Wondering about the status of SB-43 implementation in California counties? Find out how local governments are taking steps to comply with this important legislation.
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Despite being signed by California Governor Gavin Newsom and enacted into law a year ago, SB-43 has yet to be fully implemented by most counties. Surprisingly, the prolonged delay in implementation does not appear to be a major concern for the State. Both the Assembly and Senate are now proposing additional mental health laws without first ensuring the proper implementation of SB-43, which was passed into law in October of last year. The new laws being proposed include AB 1316, which ensures psychiatric emergency care regardless of voluntary or involuntary status; AB 2159, which requires LPS facilities to provide a Patients Rights Handbook to families; SB 11, which mandates that the CSU system offer mental health counseling services to all students; SB 402, which guarantees 5150 authority for designated non-county staff or contractors; and SB 1184, which changes the duration of a finding of incapacity.
It is important to question why the State is introducing new mental health legislation before ensuring that counties are able to effectively implement SB-43. It may be more beneficial for the State to first provide support to counties in implementing existing laws before passing additional legislation.This approach would allow for a more comprehensive and effective mental health system, as counties would have the resources and capacity to fully implement and enforce existing laws. By prioritizing support for counties, the State can ensure that individuals with mental health needs receive the care and services they require without overwhelming the system with new legislation. Additionally, focusing on implementation of current laws before introducing new ones can help identify any gaps or challenges in the system that need to be addressed before moving forward. Ultimately, taking a step-by-step approach to mental health legislation can lead to better outcomes for individuals in need of support.
oss California are forming regional coalitions to unite against the enforcement of SB-43. In Northern California, for instance, seven counties - Sacramento, San Joaquin, Placer, El Dorado, Yolo, Sutter, and Yuba - have collectively decided to officially delay the implementation of SB-43 until 2026. It remains uncertain whether they will need further extensions beyond that deadline. The decision to delay the implementation of SB-43 in Northern California reflects a growing resistance to the state's efforts to update the current mental health laws. By forming regional coalitions, the counties are able to pool their resources and coordinate their efforts in challenging the enforcement of SB-43. This united front not only sends a strong message to state lawmakers, but also allows for a more coordinated and effective response to any legal challenges that may arise.
In April 2024, Sacramento Region saw the formation of the SB 43 Implementation Collaborative. This collaborative was established with the goal of creating a sustainable implementation system that aligns with SB 43's expanded definition of "gravely disabled" and the subsequent authorization to place individuals on involuntary holds due to substance use disorder as a primary diagnosis. It was recognized that without consistent application of the law and a supportive structure across the region, smaller jurisdictions would face challenges in meeting compliance requirements. Upon identifying potential obstacles presented by the new law, such as increased ambulance patient offload times, workforce violence, and boarding times, the collaborative established multiple workgroups. These workgroups were tasked with collecting data, assessing existing resources, planning engagement with users and advocates, and more. All participants expressed a willingness to collaborate in establishing standardized protocols and potentially introducing new services.
This collaborative brought together emergency department and social work leaders from prominent healthcare institutions such as Kaiser Permanente, Sutter Health, Dignity Health, UC Davis Health, Adventist Health, and Marshall hospitals. Additionally, county behavioral health department leaders from Sacramento, San Joaquin, Placer, El Dorado, Yolo, Sutter, and Yuba counties, as well as community-based providers from the Sacramento region, were also part of this initiative. A total of forty hospital, county, and community leaders in behavioral health from the seven-county Sacramento region gathered on April 30 to explore collaborative strategies for complying with Senate Bill (SB) 43. Despite the fact that all seven counties have officially delayed implementation until as late as January 2026, it was evident that a significant amount of time would be required to achieve readiness.
In conclusion, the unexpected and prolonged delay by counties in implementing SB-43 underscores the persistent challenges in addressing mental health issues at the local level. The introduction of new legislation by the State Assembly and Senate indicates a recognition of the need for further action to assist individuals grappling with mental health concerns. It is imperative that these proposed laws are not only approved but also effectively put into practice to ensure that those in need receive the essential support and resources. Moreover, counties must prioritize the implementation of existing laws, such as SB-43, to better serve their communities and enhance mental health outcomes for all residents. The State should provide support to counties to expedite the implementation of SB-43, thereby paving the way for the enactment of additional mental health laws.