A 5270 hold in California is an additional 30-day involuntary psychiatric certification that can follow a 14-day (5250) hold when a person remains gravely disabled from a mental disorder, chronic alcoholism, or a severe substance use disorder and is unwilling or unable to accept treatment voluntarily.1California Legislative Information. California Welfare and Institutions Code WIC 5270.15 It carries real consequences — a court hearing, a five-year firearm ban, and in some cases a path toward conservatorship — and the person being held has specific legal tools to push back.
Where the 5270 Fits in the Hold Sequence
A 5270 never comes first. It sits at the end of a sequence:
- A 5150 hold runs up to 72 hours. A peace officer or designated clinician starts it when someone appears to be a danger to self, a danger to others, or gravely disabled.
- A 5250 hold runs up to 14 days. If the person still meets the criteria after the 72 hours, the facility can certify them for intensive treatment, with a certification review hearing during that period.
- A 5270 hold runs up to 30 days. It applies only to gravely disabled people who still won’t accept voluntary treatment after the 14-day hold.
The combined maximum through this sequence is 47 days. A court can approve a second consecutive 30-day period in rare cases, pushing the statutory ceiling for gravely disabled individuals to 77 days.2California Legislative Information. California Welfare and Institutions Code WIC 5270.55
Who a 5270 Hold Applies To
Two conditions have to be present. The facility’s professional staff must find the person remains gravely disabled from a mental disorder or chronic alcoholism, and the person must be unwilling or unable to accept treatment voluntarily.1California Legislative Information. California Welfare and Institutions Code WIC 5270.15 A person who is gravely disabled but agrees to keep receiving treatment voluntarily cannot be certified.
Grave disability historically meant that a person, because of a mental disorder, could not provide for their own basic needs for food, clothing, or shelter. Senate Bill 43, effective January 1, 2024, broadened that definition to include the inability to provide for personal safety or necessary medical care, and added severe substance use disorders and co-occurring conditions as qualifying diagnoses.3California Department of Health Care Services. Senate Bill 43 Changes to Gravely Disabled FAQs Counties were allowed to defer implementation until January 1, 2026, so the broader standard may not be in force in every county yet.
One boundary is worth stating plainly. A 5270 hold is not available for someone who is suicidal or violent but otherwise able to care for themselves. Those situations are handled through other provisions: Section 5260 for suicidal individuals, Section 5300 for those imminently dangerous to others. The 5270 exists specifically for people who cannot meet their own basic survival needs.
How the Certification Is Issued
The facility completes a second notice of certification signed by two people: the professional person in charge of the facility providing treatment, and either a physician (preferably a board-qualified psychiatrist) or a licensed psychologist with a doctoral degree and at least five years of postgraduate experience diagnosing and treating mental disorders. The physician or psychologist who signs must have personally participated in evaluating the patient.4California Legislative Information. California Welfare and Institutions Code WIC 5270.20
The certification is filed with the court and personally delivered to the patient. At delivery, the patient must be told that a certification review hearing will determine whether probable cause exists to continue detention, and that they have the right to help preparing for it.5California Legislative Information. California Welfare and Institutions Code – Article 4.7 Additional Intensive Treatment The facility must also make reasonable efforts to notify family members or designated contacts at least 36 hours before the hearing, unless the patient asks that they not be told.1California Legislative Information. California Welfare and Institutions Code WIC 5270.15
The Certification Review Hearing
A certification review hearing must be held within four days of the certification date, unless the patient or their attorney asks to postpone it.6California Legislative Information. California Welfare and Institutions Code WIC 5256 A hearing officer, not a judge, decides whether probable cause exists to keep holding the person for treatment.
The patient has the right to an attorney or a county patients’ rights advocate. The advocate meets with the patient beforehand, explains the process, helps gather evidence, and can represent the patient at the hearing.6California Legislative Information. California Welfare and Institutions Code WIC 5256 The patient can present evidence, call witnesses, and challenge the facility’s claims. If probable cause is not found, the hold ends.
Requesting a Court Hearing Through Habeas Corpus
Anyone detained under the LPS Act has the right to file a writ of habeas corpus asking for release, and the request can be made at any point during the hold. A friend, relative, or attorney can also make it on the patient’s behalf.7California Legislative Information. California Welfare and Institutions Code WIC 5275 The request can be given to the person who delivers the certification notice or to any member of the treatment staff, who must provide a form to sign and pass the request along. The California Judicial Council publishes petition form HC-002 for people held under the LPS Act.8California Courts. HC-002 Petition for Writ of Habeas Corpus – LPS Act
When a patient requests judicial review, the certification review hearing does not happen. The court hearing replaces it, is heard by an actual judge, and carries more procedural protection than the administrative review. For patients who feel the certification review process is inadequate, habeas corpus is the stronger option.
