BILL NUMBER: SB 1606 INTRODUCED
BILL TEXT
INTRODUCED BY Senator Yee
(Coauthor: Assembly Member Wolk)
FEBRUARY 22, 2008
An act to amend Sections 5250, 5256.4, 5257, 5346, 5347, and 5348
of, and to repeal Section 5349 of, the Welfare and Institutions Code,
relating to assisted outpatient treatment services.
LEGISLATIVE COUNSEL'S DIGEST
SB 1606, as introduced, Yee. Assisted outpatient treatment
services.
(1) Existing law, Laura's Law, allows courts in participating
counties to order a person suffering from a mental illness to undergo
assisted outpatient treatment if the court finds by clear and
convincing evidence that the requirements for assisted outpatient
treatment are met. One of these requirements is that the person has
been given an opportunity by the local director of mental health or
his or her designee, to participate in treatment on a voluntary basis
and the person fails or refuses to engage in treatment.
This bill would instead allow an order for assisted outpatient
treatment for a person who had been offered any opportunity to
participate in treatment but continues to fail to engage in
treatment.
(2) Existing law provides for up to 14 days of intensive treatment
for a mental disorder or impairment by chronic alcoholism for a
person who has been involuntarily committed and received an
evaluation that meets certain specified criteria. Under existing law,
before a person may be certified for a 14-day intensive treatment
program, he or she is entitled to a certification review hearing
conducted by a court-appointed commissioner or referee, or a
certification review hearing officer.
This bill would add to the list of those eligible for intensive
treatment, persons who have been ordered to, or agreed to, undergo
assisted outpatient treatment. This bill would allow the releasing
treatment provider or the director of the facility where a person has
been certified for intensive treatment, upon release of that person,
to refer him or her to the county mental health director for
evaluation for assisted outpatient treatment.
This bill would allow any relevant evidence of the person's
eligibility for assisted outpatient treatment to be admitted in the
certification review hearing. This bill would also allow the person
conducting the hearing to refer the person to the county mental
health director for assessment for assisted outpatient treatment if
the person does not meet the criteria for certification for intensive
treatment.
(3) Under existing law, the county mental health director, or his
or her designee, may be petitioned by certain specified individuals
to seek a court order authorizing assisted outpatient treatment.
After an investigation, the county mental health director is required
to make a determination as to whether there is a reasonable
likelihood that all the necessary elements to sustain the petition
can be proven in a court of law by clear and convincing evidence.
This bill would only allow the county mental health director or
his or her designee to file the petition with the court if he or she
reasonably believes that mental health services that will improve or
stabilize the person subject to the petition are available.
(4) Existing law requires the hearing on the petition to be
limited to facts stated in the petition in order to ensure adequate
notice to the person who is subject to the petition.
This bill would delete that requirement.
(5) Existing law allows for extensions, for up to 180 days, of a
court order requiring the person subject to the order to participate
in assisted outpatient treatment.
This bill would allow for extensions of up to 360 days and
provides that, if the administrative process for the extension is not
complete before the expiration of the current order, that order
would remain in effect until the process is final.
(6) Existing law requires the director of the outpatient treatment
program to file an affidavit with the court at least every 60 days
stating that the person subject to the order still meets the criteria
for assisted outpatient treatment.
This bill would delete this requirement.
(7) Existing law permits settlement agreements allowing persons
who have been determined by a court to meet the criteria for assisted
outpatient treatment to undergo voluntary treatment, if certain
conditions are met. Existing law prohibits treatment under a
settlement agreement from exceeding 180 days and authorizes either
party to request the court to modify the treatment plan at any time
during that period.
This bill would instead provide that the 180-day limit on
treatment under a settlement agreement shall only apply for an
initial period of treatment and would prohibit settlement agreements
for continuing assisted outpatient treatment from exceeding 360 days.
(8) Under existing law, Laura's Law is operative only in those
counties in which the county board of supervisors, by resolution,
authorizes its application. Existing law requires participating
counties to provide specified assisted outpatient treatment services,
and to report specified data to the State Department of Mental
Health.
This bill would make the law operative in all counties and would
revise the types of services counties would be required to provide
for assisted outpatient treatment. By imposing new duties on
counties, this bill would impose a state-mandated local program.
(9) The California Constitution requires the state to reimburse
local agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 5250 of the Welfare and Institutions Code is
amended to read:
5250. If a person is detained for 72 hours under the
provisions of Article 1 (commencing with Section 5150), or
under court order for evaluation pursuant to Article 2 (commencing
with Section 5200) or , Article 3
(commencing with Section 5225) , or Article 9 (commencing with
Section 5345) and has received an evaluation, he or she may be
certified for not more than 14 days of intensive treatment related to
the mental disorder or impairment by chronic alcoholism, under the
following conditions:
(a) The professional staff of the agency or facility providing
evaluation services has analyzed the person's condition and has found
the person is, as a result of mental disorder or impairment by
chronic alcoholism, a danger to others, or to himself or herself, or
gravely disabled.
(b) The facility providing intensive treatment is designated by
the county to provide intensive treatment, and agrees to admit the
person. No facility shall be designated to provide intensive
treatment unless it complies with the certification review hearing
required by this article. The procedures shall be described in the
county Short-Doyle plan as required by Section 5651.3.
(c) The person has been advised of the need for, but has not been
willing or able to accept, treatment on a voluntary basis.
(d) (1) Notwithstanding paragraph (1) of subdivision (h) of
Section 5008, a person is not "gravely disabled" if that person can
survive safely without involuntary detention with the help of
responsible family, friends, or others who are both willing and able
to help provide for the person's basic personal needs for food,
clothing, or shelter.
