Conservatorship

LPS CONSERVATORSHIP

A Mental Health Conservatorship, established by the Lanterman-Petris-Short (LPS) Act of 1967, is the legal term in California which gives one adult (conservator) the responsibility for overseeing the comprehensive medical (mental) treatment for an adult (conservatee) who has a serious mental illness. The purpose of conservatorship, established by the LPS Act, “is to provide individualized treatment, supervision and placement” for the conservatee which means that the conservator is responsible for ensuring basic needs such as food, clothes and shelter, as well as medical treatment and financial matters are met.

L.A. County Conservatorship Process

  1. Conservatorship starts with an evaluation of the individual by authorized Mental Health Professionals, usually within a facility designated by the Department of Mental Health to do LPS evaluations.  Often, the individual has been placed on a 72 hour hold (5150). At this time the Psychiatrist must obtain current knowledge of the individual’s condition, in order to deem the person as having a mental illness and, as a result, unable to provide for themselves food, clothing or shelter.
  2. After the Psychiatrist’s determination is made, they may submit an application for conservatorship to the Public Guardian Office within the Department of Mental Health.
  3. A Deputy Public Conservator of the Public Guardian will interview the referred individual, review medical charts and talk to medical staff and family members in order to submit a written report. This report is sent to Department 95 of the Mental Health Superior Court with a recommendation for or against establishing the conservatorship.
  4. If the Public Guardian recommends the establishment of a conservatorship, the court hearing will usually be held three weeks after the Superior Court’s receipt of the application.
  5. At the court hearing, the Proposed Conservatee and all interested parties, such as family members, are present. The County Counsel will present the case and may call witnesses. The Proposed Conservatee’s representative attorney (usually the Public Defender) will then oppose or affirm the recommendation for conservatorship.
  6. Based on the evidence and unique factors of the individual case, the Superior Court can deny the request or appoint a Conservator. If a family member is appointed Conservator, that person will receive further information and instruction from the court.

WHERE TO CALL for further information:
L.A. Public Guardian Office: 213-974-0515
Emergency only, after hours: 213-974-1234

Further Resources:

  • California Welfare and Institute Codes 5150, 5250, 5332 available on the internet
  • Los Angeles Office of the Public Guardian (Kathie Van Dyke) – public conservator 213-974-0549
  • SSI and SS 800-772-1213
  • Medi-Cal 877-597-4777
  • LA County of Mental Health 800-854-7771
  • Search the internet for LPS Conservatorship (not conservatorship)
  • Helen Ditko (LA Department of Mental Health) family advocate for conservatorship; Call her to help get the doctor to initiate the conservatorship 213-738-3948
  • Dr . Roderick Shaner,  LA Medical Director for DMH  213-738-4603
  • DMH Countywide Resource Management  email 323-226-4447
  • LA Patient Rights Advocacy  213-738-4873
  • Assisted Outpatient Treatment 213-738-3433
  • Full Service Partnership 213-738-4620
  • Criminal Court Mental Health Liaison 626-403-4370
  • County of Mental Health 800-854-7771

Printable LPS Conservatorship Page:

Download LPS Conservator Pamphlet 2014 (pdf)
DMH Public Guardian Conservatorship Pamphlet 2013 (pdf)

What To Do When Petitioning for LPS Conservatorship

How to Prepare when Petitioning for a Loved One's LPS Conservatorship

If you need an LPS Conservatorship for a loved one who is gravely disabled by a mental illness, the concise information you produce will help provide the doctor a fuller understanding of the serious nature of your loved one’s condition. You may follow the steps below:

  1. Use the given TWO TEMPLATES below to compile information (Medical History and Symptoms) for the person who is to be conserved.
  2. Then, give this information to the Police and the Psychiatric Evaluation Team (PET).
  3. When your loved one is hospitalized, give a copy to the Social Worker at the hospital, and request that they give this information to the Psychiatrist. You can ask if the Psychiatrist received your provided information in order to validate that he/she has received it.
  4. Send a copy to the Public Guardian’s Office after the Hospital’s referral for the LPS Conservatorship is filed.

