Changes conservatorship rules for serious mental illness

Existing law establishes a procedure, until January 1, 2024, for the County of Los Angeles, the County of San Diego, and the City and County of San Francisco, if the board of supervisors authorizes the appointment of a conservator for a person who is incapable of caring for the person’s own health and well-being due to a serious mental illness and substance use disorder, as evidenced by frequent detention for evaluation and treatment, which is 8 or more detentions for evaluation and treatment in the preceding 12 months. Existing law automatically terminates a conservatorship initiated pursuant to these provisions one year after the appointment of the conservator unless the court specifies a shorter period. Existing law authorizes the person for whom conservatorship is sought to demand a court or jury trial on the issue of whether the person meets the criteria for the appointment of a conservator pursuant to these provisions. Existing law authorizes the Judicial Council to adopt rules, forms, and standards necessary to implement these provisions.

This bill would additionally authorize the court to establish a temporary conservatorship for a period of 28 days or less if the court is satisfied that the person is presently incapable of caring for the person’s own health and well-being due to a serious mental illness and substance use disorder, as those terms are defined by the bill, the person has been detained 8 times for evaluation and treatment in a 12-month period pursuant to existing law authorizing the detention of mentally disordered persons who are a danger to self or others or gravely disabled, without reference to evidence of frequent detention for evaluation and treatment, the temporary conservatorship is necessary, and the county health director, or their designee, has met specified requirements relating to those previous detentions. The bill would also change the definition of “frequent detention for evaluation and treatment” for purposes of these conservatorship provisions to mean 8 or more detentions in a 12-month period.

The bill would require that a petition seeking to establish the above-described conservatorship be filed with the court no later than 28 days following the 8th detention in a 12-month period, and would provide that the petition may be filed only in conjunction with a petition to establish a temporary conservatorship. The bill would require a supplement to the petition, which includes a detailed description of the comprehensive clinical evaluation of the person conducted during the temporary conservatorship, to be filed within 14 days after the initial petition. The bill would require a court making the determination of whether a person meets the criteria for appointment of a conservator to make that determination by clear and convincing evidence based on comprehensive clinical evaluations conducted under temporary conservatorship. This bill would require that the person for whom the conservatorship is sought have the right to demand a court or jury trial to determine whether the person meets the criteria for appointment of a conservator beyond a reasonable doubt.

The bill would provide that the conservatorship would automatically terminate 6 months, rather than one year, after the appointment of the conservator by the superior court, or a shorter period if ordered by the court. The bill would require the conservator to file a report with the court every 60 days regarding the conservatee’s progress and engagement with treatment and, if the court is not satisfied that the conservatorship continues to be justified, the bill would require the court to terminate the conservatorship.

Existing law makes the establishment of a conservatorship pursuant to these provisions subject to, among other things, a finding by the court that the behavioral health director of the county or the city and county has previously attempted by petition to obtain a court order authorizing assisted outpatient treatment pursuant to the Assisted Outpatient Treatment Demonstration Project Act of 2002, known as Laura’s Law, for the person for whom conservatorship is sought, that the petition was denied or the assisted outpatient treatment was insufficient to treat the person’s mental illness, and that assisted outpatient treatment would be insufficient to treat the person in the instant matter in lieu of a conservatorship.

This bill would instead make the establishment of the above-described conservatorship subject to a finding by the court that the health director, or the director’s designee, has fulfilled specified requirements and (1) has previously attempted to obtain the above-described court order and that the petition was denied or the court finds by clear and convincing evidence that assisted outpatient treatment was insufficient to treat the person’s mental illness, or (2) recommends, and the court finds by clear and convincing evidence, that the person, as a matter of law, does not meet the criteria described for assisted outpatient treatment or determines that assisted outpatient treatment would be insufficient to treat the person in lieu of a conservatorship, as specified. The bill would authorize assisted outpatient treatment to be ordered at that hearing if the behavioral health director, or the director’s designee, fails to demonstrate that assisted outpatient treatment would be insufficient to treat the person, and the person qualifies for that treatment.

Existing law requires the County of Los Angeles, the County of San Diego, and the City and County of San Francisco to establish a working group to conduct an evaluation of the effectiveness of the implementation of the above-mentioned provisions in addressing the needs of persons with serious mental illness and substance use disorders in the county or the city and county, and requires the evaluation to include an assessment of the number and status of persons who have been conserved under those provisions, among other things.

This bill would additionally require the evaluation to include, among other things, the service planning and delivery process for those conserved persons, an analysis of demographic data of those conserved persons, and the number of those conserved persons who successfully complete substance use disorder treatment programs.

This bill would declare that it is to take effect immediately as an urgency statute.