SB 43: Legal Changes to
Involuntary Hold Criteria
Expanding Behavioral Health
Support in Riverside County
Senate Bill 43 (SB 43), signed in October 2023,
provides the most signifi cant updates to
California’s Lanterman-Petris-Short (LPS) Act in
over 50 years. (The LPS Act is a 1967 state law
governing the involuntary detention, treatment,
and conservatorship of people with behavioral
health conditions.) SB 43 expands access to
care for people facing serious mental health or
substance use challenges who are unable to seek
help on their own.
Riverside County plans to fully implement the
program on January 1, 2026.
What Does SB 43 Change?
SB 43 expands the defi nition of “gravely
disabled” to include individuals who:
Are facing serious risks to their health or
safety, such as repeated overdoses, severe
withdrawal symptoms, or other medical
emergencies.
Are unable to access essential medical care,
such as treatment for infections, chronic
conditions, or critical medications.
Are living with a signifi cant mental health or
substance use condition that interferes with
their ability to meet their basic daily needs.
Example: A person who does not recognize
their need for care or who is experiencing
repeated medical emergencies due to an
untreated condition may now qualify for
additional support under SB 43.
How Does SB 43 Work?
SB 43 strengthens existing intervention pathways
by expanding who qualifi es for care and providing
clear steps for support. These pathways are part of
California’s Welfare and Institutions Code (WIC), the
state law that outlines how behavioral health crises
are addressed:
WIC 5150 (Up to 72 hours): Immediate care and
safety in a designated facility for individuals in crisis.
WIC 5250 (Up to 14 days): short-term stabilization
and support, with legal review to guide next steps.
WIC 5270.15 (Up to 30 days, new in Riverside
County, eff ective September 2024) extended care
and recovery planning for those needing additional
time before transitioning to community-based
services.
WIC 5350 (LPS Conservatorship, 6 months to 1
year, renewable): a supportive legal arrangement
for individuals who need structured assistance with
medical care, housing, and treatment coordination.
Protecting Individual Rights
SB 43 emphasizes dignity, recovery, and the least
restrictive care possible.
Even when receiving care under SB 43, individuals
retain the right to:
A legal hearing before extended treatment can
occur.
Advocacy and representation to ensure fairness
in all decisions.
Regular case reviews to evaluate the least
restrictive level of care.
Riese Hearings to protect the right to make
decisions about medication, except in
emergencies.
SB 43 and Minors
SB 43 does not change the defi nition of “grave
disability” for children and youth under 18.
A separate statute, Welfare and Institutions Code
(WIC) 5585.25, outlines the criteria for minors
who may require involuntary support.
Minors experiencing a behavioral health crisis may
be placed on a WIC 5585.50 hold (similar to a 5150)
for up to 72 hours of evaluation and care.
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SB43: Frequently Asked
Questions
Can SB 43 help my loved one
if they are struggling with
substance use?
Yes. Before SB 43, individuals with severe
substance use conditions did not qualify for
involuntary care unless they also had a mental
health diagnosis. Now, if their substance
use places their health or safety at serious
risk, such as repeated overdoses or not
seeking critical care, they may be eligible for
intervention.
Does SB 43 mean someone will be
forced into treatment?
SB 43 is not about forcing treatment
unnecessarily. It is intended for situations
where someone is at serious risk and unable
to recognize their need for care. The goal is
to provide stabilization and recovery, not to
remove rights.
How to Get Help Now
What happens if my loved one is
placed on an involuntary hold?
If placed on a 5150 (up to 72 hours), your loved
one will receive a crisis evaluation and short-term
support. If more care is needed, a 5250 (up to
14 days) or the new 5270.15 (up to 30 days) may
follow, with legal safeguards in place.
How does SB 43 protect my loved
one’s rights?
SB 43 involves legal protection at every step.
Individuals on extended holds have the right to
representation, hearings, and regular reviews
to ensure care is appropriate and minimally
restrictive.
Will my loved one be arrested or
sent to jail?
No. When someone is placed on a 5150
hold, they are being detained for psychiatric
evaluation—not arrested. SB 43 prioritizes
healthcare, not incarceration. Individuals receive
care in hospitals, crisis stabilization units, or
supervised community settings, not in jail.
What if my loved one refuses
medication?
Individuals may refuse medication unless a judge
determines otherwise in a Riese Hearing or in
emergencies where there is a risk of harm to
self or others. Riese Hearings ensure treatment
decisions respect individual rights.
Will we be turned away if we can’t
afford treatment?
No. Services are provided regardless of ability to
pay.
Call the CARES Line: (800) 499-3008. Available 24/7 for service questions, referrals, and help determining where to start. For urgent concerns: Call 911 or the Crisis HELP Line at 951-686-HELP (4357).
For questions about SB 43: Call (951) 743-9451
Visit: ruhealth.org/behavioral-health
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