Caretakers & Parents
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LPS conservatorships are used to care for adults with serious mental health illnesses who need special care.
These conservatorships are used for people who usually need very restrictive living arrangements (like living in locked facilities) and require extensive mental health treatment (like very powerful drugs to control behavior). Welfare & Institutions Code 5000-et seq
Conservatees in LPS conservatorships cannot or will not agree to the special living arrangements or treatment on their own. LPS conservatorships must be started by a local government agency. courts.ca.gov
The Act in effect ended all hospital commitments by the judiciary system, except in the case of criminal sentencing, e.g., convicted sexual offenders, and those who were “gravely disabled“, defined as unable to obtain food, clothing, or housing CA Jury Instruction 2002 * psycheteria.org * [Conservatorship of Susan T.]. It did not, however, impede the right of voluntary commitments. It expanded the evaluative power of psychiatrists and created provisions and criteria for holds. Wiki Pedia
What exactly is it?
The statutory definition of commitment for grave disability is
“a condition in which a person, as a result of a mental disorder, is unable to provide for his basic personal needs, for food, clothing, or shelter.’ CAL. WELl. & INST. CODE § 5008(h) 5250
“a finding of imminent danger as evidenced by a recent overt act, attempt or threat,” CA Civil Jury Instructions 4002 * Capacity Declaration GC 335 * Grave Disability Includes Financial & Health Issues
Be sure to check out our main page on Conservatorship for an introduction
From the LPS Lanterman Petris Short act, grave disability is defined with three seemingly simple reasons – criteria:
- Inability to provide for
- Cannot distinguish between food and non food
- Endangers health by gross negligence in needed diet and nutrition
- Begging or stealing food
- Eating out of refuse or garbage cans
- Ordering meals at restaurants without having funds
- Demonstrates excessive and consistent food preferences or aversions which endanger health (except for genuine religious reasons)
- Having spoiled food in refrigerator or no food for a lengthy period of time in the house
- Engaging in public nudity or “unthinking” exhibitionism
- Engaging in bizarre style of dressing that does would be apt to lead to social difficulties (if not used by social group or personal preferences)
- Wearing filthy or soiled clothes with lack of recognition of personal hygiene problem
- Wearing disheveled clothes for prolonged period of time
- Leading a nomadic existence with an inability to establish stable community living, including living in the streets or other public places
- Unable to locate housing and make the appropriate arrangements with an inability to ask for or accept assistance in doing so
- Unable to manage his or her household in such a way as to avoid clear dangers to health
- Presence in household of filthy conditions) fire hazards that the person cannot correct, vermin infestations, and lack of bathing and toilet facilities
- Resists leaving residence even if evicted or the residence is sold
- Hoarding nonsensical items while misplacing necessary items
- Unable to earn an income and unable to avail himself of financial assistance from public or private agencies
- Completely dependent on family or friends to provide financial assistance for basic personal needs
- Has funds but no longer knows or understands the location and/or extent of them
- Refusing to expend funds to the extent of endangering personal health and/or safety
- Has no funds and does not see this as a problem
- Grossly and inappropriately expends funds needed for basic personal needs
- Has untrue beliefs as to having extensive money or property
- Mismanages funds so that rent and utility bills remain unpaid
- Unable to accept inability or loss of ability to understand complex financial matters leaving him vulnerable to manipulation by unscrupulous individuals
Incompetence in regard to health
- Unable or unwilling to follow medical instruction regarding treatment and self care which are essential to health
- Loss of weight or other evidence of malnutrition due to not eating or lack of proper food
- Wanders away from residence and becomes lost frequently without recognition of the seriousness of the problem
- Failure to adjust in the community
- Involved in frequent confrontations with family members or neighbors involving abusive, threatening, or assaultive behavior
- Engages frequently in disruptive, destructive acts in the home or neighborhood, possibly leading to threatened or actual eviction
- Engages in bizarre or other behavior which may be self-endangering and/or a threat to others requiring police intervention Jewish Family Service Summary
Though these criteria may seem simple, they aren’t. For example, just because someone is mentally ill and homeless does not mean that they are gravely disabled. If they can provide a reasonable, executable plan for where they would stay or if they are stable being homeless, then they do not meet LPS criteria. If, on the other hand, they are homeless in a location in which their life or health is often in jeopardy and, as a result of mental illness, they do not comprehend this, then they likely are gravely disabled. These issues achieve marked salience in hearings for 5250‘s in which the argument is made that someone is gravely disabled. It is often helpful to identify which underlying issues lead you to the conclusion rather than requiring the hearing officer to identify the issues. If someone is gravely disabled for an extended period of time, they can be placed on an LPS conservatorship. Note, however, that there are So, below are examples of states or conditions that have been upheld as evidence of grave disability. Note that they extend beyond a simplistic definition relating to food, clothing, and shelter. That is, there are a variety of ways one can demonstrate incompetence in these areas.
the Court, in Addington v. Texas, held that the need for civil commitment must be provided by clear and convincing evidence. In the Lanterman-Petris-Short Act (LPS), the legislature opted to reduce long-term confinement of the mentally ill. “habeas corpus” meaning literally “that you have the body”) is a recourse in law through which a person can report an unlawful detention or imprisonment to a court and request that the court order the custodian of the person, usually a prison official, to bring the prisoner to court, to determine whether the detention is lawful.
