About Senate Bill 43

Senate Bill 43 (SB 43) updates California’s Lanterman–Petris–Short (LPS) Act, originally passed in 1967. The law expands the definition of “gravely disabled” to include individuals with a severe substance use disorder, or a co-occurring mental health and substance use disorder. It also broadens the meaning of “basic needs” to cover access to necessary medical care and personal safety, in addition to food, clothing, and shelter.  

SB 43 modernizes conservatorship proceedings by allowing certain medical testimony to be considered without in-person cross-examination, requires counties to evaluate less restrictive alternatives in conservatorship investigations, and increases state reporting requirements. 

Implementation and Impact

SB 43 was signed into law in October 2023 with the option to delay implementation until January 1, 2026. We are currently in the planning phase for SB 43 implementation. The planning phase includes partner and community engagement, infrastructure capacity building, developing workflows, and training staff and community partners.

SB 43:

  • Offers more resources and support for the community in navigating the complex issues of severe substance use and mental health disorders.
  • Expands access to the necessary care and treatment needed for people experiencing severe substance use and mental health challenges.
  • Enhances community safety and health by linking those who are at highest risk for medical and behavioral health complications to appropriate care.
  • Promotes collaboration between multiple agencies ensuring coordinated care for people in crisis.

Understanding SB 43: Key Definitions and Concepts

New definition of grave disability: A condition in which a person, as a result of a mental health disorder, a severe substance use disorder, or a co-occurring mental health disorder and a severe substance use disorder, is unable to provide for their basic personal needs for food, clothing, shelter, personal safety, or necessary medical care.

SB 43 modernizes conservatorship proceedings by allowing certain medical testimony to be considered without in-person cross-examination, requires counties to evaluate less restrictive alternatives in conservatorship investigations, and increases state reporting requirements.

This new definition applies to the three primary LPS Act processes:

  • Crisis Intervention: Assessment, evaluation and crisis intervention or placement in an LPS-designated facility for evaluation and treatment for up to 72 hours.
  • Intensive Treatment: Up to 14 days if necessary and appropriately authorized, the intensive treatment period for grave disability may be extended for up to two periods of 30 days each.
  • Conservatorship: Up to one year, and renewable, for ongoing behavioral health treatment and support.

A "5150" is the Welfare and Institutions Code section that allows a person to be held involuntarily for a behavioral health assessment and evaluation for up to 72 hours to determine if the person needs inpatient psychiatric treatment.

  • A 5150 is not a criminal arrest.
  • Grave Disability is one of the criteria use to determine if a person should be placed on a 5150 hold. The other criteria include danger to self and danger to others.
  • A 5150 hold does not authorize involuntary medical treatment or medication.
  • During the 5150 hold, the person will be evaluated to determine if there is a need for inpatient treatment. The person may be released before the end of the 72-hour hold if it is determined this is safe to do. What happens after the 5150 hold (up to 72 hours) ends? The person is discharged from the hold and the hospital. OR The person is admitted as a voluntary patient for ongoing treatment OR The person continues to be held involuntarily for up to 14 additional days

After a 5150 hold (of up to 72 hours) ends, one of the following occurs:

  • The person is discharged from the hold and the hospital OR
  • The person is admitted as a voluntary patient for ongoing treatment OR
  • The person continues to be held involuntarily for up to 14 additional days.

If a person continues to be gravely disabled after inpatient hospitalization, they may be considered for conservatorship.

  • A court will review the case to determine if the person requires ongoing treatment for up to one year (renewable).
  • The conserved person retains some rights and can contest their conservatorship.

“Personal safety” means the ability of one to survive safely in the community without involuntary detention or treatment pursuant to the LPS Act.

Resources


Walk-in crisis services for children and adults are available Monday to Friday, 8:00 a.m. to 4:00 p.m. at:
1400 Emeline Ave. Bldg. K, Santa Cruz, CA 95060
1430 Freedom Blvd. Ste. F, Watsonville, CA 95076

Dial 2-1-1 for free information about health services in your community. Available 24 hours a day, 7 days a week.
988 Suicide & Crisis Lifeline - Call, text, or chat 988 for free, non-judgmental support with mental health, substance use, or if you just need to talk. Available 24/7. www.988lifeline.org
County Substance Use Disorder Services: Get connected to local substance use recovery resources.
Mobile Crisis Response Team: Helps stabilize youth and adults in mental health crisis and connect them to ongoing care and resources.