Lanterman-Petris-Short (LPS)
Conservatorships

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 ownLPS 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

#Gravely Disabled

What exactly is it?

Definition? Criteria?

 

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

Grave disability

From the LPS Lanterman Petris Short act, grave disability is defined with three seemingly simple reasons – criteria:

  • Inability to provide for

Need for food

  • 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

Need for clothing

  • 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

Need for shelter

  • 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

Financial incompetence

  • 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”)[1] 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.[2]

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.

 

Kanuri Surgury QAWI, on Habeas Corpus Conservatorship of Carol K. Conservatorship of the Person and Estate of JESSE G HTML

Conservatorship of Chambers

Conservatorship of Davis (1981)

Conservatorship of Smith (1986)

Conservatorship of K.W.

#Institute for the Mentally Ill (IMD)

 

IMDs are long term care psychiatric facilities, licensed by State DHS and/or State DMH, that are contracted by DMH to provide care for persons who no longer meet criteria for acute care but are not clinically ready to live in a board and care facility or to live independently.

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 ===>

 

Therapeutic Pass Request Forms

cobbcsb.com/Client-Request-for-Passes-and-Therapeutic-Leave-and-AWOL-Protocol

#Probate Conservatorships

 

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 financesMORE »

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 »

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 »

What’s all this about getting the courts #permission for Medical Care?

What’s a 7 point letter?
LA Court Form  

Consenting to Medical Treatment

In most cases, the conservator and the conservatee share the right to make decisions about the conservatee’s health care. In other words, you or the conservatee may authorize medical treatments. However, you may not arrange for a particular treatment if the conservatee objects to it.

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.

All Probate & Guardianship Forms on CA Court Website

     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.

Actual Case

OPINION

IKOLA, J.—

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.

 

Medi-Cal Dental Benefits

Medical Benefits

Letters of Conservatorship  GC 350

courts.ca.gov/selfhelp-conservatorship

Powers of Conservator

Riese Petition WIC 5332 b

Consent for ECT Electroconvulsive Treatment

Handbook for Conservators 318 Pages

All Probate & Guardianship Forms on CA Court Website

Hitler & Mental Health - Medicare for All - National Health Care  

Hitler Mental Health Euthanasia Program

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).[7] 

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.[31] 

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

See footnotes & brochures above

LPS Holds Chart

Grave Disability Includes Financial & Health Issues

Handout from NAMI Los Angeles Seminar March 2018

How to navigate CA Department of Mental Health Website

Disability Rights LPS 6 pages

Disability Rights CALPS Search

Pamphlet LPS 12 Pages Guide AB 1424 10.2001 Families be part of the LPS Process

Guide to AB 1424-Law (Word Document)

LPS Conservatorship – Kings County

NAMI Los Angeles Guide to LPS

LPS Training Manual Santa Clara County Mental Health Dept 14 pages Rev 1.2011

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)

Nolo.com on Conservatorships

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

dmh.la county.gov

Social Security Representative Payee

Find an Attorney

Los Angeles Area Conservatorship Clinics

Petition for Guardianship of the Person

Los Angeles Bar Assoc on the Process to get conservatorship

Capacity Declaration

CANHR.org how to represent a conservatee 24 pages pdf

Summary by Daniel Pone, Esq.

Harry Gin’s Presentation on LPS Conservatorship in CA

Legal Codes

THE LANTERMAN-PETRIS-SHORT ACT  WIC §5000 et seq

Judges Bench Guide to LPS Conservatorships

Law Journals

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.

Our webpages   on Estate Planning,     Sample Will  &   Probate

Handbook for Conservators 313 pages

Helping your loved one – LA County Dept of Mental Health 61 pages Rev 2013

Autism Speaks.org Guardianship & Conservatorship

CA Courts Self Help Site  on Conservatorship

Santa Clara County

Sacramento  – includes forms

Court – JCC forms

LPS Holds Chart

Courts Quick Reference Guide – 21 page Word document

Powers of Conservator

Donald Sterling – Needs Conservatorship? Sale of Clippers? Los Angeles Times

Attorney Help

Mike Flannagan, Esq.

Lisa Fisher, Esq.

3 comments on “Lanterman – LPS – Conservatorship

  1. 7 comments on “IMD – Institute for Mental Disease”

    1. Anonymous says:

      Can someone come to the facility from another state

      Reply
      • I would imagine so. Have your therapist check with the specific institution you want to go to. I’m not a therapist… I haven’t read 1/2 the material I’ve linked to here.

        Reply
    2. Wendell Silva says:

      Would it be helpful to have an online mental health self-test to identify possible areas that might need treatment?

      Reply
    3. Barbara says:

      i have a granddaughter who is mentally ill . Her diagnosis is Bipolar Schizophrenia .
      She is currently in Los Angeles Ca , i have LPS Conservatorship ,she has medi cal insurance .
      I am trying to get her moved closer to where i live which is here in Temecula,Ca .

      My question is do you except her insurance or do you except Medi Medi ?

      Reply
    4. Zane D says:

      I was wondering if I can put my son in a IMD facility from collage hospital Costa Mesa.

      He has cal optima and me and my wife are LPS conservators.

      He is unable to function in society and unable to provide for himself and hygiene.

      He is also a marijuana as meth user.

      Reply

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