*State health care providers MUST take your information by Law.* If health care providers refuse your information, provide them a copy of the CA Welfare and Institutions Code 5008.2

Template One: Mental Health History

  1. On one page list a history in chronological order of hospitalizations, incarcerations, homelessness and any restraining orders which have taken place for your loved one. If you have more information to provide and you need more than one page, make a note as to how long the person has been ill or an approximate number of previous hospitalizations.
  2. Bold the event and underline the diagnosis. Beyond this information it is not necessary to give details, state why the person was hospitalized or that they were on a 5150. Only list the information you are aware of since you are not expected to have access to all your loved ones medical history. State the diagnosis, or use the term “psychotic behavior” when you do not know the diagnosis.
  3. At the bottom of the page, list the patient’s insurance such as Medi-Cal, Medicare, or private insurance. State if they receive income such as SSI. Note any allergies, medical illnesses or any pertinent information the doctor needs to know. List the following information:
    1. Event;
    2. Date or Timeframe;
    3. Diagnosis or Behavior; (underline)
    4. Hospital/Prison Name;
    5. Hospital/Prison Address;
    6. Hospital/Prison Contact Information;
    7. Treating Doctor’s Name;
    8. Medications prescribed
  • NOTE: If there is not a history of previous hospitalizations, incarcerations or homelessness, it is still possible to acquire an LPS Conservatorship. This can take place when it is clear that the person is gravely disabled and there are no alternatives but to conserve them because they are seriously mentally ill, refuse medications and have no insight into their illness.
  • NOTE: Do not put the person’s social security number on these papers

EXAMPLE:

Template Two: List of Symptoms and Characteristics

  1. Prepare a short detailed summary of the DSM IV symptoms of the mental illness as it applies to your loved one.
  2. Use short phases. Bold the titles and bullet your examples.

EXAMPLE:

UNDERSTANDING LPS CONSERVATORSHIP Q & A

1.   Why is an LPS Conservatorship important to obtain?
2.   What is an LPS Conservatorship?
3.   How long is an LPS Conservatorship granted?
4.   Who can be conserved?
5.   What types of LPS Conservatorships do the courts grant?
6.   What are the responsibilities of the conservator with respect to the conservatee?
7.   What are the responsibilities for the conservatee with respect to the estate?
8.   What qualifies a person for an LPS Conservatorship?
9.   How do I know if my loved one is considered a harm to self or others?
10. What defines gravely disabled?
11. How does a person get a gravely disabled status?    
12. Who can be the conservator?
13. Why is it necessary to seek an LPS Conservatorship?
14. How much does it cost to acquire an LPS Conservatorship?
15. Where is the conservatorship court?
16. What is the usual process in seeking an LPS Conservatorship?
17. What is a Reise hearing?
18. Who can initiate a 5150 hold?
19. How do I get hospitalization for my loved one?
20. Does my loved one need Medical or insurance to get hospitalization?
21. Does my loved one need SSI or Social Security to be hospitalized?
22. All these officials, who are they and what are their roles?
23. What powers and responsibilities are given when the conservatorship is granted?
24. What is imposed on the Conservatee?
25. Why should I keep a journal?
 
1.    Why is an LPS Conservatorship important to obtain?
An LPS Conservatorship is a tool which gives the conservator the power to work with the doctor to achieve treatment for a mentally ill individual beyond the standard of “stable.”  It helps the conservator in guiding the treatment team to get your loved one’s life back as they knew it to be before they became ill.
 
2.   What is an LPS Conservatorship?
A Lanterman Petris Short (LPS) Conservatorship is the legal term used in California which gives one adult (conservator) the responsibility for overseeing the comprehensive medical treatment for an adult (conservatee) who has a serious mental illness.
 
3.  How long is an LPS Conservatorship granted? 
An LPS Conservatorship is granted for one year term but can be renewed for another year.  It is important to pay attention to the requirement required for renewal from the court and mark the date on your calendar.
 
4.   Who can be conserved?
Conservatorships are only granted by the court for adults with a mental disorder and who are gravely disabled as listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV).  These are granted for people with:
  • Schizophrenia
  • Schizoaffective disorder
  • Obsessive compulsive disorder 
  • Bipolar Disorder (Manic Depression)
  • Clinical Depression
  • Chronic Alcoholism
 
5.   What types of LPS Conservatorships do the courts grant?
There are two types of LPS Conservatorship which the court can grant.The first is an LPS Conservatorship of the Person.  A qualified psychiatrist initiates a petition to   the public guardian’s office, which in turns petitions the court for the conservatorship of the person.  The second is an LPS Conservatorship of the Estate.  The public guardian’s initial investigation    determines if there is a need for this conservatorship.  The family can also request that the public guardian petition the court for the estate conservatorship, or the family can at some time later petition the court for this conservatorship.  The doctor is not involved with this matter.
 
