photo credit: County of Sonoma
Sonoma County's Behavioral Health Urgent Care Center in Santa Rosa.

When calendars turn over to January 1st each year, a slate of new state laws go into effect.

One of those, Senate Bill 43, is going to mean tradeoffs for Sonoma, and the rest of California's 58 counties.

'Grave disability' is one of the main focus points of Senate Bill 43.

Signed by Governor Gavin Newsom in 2024, the law expands the definition.

Now 'grave disability' means a severe substance use disorder, and an inability to provide for one’s personal safety or necessary medical care

Both are now reason for involuntary mental health holds as well.

Sonoma County Health Services' David Evans provided an example scenario.

"We all know and see sometimes people wandering in traffic," Evans said. "You wonder to yourself, 'how can we get that person to a higher level of care?' That person can now be placed into an involuntary setting because of the change in this law."

SB 43 also changes California's conservatorship laws.

The 1967 Lanterman-Petris-Short Act reshaped the mental health care landscape in California; ending the era of indefinite and involuntary commitment for those with mental health issues.

The LPS Act created what's called 5150's. Those are 72 hour mental health holds.

It also created LPS conservatorships. That's a legal mechanism in which a court appoints a "conservator" to make legal decisions for an incapacitated individual.

197 Sonoma County residents are currently under LPS conservatorships, many of them are being cared for at mental health facilities outside the county.

There an additional 12 individuals from Sonoma County under Murphy conservatorships, meant for individuals who are deemed 'gravely disabled' and have often committed violent felonies.

While the new SB43 rules open up more opportunities to place mentally unstable or incapacitated individuals into treatment, the law doesn't have any state funding attached to it, and that's a worry said Supervisor David Rabbitt.

"Unfunded mandates are way too easy to pass," Rabbitt said at the October 28th Board of Supervisors meeting. "There's nuggets in there that would be great if we could have the resources in there to go forward with that."

Sonoma County health staff estimate the new rules under SB 43 could add another 50 individuals into conservatorships, bringing the county's total to around 250.

County health staff said they are concerned they will need to cut costs in some areas of the county's healthcare system to cover the increased costs associated with the likely new conservatorships.