consistently struggle to access housing and healthcare services due to the mismatch of their gender identity and the gender indicated on identification documents. This mismatch exposes them to potential discrimination and denial of vital services. Although transgender individuals can petition the court to correct their documents, the petition and related filings may still expose sensitive information. This bill takes the first step to ensure gender identity is not a barrier to services and supports that affirm gender identity.

It is for these reasons that LIVE supports SB 59 (Wiener) and asks for your “Aye” vote. If you have any questions, or if LIVE can provide assistance on this bill or any other legislation, please do not hesitate to contact me at agaribaymena@mhac.org or our Public Policy Coordinator, Danny Thirakul, at dthirakul@mhac.org.

In Community,

Anthony Garibay-Mena
LGBTQ+ Inclusivity, Visibility, and Empowerment
Program Manager

SB 244 (GRAYSON) Disabled Student Services – Support

July 1^st, 2025

The Honorable Mike Fong
Assembly Higher Education Committee
1020 N Street, Room 173
Sacramento, CA 95814

RE: CAYEN Support for SB 244 (Grayson)

Dear Chair Fong,

The California Youth Empowerment Network (CAYEN) is pleased to support SB 244 (Grayson), legislation that would require the Trustees of the California State University, the Board of Governors of the California Community Colleges, and the respective governing bodies of private institutions of higher education, and would request the Regents of the University of California, to cover the costs of diagnostic assessments as proof for academic accommodations.

CAYEN is a youth-led statewide network comprised of TAY Action Teams and CAYEN Board members which engages, empowers and represents Transitional Age Youth (TAY), ages 15-26, in mental health advocacy on issues that directly affect TAY. These issues include expanding support and services for TAY living with mental health disabilities.

Despite existing legal protections, many TAY face a significant financial hurdle when seeking academic accommodations for their mental health disability: the cost of required diagnostic assessments. For instance, a psychoeducational assessment can cost between $2,500 and $7,000.[1] While some students’ health insurance may cover these costs, many must bear this financial burden themselves.

It is for these reasons, CAYEN supports SB 244 and asks for your “Aye” vote. Economic barriers should not prevent youth from being able to access the support and services needed to achieve academic success. If you have any questions, or if CAYEN can provide assistance on this bill or any other behavioral health legislation, please do not hesitate to contact me at dthirakul@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhac.org

Sincerely,

Danny Thirakul
California Youth Empowerment Network
Public Policy Coordinator

[1] Ezarik, M. (2024, July 11). Donors fund evaluations for student academic accommodations. Inside Higher Ed | Higher Education News, Events and Jobs. https://www.insidehighered.com/news/student-success/academic-life/2024/07/11/donors-fund-evaluations-student-academic

SB 27 (UMBERG) CARE Court – Oppose

July 11^th, 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.

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.

SB 331 (MENJIVAR) Expanding eligibility for involuntary commitment – Oppose Unless Amended

April 4, 2025

Honorable Caroline Menjivar
Chair, Senate Health Committee
California Senate
1021 O Street, Room 1200
Sacramento, CA 95814

RE: SB 331 (Menjivar) as amended 03/24/25 – OPPOSE UNLESS AMENDED

Dear Chair Menjivar:

On behalf of Disability Rights California (DRC), we write to express our opposition to SB 331 unless amended. This bill would significantly expand eligibility for involuntary commitment.

SB 331 defines “mental health disorder” as a condition outlined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under current law, “mental health disorder” is not defined in statute or regulation. Notably, there was a definition in regulation similar to that proposed by this bill but that regulation was repealed.