6.   What are the responsibilities of the conservator with respect to the conservatee?
As a conservator you will be responsible for approving or disapproving a place for the conservatee to live, and approving or disapproving the treatment and the medication program for the conservatee.  You should also participate in developing and overseeing a treatment plan that supports and encourages the conservatee to regain his/her life as close as it was prior to the illness.  It is a good idea for you to learn about mental disorder.  This can be done by taking the free Family-to-Family class which is offered by NAMI.
 
7.   What are the responsibilities for the conservatee with respect to the estate?
As conservator of the estate, you will be responsible but not personally liable for all financial matters pertaining to the estate.  You do not need an estate conservatorship to be the representative
payee for their SSI benefits.
 
8.   What qualifies a person for an LPS Conservatorship?
To qualify for the LPS Conservatorship, the person must be gravely disabled, have a serious mental illness and there are no other alternatives to help them in the recovery of their impairment. 
 
9.   How do I know if my loved one is considered a harm to himself or others?
You do not need to wait until your loved one tries to commit suicide or tries to hurt someone or   themselves before you seek treatment for them.  If your loved one has delusional conversations expressing the need for knifes or other items to protect him/her self; if they walk in front of moving cars, oblivious of the vehicles; if they seemed obsessed with others killing them; if they leave gas burners on after cooking; or are losing weight because they are afraid the food is contaminated, these are the red flags that will help you get your loved one hospitalized which is   usually the first process in acquiring a conservatorship.
 
10.  What defines gravely disabled?
Gravely disabled means the mentally ill person cannot take care of his/her basic needs for food, clothing and/or shelter.  With that said, the state feels that if another person provides for their food, clothing or shelter, or if a person can get food or clothing from the shelters then they are not    considered gravely disabled.  The fact that a mentally ill person lives on the streets does not mean that they are gravely disabled either.   With this said, it is still possible to get the person in treatment and gain conservatorship for them even when they are living on the street.
 
11. How does a person get a gravely disabled status? 
When a person with mental illness is hospitalized or incarcerated for being a harm to self or others, then the family or others can provide pertinent information to establish “gravely disabled” for food, clothing or shelter.  Gravely disabled by California definition means a person cannot provide for their food clothing or shelter.  BUT if someone else provides for their food, clothing or shelter they are not considered gravely disabled.  Not meeting any one of these three criteria can establish gravely disabled.
 
Gravely disabled can be established if the person has 1. no place to live safely; they may not  come home unless they are under the LPS Conservatorship and have gone through treatment, and/or 2. If the person has lost significant weight or is paranoid by food, and/or 3. a person creates a health risk by dressing inappropriate for the weather resulting in a health risk or they take their clothes off at inappropriate times or places, can be considered gravely disabled.  This is very important in requesting an LPS Conservatorship.  In addition, if the person is not compliant with treatment and medication this helps to build a case for the LPS Conservatorship.  To prove that a person cannot provide food or clothing is extremely difficult because if they can go to the Salvation Army or a dumpster to acquire clothes, pan handle for money, or find the food kitchens; then they are not considered gravely disabled. 
 
12. Who can be the conservator?
  • Public guardian- paid for by the state
  • Private professional conservator
  • You, a relative or a friend- the state prefers a family member for conservator
13. Why is it necessary to seek an LPS Conservatorship?
If a person with mental illness does not have insight into their illness, and they are not compliant with their medications, it is very wise to seek an LPS Conservatorship to keep them safe, out of the revolving doors for the hospitals and out of jail but especially to help them on their road to recovery.  Because treatment and medication can be given under the LPS Conservatorship, it has been found that the brain will not have to continue to suffer further damage.  An LPS Conservatorship is one significant tool which will help your loved one regain his/her life. 
 
14. How much does it cost to acquire an LPS Conservatorship?
You can hire an attorney to help you acquire the conservatorship, but this is not always necessary.  The attorney cannot force the doctor to seek the conservatorship.  Attorneys are somewhat expensive.
 
