SB 989 amends the CARE Act by permitting first responders to request that the county behavioral health agency file a petition to commence the CARE process on behalf of an adult believed to meet CARE criteria, instead of the first responder filing directly. The bill requires counties to review referrals and decide whether to file within 30 business days, to notify the referrer of the outcome, and to collect and report specified data to the state.
The change creates a new procedural route intended to centralize screening at county behavioral health agencies and standardize information and reporting. It also creates enforceable remedies: requesters may ask a court to compel a county to investigate or to revisit a negative determination.
Because counties must provide a higher level of service under the bill, it establishes a potential state‑mandated local program subject to reimbursement rules.
At a Glance
What It Does
The bill authorizes first responders to contact the respondent’s county behavioral health agency and request that the agency file a CARE petition. The agency must review the referral and, within 30 business days, assess whether the respondent likely meets CARE criteria and file a petition if the respondent does and refuses voluntary treatment. The department must provide a referral form and issue guidance and data reporting rules.
Who It Affects
First responders listed in the CARE Act, county behavioral health agencies, CARE Court dockets and judges, adults with diagnoses in the schizophrenia/psychotic disorder class and their families, and counties that will collect and report referral data.
Why It Matters
SB 989 shifts initial filing responsibility away from on-scene responders to county behavioral health systems and creates enforceable timelines and reporting obligations. That changes operational workflows for emergency personnel and county programs, raises capacity and funding questions, and generates the first statutorily required dataset about CARE referrals from first responders.
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What This Bill Actually Does
SB 989 adds a new Section 5974.5 to the Welfare and Institutions Code. Under the new procedure, a first responder who thinks an adult may meet CARE criteria can submit a referral to the county behavioral health agency where the person lives instead of (or before) filing a CARE petition in court.
The referral must include contact information and other details the department prescribes on a standardized form. The intent is to move the screening step into the county behavioral health system so clinicians and caseworkers can evaluate suitability for CARE before a court petition is filed.
Once a county receives a referral, the bill requires the county to complete an assessment and decide whether to file a CARE petition within 30 business days. If the county determines the person meets CARE criteria and the person will not engage voluntarily, the county must file the petition consistent with existing CARE Act procedures (cross‑referencing Section 5975).
If the county decides not to file, the first responder can request an appeal hearing in court seeking reinvestigation. Separately, if the county fails to act within the 30‑business‑day window, the referrer may apply to a court for an order compelling the county to investigate.SB 989 also assigns the Department of Health Care Services (the department) two operational tasks: create the referral form first responders must use and issue procedural guidance for how to make a referral and how counties should report data.
Counties must collect and report specified metrics — the bill lists examples such as number of requests, outcomes, reasons for not filing, time from request to outcome, and services provided for those who accept voluntary help — and the department must include that information in the annual CARE Act report. Finally, the bill includes the standard state‑mandated local program language: if the Commission on State Mandates finds costs, reimbursement will follow the usual Government Code procedure.
The practical effects are straightforward: counties need processes, staff, and recordkeeping to meet the 30‑day clock and reporting obligations; first responders get a formalized referral route and a court remedy if counties do not act; courts may see new motions to compel investigation or rehear determinations.
The Five Things You Need to Know
A referring first responder must provide contact information for the respondent and additional department‑specified details on a standardized referral form.
The county behavioral health agency must review the referral and determine whether to file a CARE petition within 30 business days of receiving the request.
If the agency finds the respondent meets CARE criteria and the respondent refuses voluntary treatment, the agency must file a petition pursuant to Section 5975.
If the county fails to investigate within 30 business days, the referrer can ask a court to order the county to investigate; if the county declines to file a petition, the referrer can request a court appeal hearing to seek reinvestigation.
The department must publish referral and reporting guidance and counties must report metrics (total requests, outcomes, reasons for not filing, timing, and services provided) for inclusion in the annual CARE Act report.
Section-by-Section Breakdown
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Referral route: first responder may request county file petition
This subdivision creates the alternative pathway: instead of a first responder directly filing a CARE petition, the responder may contact the respondent’s county behavioral health agency and request that the county file. Practically, this shifts the initial screening from emergency personnel and on‑scene decisionmaking to county clinical staff and caseworkers.