The definition of mental health disorder is important for determining eligibility for involuntary commitment, as there must be a nexus between an individual’s mental health disorder and harmful behaviors to meet involuntary commitment criteria.1

The DSM includes a broad range of conditions, many of which are concerning when considered as potential grounds for involuntary commitment under SB 331. The DSM-5-TR, the most recent version, lists 265 conditions, including developmental disabilities, substance disorders, caffeine use disorder, restless leg syndrome, female sexual interest/arousal disorder, and erectile disorder.2 The historical discrimination within the DSM, reflecting societal attitudes, cannot be overlooked. For example, the first two versions of the DSM classified “homosexuality” as a mental disorder, and the current edition includes “gender dysphoria.” Clearly, the DSM includes conditions that are inappropriate for involuntary commitment.

In practice, “mental health disorder” is generally understood to refer to conditions appropriate for inpatient psychiatric treatment, as supported by state and federal law. This understanding aligns with the Lanterman-Petris-Short (LPS) Act, which mandates that individuals involuntarily committed receive appropriate treatment services to “promote the potential of the person to function independently” in the least restrictive environment.3 Involuntarily institutionalizing people who cannot be treated for the condition for which they are held is a violation of the Americans with Disabilities Act.4

We believe this provision should be removed from the bill but if that is not acceptable we would like to work with you on language.

Our remaining concerns center primarily on the process by which the bill seeks to permit an original petitioner to continue in that role after the initial court appearance. There are several sections in the bill where this is addressed, and we find it confusing to use the term “nonsubstituted petitioner” as we try to understand the meaning of each instance. We understand the bill will be amended to require the respondent’s consent and we do see that as an improvement.

For the reasons outlined above, we respectfully oppose SB 331 unless
amended.

Sincerely,

Deb Roth
Senior Legislative Advocate
Disability Rights California

Samuel Jain
Senior Policy Attorney
Disability Rights California

cc: Reyes Diaz, Principal Consultant, Senate Health Committee

1 Welfare & Institutions Code § 5150(a).
2 American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (5th ed. 2013), table of contents available at: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM-5-Contents.pdf
3 Welfare & Institutions Code § 5325.1(a).

SB 622 (GROVE) Sex-segregated school programs and activities – Oppose

April 15^th, 2025

The Honorable Sasha Renée Pérez
Chair, Senate Education Committee
1021 O Street, Room 6740
Sacramento, CA 95814

Re: LIVE Opposition of Senate Bill 622 (Grove)

Dear Chair Pérez,

LGBTQ+ Inclusivity, Visibility, and Empowerment (LIVE) strongly opposes Senate Bill 622 (Grove), which would remove protections that currently allow transgender youth to participate in sex-segregated school programs and activities consistent with their gender identity and instead mandate that they participate based on their sex assigned at birth.

LIVE is a program of changemakers that celebrates LGBTQ+ diversity and creates a more inclusive world where LGBTQ+ community members can live authentically. LIVE creates positive change by uplifting and empowering individuals to bolster their voices in policy, stigma reduction and unifying community. LIVE is committed to advocating for the health, wellness, and rights of the LGBTQ+ community, ensuring that all individuals can thrive without facing discrimination or barriers to their livelihood.

Senate Bill 622 (Grove) poses an existential threat to transgender youth by denying their participation in school programs and activities that support their gender identity. This bill not only prevents transgender individuals from participating but forces them to participate in an environment that requires them to deny who they are. According to a 2023 report from The Trevor Project, there has been a 72% increase in suicide attempts among transgender youth due to the rise in anti-transgender laws.[1] These laws attempt to erase the existence of the transgender community and further jeopardizes the health and safety of transgender youth.

It is for these reasons that LIVE opposes SB 622 (Grove) and asks for your “No” vote. If you have any questions, or if LIVE can provide assistance on this bill or any other legislation, please do not hesitate to contact me at agaribaymena@mhac.org or our Public Policy Coordinator, Danny Thirakul, at dthirakul@mhac.org.

In Community,

Anthony Garibay-Mena
LGBTQ+ Inclusivity, Visibility, and Empowerment
Program Manager

[1] News, T. (2025a, February 11). Anti-transgender laws cause up to 72% increase in suicide attempts among transgender and nonbinary youth, study shows. The Trevor Project.