The public guardian submits a report to the court recommending that the person be conserved and whether or not a family member should be appointed as the conservator.  The county counsel who is the public guardian’s attorney, represents and upholds the public guardian’s recommendation.  From my experience, the county counsel deals with these situations every day.  They are very knowledgeable and understand the proceedings of the conservatorship court.  If the court sees a need for an attorney to be assigned to the family’s conservator, then the judge will select from the court’s panel of attorneys at the court‘s cost. 
 
15.  Where is the conservatorship court?
In Los Angeles County, the court is located at: 1150 N. San Fernando Road, Los Angeles, CA 90065-1100.  This is an obscure small building with the exterior that does not resemble the usual appearance of court houses.  Don’t confuse this court house with the “Behavioral Courthouses” for the mentally ill.  
 
16.   What is the usual process in seeking an LPS Conservatorship? 
  • First, the person who exhibits harm to self or others is placed on a 72 hour hold (5150) by a qualified police officer, psychiatrist or mental health personnel.  Usually someone will call either the police or the crises intervention team to initiate this process. To prevent the person from being harmful to others, the police make sure the person is contained. The crisis intervention team evaluates the individual and makes a recommendation for the 72 hour hold.   Note that when the person is transported they are usually handcuffed to keep them safe.
  • After the 72 hour hold in the hospital, the treating psychiatrist may initiate a 14 day hold to continue the treatment for stabilization.  A 14 day hold must have a Probable Cause hearing within 4 working days.  Often families are not aware the probable cause hearing has taken place.  This hearing allows the hospital to hold the patient for the 14 days.
  • During the 14 day hold the doctor may request an LPS Conservatorship investigation from the public guardian‘s office.  The public guardian will review the application and may petition the court for a Temporary Conservatorship AKA T-Con. They will also set the date for the LPS Conservatorship court hearing.  The person will be held in the hospital under the T-Con until the court hearing. The T-Con can hold the person in the hospital up to 30 days.
  • The treating psychiatrist initiates the LPS Conservatorship request with the public guardian‘s office. 
  • The public guardian will visit and evaluate the patient and make a recommendation to the court to either proceed or dismiss the LPS Conservatorship case. 
  • It is important to contact the public guardian’s office and submit the history and symptoms papers.  Also, be sure to give a copy of these papers to the treating psychiatrist as soon as the person is taken to the hospital. If you don’t know which hospital the person will be transported, then you might give those papers to the crisis intervention team to deliver to the hospital.  You can contact DMH Family Advocate or Patient Advocate to locate your loved one if you do not know where they were transported
  • An estate conservatorship is initiated through the public guardian’s office and not through the psychiatrist.  The family member may discuss the estate issues with the public guardian investigator.  Or, the family conservator may request, if needed, the Estate LPS Conservatorship even after they are appointed as conservator of the person.
17.  What is a Riese hearing?
This hearing is held at the hospital, often because the patient is becoming violent and needs medication, but is unwilling to voluntarily to take medications.  It is a capacity hearing that is held to require the patient to take medication to calm him/her.
           
18. Who can initiate a 5150 hold?
Certain trained designated officials may initiate the 72 hour hold/section 5150.
  • Police officer
  • Approved mental health professional
  • Approved psychiatrist
Transportation to the hospital must be arranged by one of the above.  In some counties if beds are not available, then the Crisis Intervention Teams may not respond because they have no place to put the person.  Therefore, it is usually wise to contact the police first and have them contact the crisis teams. The police have access to the beds.  Otherwise, if a bed is not available, then the   crisis team would not able to process the transportation, resulting in having to release the person.  Police are usually contacted for “harm to self or others” and the psychiatric evaluation teams are   requested if the person is gravely disabled.
 
19. How do I get hospitalization for my loved one?
There are many ways to get hospitalization.  Often, a person is willing to go to the hospital because they know something is not right.  If they are not willing to go and they are harmful to themselves or others, you should contact the police and explain the situation.  It is important to let the police know why you think the person is a possible harm to themselves or others.  Just by being psychotic does not, by law, allow for a 5150 hold.
 
If your loved one has private insurance or Medi-Cal or Medicare, then the police can transport your loved one to a hospital covered by the insurance.  Otherwise a county hospital is where they will usually transport them.  Generally county hospitals employ good psychiatrists and offer very good treatment. 
 
