California’s Conservatorship Laws Aim to Help Those Most in Need

A change to the law expands the definition of grave disability

By Benjy Schirm, J.D. | Reviewed by Canaan Suitt, J.D. | Last updated on July 12, 2024

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In October 2023, California Gov. Gavin Newsom signed Senate Bill 43, updating California’s conservatorship laws to make individuals eligible for conservatorship who cannot provide for their own safety or necessary medical care due to severe substance use disorder or serious mental health illness eligible for conservatorship.

SB 43 went into effect on January 1, 2024. Here’s what you need to know about conservatorship in California.

What Are Conservatorships Used for in California?

A conservatorship is a legal arrangement in which a judge appoints a responsible adult (the conservator) to have decision-making authority over the personal care or financial matters of an adult with developmental disabilities (the conservatee). To get money or make healthcare decisions for treatment plans, the conservator must sign off on it.

For a judge to appoint a conservator, it must be the least restrictive option available to provide necessary aid to the impaired adult. Conservatorships may be general in scope, where the conservator has decision-making authority over all matters, or is limited to specific occasions, such as giving or withholding medical consent.

Under SB 43, individuals may be placed in a conservatorship if they meet the law’s expanded definition of having a “grave disability.”

Involuntary Holds and an Expanded Definition of Grave Disability

An involuntary hold, or 5150, is a provision in California state law that allows individuals to be involuntarily detained for 72 hours for mental health services and assessment. It does not authorize involuntary mental health treatment. An involuntary hold is not a criminal arrest, and there are specific criteria that police officers or other officials must follow to trigger an involuntary hold for someone.

SB 43 makes having a “grave disability” one of the reasons to request an involuntary hold. Under the law, the definition of grave disability is expanded to include having a severe substance use disorder or serious mental illness that makes the person incapable of providing for their personal safety, necessary medical care, or basic provisions such as food, clothing, or shelter. If the person is deemed to have a grave disability, an involuntary hold may lead to a conservatorship.

The Rationale for Conservatorships

The rationale for SB 43’s expanded definition of grave disability is to provide severely ill individuals with the help they need and otherwise could not access. As such, SB 43 follows earlier efforts of California lawmakers to help individuals with mental health and substance use issues.

For example, Senate Bill 1045 was a bill proposed by Sen. Scott Wiener and signed into law in 2018, then revised in 2019 to help address the state’s mental health, substance abuse, and homelessness crises. SB 1045 law created a five-year pilot program for implementation by local governments in Los Angeles, San Diego, and San Francisco to increase the power of the courts to place people under a conservatorship or court-ordered observation. The law focused on individuals experiencing homelessness who suffer from mental health and substance abuse issues and who cannot care for themselves. 

Additionally, in September 2022, Gov. Gavin Newsom signed the CARE Act into law, creating a framework for CARE Courts to help individuals with schizophrenia spectrum or other psychotic disorders get the help they need.

While SB 43 and other conservatorship laws are intended to help those who are in most need of mental health services, there is always two sides to a story. Critics of the law ask what will happen to the civil rights of Californians placed in a conservatorship—do they lose civil liberties, money, freedom? Proponents argue that these programs provide individuals with help before worse outcomes, such as being arrested, placed in a State Hospital, or death.

If you have a family member you think requires help, consider speaking with a reputable and experienced attorney about how to create a care plan or access California health services. For more information on conservatorships and other life-planning tools, see our overview of estate planning.

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