Governor Gavin Newsom announced he has signed Senate Bill 43 (Eggman, D-Stockton) to modernize the state’s conservatorship laws for the first time in more than 50 years. The law updates the definition for those eligible for conservatorship to include people who are unable to provide for their personal safety or necessary medical care, in addition to food, clothing, or shelter, due to either severe substance use disorder or serious mental health illnesses. The Governor was joined by Senator Susan Talamantes Eggman and mental health advocates and clinicians as he signed Senate Bill 43.

Governor Gavin Newsom: “California is undertaking a major overhaul of our mental health system. The mental health crisis affects us all, and people who need the most help have been too often overlooked. We are working to ensure no one falls through the cracks, and that people get the help they need and the respect they deserve.”

WHAT SENATE HEALTH COMMITTEE CHAIR SENATOR SUSAN EGGMAN SAID: “The LPS Act was adopted at a time when public policy was essentially to warehouse people that were mentally ill. The Act established strong and important civil liberty protections to ensure individual rights are protected. Like many things that are decades old, it has long been time to make some adjustments to the law to address the realities we are seeing today on our streets. SB 43 maintains the strong due process protections provided in the LPS Act, while expanding the criteria for making a “gravely disabled” determination, so that the most severely ill can get the help they need and the dignity they deserve. Over the last couple of years we have made critical investments and instituted important changes in our behavioral health laws, including the adoption of better data gathering requirements and, of course, the adoption of the CARE Act. Changing the LPS Act has been a glaring missing piece of the puzzle and I am so grateful to Governor Newsom, my colleagues in the legislature and our tremendous coalition of supporters for getting this across the finish line.”

WHY THIS MATTERS: Updating conservatorship laws and increasing transparency will provide county mental health departments, courts, family members, clinicians, and people with serious mental illnesses and substance use disorders a more effective approach for delivering last-resort behavioral health care.
WHAT ADVOCATES AND MEDICAL PROFESSIONALS ARE SAYING

NAMI California CEO Jessica Cruz: “NAMI California believes Senate Bill 43 is essential to both those living with severe mental illness and their families by making it easier to provide mental health treatment for individuals unable to care for themselves. We thank Governor Newsom for signing this important legislation and are grateful to Senator Eggman for her leadership to ensure families are provided the ability to secure critically needed treatment for their loved ones living with severe mental illness.”
Psychiatric Physicians Alliance of California President Ron Thurston, M.D.: “Treatments for mental illness can be wonderfully effective, but our laws often prevent us from providing them to individuals who are at mortal risk on our streets. SB 43 will help us provide life saving care.”
California State Association of Psychiatrists Chairwoman Dr. Jessica Thackaberry: “SB 43 contains several changes to law to ensure that individuals who are truly the most gravely disabled Californians obtain the services they need. The California State Association of Psychiatrists and its thousands of members are grateful to Senator Eggman for her dedication of patients and their families, and to Governor Newsom for understanding that state law needs to be updated so that it reflects the unfortunate realities of what behavioral health professionals see manifesting every day in our communities.”
WHAT LOCAL ELECTED OFFICIALS ARE SAYING

SAN DIEGO MAYOR TODD GLORIA: “With today’s signing of Senate Bill 43, Gov. Gavin Newsom once again demonstrated his steadfast commitment to meaningfully addressing the devastating impacts California’s mental health and addiction crises are having on families and our communities,” Mayor Todd Gloria said. “SB 43 will help us reach a small but very visible segment of our homeless population who up till now have been allowed to languish on the streets, often dying alone and forgotten by society. I want to offer my most sincere gratitude to Sen. Susan Eggman, who refused to give up on these very sick Californians,” Mayor Gloria added. “Due to her persistence and tenacity, conservatorship laws that have not been updated since the 1960s can finally help us address 21st century challenges.”
SACRAMENTO MAYOR DARRELL STEINBERG: “We must never accept the reality that people with severe mental illness and substance abuse must live in inhumane and dangerous conditions. Voluntary services will remain the priority for mental health and substance abuse care. But sometimes people can not avail themselves of help when it is repeatedly offered. SB 43 will ensure a much better balance and help people who are unable to help themselves get the lifesaving care they need. Decades after the passage of the Lanterman Petris Short Act, the pendulum around involuntary care must swing back towards the center. SB 43 will do just that. Thank you Governor Newsom and Senator Eggman for your courage and leadership.”
WHY SENATE BILL 43 WAS NEEDED: Under existing law, people may be eligible for a conservatorship if they have a serious mental illness that leaves them unable to secure food, clothing or shelter. Senate Bill 43 broadens eligibility to people who are unable to provide for their personal safety or necessary medical care. In addition, Senate Bill 43 encompasses people with a severe substance use disorder, such as chronic alcoholism, and no longer requires a co-occuring mental health disorder. The new law will update the situations when this intervention can be considered and create the first-ever meaningful transparency into data and equity on mental health conservatorships.

ABOUT CONSERVATORSHIP: Conservatorship is a last resort to help connect people with severe behavioral health care needs with the resources and support to protect them and others. The process begins with a county mental health department petitioning a court to appoint a third party, often a family member, to direct the person’s care for a limited time, across the full range of behavioral health care, including but not only secure settings. Conservatorship can help break the cycle of repeated crises including arrest and imprisonment, psychiatric hospitalization, homelessness, and even premature death – and instead provide the care that can restore mental health and end the conservatorship.

BIGGER PICTURE: Today’s action builds on Governor Newsom’s historic efforts to modernize California’s mental health services and substance use disorder treatment systems – especially for the most serious mental illnesses and substance use disorders. This legislation is part of the comprehensive efforts by the Governor and Legislature to transform California’s services for people with serious mental illnesses and substance use disorders, who are too often suffering without treatment and facing repeated homelessness, hospitalization, and jail time – and often premature deaths. More services for persons with the most serious behavioral health conditions, as well as treatment beds, supportive housing, and new behavioral health workers will be prioritized from the proposed behavioral health transformation in Senate Bill 326 (Eggman, D – Stockton) and Assembly Bill 531 (Irwin, D – Thousand Oaks), which are expected to go before voters on the March 2024 ballot. In addition, the new CARE Court program that is being implemented in eight counties this year (and statewide next year) are helping to hold counties and people with untreated psychosis accountable for care plans, and empower families and others to petition for help.

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