The purpose of mental health conservatorships is to provide individualized treatment, supervision, and living arrangements for people who are seriously mentally ill and are not among the majority of mentally ill persons that agree to treatment, while still protecting their individual rights. The Los Angeles County Department of Mental Health (LACDMH) provides an informative 2013 guide titled HELPING YOUR LOVED ONE; the Judicial Council of California provides a 2016 HANDBOOK FOR CONSERVATORS; and LACDMH and NAMI LACC offer the FAMILY GUIDE of Lanterman-Petris-Short Act Guidelines & FAQs.
A mental health conservatorship, which is sometimes called an LPS Conservatorship because it is governed by the Lanterman-Petris-Short Act, can involve confinement in a locked psychiatric facility, which means the person is deprived of personal liberty. Accordingly, there are strict legal procedures and laws that must be followed by doctors and hospitals and that involve review and monitoring by a court.
Starting a Conservatorship
Family members or other private parties cannot start a mental health conservatorship. In Los Angeles County, because it is based upon grave disability as a result of a mental disorder, referrals to the Public Guardian’s Office are accepted only from mental health professionals designated to evaluate for both: (a) the grave disability (inability to provide for one’s basic personal needs for food, clothing or shelter); and (b) the mental disorder. The two sources for qualified professionals to complete psychiatric evaluations and make referrals to the Public Guardian’s Office are:
- Private and public acute psychiatric hospitals officially designated by the Los Angeles County Department of Mental Health to treat involuntary patients.
- The Los Angeles County Department of Mental Health and its regional offices.
If you, as a relative, friend, or other concerned citizen, believe a person needs an LPS Conservatorship, Los Angeles Court website directs that the proper course to follow is to contact the appropriate source and request an evaluation for grave disability and referral to the Public Guardian as follows:
If the patient is in an acute psychiatric hospital designated by the Los Angeles County Department of Mental Health to accept and treat involuntary patients, contact the treating therapist at the hospital and request an evaluation for conservatorship.
If the patient is living at home or residing in any other facility, contact the Los Angeles County Department of Mental Health’s Regional Office that covers the area where the patient is located and request a conservatorship evaluation.
How it Works
When a person is under an LPS Conservatorship, then the California Welfare and Institutions Law 5358.5 allows the conservator to place the conservatee in treatment at the discretion of the conservator. This prevents the person who is afflicted with mental illness from having to decompensate to the point of harm to self or others but rather to get back into recovery as soon as possible.
For more information, see the Los Angeles County Department of Mental Health FAQ Page on Conservatorship.
NAMI South Bay is within LACDMH Service Area VIII (562) 435-2337.
Video Ventura Superior Court – Conservatorship
From the LPS act, grave disability is defined with three seemingly simple criteria:
Inability to provide for
Inability to provide for
Inability to provide for
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.
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
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
Handout from NAMI workshop on Conservatorships https://steveshorr.com/steveshorr/Mental_Health/nami.handout.pdf
IMD Institute for Mental Disease Training Manual
Click to access IMD_Manual_FINAL.pdf
Updated conservatorship hand book http://www.courts.ca.gov/documents/handbook.pdf
LPS FAQ’s Summary of Conservator Manual http://namilacc.org/wp-content/uploads/2015/02/LPS-Guidelines-FAQs-from-LAC-DMH-and-NAMI-LACC.pdf
May 13th, 2017 (Saturday)
8:00 AM to 1:00 PM
Kaiser Permanente Medical Care Program
6041 Cadillac Ave
Los Angeles, CA 90034
Neighborhood: West Los Angeles
LPS Conservatorship Mentoring Meeting
You are invited to the LPS Conservatorship Mentoring Meeting. The program is designed to provide guidance on how to acquire mental health treatment for your loved one. LPS Conservatorship, AOT and FSP benefits will be discussed.
You can park at the Kaiser Permanente Hospital facility as parking vouchers will be provided.
Reservations are not necessary-just join us.
Our guest speakers are Dr. Jonathan Sherin, the new Director for DMH, Dr. Rod Shaner, DMH Medical Director and Connie Draxler, Director Deputy Public Guardian.
I do hope that you will be able to join us for this most informative meeting and meet the new
Director of DMH.
8:00-8:45 Educational Section: Kathy Van Dyke, Public Guardian, will cover the process, purpose, and laws pertaining to LPS Conservatorship.
8:45-9:30 Practical Section: Gail Evanguelidi, will discuss building a powerful written case for
treatment, information pertaining to LPS Conservatorship treatment, placing a person in the hospital, acquiring financial and medical benefits, and possible solutions to many roadblocks you may encounter in seeking mental health treatment.
