The Hold Types at a Glance
| Hold | Duration | Core Criteria | Who Initiates |
|---|---|---|---|
| 5150 | Up to 72 hours | Danger to self, danger to others, or gravely disabled | Peace officer, or an LPS-designated/county-authorized clinician |
| 5250 | Up to 14 additional days | Same criteria continue to be met after the 72-hour evaluation | Treatment facility certifies; requires a Certification Review Hearing (probable cause hearing) |
| 5260 | Up to 14 additional days | Continued danger to self only, following a 5250 | Certifying psychiatrist |
| Post-certification (5270.15 / grave disability) | Up to 30 additional days | Gravely disabled and unwilling/unable to accept voluntary treatment | Facility petitions the court |
| LPS Conservatorship | Up to 1 year, renewable | Grave disability persists; least restrictive alternatives considered first | Court-ordered, following investigation |
What Changed Under SB 43
SB 43 (effective statewide January 1, 2026) expanded the definition of "gravely disabled" under the LPS Act. It now includes:
- People with a severe substance use disorder — or a co-occurring mental health and severe substance use disorder — not just a mental health disorder alone
- Inability to provide for personal safety or necessary medical care, in addition to the original food, clothing, and shelter criteria
In practice: more patients presenting primarily with substance use may now meet criteria for a hold than before SB 43 — evaluate against the full expanded definition, not the pre-2026 one.
Patient Rights During a Hold
Right to be informed, in writing, of the reason for detention and hold status
Right to access a patients' rights advocate
Right to a timely evaluation and, for a 5250, a Certification Review Hearing
Right to legal counsel and to petition for habeas corpus
Right to refuse most non-emergency treatment — a hold alone does not authorize involuntary medication
Right to the least restrictive appropriate level of care
Documentation Checklist for Nurses
- Chart specific observed behaviors and direct patient statements — not conclusory labels like "agitated" or "psychotic" alone
- Note the exact date, time, and identity of the person who initiated the hold
- Confirm and document that the patient was notified of their hold status and rights (e.g., facility notification form)
- Reassess and re-document whether criteria continue to be met at each shift, not just at intake
- If grave disability is the basis, document specifically which basic need — food, clothing, shelter, personal safety, or medical care — the patient cannot meet, and why
- Know your facility's LPS-designation status and county-specific forms before you need them
Sources: California Welfare & Institutions Code §§5150, 5250, 5260, 5270.15; SB 43 (Eggman, 2023), effective statewide January 1, 2026. This page reflects our understanding of the law as of publication and is not a substitute for legal counsel. Questions or corrections: hello@calmn.us