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Sutter‑Yuba Behavioral Health warns counties that SB 43 could raise conservatorship demand and costs
Summary
Sutter‑Yuba Behavioral Health director Rick Bingham told supervisors SB 43 expands LPS conservatorship criteria to include severe substance use disorder and inability to access essential medical care; he said counties are already seeing a 7‑year rise in conservatorships and that housing individuals in locked facilities costs the counties about $6.7 million annually.
Rick Bingham, director of Sutter‑Yuba Behavioral Health, briefed the Yuba County Board of Supervisors on Senate Bill 43 — the 2023 law that expands Lanterman‑Petris‑Short (LPS) conservatorship criteria — and the implications for local services and budgets.
Bingham explained that SB 43 broadened the definition of “grave disability” under the LPS Act to include a standalone severe substance use disorder or a co‑occurring mental health/substance‑use disorder, and to permit conservatorship where an individual is at serious risk to health or cannot access medically necessary care. Implementation windows began in 2024 and could run through Jan. 1, 2026 for counties that delayed implementation.
He showed county data that LPS conservatorships have roughly doubled over seven years across the two counties Sutter‑Yuba Behavioral Health serves, with current annual facility housing costs near $6.7 million and an average per‑client cost of roughly $6,000 per year and average stays of about 2.5 years. Bingham noted much of that care is paid fully by counties because many placements are not reimbursable by Medi‑Cal.
Bingham warned that early reports from counties that implemented SB 43 suggest initial impacts have been limited (San Diego reported a low percentage of 5150 holds linked to severe substance use disorder), but he cautioned that wider awareness and rollout could increase conservatorship numbers. He also said there are currently few or no facilities that will involuntarily take patients with sole substance‑use diagnoses until licensing and regulatory changes are finalized; the Department of Health Care Services has issued interim guidance but final regulations and an 18‑month compliance window remain outstanding.
Supervisor questions focused on local capacity and costs. Board members urged staff to consider proactively encouraging private‑sector facility development and to coordinate on potential Proposition 1 bond funding that could create 16 local beds if awarded. Bingham said the county had supported a local partner’s Proposition 1 application for a 16‑bed facility and expected notification in the spring.
The board thanked the presenters and did not take additional policy action at the meeting; the briefing was informational and flagged budgetary and placement challenges the county will need to monitor as SB 43 implementation continues.