20. Does my loved one need Medi-Cal or insurance to get hospitalization?
No.  But if you do not have insurance, the psychiatrist will tend to stabilize and put your loved one back on the streets.  You will have to fight like hell to get them the LPS conservatorship.
 
21. Does my loved one need SSI or Social Security to get hospitalized?
No.  But I suggest that you go immediately to the social security office and apply for SSI for your loved one.   This establishes an “application date.”  When SSI is granted, the payments will be retroactive to the date which you submitted the initial application. It is also important to request to be the “representative payee.”  The doctor can complete a form to be given to the SS office stating that the patient is refusing to sign papers and is not capable of managing their money. When he/she is hospitalized this is the best time to notify the social security office and inform them your loved one is in the hospital. When SSI is granted, the payments will be retroactive to the date which you submitted the initial application.  
 
The social security office will give you forms for you to fill out and have your loved one sign.  Also, a doctor will evaluate your loved one for approval for SSI.  If they are turned down for SSI, you need to appeal the decision within the 60 day time period.  When you are approved for SSI then usually MediCal is approved simultaneously.  Sometimes you can get Medi-Cal without SSI.  Therefore, also apply for Medi-Cal. 
 
22. All these officials, who are they and what are their roles?
  • Office of the County Counsel- represent Los Angeles County in all legal proceedings, including Public Guardian in establishing conservatorship;
  • Attorney- mental health court utilizes a panel of private attorneys and draws from this panel to assign the conservator an attorney when needed.   This attorney may be paid for by the court.  A conservator may al so chose to retain their own attorney.
  • Public Defenders- represent person to be conserved and not the family
  • Public Guardian- investigates LPS Conservatorship referrals and makes recommendations to the court
  • District attorney- represents the hospitals with involuntary treatment; also can be more involved in criminal matters
  • Court- ensures fairness and compliance with the laws in all proceedings involving involuntary treatment and conservatorships.
23. What powers and responsibilities are generally given when the conservatorship is granted?
 
Conservator Powers With Respect to the Conservatee: Generally these authorities are granted by the court but occasionally some are not granted by the judge to the conservator.
  • To place the conservatee in a private residence, licensed psychiatric or non-psychiatric residential care facility, board and care, nursing or other State licensed facility where the conservatee has free access into or out of the premises.
  • To place the conservatee in a portion of a private acute care psychiatric hospital, State or County hospital operated by the Regents of the University of California or by the United States Government, where the conservatee has free access into or out of the hospital.
  • To place the conservatee in a licensed medical acute psychiatric hospital or psychiatric nursing facility (Institute for Mental Disease AKA IMD) or other State or County licensed facility, where the conservatee does not have free access into or out of the premises.  Pending further order of the Court, this power shall terminate within one year.
  • To require the conservatee to have treatment related specifically to remedying or preventing the recurrence of his her being gravely disabled.
  • To require the conservatee to accept psychotropic medications.
24. What limitations are suspended for the Conservatee?  These limitations can be reinstate with the courts approval.
  • The privilege of possessing a license to operate a motor vehicle is suspended. This power can be returned with the courts approval.  The conservator can ask the psychiatrist to petition the court to allow the person to drive.  It is up to the court to grant permission for driving and it is the DMV that evaluates and issues the license. Don’t ask for this at the LPS hearing.
  • The privilege of possessing, controlling or maintaining custody of a firearm or any other deadly weapon is suspended.
  • The right to refuse or consent to psychiatric treatment related specifically to the conservatee’s being gravely disabled.  Another words, they must take the medications when the conservator consents and approves of the medications.
  • The right to enter into any contract, in which the consideration for performance is money or property, is suspended. This power can be returned to the conservatee with the courts approval.
  • The right to refuse or accept medical treatment is suspended.  The court must approve the medical treatment for the conservatee.
25. Why should I keep a journal?
It is important to keep a journal to document hospitalizations, medications, behaviors and symptoms and their side effects. Your journal will help to cover the doctor’s blind spot. It will assist the doctor and treatment teams to better evaluate and assess the treatment for diagnosis and recovery.
 

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  • Amber Lucido
    published this page in Get Help 2016-05-16 17:20:21 -0700

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