Policy Text
Roll Call Training Bulletin
Produced by: Officer N. Bassett, PSU Katherine Lester , Chief of Police
Prepared by: Officer N. Bassett, PSU Volume 25-1
Senate Bill 43 Legal Update
1-2-2025
On January 1, 2025, Senate Bill 43 went into effect in the County of Sacramento. Broadly, the bill expands the
definition of “gravely disabled” to include individuals unable to provide for their basic needs (e.g., food, clothing,
shelter, personal safety, or necessary medical care) because of a serious mental health illness, substance use
disorder (SUD), or a combination of both. This change in definitions allows for a broader application of Welfare
and Institutions Code § 5150 holds.
Whether a person meets the new definition of “gravely disabled” is a factual determination based on the totality
of circumstances which may include statements or actions observed by officers, clinicians , family members or
historical information about the individual . While officers are unable to make a SUD diagnosis, they should
consider the below criteria when articulating their justification for a 5150 WI hold based on a SUD.
1. Taking the substance in larger amounts or for longer than you're meant to.
2. Wanting to cut down or stop using the substance but not managing to.
3. Spending a lot of time getting, using, or recovering from use of the substance.
4. Cravings and urges to use the substance.
5. Not managing to do what you should at work, home, or school because of substance use.
6. Continuing to use, even when it causes problems in relationships.
7. Giving up important social, occupational, or recreational activities because of substance use.
8. Using substances again and again, even when it puts you in danger.
9. Continuing to use, even when you know you have a physical or psychological problem that could have
been caused or made worse by the substance.
10. Needing more of the substance to get the effect you want (tolerance).
11. Development of withdrawal symptoms, which can be relieved by taking more of the substance.
Listed below are several examples of observable functional impairments one might see in the community when
determining grave disability criteria based on a severe SUD related to:
Necessary Medical Care
• Signs of malnourishment (loss of weight or dehydration).
• Unwillingness to eat when food is provided.
• Irrational beliefs about food that is available (e.g., it is poisoned).
• Inability to articulate a plan for getting food.
• Unwillingness to clothe oneself when clothing is provided.
• Unable to utilize shelter when provided or to formulate a reasonable plan for shelter.
• Inability to engage in personal hygiene.
• Inability to utilize medical care when needed and available.
• Wound care and infection issues that are likely to lead to loss of limb or life if not treated.
• Untreated comorbidities such as HIV, d iabetes, or cancer liver / kidney disease that is life threatening.
Roll Call Training Bulletin
Produced by: Officer N. Bassett, PSU Katherine Lester , Chief of Police
Prepared by: Officer N. Bassett, PSU Volume 25-1
• Extreme physical pain.
Personal Safety
• Running in and out of traffic.
• An individual incapable of defending themselves against ongoing victimization.
• Being assaulted, abused, exploited or victim of crime.
• Unhygienic / uninhabitable conditions at home or other home safety issues such as arson.
• Inability to care for hygiene, cleanliness, needles, which leads to illness (especially if doesn’t rise to
level of serious bodily injury).
• Failure to thrive (may be a crossover with medical care).
• Multiple near -fatal overdoses requiring inpatient hospitalization (note: Narcan reversals alone would not
meet this criteria).
Food, Clothing, or Shelter
If there are questions or concerns regarding examples of food, clothing, or shelter, please contact Deputy City
Attorney Jordan Lowery at jlowery@cityofsacramento.org or (530) 410- 9116.
Report Writing
Officers cannot make a diagnosis for a SUD, as it would be out of our area of expertise, but simply need to
describe and document the observable behavior or conditions ( e.g., symptoms ) that justify a 5150 WI hold
being placed due to a SUD . See examples above.
With SUD added to the definition of gravely disabled, it does not change the procedures for processing a
person placed on 5150 WI hold. Officers shall continue to follow the guidelines of General Order 522.01
(Handling Mentally Ill Persons) . If there are questions or concerns regarding the content of this bulletin, please
contact PSU.