Shasta County conserves first client for severe substance use under SB 43
Senate Bill 43 went into effect locally in January. It empowers the county to institutionalize qualifying individuals for mandated substance use treatment. The law was initially touted as a partial solution to California’s homelessness crisis, but implementation has been slow.
Earlier this summer, at a monthly public meeting focused on the county’s mental health and substance use services, a representative of Shasta’s Health and Human Services Agency made an announcement: the county had conserved its first client under Senate Bill 43.
The milestone represents the first time Shasta County has been able to force an individual with severe substance use disorder into treatment, by using the courts to strip their legal right to refuse.
No further information about Shasta’s first SB 43 case has been shared for confidentiality reasons. But the placement is the result of relatively new law which was passed by the state in 2023 and became active in Shasta County in 2026. SB 43 expanded the criteria under which someone can be placed in what is known as an LPS conservatorship.
In order to be placed in a conservatorship, California law has long required that an individual be found to be “gravely disabled” as the result of a serious mental illness that directly impedes one’s ability to meet their basic needs like food and shelter. That’s something that can occur for people with severe schizophrenia, bipolar, or schizoaffective disorder diagnosis, if left untreated. The determination of grave disability is made through an investigation process carried out by the county and confirmed by the court.
Under SB 43, the legal definition under which individuals can be labelled gravely disabled has expanded to include people with severe substance use disorder. Once legally conserved, a county-appointed staffer takes control over an individual’s medical and financial decision making. Conservatorships are reassessed at least annually, and individuals who have significantly improved with treatment can be released from their conservatorships to handle their mental health and substance use issues independently again.
The legislation was intended to move those with severe substance use disorder off of California’s streets. But statewide, rollout of the bill hasn’t been smooth, whether in huge and better resourced counties like San Francisco, or right here in Shasta.
Since January, the county’s efforts have culminated in the forced treatment of only a single individual, though three in total have been referred to the county for assessment under SB 43. One did not meet the court’s criteria to be deemed gravely disabled. Referrals come from LPS-designated mental health professionals.
Enacting Shasta County’s first SB 43 conservatorship was a highly complex process, a representative of HHSA told Shasta Scout this month — from the scrupulous investigative process required to determine someone is sick enough to take away their personal liberties, to actually finding a place for them to be treated against their will.
“One thing the public should understand is that implementing SB 43 is not just about changing the law — it also requires the treatment system to evolve,” said Genell Restivo, the HHSA Clinical Division Chief for Adult and Children’s Services. “The availability of treatment programs that can appropriately serve those individuals has not expanded at the same pace.”
There are a combination of challenges at play, according to Restivo, who noted that even once someone meets the threshold of a psychiatric hold, that does not mean that a facility will accept them. Depending on its capacity and appropriateness, a facility can deny a SB 43 placement if the patient has “acute medical needs,” in addition to substance use disorder.
Another complexity of implementing SB 43 is that the new law did not come with designated funding from the state.
Shasta County LPS conservatorships are managed under the Public Guardian’s office, a subset of HHSA. Over the last few years, budget documents show, the Public Guardian has managed around 140-150 LPS conservatorships each year with a budget of close to three-quarters of a million dollars. Funds are used not only to administrate the program but also to pay for necessary expenses for client care that are not covered by an individual’s own resources.
Beyond the difficult practicalities of implementing SB 43 in counties like Shasta, critics of the law have pointed out that the conservatorship system itself both erodes patients’ rights and only rarely provides off-ramps for the gravely disabled once they’re discharged from forced treatment. While some Shasta families have desperately pushed for their loved ones to be conserved in the hopes of saving their lives, past reporting has examined how the lack of an adequate continuum of care after their release has left them back out on the street without stable housing or mental healthcare.
Do you have information or a correction to share? Email us: editor@shastascout.org.
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Thank you AP for the reply. I think an honest answer would be “NC, we are trying to use the most up to date and accepted code book in our articles… what else should we, can we do?” And then I would say “youre right and maybe i shouldnt complain/troll because i do value SS so much.”
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However…
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DSM-5 is highly controversial (among the medical professions you cite) specifically in the area of combining the diagnosis and definition of substance abuse/addiction with chronic mental illness. It doesnt mean you are incorrect to choose this as your subject authority, but it is a controversial choice.
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I bristle at the notion that the majority of patients who will use public support services are mentally ill by birth condition. The intentional marketing of drug rehab centers as general mental health facilities is a way to make it palatable to voters.