Joint Sunset Review – Board of Psychology – Exception to Psychotherapist-Patient Privilege for Board Investigations—OPPOSE

May 19^th, 2025

Marc Berman
Chair, Assembly Committee on Business and Professions
1020 N Street, Room 379
Sacramento, CA 95814

Angelique Ashby
Chair, Senate Committee on Business, Professions, and Economic Development
1021 O Street, Room 3320
Sacramento, CA 95814

RE: Joint Sunset Review – Board of Psychology – Exception to Psychotherapist-Patient Privilege for Board Investigations—OPPOSE

Dear Chair Berman and Chair Ashby,

Mental Health America of California (MHAC) would like to express opposition to the California Board of Psychology’s proposed exception to the psychotherapist-patient privilege in Board investigations (Proposal #1 of Section 10 of the Sunset Review Report, page 97) and request that proposal not move forward. The proposal would establish a psychotherapist-patient privilege exception for Board investigations.

MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues. The people and communities we aim to serve include those of all ages; sexual orientation, gender identity or expression; language, racial and ethnic backgrounds, national origin, and immigration status; spirituality and religious affiliations; or socioeconomic status. Our communities rely on the expectation of privacy when accessing mental health care.

Currently, if a patient refuses to disclose records in a Board investigation, the Board has recourse to obtain the records through a subpoena and obtain a civil court order to enforce the subpoena. This ensures that the Board demonstrates compelling interest that the disclosure of such records is relevant and material to the issue. This court process offers the Board an avenue to obtain records while upholding the psychotherapist’s duty to patient privilege and protecting the patient’s constitutional right to privacy.

Confidentiality is essential to successful psychotherapy because it allows for open dialogue between the Psychologist and the patient on extremely personal and sensitive issues. Patients rely on the expectation of privacy every time they attend a therapy session, and without the guarantee of privacy, patients will be less likely to be forthcoming with their therapist and possibly be less likely to seek care.

In addition, this proposal has the potential to severely undermine the quality and effectiveness of psychotherapy. If Psychotherapists fear that their client records could be seized without proper protections, this could result in less than accurate and potentially reductive work products.

The Board has reported that over the last four years it has had to close only three cases due to an inability to access records. The low number of cases being closed does not provide any significant or compelling arguments for a psychotherapist-patient privilege exception. It is for these reasons that MHAC asks you not to move forward with the Board’s proposal. If you have any questions, or if MHAC can provide any assistance on this issue or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.

In Community,

Heidi L. Strunk

President & CEO

Cc: Honorable Members, Assembly Business and Professions Committee
Honorable Members, Senate Business and Professions and Economic Development Committee
Kaitlin Curry, Consultant, Assembly Business and Professions Committee
Anna Billy, Consultant, Senate Business and Professions and Economic Development Committee

SB 812 (ALLEN) Qualified Youth Drop-In Center Health Care – Support

April 16^th, 2025

The Honorable Caroline Menjivar
Chair, Senate Health Committee
1021 O Street, Room 3310
Sacramento, CA 95814

RE: CAYEN Support for Senate Bill 812 (Allen)

Dear Chair Menjivar,

The California Youth Empowerment Network (CAYEN) is pleased to support Senate Bill 812 (Allen), legislation that would expand coverage of mental health and substance use services provided at qualified youth drop-in centers.

CAYEN is a youth-led statewide network comprised of TAY Action Teams and CAYEN Board members that engages, empowers, and represents Transitional Age Youth (TAY), ages 15-26, in mental health advocacy on issues that directly affect TAY. Since CAYEN’s inception in 2006, CAYEN has taken many forms of action to empower TAY in their personal lives and spark progressive change in public policy.

