When California’s CARE Court arrived in the Bay Area, families and local officials hoped it would quickly connect people with severe psychosis to treatment and housing. Instead, they say they’ve found a system heavy on paperwork and light on active cases — and frustration is mounting.
A survey of the region’s five largest counties tallied 439 CARE Court petitions but just 99 voluntary care agreements, leaving roughly 100 people currently participating across the Bay Area. That accounting comes from The Mercury News, which reviewed county filings and statements.
State reporting suggests the slow rollout isn’t unique to the Bay Area: a California Health and Human Services implementation update found 2,008 petitions had been filed statewide through May 31, 2025, and counties reported 1,358 people diverted into other services through Dec. 31, 2024. The diversion figures show outreach often sends people to alternatives rather than formal CARE agreements.
Why uptake has lagged
Experts and county officials cite tight eligibility rules, a burdensome petition process and a high dismissal rate as key obstacles to scaling CARE Court, according to KFF Health News. CalMatters found that only a few hundred petitions had turned into CARE agreements or plans through July, while KFF Health News documented how early projections have far outpaced reality.
Bay Area counties' response
Some local officials say they’re steering people toward other treatment tracks and outreach rather than pushing every possible case through court. County sources quoted in The Mercury News said Santa Clara has focused on alternatives and that the governor’s office reported Alameda had 27 active participants with 23 more who agreed to enroll. Newsom’s deputy communications director Tara Gallegos told the paper, “It’s time for lagging counties to stop making excuses and start delivering the help Californians desperately need.”
New law could change the math
On Oct. 10, Gov. Gavin Newsom signed SB 27, which expands CARE Court eligibility to include mood disorders with psychotic features and allows some hearings to be combined to speed cases. Sen. Tom Umberg's office and the bill record say the changes could widen the pool of people who qualify — but counties will still need beds, staff and permanent housing to make that meaningful.
Advocates say expansion won’t fix shortages
Disability-rights groups warn that broadening eligibility without new funding for housing or long-term services risks putting more people under court supervision without meaningful supports, a concern highlighted by CalMatters. Local chapters of the National Alliance on Mental Illness and county leaders say outreach and training for petitioners and first responders are part of the answer, but those efforts take time and staff capacity to scale up, according to reporting in LAist.
For Bay Area families and providers, the real test will be whether SB 27 and stepped-up outreach lead to sustained enrollments — not just more petitions. Counties say success will come down to staffing, persistent street outreach and whether additional housing and long-term services arrive alongside court orders.