Required referral content and department role in specifying form fields
The bill requires referrals to include the respondent’s contact information (telephone and address, if available) and any other items the department prescribes. That delegates important data‑collection decisions to the department and lets the state standardize inputs across counties, but it means counties and first responders will need the department’s form to comply.
30‑business‑day assessment and filing obligation
Counties must complete an assessment and decide whether to file a CARE petition within 30 business days. The statute ties filing to existing CARE criteria and to the condition that the respondent will not engage in voluntary treatment, referencing the filing mechanism in Section 5975. The clock creates a measurable performance obligation that counties must operationalize.
Court remedies: compel investigation and appeal negative determinations
If a county does not act within 30 business days, the referrer may petition the court to compel an investigation. If the county reviews and declines to file because it determined the respondent does not meet the CARE criteria, the referrer can request a court hearing to seek reinvestigation. Those remedies insert the judicial branch as an enforcement backstop for county inaction or disagreement.
Department guidance and county reporting requirements
The department must develop a referral form and issue guidance covering the referral procedure and the data counties must report. The guidance enumerates required data points such as counts of requests, outcomes, reasons for not filing, time between request and outcome, and services provided when people accept voluntary help; counties must collect these metrics for state reporting.
Inclusion in annual CARE report and state‑mandated local program language
The department must include referral data in the annual CARE Act report (Section 5985). Section 2 preserves the statutory reimbursement process: if the Commission on State Mandates determines the bill imposes costs on local agencies, counties and districts would seek reimbursement under the Government Code’s prevailing procedures.
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Who Benefits
- First responders — obtain a formal, standardized referral mechanism and a court remedy if a county does not act, reducing the pressure to file or litigate from the field.
- Adults with severe psychotic disorders and their families — gain an additional channel for county clinical review that can lead to earlier connection with CARE services and a consistent record of county response.
- State policymakers and researchers — receive new, standardized data about first‑responder referrals and county decisions that can inform program evaluation and funding decisions.
- CARE Court judges and court staff — get clearer records about whether counties followed state guidance and may see more formally framed petitions with county clinical involvement.
Who Bears the Cost
- County behavioral health agencies — must staff and document a timely (30 business days) assessment process, prepare and file petitions when appropriate, and meet new reporting duties; those are operational costs.
- Counties and local taxpayers — face potential fiscal exposure if the Commission on State Mandates determines the law creates reimbursable costs and the state does not fully fund them.
- County courts — may see increased motions to compel investigations and rehearings of county determinations, adding docket and administrative pressure.
- Respondents — may face a lower threshold for having a county‑initiated petition filed, since referrals from trained first responders will trigger standardized county reviews and potential court involvement.
Key Issues
The Core Tension
The bill tries to widen access and create accountability by routing first‑responder concerns into county clinical review with enforceable timelines; but that increases demands on counties and courts and risks substituting procedural fixes for the harder work of funding and building local behavioral health capacity and safeguards to protect due process and privacy.
SB 989 tightens the procedural channel between first responders and county behavioral health agencies, but it leaves several operationally significant details to implementation. The department controls the referral form content and reporting fields, so the practical burden on first responders and counties depends on how detailed that form is and how the department advises agencies to triage referrals.
The statutory 30‑business‑day clock creates clarity but may be unrealistic in under‑resourced counties; meeting it reliably will require hiring, training, or reassigning staff and building record systems to track requests and outcomes.
The bill also creates new judicial enforcement levers. Allowing referrers to ask a court to compel investigation or to seek rehearing of a county’s negative finding can protect against county inaction but risks turning disagreements about clinical thresholds into litigation.
That could produce uneven outcomes across counties and increase court and administrative burdens. Finally, the reporting requirements raise privacy and operational concerns: counties must decide how to collect and transmit the required metrics without creating duplicative records or running afoul of confidentiality rules, and the data may reflect practice variation rather than program performance unless the department standardizes definitions and audits submissions.
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