A quick commentary on AB 2020 (link above). This proposal is noble as many people would find that the current definition of grave disability is limiting in who can get care and not. However, to understand why this may or may not pass, we need to understand some possible issues.
First we have case law, that states that grave disability is not unconstitutionally vague or overbroad; ie GD is sufficiently precise to exclude unusual or nonconformist life-styles and implies an inability or refusal to care for food, clothing, or shelter. Conservatorship of Chambers, 71 Cal. App. 3d 277, 139 Cal. Rptr. 357 (Ct. App. 1977). All of CA courts honor stare decisis at this point and have made no effort to overcome this. However, that does meant that passing this bill could change that.
Second the wording about "without significant supervision and assistance from another person" has been addressed in two cases. Conservatorship of Johnson, 235 CA3d at 698 held that even if a third party offers assistance, the court may still determine that that assistance offered may not sufficient to permit the conservatee to survive safely. . Conservatorship of Jesse G. (2016) 248 CA4th 453 held the opposite where if third party assistance is sufficient to keep the proposed conservatee safe and their needs of food, clothing, or shelter then it would be error to make a finding of grave disability "without the more". Although I understand that this bill intends to make it so that PERT and treating clinicians don't need to search the case law, people opposing this bill may cite that these cases already exist so no changes to the GD definition needs to be made.
Third the line about The bill would also define “gravely disabled” to mean a condition in which a person has an incapacity to provide informed consent to treatment due to anosognosia has been in part answered by case law. It is important to note that because CA does not adhere to horizontal stare decisis, I understand why passing this bill is important. The case law is split on this issue. In Conservatorship of Guerrero, 69 Cal. App. 4th 442, 81 Cal. Rptr. 2d 541 (1999) the court held that patients cannot be found GD, merely because they will not voluntarily accept treatment. Other case law, Conservatorship of Walker, held that a doctor who provided evidence that the patient lacked insight was enough make a finding of GD and establish LPS conservatorship. And then we have totally adverse case law that holds despite doctor's expert testimony that patient will likely relapse into GD because of a propensity not to take their meds does not meet the burden of proof (beyond a reasonable doubt) for a finding of current GD. Conservatorship of Benvenuto, 180 Cal. App. 3d 1030, 226 Cal. Rptr. 33 (Ct. App. 1986). Why bring all these cases up? Same reason as people who oppose change may cite to these cases and our horizontal stare decisis problem and "let each district/superior court handle application of this conflicting case law".
I am all for changing GD as stare decisis should be overruled when (1) there is high "workability" of new (legal) precedent, (2) changes to current precedent are very well-reasoned, (3) the current laws are outdated, and (4) the very high liberty/public interests at stake demand the change. If juvenile dependency is looking at removing ICWA protections then WE can and should demand change for mental health and expanding GD definitions.
I do not know enough about the California Realignment Act (bronzan-mccorquodale act) to comment on the funding changes. In re: "By increasing the level of service required of county mental health departments, this bill would impose a state-mandated local program". I know that we need way more funding for MH but due to the current structure of MH funding, I cannot accurately predict how people will react to this particular aspect.
Juvenile Dependency and