This is a step in one direction at least its a direction and a learning curve.
they paint a clear picture with shady boarder. they say they are only out to help but this is grandchild and goes against our civil rights there are people that are homeless that don’t do drugs but have mental health issues that they didn’t get because of drugs yet just because they are homeless they risk being institutionalized for the rest of their lives and being stripped of all of their rights to make any type of decision for themselves just because they fallen on hard times and are homeless that’s disgusting how foul and how low are we going to allow our city to become this is tyrannical beyond comprehension I cannot believe that the people aren’t throwing a fit over this right now you actually seen this as a good thing all because people are tired of looking at homeless people why because they make you feel bad or because they’re dirtier than you so you gross nasty but if they were just given certain amenities as a community right to have like water fountains public bathrooms even a little community showers even if they had to pay a couple of bucks I bet you they would or big huge dumpsters to put all this garbage I bet you they’d fill them and there wouldn’t be garbage all over the freaking place but not in our city right our local leaders don’t give a flying fuck about anybody except for the bottom line and monuments to self all they care about as many and trying to be the next Sacramento but this is just another giant leap away from being anywhere near how great Sacramento is Redding will never be Sacramento because it’s full of the good old boys who run half of our city the rest is bethel and the McConnell foundation bunch of people running around brainwashing everybody else anybody and everybody they can this is a successful criminals and it’s not the people that live on the streets that are just struggling to wake up every freaking day and survive to be able to go to bed at night it’s the people that run this city that give themselves titles Pat himself on the back and still are able to sleep after demonizing everybody in the city still able to sleep soundly every night it’s beyond horrific it’s terrifying with this town has become.
One step closer to this …
Remember when Redding Bethel Church member and Mayor of Redding Julie Winter had the idea of pushing homeless people into a shelter where they’re not allowed to leave until they “demonstrate self-sufficiency?
This California City Wants to Build a Homeless Shelter That’s Basically a Jail
https://www.vice.com/en/article/a-california-mayor-wants-to-build-a-homeless-shelter-thats-basically-a-jail/
I tried everything I could as a homeless advocate to save this mans life as I saw him rotting away on the streets of Redding in front of Safeway on Pine Street. I did a drive by picture of him, later to find out he was dead. Hundreds of people drove by him, until I got home to see the details of that picture, then the police were called. Although I am very passionate as far as the civil and constitutional rights of homeless are concerned, this mans death affected me deeply. No homeless person has a right a right to commit suicide on the
streets of Redding, not on my watch. I wonder if forced conservatorship could have saved this mans life…
Redding Homeless Blog – Marcus
https://reddinghomeless.blogspot.com/2019/05/oh-how-i-believe-powers-that-be-at-city.html
So, this is the new terminology for drug abuse?
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Substance use disorder
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This is in the woke lexicon with, unhoused, undocumented, latin-x, They/them…. please fill in or update us on the official SS style guide for the ones im missing.
NC: This terminology extends across the professional field of mental health, where credentialed practitioners use the DSM, or Diagnostic and Statistical Manual of Mental Disorders, for official diagnosis. The same DMS terminology then extends into the courts, service providers, medical billing and beyond. The DSM-5 uses eleven criteria to determine substance use disorder, also known as SUD. https://www.gatewayfoundation.org/blog/dsm-5-substance-use-disorder/
Don’t confuse him with the facts!
OMG.
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Professionals in a trade actually use language that is different than the common lay people.
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Oh no, the whole world has gone woke.
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Hey NC, in the construction biz, do you use language that is more technical? You know, language that normal people who aren’t in that business don’t use??
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So using more technical language is now “woke”??
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Please stop embarrassing yourself..
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You might have some “street” cred with your neighbor, but otherwise you are not convincing.
New? Must be nice to be so out of touch with what is going on
What’s next? Where will the government draw the line on personal choices?
Drug use/substance abuse is not a personal choice for crying out loud. When it affects the entire remaining family it is a problem, not to mention the rest of our community. This is not the time to join the Libertarianism mantra that ‘anything goes as long as it doesn’t hurt themselves or others’. Well, in this case it does. There’s a limit to Liberty and this is it. Be thankful we here in CA have legislators that aren’t afraid to bring laws into effect that make us the protected state that we are.
“forced treatment” does not work
this will be ‘treated’ with massive amounts of MORE addictive ‘meds’
this is just part of that slippery slope
(see “JADE HELM” for more similarities)
It is NOT THE GOVERNMENTS JOB to define, determine, or regulate the family system.
When we become comfortable with outsourcing our care to the terms the government sets, we give up personal responsibility for keeping OUR OWN PEOPLE SAFE.
I don’t WANT OR NEED the government stepping in to decide they know what’s best for my loved ones or any other human being.
What I WANT AND NEED is a COMMUNITY that STOPS DEHUMANIZING MY PEOPLE, and STOPS discarding HUMAN BEINGS because they don’t want to put in the work it takes to LOVE AND FEED AND CLOTHE one another.
Further, LIFE and HUMANS come with DISCOMFORT. If you feel uncomfortable with seeing homeless folx dying on the streets, SENDING THEM TO DIE IN INSTITUTIONS doesn’t make the problem stop— it just makes you not have to see it and feel the discomfort of the problem at hand.
Putting human lives that are vulnerable in the hands of the government – ESPECIALLY THE GOVERNMENT IN THIS GOD FORSAKEN TOWN- is the most inhumane, cruel, stupid thing anyone claiming to want to preserve life could do.
You don’t care about them getting well- you care about not having to feel your own discomfort when you realize you don’t actually love them or want them to get well – you just don’t like having to feel that every time you encounter them in the community.
Covid was a recent example of how civil liberties are unofficial.
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The right to sit and lie on sidewalks.
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Smoking in doors.
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Tule Lake incarceration.
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Nothing is static.