Orange — LPS Conservatorship Reappointment Procedure

Source: https://www.occourts.org/system/files/general/shc-pb-05.pdf

SUPERIOR COURT OF CALIFORNIA Self-Help Services COUNTY OF ORANGE www.occourts.org/self-help

LPS CONSERVATORSHIP REAPPOINTMENT PROCEDURE

SELF-HELP FORM PACKET Attention New Probate Court and In-Person Location: Costa Mesa Justice Complex 3390 Harbor Boulevard Costa Mesa, CA 92626 SHC-PB-05 (Rev. 04/24/2025)

Self-Help Services can review your completed forms before you file them with the Court. To request review of your completed forms:

1. Complete the attached forms in black ink.
2. Scan your completed forms and save as a single PDF file.
3. Go to www.occourts.org/self-help (click the teal button labeled Contact Self-Help), attach the PDF, and complete the online request form. Make sure to select PROBATE as the case type on the form.

www.occourts.org/self-help

Rev. 4.24.2025 LPS CONSERVATORSHIP 3 REAPPOINTMENT COMMON WORDS OVERVIEW Conservatorship: Court An LPS Conservatorship gives one adult the legal responsibility to process giving one adult the legal make certain decisions for another adult who has a serious Mentalresponsibility to make decisions Disorder and is Gravely Disabled. Family members or otherfor another adult who is unable individuals cannot start the LPS Conservatorship process. Into care for themselves. The Orange County, the process is started by the Orange County Publicreason why the adult is unable to care for themselves determines Guardian. However, family members or other individuals can be the type of Conservatorship named an LPS Conservator. needed. This form packet is for adults that have already been named LPS Evidentiary Hearing: A Conservator and want to be reappointed for another year. This is hearing scheduled if a not a form packet to request a new LPS Conservatorship. Conservatee opposes a Petition for Reappointment. The LPS If you need assistance starting a new LPS Conservatorship, contactConservator must present the Orange County Public Guardian at:evidence proving an LPS Conservatorship is necessary. 1300 S. Grand Ave., Building C, Santa Ana, California 92705 Gravely Disabled: Court Monday – Friday, 8:00 a.m. – 5:00 p.m. finding that an adult cannot 714-567-7660 meet their own basic needs for food, clothing, or shelter because If you need assistance starting any other type of Conservatorship, of a Mental Disorder. please reach out to Self-Help. LPS Conservator: Adult Petition for Reappointmentappointed by the Court to make decisions for a Gravely Disabled An LPS Conservatorship only lasts one year. About 90 days before adult. it expires, the Court will mail a notice of expiration warning that the LPS Conservatorship: Legal LPS Conservatorship will expire soon. A sample notice of process that gives one adult the expiration is attached. authority to make decisions for a The Court will not automatically approve reappointment. The LPSGravely Disabled adult. Conservator must file a Petition for Reappointment at least 30 LPS Conservatee: Adult found days before the termination date. by Court to be Gravely Disabled. A hearing will be required for the LPS Conservator to show that: Mental Disorder: A serious mental health diagnosis, The LPS Conservatee continues to be Gravely Disabled, including, but not limited to, As a result of a Mental Disorder, and schizophrenia, bi-polar disorder, Is unwilling to accept or incapable of accepting treatment schizoaffective disorder, clinical voluntarily. depression, and obsessive- compulsive disorder. There is no limit to how many times an LPS Conservatorship may be renewed.

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PROCEDURE PROCEDURE[Forms in BOLD are attached. If you are viewing this packet on an internet enabled device, you can click on them to open electronic fillable versions.] ROADMAP

Required Forms

L-0984a: Petition for Reappointment of Conservator

L-0984b: Declaration of Physician or Qualified Licensed Psychologist Forms L-0984c: Notice of Hearing on Petition for Reappointment of Conservator

L-0984d: Declaration of Service

L-0984e: Order Reappointing Conservator

Complete Forms Medical Declaration L-0984a: Petition for Reappointment of Conservator o The LPS Conservatee’s name must appear exactly as it does on the Letters of Conservatorship. ▪ For example, if the name is listed as “John Smith AKA John J. Smith,” that is how it must appear on all reappointment forms. File

L-0984b: Declaration of Physician or Qualified
Licensed Psychologist
o Must be completed and signed by two physicians or
licensed psychologists treating the LPS
Conservatee. Service
o Most professionals will need time to complete it, plan
accordingly and provide the form as soon as possible.
o Once complete, attach it to L-0984a: Petition for
Reappointment of Conservator.