Rights During the Hold
Involuntary detention doesn’t erase civil rights. Welfare and Institutions Code Section 5325 lists rights that apply to every person held under the LPS Act, including anyone on a 5270:9Justia Law. California Welfare and Institutions Code 5325-5337 – Legal and Civil Rights of Persons Involuntarily Detained
- The right to wear your own clothes and keep personal possessions, including toiletries.
- The right to see visitors each day.
- Reasonable access to telephones for confidential calls.
- The right to see and receive services from a patients’ rights advocate with no clinical or administrative role in your care.
These rights can be restricted only in specific, documented circumstances, and any restriction has to be noted in the medical record. Blanket denial of phone access or visitors without individual justification violates the statute.
The Right to Refuse Antipsychotic Medication
One of the most consequential rights during a 5270 hold is the right to refuse antipsychotic medication. In Riese v. St. Mary’s Hospital, the California Court of Appeal held that involuntarily committed patients cannot be forced to take antipsychotic drugs outside an emergency unless a hearing officer first finds they lack the capacity to give informed consent.10Justia Law. Riese v St Marys Hospital and Medical Center
A Riese hearing looks at three questions: whether the patient acknowledges their condition, whether the patient can understand the benefits, risks, and alternatives to the proposed medication, and whether the patient can process that information rationally. The facility must prove lack of capacity by clear and convincing evidence, and the determination is a judicial function rather than a medical one. Delusions that have no clear connection to the treatment decision do not defeat the presumption of rational thought.10Justia Law. Riese v St Marys Hospital and Medical Center For patients held beyond 14 days who are found to lack capacity, informed consent must come from a responsible relative, guardian, or conservator before forced medication can proceed.
Firearm Restrictions After a 5270 Certification
A 5270 certification triggers a five-year ban on owning, possessing, or purchasing any firearm, other deadly weapon, or ammunition. The prohibition takes effect automatically under Welfare and Institutions Code Section 8103. Nothing has to be filed for it to attach; it follows the certification.11California Legislative Information. California Welfare and Institutions Code WIC 8103
A person subject to the ban can petition the superior court in their county of residence for an order restoring firearm rights. The court must set a hearing within 60 days of receiving the petition. The district attorney represents the state and can request continuances of up to 60 days total. The petitioner has to show by a preponderance of the evidence that they would be likely to use firearms safely and lawfully, and can request a confidential hearing if a public one would be harmful.11California Legislative Information. California Welfare and Institutions Code WIC 8103 The California Department of Justice publishes form BOF 4009C for starting this process.12California Department of Justice – Bureau of Firearms. Request for Hearing for Relief From Firearms Prohibition
What Happens When the 30 Days End
The 30 days is a ceiling, not a sentence. The treating psychiatrist must release the person as soon as they believe, based on personal observation, that the patient no longer meets the criteria or is willing to accept treatment voluntarily.13California Legislative Information. California Welfare and Institutions Code WIC 5270.35
At the end of 30 days the person must be released unless one of three things is true: the patient agrees to keep receiving treatment voluntarily, a conservatorship petition has been filed, or a Section 5300 petition for postcertification treatment as a dangerous person has been filed.13California Legislative Information. California Welfare and Institutions Code WIC 5270.35 A facility that knowingly holds a patient past 30 days without one of these legal bases faces civil liability for damages.
If a conservatorship becomes necessary during the hold, the temporary conservatorship must run concurrently with the 30 days, so the conservatorship hearing has to happen before day 30. Because of the required notice periods, a referral to the Public Guardian typically has to be made within the first few days of the 5270 hold.2California Legislative Information. California Welfare and Institutions Code WIC 5270.55
Who Pays for the Treatment
Financial responsibility for care during a 5270 hold is one of the least transparent parts of the process. California law has allowed state hospitals to bill patients for their care since the 1930s, and some patients have received bills totaling hundreds of thousands of dollars for extended stays. Medi-Cal does not cover people while they are confined in state hospitals, which can leave involuntarily committed individuals personally liable for treatment they never chose.
For patients held in county-designated facilities rather than state hospitals, the cost depends on insurance coverage, the county mental health plan’s contracts, and individual financial circumstances. If you or a family member faces unexpected bills after a 5270 hold, the facility’s patient financial services office and the county patients’ rights advocate are the most practical first calls. The Department of State Hospitals has a financial assistance program that can reduce or forgive patient debt in some cases.