State Hospital Placement

State hospital is the highest level of placement for conservatees. Most conservatees will not be eligible or considered for state hospital in San Diego county. San Diego has contracted a certain number of beds in each state hospital but most of those beds are reserved for murphy conservatorships, NGRI, or SVP.

​State Hospital: A California State operated psychiatric hospital for adults. The hospital provides evaluation and treatment for individuals with serious and persistent mental illness.


This is the highest level of care available to San Diego County beneficiaries and serves clients who are unable to be maintained at all other levels of care.

The client must meet the following required criteria for San Diego County funded bed at a California State Hospital:
1. Is a current resident of the State of California and has Medi-Cal eligibility for the County of San Diego.
2. Is at least 18 years of age.
3. Is not entitled to comparable services through othersystems, i.e. Veterans Affairs (VA), Regional Center, or private insurance.
4. Cannot be safely managed in a less restrictive level of care.
5. Is currently being treated in an LPS psychiatric hospital or is in a SF/LTC bed currently funded by San Diego County.
6. Is on LPS Permanent Conservatorship.
7. Is assigned to or will be assigned to a Case Management program funded by the County of San Diego.
8. Has an adequately documented Title 9, DSM IV-TR Primary diagnosis of a serious, persistent, major mental disorder or an eating disorder; the primary diagnosis cannot be a substance abuse related disorder. a. The symptoms must not be primarily a manifestation of a developmental disorder, dementia, or TBI. b. May have a substance abuse diagnosis as a concurrent diagnosis. c. May also have a concurrent Personality Disorder diagnosis, but diagnosis alone is not sufficient to meet criteria.

9. Is a current or recurrent danger to self or others, which includes chronic or recurrent episodes of assaultive or suicidal behavior. Documentation must show that assaultive behavior is a result of psychosis that has been resistant to treatment rather than antisocial behavior, Dementia, or Traumatic Brain Injuries(TBI).
10. Has a tuberculosis (TB) clearance within thirty days of application.
11. Has been tried on multiple medication trials and they have been insufficient to resolve or reduce the presenting symptoms to the point the client could be placed at a lower level of care.
12. Is approved for admission to State Hospital by the San Diego County LTC Coordinator. And the client must meet at least one of the following clinical criteria (these criteria are not intended for use solely as a long-term solution to maintain stability acquired during treatment in a residential facility/ program):


a. The client’s psychosocial functioning has deteriorated to the degree that the client is at County of San Diego Behavioral Health Services INPATIENT OPERATIONS HANDBOOK 1/15/2020 55 | Page risk for being unable to safely and adequately care for themselves in the community or at a less restrictive setting and there is a reasonable expectation that treatment will produce a higher level of functioning.

b. A lower level of care in which a client may be effectively treated is unavailable, an intensified schedule of ambulatory care or a change in the treatment plan has not proven effective, or community supportservices that might augment ambulatory mental health services and pre-empt the need for State Hospital Treatment is unavailable, insufficient, or inadequate.







Documentation Needed for State Hospital Referral

State Hospital referrals require that these documents be submitted in the following order. Please use dividers to identify the documents since document titles may differ from the language used by the state hospital. Documentation needed by Optum:
• Referral Screening Form requesting State Hospital
• Case Manager Recommendation requesting State Hospital
• Documentation of San Diego County Medi-Cal (POS strip) or written statement from Case Manager that they believe client is eligible for Medi-Cal and that Case Management is taking responsibility for following up on the Medi-Cal status
• Documentation of SSI if not included on Case Manager Recommendation form or written statement from Case Manager that they believe client is eligible for Medi-Cal and that Case Management is taking responsibility for following up on the Medi-Cal status
• Electronic Short Doyle Form