Conservatorship of Roulet – Proof beyond a reasonable doubt
Parham (Test) v J.R. 442 US 584 1979 Gravely Disabled vs dangerous to self and others? The court in Doe I held that the grave disability term was sufficiently precise. The court found that grave disability implicitly required a finding of harm to oneself, i.e. an inability to provide for one’s basic physical needs, and therefore met the constitutional requirement of dangerousness. The right to choose and practice a particular life style is protected by the first amendment rights of association, assembly, and free expression Law.SCU.Edu Written 1.1982 *
Case Law if nothing else, the background information is an interesting story.
An IMD is also a locked facility for patients that are higher functioning than a sub-acute level, but still require a locked setting. Again, the PG or family member acts as the conservator, and the patients length of stay is determined by their mental stability and improvement.
“IMD exclusion,” to allow Medicaid in CA Medi Cal to pay for short-term stays of adults ages 21-64 in psychiatric hospitals and facilities.
Note: IMD stands for “Institutions for Mental Disease,” an outdated term that remains in federal law.
Learn More ===>
- Click here for the other 5 levels of care psychcentral.com
- lacounty.gov IMDInformation
- Listing of IMD’s in Los Angeles – Resources Directory
- How to choose a mental health facility
- IMD Training Manual 270 pages
- How to write a personalized treatment plan
- Positive Psychology.com treatment plan
- Rights for Individuals in Mental Health Facilities admitted under LPS
- Mental Health Services Act – CA – Fiscal Year Update 2018 – 2019
- Issues with Private Insurance vs Medi Cal. One can go back on re enroll back to private coverage – Class Action Lawsuit – Kaiser
Therapeutic Pass Request Forms
A probate conservatorship is a court proceeding where a judge appoints a responsible person (called a conservator) to care for another adult who cannot care for him/herself or his/her finances. MORE »
An LPS (mental health) conservatorship makes one adult responsible for a mentally ill adult. This type of conservatorship is only for adults with mental illnesses listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). An LPS conservatorship is only for people who are seriously mentally ill and need special care (usually placement in a locked facility and/or very powerful drugs to control behavior). MORE »
A limited conservatorship is a court proceeding where a judge gives a responsible person certain rights to care for another adult who has a developmental disability. Generally, a person qualifies as developmentally disabled if s/he has an IQ less than 70 or is diagnosed with autism. Because developmentally disabled people can usually do many things on their own, a limited conservator has more limited powers than an LPS conservator. MORE »
Medicare & You - Mental Health
Medicare & Mental Illness # 11358 2 pages
Our webpage on EOC Evidence of Coverage - Plain English, even if they are 2 to 300 pages
Mental Health Videos
- Mental Health Video - updates on Mental Health Parity - Mental Health must be covered the same as physical health
- Video Medicare-covered benefits for mental health.
- Sharp Health Care - Mental Health Videos - Play List
- Mental Health Insurance Coverage: Get the Whole Picture
- Veteran's Mental Health
See our Main Webpage on Mental Health
If you think the conservatee is making a mistake by refusing treatment, talk to your lawyer about your options. L
Legal Advice The symbol L notes a situation that may require your lawyer’s advice or assistance.
Read this page, follow the links at least three times… then consult with your attorney.
Exclusive authority. A request for the conservator to have exclusive authority to make medical decisions for the conservatee is usually made in the initial petition for conservatorship. If this request was made in your petition for appointment, your Letters will show that you have this authority.
If you do not have this authority and at some point believe that the conservatee has lost the ability to make sound medical choices, you may have to petition the court to take away the conservatee’s right to make medical treatment decisions and to give that right and responsibility solely to you. To do so, you must complete, sign, and file Judicial Council form GC-380, Petition for Exclusive Authority to Give Consent for Medical Treatment. The court’s order granting that authority is filed on Judicial Council form GC-385, Order Authorizing Conservator to Give Consent for Medical Treatment. Links to both forms are included in Appendix F.
