Mayor Todd Gloria announced during his State of the City address last week that he is lobbying the state to make it easier to force vulnerable homeless San Diegans into care rather than continued languishing on the street.
Gloria has plenty of company in pushing for changes to the state’s so-called conservatorship process. And so far, he and other political leaders pushing the issue have offered few specifics on how those reforms might look.
Gov. Gavin Newsom last week revealed he plans to propose changes to make it easier to appoint so-called conservators to oversee treatment and other decisions for homeless people who “truly can’t help themselves.”
Newsom declined to elaborate when pressed by reporters, saying he expects to share more details in coming weeks.
State legislators are interested, too. The state’s Assembly Health and Judiciary Committees held a day-long joint hearing in December to discuss how the state conservatorship law has played out statewide with an eye toward potential reforms.
For now, the more than five-decade old state Lanterman-Petris-Short Act allows people considered a danger to themselves or others – or deemed “gravely disabled” – to be held up to 72 hours for evaluation and then, with a court’s approval, for up to a month. The court can later sign off on a conservatorship that can last far longer.
Newsom, Gloria and an avalanche of advocates across the state argue the current process often fails to aid people who need care and are unable to seek it on their own. Other advocates have long argued there should be a higher bar for draconian conservatorships, a crowd that has grown with a movement to free pop star Britney Spears from a 13-year conservatorship.
Gloria is focused on so-called LPS conservatorships rather than the distinctly different probate conservatorship that Spears lived under for more than a decade.
Gloria told Voice of San Diego he sees a particular issue with the definition of “gravely disabled” in state law, usually relating to people with serious mental illnesses. Gloria doesn’t think it is broad enough to cover homeless San Diegans he says clearly need help such as the man he saw Tuesday morning screaming as he walked down the street sans shoes and appearing to not have bathed in days.
“Gravely disabled” generally means a person can’t address their need for food, clothing or shelter – though there are many potential caveats to that definition and street homelessness alone doesn’t qualify someone for a conservatorship.
“I think the bar for ‘gravely disabled’ is extremely high, and probably appropriately so, but I think it’s so high that even acute cases without reasonable solutions don’t qualify, and that’s essentially assigning those people to living on our streets, and that’s just not compassionate and it’s not appropriate, and it needs to change,” Gloria told VOSD.
Gloria isn’t the first to champion this change. Los Angeles County’s mental health director has been on a years-long crusade to expand the definition of “gravely disabled” and penned a 2020 Los Angeles Times op-ed with Sacramento Mayor Darrell Steinberg laying out his frustrations with state law. The op-ed was published a couple years after related state legislation crumbled.
Even with the changes Gloria and Newsom want, it’s not clear how expansive the use of conservatorships could become. During a previous reform push, San Diego County officials estimated just eight – yes, you read that right, eight – people in the county would have been eligible for the program.
Gloria said he envisions conservatorships being applied in only limited circumstances – more than eight, but far less than the hundreds who sleep on city streets each night.
“Most people on the street simply need housing and supportive services and they will get off the street and be able to take care of themselves,” Gloria said.
For now, San Diego County’s Public Conservator’s Office leads the charge on petitions for such conservatorships – and Gloria said he isn’t sure it’s appropriate for the city to play a more direct role in the process.
Still, representatives for Gloria and City Attorney Mara Elliott said city attorneys have formally made a dozen referrals to the county in the last year to urge officials to pursue probate conservatorships for people the city deemed unable to care themselves.
“Some of those cases were subsequently filed, others await the county’s response,” Elliott spokeswoman Leslie Wolf Branscomb wrote in an email.
Cathryn Nacario, CEO of National Alliance on Mental Illness in San Diego, said her organization has also been in talks with San Diego District Attorney Summer Stephan’s office about potential state legislation to broaden the definition of “gravely disabled” to include psychiatric deterioration. Some states already include it.
Nacario believes an amendment could make it easier to get temporary holds for evaluation and when necessary, conservatorships.
Nacario said the current definition often keeps authorities from stepping in.
In one recent instance, Nacario said, a local mother whose adult son with a documented serious mental illness lives on the street carried conservatorship papers as she went looking for him. She found him eating out of a garbage can and called police, hoping to secure a 72-hour hold. An officer who responded told the man’s mother he couldn’t be deemed “gravely disabled” because he was finding food in the trash.
“(A change) will allow somebody, for example, eating out of a trash can, clearly disheveled, to be able to at least be held for 72 hours,” Nacario said.
But Nacario, whose organization provides services for people with behavioral health challenges and their families, said policymakers need to tread lightly as they explore changes to ensure the civil rights of those deemed in need are respected.
“It’s a really fine balance,” Nacario said.
Indeed, Susan Mizner of the American Civil Liberties Union once declared conservatorships “the biggest deprivation of civil rights aside from the death penalty.”
Gloria said he has spoken to Newsom’s team and other California mayors and expects to work with stakeholders with lived experience, service providers, legislators and others to hammer out more detailed proposals.
Gloria said he hopes the group will also dig into the demise of past failed reforms, including one that Gloria advocated as a state legislator that San Diego County quietly backed away from in late 2020.
He acknowledged those dives may reveal that policymakers need to consider funding support for counties or new programs to make reforms successful.
“We know we can do better,” Gloria said. “It just seems as though we’re choosing not to do better. And I’m saying that it’s time that we choose to do better.”