Consent-Health & Human Services # 40.
Board of Supervisors
- Meeting Date:
- 12/05/2023
- Brief Title
- Resolution to Defer Implementation of SB43
From:
Nolan Sullivan, Director, Health and Human Services Agency
Staff Contact:
Karleen Jakowski, Assistant Director, Health and Human Services Agency, x2978
Supervisorial District Impact:
Countywide
Subject
Adopt resolution deferring implementation of the changes made to California Welfare and Institutions Code section 5008 by Senate Bill 43 (2023-2024 Reg Session). (No general fund impact) (Sullivan)
Recommended Action
Adopt resolution deferring implementation of the changes made to California Welfare and Institutions Code section 5008 by Senate Bill (SB) 43 (2023-2024 Reg Session) to provide adequate time for impacted systems to develop the extensive array of new policies, procedures, workforce, training, and treatment capacity needed to effectively, and ethically, implement the requirements of SB43.
Strategic Plan Goal(s)
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Thriving Residents |
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Safe Communities |
Reason for Recommended Action/Background
Senate Bill (SB) 43 was signed by Governor Newsom on October 10, 2023 and takes effect on January 1, 2024. SB 43 makes several significant changes to the state’s involuntary detention and conservatorship laws under the Lanterman-Petris-Short (LPS) Act for the first time in more than 50 years. Most importantly, it expands the definition of gravely disabled as set out in California Welfare and Institutions Code (WIC) section 5008 effective January 1, 2024.
SB 43 changes include, but are not limited to:
SB 43 changes include, but are not limited to:
- Expanding the state’s “gravely disabled” criteria to allow for the involuntary detention and conservatorship of individuals on the basis of a standalone “severe” substance use disorder (SUD) or co-occurring mental health disorder and severe SUD;
- Expanding the definition of grave disability to include individuals who are unable to provide for their basic personal need for personal safety or necessary medical care;
- Defining “necessary medical care” to mean care that a licensed health care practitioner determines to be necessary to prevent serious deterioration of an existing medical condition which is likely to result in serious bodily injury if left untreated;
- Modifying hearsay evidentiary standards for conservatorship hearings in order to expand the array of testimony that can be submitted into conservatorship proceedings without requiring in-person cross examination; and,
- Requiring counties consider less restrictive alternatives such as Assisted Outpatient Treatment (AOT) and CARE Court in conducting conservatorship investigations. Yolo County is not scheduled to implement CARE Court until December 2024, further complicating the feasibility of a January 1, 2024 implementation for SB 43.
Yolo County will need to develop an extensive and coordinated array of new policies, procedures, workforce, training, and treatment capacity, in partnership with several county departments, local hospital partners, and the Yolo County Superior Court, in order to implement SB 43. The California Behavioral Health Directors Association (CBHDA) is currently conducting further analysis to understand the full scope of state and local secondary guidance and other changes that will be required to support full implementation.
Because SB 43 has not come with dedicated state funding to support these expanded obligations, Yolo County will need additional lead-time to arrange the staffing, training, treatment, and other resources necessary to support implementation. Locally, this would impact the already strained Public Guardian’s Office, which is funded via County general funds and was already understaffed prior to this expansion. The changes included in SB 43 will also significantly impact local hospitals as well as the Yolo County Sheriff’s Department and County Jail, Yolo Superior Court, Yolo County Public Defender’s Office, and the Yolo County Health and Human Services Agency (including the Public Guardian’s Office and Behavioral Health).
The recommendation to defer Yolo County’s implementation of the changes made to the definition of gravely disabled by SB 43 until January 1, 2026, as allowed by law, is currently recommended by CBHDA and is supported by the California Association of Hospitals (CHA) and both of Yolo County’s local hospital partners, Dignity Community Care and Sutter Valley Hospitals. Deferring implementation will provide much needed time to properly prepare for the increased system demands resulting from the passage of SB 43.
Because SB 43 has not come with dedicated state funding to support these expanded obligations, Yolo County will need additional lead-time to arrange the staffing, training, treatment, and other resources necessary to support implementation. Locally, this would impact the already strained Public Guardian’s Office, which is funded via County general funds and was already understaffed prior to this expansion. The changes included in SB 43 will also significantly impact local hospitals as well as the Yolo County Sheriff’s Department and County Jail, Yolo Superior Court, Yolo County Public Defender’s Office, and the Yolo County Health and Human Services Agency (including the Public Guardian’s Office and Behavioral Health).
The recommendation to defer Yolo County’s implementation of the changes made to the definition of gravely disabled by SB 43 until January 1, 2026, as allowed by law, is currently recommended by CBHDA and is supported by the California Association of Hospitals (CHA) and both of Yolo County’s local hospital partners, Dignity Community Care and Sutter Valley Hospitals. Deferring implementation will provide much needed time to properly prepare for the increased system demands resulting from the passage of SB 43.
Collaborations (including Board advisory groups and external partner agencies)
Yolo County Health and Human Services Agency
Dignity Community Care (Woodland Memorial Hospital)
Sutter Valley Hospitals (Sutter Davis Hospital)
Yolo County Public Defender
Yolo County Superior Court
Yolo County Sheriff
Yolo County Counsel
Dignity Community Care (Woodland Memorial Hospital)
Sutter Valley Hospitals (Sutter Davis Hospital)
Yolo County Public Defender
Yolo County Superior Court
Yolo County Sheriff
Yolo County Counsel
Fiscal Impact
No Fiscal Impact
Fiscal Impact (Expenditure)
- Total cost of recommended action:
- $
- Amount budgeted for expenditure:
- $
- Additional expenditure authority needed:
- $
- On-going commitment (annual cost):
- $
Source of Funds for this Expenditure
- General Fund
- $0
Attachments
Form Review
| Inbox | Reviewed By | Date |
|---|---|---|
| County Counsel | Hope Welton | 11/28/2023 04:30 PM |
| Cindy Perez | Cindy Perez | 11/30/2023 08:52 AM |
- Form Started By:
- Jonathan Bartlett
- Started On:
- 11/17/2023 01:44 PM
- Final Approval Date:
- 11/30/2023