As expected, the Governor’s Community Assistance, Recovery and Empowerment (CARE) Act (SB 1338) was amended for the last time on August 26, before its passage by the Assembly and then final concurrence by the Senate on Wednesday evening. This last round of Assembly floor amendments builds on the prior rounds and addresses many RCRC priority issues. Below is a summary of key amendments contained in the final version of the bill:  

  • A list of “cohort one” counties. Prior iterations of the bill identified that a cohort of counties representing half of the state would implement October 2023 and the remaining half in December 2024. The bill now identifies the first cohort of counties as Glenn, Orange, Riverside, San Diego, Stanislaus, Tuolumne, and San Francisco. The second cohort will include the remainder of the state. The bill maintains provisions regarding the potential approval of a further implementation delay to December 2025.  

  • Clarity on sanctions provisions. After several iterations of language, amendments clarify that funds paid to the state by a sanctioned local government are allocated back to the local government, paying the fine for local expenditure: “All moneys in the fund shall be allocated and distributed to the local government entity that paid the fines, to be used by that entity to serve individuals who have schizophrenia spectrum or other psychotic disorders and who are experiencing, or are at risk of, homelessness, criminal justice involvement, hospitalization, or conservatorship.”  

  • Changes to the judicial authority to sanction local governments. While the last round of amendments placed this authority with the presiding judge of each superior court, final amendments state “the presiding judge or their designee.”  

  • County employee liability protection. Amendments specify that a county or county employee/agent shall not be held civilly or criminally liable for any action by a respondent in the CARE process, with the exception of gross negligence.  

  • A commitment to allocate funds to implement. The bill includes new language stating, “This part shall become operative only upon the department, in consultation with county stakeholders, developing a CARE Act allocation to provide state financial assistance to counties to implement the care process in this act.” We expect that these conversations will take place throughout the fall as the Administration prepares the Governor’s January Budget for 2023-24.  

In addition, the Budget Bill Junior (AB 179/SB 179) identifies $31 million in one-time implementation/start-up funding for counties for all 58 counties to begin implementation planning/activities and separate additional funds of $26 million for the seven “cohort one” counties previously discussed. The Department of Health Care Services will develop the allocations for funding in consultation with CSAC, RCRC, and UCC.  

While conclusion was reached for the CARE Act with the end of the 2021-22 legislative session, follow-up legislation is already under consideration for next year, to address technical elements requiring more discussion. Between future technical “clean-up” and fiscal negotiations, readers may expect to see CARE Act updates in the future.