L-0984c: Notice of Hearing on Petition for
Reappointment of Conservator Complete
o Do not complete the date, time, and department Declaration of Service
fields. These will be provided when L-0984a:
Petition for Reappointment of Conservator is
filed.

L-0984e: Order Reappointing Conservator
Hearing o After the hearing, the Judge will sign this form.
However, before filing, the captions, headings, Items 1
and 3a must be completed.

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Document Review NOTICEPROCEDUREOF HEARINGTheCalculateSelf-HelpNumberProbateofTeamDaysoffersSincea freeDecedentoptionalDieddocument review ROADMAPROADMAPROADMAPROADMAPROADMAPservice for self-represented litigants. As part of this service, an At least 40 days must have passed since the Decedent died.attorney or paralegal will review your documents for completion before filing. Our staff cannot provide you with legal adviceIf the total value of the Decedent’s Estate is $166,250.00 or or strategy during the review. To have your completedless and 40 days have passed since the death of the documents reviewed, please attach them to your contact requestDecedent, you may use the Small Estate Affidavit process. here: www.occourts.org/self-help/ Complete the Small Estate Affidavit CalculateFormsFormsFormsForms Filing Fee Verification The first time L-0984a: Petition for Reappointment of o Make sure that a Formal Probate proceeding has Conservator is filed; there is a filing fee. To learn more visit: not been filed. If it has, you cannot use the Small https://www.occourts.org/forms-filing/fee-schedule Estate Affidavit unless the Personal Representative agrees in writing.If the LPS Conservatee cannot afford the fee, a request asking the Fill Out MedicalFillReviewReviewCopiesOutCourt to waive the fee can be filed on their behalf by completing: Declaration o A Small Estate Affidavit.https://www.occourts.org/system/files/selfhelp/shc-pb- ▪ A sample is attached.12.pdf • Many banks and other financial The fee or fee waiver must be institutionsprovided at thehavetimetheirofown.filing.Please check before using this one. After the first time, there is no filing fee. EnvelopesAttachFileFile File File Your Forms

You may file your completed forms by choosing one of the following:

In Person: o Costa Mesa Justice Complex, 3390 Harbor Boulevard, Costa Mesa, CA 92626 PrepareNotarizeServiceServicefor the Hearing DropBox: Service o Costa Mesa Justice Complex, 3390 Harbor Boulevard, Costa Mesa, CA 92626 Mail: o Costa Mesa Justice Complex, ATTN: Probate Filing Clerk, 3390 Harbor Boulevard, Costa Mesa, CA 92626 E-Filing: o For additional information visit the court’s website: CompletePrepareCompleteHearingSubmitforProoftheofHearingService ▪ https://www.occourts.org/online- DeclarationFormsof Service services/efiling/efiling-probate.html

Serve Your Forms

Service is the act of giving certain forms to persons or entities. The following forms must be served: After the Hearing Hearing Copy of filed L-0984a: Petition for Reappointment of File AdvocateHearing Conservator

Copy of filed L-0984c: Notice of Hearing on Petition for Reappointment of Conservator Pg. 3

How Must Service be Completed? PROCEDURE Service by mail is required. Standard mail is sufficient. NOTICE OF HEARING ROADMAPROADMAPROADMAPROADMAP The LPS Conservator completes service. ROADMAP

Who Must be Served?

Orange County Health Care Agency
o Mental Health Director
405 West 5 th Street, Suite 458
Santa Ana, CA 92701 CalculateFormsFormsFormsForms
Orange County Public Guardian
o P.O. Box 11526
Santa Ana, CA 92711
Orange County Public Defender
o 200 W. Santa Ana Blvd., Suite 970
Santa Ana, CA 92701
LPS Conservatee MedicalFillReviewReviewCopiesOut
If Applicable: Declaration
o Facility where LPS Conservatee resides.

Complete and File Declaration of Service

L-0984d: Declaration of Service
o The date of service, how service was completed, name EnvelopesAttachFileFile File
or entity served, and the address where service was
provided must be listed.
o The completed form must be filed as soon as possible.

Hearing

The LPS Conservator must attend the hearing. PrepareNotarizeServiceServicefor the Hearing
The LPS Conservatee may attend but is not required to. Service
The LPS Conservatee has the right to oppose the
reappointment.