9:30-9:45 Award Session: The NAMI LPS Conservatorship Dedication to Service Award will be
10:00-11:00 Dr. Jonathan Sherin, DMH Director, will present his vision for mental health treatment and solutions for improvement as they pertain to LPS Conservatorship.
11:00-12:00 Dr. Rod Shaner, DMH Medical Director, presentation will address hospital holding patients and placing patients in appropriate treatment solutions. Connie Draxler, Deputy Director Public Guardian, is present to answer questions pertaining to the public guardian’s role.
Jonathan E. Sherin, M.D., Ph.D.
Los Angeles County Department of Mental Health
Dr. Sherin, a psychiatrist and neurobiologist by trade with a wide range of professional
experience, was appointed by the Los Angeles County Board of Supervisors as the County’s
Director of Mental Health effective November 1, 2016. In this role, he leads the largest public
mental health system in the country, serving over 250,000 clients annually in the most populous and one of the most ethnically diverse counties in the nation.
Most recently Dr. Sherin served as the chief medical officer and executive vice president of
military communities for Volunteers of America. Considered a leading authority on the care of
veterans struggling with trauma and reintegration challenges, he has testified in Congress on
veteran homelessness and suicide. Prior to joining Volunteers of America, he had a distinguished career in the Department of Veteran Affairs (VA) where he held various clinical, teaching, research and administrative leadership positions. In his last VA post, he served as chief of mental health for the Miami VA Healthcare System.
An accomplished neurobiology researcher, Dr. Sherin has garnered international recognition for his work discovering a core sleep circuit in mammals that was published in “Science” magazine. He is a recipient of the prestigious Kempf Award from the American Psychiatric Association for his conceptual model of the psychotic process.
Dr. Sherin completed his undergraduate studies in neuroscience at Brown University, his graduate work at the University of Chicago and Harvard, and his postgraduate training at UCLA. He is a volunteer clinical professor as well as a member of the Center on Aging at the University of Miami and a volunteer clinical professor at UC
Dr. Roderick Shaner, DMH Medical Director
Roderick Shaner, M.D. serves as the Medical Director of the Los Angeles County Department of Mental Health (LAC DMH). His office encompasses development of clinical standards, clinical risks management, managed care, pharmacy, LPS designation, clinician credentialing, physician recruitment, and peer review. He previously served as the Director of the Psychiatric Emergency Service at LAC+USC Medical Center. Dr. Shaner serves as Co-Chair of the California Psychiatric Association (CPA) Public Psychiatry Committee. He has served in the American Psychiatric Association Assembly, in positions at the Southern California Psychiatric Society (SCPS), in regional organizations in the Los Angeles area,
as well as in statewide organizations. He is a past president of the Southern California Psychiatric Society, a Distinguished Fellow of the American Psychiatric Association and a fellow of the American Association of Child and Adolescent Psychiatry. Dr. Shaner is a Clinical Professor of Psychiatry at the Keck School of Medicine at USC and has participated in published research about managing decreased hospital resources and on the effectiveness of police/mental health teams, as well as publications involving more clinical topics
and a psychiatric review text. He previously served as Director of the Divisions of Emergency
Psychiatry and Medical Student Education at Keck. He completed his undergraduate medical
education at the UCLA School of Medicine and his residency training in both general and child and adolescent psychiatry at the USC Keck School of Medicine at USC.
Dr. Shaner is Board Certified in General Psychiatry, Child and Adolescent Psychiatry, and Addiction Medicine, and has Added Qualifications in Geriatric Psychiatry, and is a recipient of a NAMI Exemplary Psychiatrist Award.
Connie Draxler, DMH Deputy Director Public Guardian
Connie Draxler is the Deputy Director of the Los Angeles County Office of the Public Guardian. She has delegated authority from Dr. Sherin to be responsible for managing the day to day operations of the Public Guardian. The Public Guardian is responsible for investigating and administering conservatorships for those with mental health disorders and for frail, vulnerable older adults unable to care for themselves. In addition to her duties with the Public Guardian, Ms. Draxler sits on the Executive Board of the California Association of Public Administrators, Public Guardians and Public Conservators.
The court has updated their website on Mental Health and Conservatorships http://www.lacourt.org/division/mentalhealth/mentalhealth.aspx
NAMI West Los Angeles on Lanterman Conservatorships http://namila.org/resources/guide-to-lps-conservatorship/ You can also call Gail Evanguelidi for more help.
Here’s my research on Lanterman Conservatorships http://mentalhealth.healthreformquotes.com/mental-health/resources-mental-health/lanterman-lps-conservatorship/
Updated link for the Helping your loved one – conservatorship 61 page booklet