Council Connect Articles

SB 43 Implementation Collaborative Forms in Sacramento Region


  • Emergency department and social work leaders from Sacramento region’s Kaiser Permanente, Sutter Health, Dignity Health, UC Davis Health, Adventist Health, and Marshall hospitals
  • County behavioral health department leaders from Sacramento, San Joaquin, Placer, El Dorado, Yolo, Sutter, and Yuba counties 
  • Sacramento region community-based providers 


Forty hospital, county, and community leaders in behavioral health from the seven-county Sacramento region convened on April 30 to discuss collaborating on strategies to comply with Senate Bill (SB) 43. Although all seven counties have formally postponed implementation for as late as January 2026, it was clear that it will take much of that time to achieve readiness. 

The aim of the collaborative is to develop an ongoing implementation system that accommodates SB 43’s expanded definition of “gravely disabled” and subsequent allowance of placing individuals on involuntary holds due to substance use disorder as a primary diagnosis.  

The consensus was that, without regional consistency in applying the law and the supporting structure, small jurisdictions would struggle to achieve compliance.  

After identifying potential challenges posed by the new law — increased ambulance patient offload times, workforce violence, boarding times, etc. — the collaborative created several workgroups to gather data, take inventory of existing resources, plan user and advocate engagement, and more.

Takeaway/Next Steps

All parties expressed willingness to cooperate in establishing common protocols and potentially develop new services. They agreed to reconvene in a month.


RVP Brian Jensen at