The CARE Act: Behind the Numbers with Alameda County Judge Sandra Bean

CARE court is a non-criminal process that authorizes certain people-such as family members or first responders-to petition a civil court for treatment and services for eligible individuals with mental illness. The following is the second of three articles exploring the perspectives of CARE court judges across California.

Passed by the California legislature in 2022, the Community Assistance, Recovery, and Empowerment (CARE) Act creates civil court proceedings, also known as CARE court, that can provide support for certain adults with severe mental illnesses. In Alameda County, Judge Sandra Bean works closely with other public agencies to best support the people appearing in her courtroom.

"You do everything you can to try and make things work," Judge Bean says.

How CARE Court Works

The process begins when an adult files a CARE petition with a civil court. Eligible petitioners include roommates, behavioral health professionals, certain relatives, or first responders. The petition asks the court to determine if an adult with schizophrenia or another psychotic disorder, or bipolar I with psychotic features, is eligible for a CARE agreement or plan. That person is called the respondent.

Once a petition is filed, the court must determine if the respondent meets the narrow eligibility criteria and if a CARE agreement or plan would be the best option. Sometimes a respondent may not meet the clinical criteria needed for a CARE agreement. Other times, collaborative courts - or courts that can order specific rehabilitation services, like veterans' court, drug court, or mental health court - may provide more appropriate care.

For eligible respondents, the court supervises the treatment, housing, or other behavioral health services they may receive through the county. As a voluntary program, CARE agreements can help respondents recover and stabilize with autonomy. While the court can order a CARE plan, which includes the same general elements and does not involve forced medication or custodial settings like jail, Alameda County only pursues agreements with respondents.

"We think it's very important for the respondent to agree," Judge Bean says. "It speaks to the whole philosophy of CARE court, which is a voluntary program."

Finding Creative Solutions

With over 210 CARE petitions filed as of December 2025 in Alameda County, Judge Bean must first consider whether the petition assigned to her has the required elements needed to move forward. In her experience, if a petition is dismissed, it's usually because the respondent is unwilling to enter into a CARE agreement, is already working with behavioral health agencies, or they can't be found.

Even if Judge Bean thinks a petition won't result in a CARE agreement, she still schedules a court date.

"I'm not going to say no," Judge Bean says. "I'm going to try to help, even if a petition doesn't meet the criteria." At these hearings, Judge Bean, the respondent, and Alameda County Behavioral Health discuss what other programs might be the right fit.

For respondents that are eligible for CARE agreements, Judge Bean uses creative problem solving to ensure respondents receive all their benefits. Last month, she helped launch a pilot program with her court's Self-Help Center to help respondents with CARE agreements fill out benefit forms.

"Social workers can fill out benefit forms, but it's not really their forte," Judge Bean says. "The Self-Help Center has great experience with filling out forms and some of the staff are lawyers, so they are very good at it."

When a respondent comes to court, Judge Bean can send them to the onsite Self-Help Center the same day to apply for benefits like food assistance, supplemental security income, or general assistance. To get the pilot program started, Judge Bean asked her presiding judge if they could use some of their budget to temporarily fund a position at the Self-Help Center specifically to support CARE court users, including petitioners.

"We've been really focused on making sure that our respondents with CARE agreements get all the benefits they're entitled to," Judge Bean adds. Sometimes, the solution can be as simple as getting the respondent an email address. At the Self-Help Center, the case worker from a local organization, such as Bay Area Community Services, can provide email addresses that can be used to register for benefits.

Collaboration Across the State

CARE court was first implemented in Alameda County in December 2024. In the year ahead of implementation, Judge Bean and other CARE court judges prepared themselves as much as possible. They visited Orange, San Diego, and San Francisco counties - some of the first counties to pilot CARE court - to see live hearings and learn about their business processes. In addition, Alameda County Behavioral Health partnered with the Indigo Project, a mental health services consultant, to help facilitate planning meetings between their department, CARE court judges, public defenders, and county counsel.

"Those meetings gave us an opportunity to get very comfortable with each other and develop some trust," Judge Bean says. Now having presided over her own CARE court proceedings, she shares the knowledge she's developed with others.

"I never turn down requests to come and talk about the CARE Act with folks," Judge Bean says. "We want to make sure that we turn over every rock to see if there are more people in the community who may need help." Recently, Judge Bean and the public defender have done educational presentations about the CARE Act for the Livermore fire and police departments, the East County Bar Association, and estate and trust lawyers.

As CARE court evolves, Judge Bean hopes that sharing resources and experience will continue to streamline opportunities for respondents to receive support.

"There's a lot of variation in what's happening with respondents from day-to-day, from week-to-week," Judge Bean says. "Every county in California is working really hard to help people."

The Judicial Council's Role in CARE Act Implementation

The Judicial Council, the administrative and policymaking body of the California courts, approved rules and forms, including a mandatory petition form, as well as a standard of judicial administration, to support the program. The council also allocated state funding for all courts to implement the CARE Act, as well as funding to the State Bar for representation of respondents by qualified legal services providers and public defenders. Additionally, the council is tasked with collecting program data from superior courts, as well as providing training and technical assistance to judges and court staff.

Learn more about the CARE Act.