Evidentiary Hearing

If the LPS Conservatee opposes the reappointment, an
CompletePrepareHearingSubmitforProoftheofHearingService Evidentiary Hearing will be scheduled. Complete
At the Evidentiary Hearing, the LPS Conservator will DeclarationFormsof Service
need to prove that the LPS Conservatorship is still
necessary because the LPS Conservatee still has a serious
Mental Disorder and is Gravely Disabled.
o The testimony of a psychiatrist or psychologist who
has examined the LPS Conservatee will be
required. After the Hearing
Hearing
Evidentiary Hearings can be complicated. If one is File
AdvocateHearing scheduled, LPS Conservator’s may want to hire an
attorney for assistance. If an LPS Conservator cannot
afford an attorney, the Court may be able to assist in finding
an attorney at no charge.
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FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF

[SAMPLE NOTICE

IN RE THE CONSERVATORSHIP OF THE PERSON OF: OF TERMINATION]

CONSERVATEE

CASE NUMBER:

NOTICE OF TERMINATION OF CONSERVATORSHIP

THE PEOPLE OF THE STATE OF CALIFORNIA TO notify the above-named conservatee and: (conservatee’s attorney, conservator, and professional person in charge of the facility in which the conservatee resides, county mental health director and county officer providing conservatorship investigations.)

The one-year conservatorship established for the above-named conservatee pursuant to Section 5350 of the Welfare and Institutions Code will terminate on . To reestablish conservatorship for another year the conservator must petition the court by at least 30 days before the termination date. Subject to a request for a court hearing by jury trial the Judge may, on his or her own motion, accept or reject the conservator's petition.

If the conservator petitions to reestablish conservatorship, notice must be given to the conservatee; the professional person in charge of the facility in which he resides, the conservatee’s attorney, and, if the conservator is a private party, the county mental health director and the county officer providing conservatorship investigation. If any of them request it, there shall be a court hearing or jury trial, whichever is requested, on the issue of whether the conservatee is still gravely disabled and in need of conservatorship. If the private conservator does not petition for reappointment, the county officer providing conservatorship investigation may recommend another conservator. Such a petition shall be considered a petition for reappointment of conservator.

Visit the Court’s website at www.occourts.org for Conservatorship Reappointment forms.

NOTICE OF TERMINATION OF CONSERVATORSHIP

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): FOR COURT USE ONLY

Telephone No.: Fax No. (Optional): E-Mail Address (Optional): ATTORNEY FOR (Name): Self-Represented Bar No: SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE Costa Mesa Justice Complex 3390 Harbor Blvd. Costa Mesa, CA 92626-1554 IN THE MATTER OF:

CASE NUMBER:

PETITION FOR REAPPOINTMENT OF CONSERVATOR

PETITIONER (name): states:

1. a. Petitioner was appointed conservator of the person of the conservatee (name): b. Petitioner qualified, and Letters of Conservatorship were duly issued on or about (date): c. Petitioner is now, and since that date has been, the duly appointed, qualified, and acting conservator of the person of the conservatee.
2. The conservatee is presently confined at: It is the professional opinion of: , M.D.

and M.D., as set forth in their
declaration dated: (attached as “Exhibit A” and incorporated by reference) that
the conservatee is still gravely disabled as a result of a mental disorder or impairment by chronic alcoholism
and is unwilling to accept or incapable of accepting treatment voluntarily.

3. Petitioner is informed and believes and on that information and belief alleges that the conservatee is still a gravely disabled person as defined in Section 5008(h) of the Welfare and Institutions Code as a result of a mental disorder or impairment by chronic alcoholism, is unwilling to accept or incapable of accepting treatment voluntarily, and is in need and does require a conservator of his or her person.
4. It is in the best interests of the conservatee and necessary that the conservator have the following powers:

a. The power to place, for the purpose of involuntary care and treatment, the conservatee in a medical, psychiatric, nursing or other state- licensed facility, or a state hospital, county hospital, hospital operated by the Regents of the University of California, United States Government Hospital, or other nonmedical facility approved by the State Department of Health Care Services or an agency accredited by the State Department of Health Care Services; or, in cases of chronic alcoholism, in a county alcoholic treatment center, as provided in Section 5358 of the Welfare and Institutions Code. b. The power to require the conservatee to receive treatment related specifically to remedying or preventing the recurrence of the conservatee’s being gravely disabled. c. The power to require conservatee to receive other medical treatment unrelated to remedying or preventing the recurrence of the conservatee’s being gravely disabled which is necessary for the treatment of an existing or continuing medical condition, namely (specify medical condition and treatment):

5. It is necessary and in the best interests of the conservatee that the conservatee not be permitted to

possess a license to operate a motor vehicle, nor to possess or carry firearms.