As California continues to expand mental health and substance use services for children and youth, significant barriers such as transportation or uncertainty about how to find care continue to limit access. Youth drop-in centers offer a non-traditional approach to support youth by being available outside of school hours and in some cases off campus. However, the inability of centers to be reimbursed for medically necessary services to youth may prevent youth from accessing services out of fear of being denied if they lack appropriate coverage.

Additionally, when centers are unable to receive reimbursement for the medically necessary services they provide, they are left with two difficult choices: absorb the cost or turn youth away. Both options compromise the center’s sustainability and reduce access for youth in need of services. This bill requires health plans and Medi-Cal to reimburse youth drop-in centers for services delivered, ensuring these safe spaces remain accessible to youth who need them most.

For these reasons, CAYEN supports SB 812 (Allen) and asks for your “Aye” vote. If you have any questions, or if CAYEN can provide assistance on this bill or any other behavioral health legislation, please do not hesitate to contact me at dthirakul@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.

Sincerely,

Danny Thirakul
California Youth Empowerment Network
Public Policy Coordinator

SB 306 (BECKER) Honoring Physician Decisions Act – Support

April 16^th, 2025

The Honorable Caroline Menjivar
Chair, Senate Health Committee
1021 O Street, Room 3310
Sacramento, CA 95814

RE: MHAC Support for SB 306 (Becker)

Dear Chair Menjivar,

Mental Health America of California (MHAC) is pleased to support Senate Bill 306 (Becker), legislation that would exempt commonly approved healthcare services from requiring prior authorization.

Commonly covered mental health and substance use services include various forms of therapy or counseling and medication management. This bill ensures that health plans that approve 90% or more of prior authorization requests for a given service in the previous year must exempt that service from prior authorization for the following year. This will help streamline access to commonly utilized mental health and substance use services and ensure more timely care.

It is for these reasons MHAC supports SB 306 (Becker) and asks for your “Aye” 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 hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.

In Community,

Heidi L. Strunk
President & CEO

SB 338 (BECKER) Mobile Health for Rural Communities Pilot Program – Support

April 16^th, 2025

The Honorable Caroline Menjivar
Chair, Senate Health Committee
1021 O Street, Room 3310
Sacramento, CA 95814

RE: Support for Senate Bill 338 (Becker)

Dear Chair Menjivar,

Mental Health America of California (MHAC), the California Youth Empowerment Network (CAYEN) and LGBTQ+ Inclusivity, Visibility, and Empowerment (LIVE) are pleased to support Senate Bill 338 (Becker), legislation that would establish the Mobile Health for Rural Communities Pilot Program with the goal of increasing access to health services, including mental health, for rural communities.

MHAC, CAYEN, and LIVE are dedicated to advancing mental health, wellness, and equity through community-led advocacy, education, and empowerment. By centering the voices of those with lived experience, including youth, LGBTQ+ individuals, and people living with mental health and substance use challenges, we aim to reduce stigma, influence public policy, and create inclusive environments where everyone has access to vital community-based culturally responsive mental health and substance use supports and services.

Access to these services is extremely challenging for individuals in the rural communities, especially youth and the LGBTQ+ community. People often travel for hours for in-person services. Additionally, rural communities lack the appropriate internet infrastructure to support telehealth or virtual services. Senate Bill 338 (Becker) invests in mobile health, bringing services directly to communities in need, reducing barriers to access in-person and virtual health services.

It is for these reasons MHAC, CAYEN, and LIVE support SB 338 (Becker) and respectfully ask for your “Aye” vote. If you have any questions or need further assistance, please do not hesitate to contact MHAC’s Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org, CAYEN’s Public Policy Coordinator Danny Thirakul at dthirakul@mhac.org, or LIVE’s Project Manager Anthony Garibay-Mena at agaribaymena@mhac.org.

In Community,

Heidi L. Strunk
President & CEO

Danny Thirakul
California Youth Empowerment Network
Public Policy Coordinator

Anthony Garibay-Mena
LGBTQ+ Inclusivity, Visibility, and Empowerment
Project Manager