SUBJECT
Title
ADOPT THE REVISED LANTERMAN-PETRIS-SHORT DESIGNATION GUIDELINES AND PROCESSES FOR FACILITIES WITHIN SAN DIEGO COUNTY AND AUTHORIZE THE BEHAVIORAL HEALTH SERVICES DIRECTOR TO UPDATE AND ADOPT FUTURE REVISIONS TO THE GUIDELINES (DISTRICT: ALL)
Body
OVERVIEW
The Lanterman-Petris-Short (LPS) Act establishes a procedure for the involuntary detention for evaluation and treatment of persons who, as a result of a mental disorder, constitute a danger to themselves or others, or are gravely disabled. The LPS Act also requires that persons detained be placed in facilities designated for LPS involuntary detention by a county’s Board of Supervisors.
In the San Diego region, LPS-designated facilities abide by the County of San Diego’s (County) LPS Designation Guidelines and Processes for Facilities (LPS Designation Guidelines), which serve as the operational framework for evaluating, designating, contracting with, and monitoring LPS facilities based on State regulations. LPS Designation Guidelines was first adopted by the San Diego County Board of Supervisors (Board) in 2013 and since then, the Board has approved various updates to revise processes to increase efficiency and reduce administrative complexity while ensuring adherence to the LPS Act. Most recently, the Board approved updates to the Guidelines on April 8, 2025 (16).
Following the enactment of Senate Bill 1238 in 2024, the California Department of Health Care Services (DHCS) issued LPS Facility Designation Interim Regulations. These regulations supersede the historical regulatory process that required the Board, or the delegated Behavioral Health Services (BHS) Director, approval of county designation of facilities authorized to provide treatment under the LPS Act. The new regulations centralize designated facility approval authority within DHCS and require BHS to revise the LPS Designation Guidelines to ensure compliance with the updated regulatory framework.
Today’s item requests the Board adopt revisions to the LPS Designation Guidelines (Attachment A), which updates language to align with new LPS Facility Designation Interim Regulations. In addition, today’s item requests the Board authorize the BHS Director to update and adopt future Guideline revisions as needed to remain consistent with any subsequent DHCS regulatory changes.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Adopt the revised Lanterman-Petris-Short Designation Guidelines and Processes for Facilities within San Diego County (LPS Designation Guidelines).
2. Authorize the Director of Behavioral Health Services to revise, and adopt on behalf of the County of San Diego, the LPS Designation Guidelines as needed to meet any programmatic needs or to conform to current or future statutory or regulatory requirements.
EQUITY IMPACT STATEMENT
The recommended actions support the County of San Diego’s (County) commitment to advancing equity in behavioral health services by ensuring that individuals experiencing a mental health crisis receive consistent, high‑quality evaluation and treatment regardless of race, income, age, or geography. Revisions to the LPS Designation Guidelines and Processes for Facilities within San Diego County strengthen requirements related to documentation and monitoring and enhance data collection to better identify inequities in involuntary hold patterns, facility access, and crisis outcomes. These improvements support transparency and help reduce disparities in service availability across regions of the County, particularly in communities with historically limited access to behavioral health services.
SUSTAINABILITY IMPACT STATEMENT
Today’s item supports the County of San Diego (County) Sustainability Goal #2 to provide just an equitable access to County services and Sustainability Goal # 4 to protect the health and well-being of everyone in the region. These goals will be advanced by ensuring LPS designation processes are equitable and prioritize treatment quality and accountability. Ensuring access to quality behavioral health care, particularly for historically disadvantaged communities, is paramount to advancing the overall well-being of every person in the community.
FISCAL IMPACT
There is no fiscal impact associated with today’s recommendations. There will be no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
This item was included on the June 4, 2026 Behavioral Health Advisory Board agenda but could not be brought to a vote because quorum was lost toward the end of the meeting.
BACKGROUND
The Lanterman-Petris-Short (LPS) Act (California Welfare and Institutions Code Section 5000 et seq.) establishes a procedure for the involuntary detention for evaluation and treatment of persons who constitute a danger to themselves or others or are gravely disabled. The LPS Act also requires that persons detained be placed in facilities designated for LPS involuntary detention. California Code of Regulations, Title 9, Section 821 states that a county’s Board of Supervisors may designate such facilities for evaluation and treatment, subject to the approval of the California Department of Health Care Services (DHCS).
In the San Diego region, LPS-designated facilities abide by the County of San Diego’s (County) LPS Designation Guidelines and Processes for Facilities (LPS Designation Guidelines), which serve as the operational framework for evaluating, designating, contracting with, and monitoring LPS facilities based on state regulations. The LPS Designation Guidelines were first adopted by the San Diego County Board of Supervisors (Board) in 2013 and since then, the Board has approved various updates to revise processes to increase efficiency and reduce administrative complexity while ensuring adherence to the LPS Act. Most recently, the Board approved updates to the Guidelines on April 8, 2025 (16).
Following the enactment of Senate Bill (SB) 1238 in 2024, DHCS issued the LPS Facility Designation Interim Regulations (Behavioral Health Information Notice [BHIN] 26-009, effective February 24, 2026). These regulations centralize approval authority for each LPS facility, superseding the historical regulatory process. Previously, the Board specifically approved each facility, and had delegated approval to the BHS Director, in accordance with Board-adopted facility criteria. The interim regulations implement SB 1238’s direction to update the regulatory framework, including an expanded definition of designated facilities. Specifically, updates as a result of the interim regulations include:
• A new required approval workflow;
• Additional facility types eligible for LPS designation;
• Updated processes for application, renewal, and adjustments to bed capacity;
• Strengthened standards for licensing, staffing, seclusion and restraint, training, and service delivery;
• Enhanced oversight and reporting requirements;
• New corrective action and enforcement authorities for both the County and DHCS, including a mandated reapplication timeline for currently designated facilities.
Upon approval of the Board, updated regulations apply immediately to all new LPS designation applications. Additionally, existing LPS facilities will be required to reapply for approval by September 1, 2027. BHS has provided the new DHCS requirements to all 23 LPS facilities in San Diego County to make the necessary updates for re-designation by the September 2027 deadline. As regulatory guidance continues to evolve, and anticipated changes from DHCS or California Legislature emerge, the approval of designated facilities, and the criteria governing such approvals, will no longer require Board action on a recurring basis.
Today’s item requests the Board adopt revisions to the LPS Designation Guidelines (Attachment A), to align with changes required under the new LPS Facility Designation Interim Regulations. In addition, today’s item requests the Board authorize the BHS Director to revise, and adopt on behalf of the County of San Diego, future Guideline as needed to remain consistent with any subsequent DHCS regulatory changes.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed action supports the County of San Diego (County) 2026-2031 Strategic Plan Initiatives of Equity (Health) and Community (Quality of Life) by ensuring effective, efficient, and quality-driven behavioral health services.
Respectfully submitted,
ebony n. shelton
Chief Administrative Officer
ATTACHMENT(S)
Attachment A: Lanterman-Petris-Short Designation Guidelines and Processes for Facilities within San Diego County