Approved for Optional Use PETITION FOR REAPPOINTMENT OF CONSERVATOR Welfare and Institutions Code, L-0984a (Rev. May 2023) §§5350-5372 www.occourts.org

IN THE MATTER OF: CASE NUMBER:

WHEREFORE, Petitioner prays that:

1. A conservator of the person be reappointed for the conservatee.

2. The conservator of the person be given the power to place, for the purpose of involuntary care and treatment, the conservatee in a medical, psychiatric, nursing, or other state-licensed facility, or a state hospital, county hospital, hospital operated by the Regents of the University of California, United States Government hospital, or other nonmedical facility approved by the State Department of Mental Health; or, in a case of chronic alcoholism, in a county alcoholic treatment center pursuant to section 5358 of Welfare and Institutions Code.

3. The conservator of the person be given the powers to require the conservatee to receive treatment related specifically to remedying or preventing the recurrence of the conservatee’s being gravely disabled and to require the conservatee to receive other medical treatment unrelated to remedying or preventing the recurrence of the conservatee’s being gravely disabled, which is necessary for the treatment of an existing or continuing medical condition, namely (specify medical condition and treatment):

4. The conservatee not be allowed to possess a license to operate a motor vehicle, nor possess or carry firearms.

5. Other relief be granted as the court deems proper.

Dated:

(TYPE OR PRINT NAME) (SIGNATURE OF CONSERVATOR)

VERIFICATION

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Dated:

(TYPE OR PRINT NAME) (SIGNATURE OF CONSERVATOR)

Approved for Optional Use PETITION FOR REAPPOINTMENT OF CONSERVATOR Welfare and Institutions Code, L-0984a (Rev. May 2023) §§5350-5372 www.occourts.org

DECLARATION OF PHYSICIAN OR QUALIFIED LICENSED PSYCHOLOGIST CONSERVATORSHIP RE-EVALUATION

Name: Case No.: ________________________________________

Address: City, State, Zip:

Age: Sex: Birthdate: Date of Current Evaluation:

Previous Diagnosis:

INSTRUCTIONS FOR EVALUATION Please complete the following three areas of interest to assist us in making a decision as to whether the above-named person should continue to have a conservator.

1. Is there a mental disorder? Please give a diagnosis and explain the symptoms.

2. Can the individual provide for his or her basic needs (i.e., food, clothing, or shelter) in an unsupervised setting? Why do you feel he or she can or cannot?

3. Do you feel this individual is incapable or unwilling to accept voluntary treatment?

   I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Executed on (date):

(SIGNATURE OF EVALUATOR) (SIGNATURE OF EVALUATOR)

(TITLE) (TITLE)

Approved for Optional Use DECLARATION PHYSICIAN OR QUALIFIED www.occourts.org L-0984b (Rev. March, 2014) LISCENSED PSYCHOLOGIST EXHIBIT A

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): FOR COURT USE ONLY

Telephone No.: Fax No. (Optional): E-Mail Address (Optional): ATTORNEY FOR (Name): Bar No: Self-Represented

SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE Costa Mesa Justice Complex 3390 Harbor Blvd. Costa Mesa, CA 92626-1554

IN THE MATTER OF:

NOTICE OF HEARING ON PETITION FOR CASE NUMBER:
REAPPOINTMENT OF CONSERVATOR

NOTICE IS HEREBY GIVEN that a Petition for Reappointment of Conservator has been filed in this court. Any interested person may appear and show cause, if any, why a conservator should not be reappointed for the proposed conservatee referred above. The hearing will be held before the judge of this court in the County of Orange, State of California, located at 3390 Harbor Blvd., Costa Mesa, CA 92626, on (date): at time: __________________ in Department ______.

REFERENCE is made to the petition on file in this matter for further particulars.

Date: ________________________

---

(TYPE OR PRINT NAME) (SIGNATURE OF CONSERVATOR)

Approved for Optional Use NOTICE OF HEARING ON PETITION FOR Welfare and Institutions Code, L-0984c (Rev. May 2023) §§5350-5372 REAPPOINTMENT OF CONSERVATOR www.occourts.org

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): FOR COURT USE ONLY

Telephone No.: Fax No. (Optional): E-Mail Address (Optional): ATTORNEY FOR (Name): Bar No:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE Costa Mesa Justice Complex 3390 Harbor Blvd. Costa Mesa, CA 92626-1554 IN THE MATTER OF:

CASE NUMBER:

