County steps up training, outreach for SB 43 implementation; launch set for Jan. 1, 2026

County health and behavioral‑health officials briefed the Board of Supervisors on efforts to implement Senate Bill 43, the 2023 change to California’s Lanterman‑Petris‑Short (LPS) statute that expanded the legal definition of “grave disability” to include severe substance use disorders and inability to secure necessary medical care or personal safety. Dr. Ferrer and Department of Mental Health staff told the board that Los Angeles County will implement the revised definition on Jan. 1, 2026, and outlined a cross‑department planning structure that includes six working groups: client flow and system mapping; designation and training for clinicians authorized to place holds; treatment and care planning; court process alignment; community education and collaboration; and managed‑care and capacity building for treatment and housing. Department staff reported training modules, outreach to hospitals and law enforcement, and a pilot to test discharge coordination across agencies. Director Rafael Carvajal confirmed DCBA’s outreach support for the rent relief item discussed the same day. The county also described capacity planning for beds and residential care: county planners estimated a modest first‑year increase in need (the county’s estimate was a conservative model projection of roughly 75 additional high‑acuity placements, a figure officials said may be an overestimate). Officials stressed a major unknown is the extent to which the rule change will increase demand for locked settings and inpatient care, which can carry higher costs and federal funding restrictions (IMD rules). Speakers flagged two implementation priorities for the board to monitor: 1) ensuring consistent, SB‑43‑specific training and LPS designation for clinicians who will evaluate holds, and 2) tracking demographic outcomes closely to detect any disproportionate impacts by race, age or housing status. Dr. Wong (DMH) said authorized practitioners who will continue to place involuntary holds must complete new county training within the next three months or risk losing designation authority; the county listed about 5,000 designated practitioners in its database, acknowledging not all evaluate holds. The board requested regular updates, and staff said they would forward detailed timelines and the 114 implementation items to supervisors’ offices.