Stanislaus County leaders set target date to start involuntary treatment for substance use
Stanislaus County supervisors on Tuesday approved a Jan. 1, 2025, target date to implement significant changes to conservatorship and involuntary mental health treatment laws.
A state Senate bill signed by Gov. Gavin Newsom in October went into effect last month, but almost all counties including Stanislaus exercised an option to delay the changes for up to two years.
Stanislaus leaders want to get started earlier than 2026 but allowed time for county staff to talk to law enforcement, hospitals and other affected agencies before setting an implementation date.
A key change in Senate Bill 43 is adding adults with severe substance use disorder to the criteria for a “5150” hold, which can lead to emergency psychiatric care and additional treatment. People with severe mental illness have been placed on a 72-hour hold under state law if they are a danger to themselves or others or are gravely disabled.
The new law expanded the definition of “gravely disabled” to include those who, because of severe substance abuse, cannot provide for their own basic needs, such as food and shelter or necessary medical care.
Supporters of SB 43 say it’s intended to extend treatment for people who are suffering on the streets because of disabling drug use.
The revised definition of gravely disabled will allow for involuntary placement in a facility or conservatorship to direct their care, based on a severe substance use disorder or co-occurring mental health disorder and a severe SUD.
Some counties may refer individuals to less restrictive alternatives such as CARE (Community Assistance, Recovery and Empowerment) Court to put them on a treatment plan.
County officials held planning meetings in January with behavioral health professionals, public guardians, court officials, hospitals, patient rights advocates and police agencies to discuss the resources and additional services needed to execute SB 43.
Hospitals including Doctors Medical Center of Modesto, Emanuel hospital of Turlock and Doctors Behavioral Health Center, along with the Modesto, Ceres and Turlock police departments, were part of the conversation. They concurred they could be ready for the changes by the end of 2024, according to a county staff report.
It’s not likely that many new services will be open by January 2025.
Supervisor calls for a firm start date
Stanislaus Supervisor Terry Withrow suggested that the county set a firm expedited start date, rather than a target date. He noted that Newsom originally was upset with foot-dragging on the part of counties.
Tony Vartan, county behavioral health director, said counties are waiting for guidance from the state on involuntary substance use treatment. It isn’t clear where the addiction treatment would be provided or when it should end.
The county is expecting to see an increase in mental health conservatorships and the need for additional staff.
Agencies will need to train first responders on the new definitions of grave disability and build resources and programs before the changes are implemented in 2025.
Vartan said San Luis Obispo County, which implemented SB 43 last month, is included in ongoing planning meetings as that county works on strategies and services for those in dire need of substance use treatment.
“We don’t want to reinvent the wheel,” Vartan said.
This story was originally published February 14, 2024 at 6:00 AM.