DECLARATION OF SERVICE

I, the undersigned, hereby declare that I mailed, or hand delivered a copy of the Petition for Reappointment of Conservator and

Notice of Hearing as follows:

1. Date: Mailed Hand Delivered to: Orange County Health Care Agency
Mental Health Director
405 West 5th Street, Suite 458
Santa Ana, CA 92701

2. Date: Mailed Hand Delivered to: Orange County Public Guardian
P.O. Box 11526
Santa Ana, CA 92711

3. Date: Mailed Hand Delivered to: Orange County Public Defender
200 W. Santa Ana Blvd., Suite 800
Santa Ana, CA 92701

4. Date: Mailed Hand Delivered to: Conservatee:
Address:

5. Date: Mailed Hand Delivered to: Facility:
Address:

6. Date: Mailed Hand Delivered to: Other:
Address:

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct

Date:

(TYPE OR PRINT NAME) (SIGNATURE OF CONSERVATOR)

L-0984d (Rev. April 24, 2025) DECLARATION OF SERVICE Welfare and Institutions Code §§ 5350-5372

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): FOR COURT USE ONLY

Telephone No.: Fax No. (Optional): E-Mail Address (Optional): ATTORNEY FOR (Name): Self-Represented Bar No: SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE Costa Mesa Justice Complex 3390 Harbor Blvd. Costa Mesa, CA 92626-1554 IN THE MATTER OF:

CASE NUMBER:

ORDER REAPPOINTING CONSERVATOR

1. The petition for the reappointment of a conservator of the person of (name): came regularly for hearing on (date): . (Name): appeared on behalf of the conservatee.

   The conservatee was present in court and was advised of his or her right to a court or jury trial. The presence of the conservatee was waived. The conservatee did not waive his or her right to trial, but consented to the reappointment of a conservator by the court.

2. THE COURT FINDS, after examining the petition and hearing the evidence, that a. All notices of the hearing have been given as required by law. b. The conservatee is still gravely disabled as defined in Section 5008(h) for the purposes of Section 5350 of the Welfare and Institutions Code. c. It is in the best interests of the conservatee that a conservator of his or her person be reappointed.

3. IT IS ORDERED, a. (Name): is reappointed conservator of the person of (name): and appropriate Letters of Conservatorship shall be issued to the conservator upon filing the oath required by Section 2300 of the Probate Code.

   b. The conservator shall have the power to require the conservatee to receive treatment related specifically to remedying or preventing the recurrence of the conservatee’s being gravely disabled and to require the conservatee to receive treatment for an existing or continuing medical condition described as follows (specify):

   c. The conservator shall be guided by the advice of medical doctors specializing in psychiatry and other qualified medical and social welfare personnel. The conservator is authorized to require that the conservatee be detained in a facility providing intensive treatment for the purpose of involuntary care and treatment, or to place this conservatee in a medical, psychiatric, nursing, or other state-licensed facility or state hospital, county hospital, hospital operated by the Regents of the University of California, United States Government hospital, or a nonmedical facility approved by the State Department of Health Care Services or an agency accredited by the State Department of Health Care Services pursuant to Section 5358 of the Welfare and Institutions Code.

Approved for Optional Use ORDER REAPPOINTING CONSERVATOR Welfare and Institutions Code, L-0984e (Rev. May 2023) §§5350-5372 www.occourts.org

IN THE MATTER OF: CASE NUMBER:

d. The conservatee shall not have the privilege of possessing a license to operate a motor vehicle, nor the
right to possess or carry firearms.

e. The conservatee shall not be allowed to refuse treatment related specifically to the conservatee’s
being gravely disabled, or to refuse treatment necessary for the treatment of an existing or continuing
medical condition described as follows (specify):

f. The Court determined that a

State Hospital
Private locked facility
Private unlocked facility
Board and care facility
Current (specify):
is the least restrictive and most appropriate placement for the conservatee.

g. In addition to the conservatee’s attorney and the county’s patients’ rights advocate, the following
persons shall be notified of a placement more restrictive than the court-determined placement (names):

h. (1) The reappointment shall be effective as of (date):
(2) The conservatorship shall terminate on (date):
unless a conservator is earlier reappointed.

i. The declarations in support of reappointment of conservator shall be sealed and are not to be
opened without a further order of the court.

j. Other (specify):

Date:
(JUDGE OF THE SUPERIOR COURT)

Approved for Optional Use ORDER REAPPOINTING CONSERVATOR Welfare and Institutions Code, L-0984e (Rev. May 2023) §§5350-5372 www.occourts.org