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Spray the inside of a 4- to 6-quart slow cooker with cooking spray.
Spray a small skillet with cooking spray and add sausage. Cook over medium heat until sausage are browned, 2 to 3 minutes. Transfer to the prepared slow cooker. Add cauliflower, cream cheese, butter, garlic powder, salt, pepper, and red pepper flakes; stir to combine.
Cover slow cooker and cook on Low until cauliflower is fork tender, about 2 hours. Stir in pepper Jack cheese and cook for 30 minutes longer.
Meanwhile, place bacon in a large skillet and cook over medium-high heat, turning occasionally, until evenly browned and crispy, about 10 minutes. Drain bacon slices on paper towels and crumble once cool enough to handle. Sprinkle crumbled bacon over finished casserole.