If the court grants your request for exclusive authority after your appointment, you would then need to prepare, sign, and ask the court
clerk to issue a new set of Letters showing that you have this authority. Your lawyer would prepare and file the petition, obtain the court’s order, and see that you receive your new Letters. L
You should give certified copies of your Letters showing your authority to the conservatee’s hospital, doctors, and care facility. Often these
people and institutions will be willing to accept or make a copy of a certified copy for their files.
The authority to make health care decisions for the conservatee is very important and should not be taken lightly. Try to involve the conservatee in your decisions and respect his or her desires as much as possible. Talk with the conservatee’s family and friends to figure out how the conservatee would want things arranged if he or she is unable to tell you directly. courts.ca.gov/handbook
On the other hand…
WIC 5358.2 If a conservatee requires medical treatment and the conservator has not been specifically authorized by the court to require the conservatee to receive medical treatment, the conservator shall, after notice to the conservatee, obtain a court order for that medical treatment, except in emergency cases in which the conservatee faces loss of life or serious bodily injury. The conservatee, if he or she chooses to contest the request for a court order, may petition the court for hearing which shall be held prior to granting the order.
Admissible Evidence Required – not just Doctors written declaration Scott v Superior Court attorney summary.
Petitioner Scott S. petitions for writ review of an order authorizing Lucille Lyon, public guardian for Orange County, to consent to amputating petitioner’s infected toe. He contends the court erred by relying on a physician’s written declaration to find the amputation was medically necessary.
(1) We agree. The Lanterman-Petris-Short Act (LPS; Welf. & Inst. Code, § 5000 et seq.)1 authorizes conservatorships for gravely disabled persons like petitioner. The conservatee generally retains the right to give or withhold consent to medical treatment. The conservator must seek authorization from the court to obtain medical treatment to which the conservatee objects. (§ 5358.2.)
Resolving an issue of first impression, we hold an LPS conservator seeking such an order must show the desired treatment is medically necessary—and must do so through admissible evidence. This conclusion follows from plain statutory language and harmonizes the LPS with the Probate Code, portions of which the LPS incorporates by reference. We grant the writ petition and direct the court to vacate its order and conduct a new hearing to determine whether admissible evidence shows the amputation is medically necessary.
Handbook for Conservators 318 Pages
#Social Security Disability Benefits # 10029
- Our webpage on SSI & SSDI Social Security Disability Income.
Hitler & Mental Health - Medicare for All - National Health Care
The T 4 program. https://en.wikipedia.org/wiki/Aktion_T4
Certain German physicians were authorised to select patients "deemed incurably sick, after most critical medical examination" and then administer to them a "mercy death" (Gnadentod).
The T4 programme stemmed from the Nazi Party policy of "racial hygiene", a belief that the German people needed to be cleansed of racial enemies, which included anyone confined to a mental health facility and people with simple physical disabilities.
This poster (from around 1938) reads: "60,000 Reichsmark is what this person suffering from a hereditary defect costs the People's community during his lifetime. Fellow citizen, that is your money too.
Consumer Resources & Links
Handout from NAMI Los Angeles Seminar March 2018
How to navigate CA Department of Mental Health Website
LPS Training Manual Los Angeles 60 Pages How to write a 5150 – 5585
California Welfare Institute Act 5358(Word Document) Conservatorship Litigation – Guide 33 pages
Probate Code 2591 Powers of Conservator
Court Notification of LPS Treatment (Word Document)
NAMI – Navigator Gail Evanguelidi 310-288-9749
Referrals to the Public Guardian’s Office are accepted only from mental health professionals designated to evaluate for both the grave disability (inability to provide for one’s basic personal needs for food, clothing or shelter) and the mental disorder
CANHR.org how to represent a conservatee 24 pages pdf
THE LANTERMAN-PETRIS-SHORT ACT WIC §5000 et seq
1-1977 Civil Commitment in California: Alan W. Tieger Michael A. Kresser Defense Perspective – LPS – Hastings Law Journal Involuntary Comittment – 1-1-1982 The Cuckoo ‘s Nest Reassessed: Involuntary Commitments in California after Suzuki v. Yuen and Doe v. Gallinot Gretchen O. BurfordLoyola Civil Comittment LPS – 2-1-1974 Civil Commitment of the Mentally Ill in California: The Lanterman-Petris-Short Act Mark Alan Hart Loyola
Involuntary Commitment for Mental Disorder:The Application of California’s Lanterman-Petris-Short Act Carol A. B. Warren Law & Society Review Vol. 11, No. 4 (Spring, 1977), pp. 629-649
Resources & Links
See also our page on Laterman Conservatorships – where one can be placed in a locked facility for treatment.
Autism Speaks.org Guardianship & Conservatorship
Sacramento – includes forms
Donald Sterling – Needs Conservatorship? Sale of Clippers? Los Angeles Times
Mike Flannagan, Esq.
Lisa Fisher, Esq.