(2) However, unless they specifically indicate in writing their
willingness and ability to help, family, friends, or others shall not
be considered willing or able to provide this help.
(3) The purpose of this subdivision is to avoid the necessity for,
and the harmful effects of, requiring family, friends, and others to
publicly state, and requiring the certification review officer to
publicly find, that no one is willing or able to assist the mentally
disordered person in providing for the person's basic needs for food,
clothing, or shelter.
(e) A person who does not meet the criteria in subdivision (a), as
determined by the professional staff of the agency or facility, may
be referred to the county mental health director pursuant to Section
5346 if there is reason to believe the person may meet the criteria
therein.
SEC. 2. Section 5256.4 of the Welfare and Institutions Code is
amended to read:
5256.4. (a) At the certification review hearing, the person
certified shall have the following rights:
(1) Assistance by an attorney or advocate.
(2) To present evidence on his or her own behalf.
(3) To question persons presenting evidence in support of the
certification decision.
(4) To make reasonable requests for the attendance of facility
employees who have knowledge of, or have participated in,
the certification decision.
(5) If the person has received medication within 24 hours or
such any longer period of time as the
person conducting the hearing may designate prior to the beginning of
the hearing, the person conducting the hearing shall be informed of
that fact and of the probable effects of the medication.
(b) The hearing shall be conducted in an impartial and informal
manner in order to encourage free and open discussion by
participants. The person conducting the hearing shall not be bound by
rules of procedure or evidence applicable in judicial proceedings.
(c) Reasonable attempts shall be made by the mental health
facility to notify family members , or any other person
designated by the patient, of the time and place of the certification
hearing, unless the patient requests that this information not be
provided. The patient shall be advised by the facility that is
treating the patient that he or she has the right to request that
this information not be provided.
(d) All evidence which that is
relevant to establishing that the person certified is or is not
, as a result of mental disorder or impairment by chronic
alcoholism, a danger to others, or to himself or herself, or gravely
disabled, shall be admitted at the hearing and considered by the
hearing officer.
(e) All evidence that is relevant to establishing whether the
person certified meets the conditions specified in subdivision (a) of
Section 5346 shall be admitted at the hearing and considered by the
hearing officer. If the hearing officer has probable cause to believe
that a person may meet the criteria specified in subdivision (a) of
Section 5346, the officer may make a referral to the county mental
health director for investigation pursuant to Section 5346.
(e)
(f) Although resistance to involuntary commitment may
be a product of a mental disorder, this resistance shall not, in
itself, imply the presence of a mental disorder or constitute
evidence that a person meets the criteria of being dangerous to self
or others, or gravely disabled.
SEC. 3. Section 5257 of the Welfare and Institutions Code is
amended to read:
5257. (a) During the period of intensive treatment pursuant to
Section 5250 or 5270.15, the person's involuntary detention shall be
terminated and the person shall be released only if the psychiatrist
directly responsible for the person's treatment believes, as a result
of the psychiatrist's personal observations, that the person
certified no longer is, as a result of mental disorder or impairment
by chronic alcoholism, a danger to others, or to himself or herself,
or gravely disabled. However, in In
those situations in which both a psychiatrist and psychologist have
personally evaluated or examined a person who is undergoing intensive
treatment and there is a collaborative treatment relationship
between the psychiatrist and the psychologist, either the
psychiatrist or psychologist may authorize the release of the person,
but only after they have consulted with one another. In the event of
a clinical or professional disagreement regarding the early release
of a person who is undergoing intensive treatment, the person may not
be released unless the facility's medical director overrules the
decision of the psychiatrist or psychologist opposing the release.
Both the psychiatrist and psychologist shall enter their findings,
concerns, or objections into the person's medical record. If any
other professional person who is authorized to release the person
believes the person should be released during the designated period
of intensive treatment, and the psychiatrist directly responsible for
the person's treatment objects, the matter shall be referred to the
medical director of the facility for the final decision. However, if
the medical director is not a psychiatrist, he or she shall appoint a
designee who is a psychiatrist. If the matter is referred, the
person shall be released during the period of intensive treatment
only if the psychiatrist making the final decision believes, as a
result of the psychiatrist's personal observations, that the person
certified no longer is, as a result of mental disorder or impairment
by chronic alcoholism, a danger to others, or to himself or herself,
or gravely disabled. Nothing herein shall prohibit the person from
remaining at the facility on a voluntary basis or prevent the
facility from providing the person with appropriate referral
information concerning mental health services.
(b) A person who has been certified for a period of intensive
treatment pursuant to Section 5250 shall be released at the end of 14
days unless the patient either:
(1) Agrees to receive further treatment on a voluntary basis.
(2) Is certified for an additional 14 days of intensive treatment
pursuant to Article 4.5 (commencing with Section 5260).
(3) Is certified for an additional 30 days of intensive treatment
pursuant to Article 4.7 (commencing with Section 5270.10).
(4) Is the subject of a conservatorship petition filed pursuant to
Chapter 3 (commencing with Section 5350).
(5) Is the subject of a petition for postcertification treatment
of a dangerous person filed pursuant to Article 6 (commencing with
Section 5300).
(c) When the person who has been certified for a period of
intensive treatment pursuant to Section 5250, and whose deteriorating
condition has been stabilized or who otherwise may meet the criteria
in subdivision (a) of Section 5346, is released, the releasing
treatment provider or the director of the facility may refer the
person to the county mental health director for evaluation pursuant
to Section 5346.
(c)
(d) The amendments to this section made by Assembly Bill
348 of the 2003-04 Regular Session shall not be construed to revise
or expand the scope of practice of psychologists, as defined in
Chapter 6.6 (commencing with Section 2900) of Division 2 of the
Business and Professions Code.
SEC. 4. Section 5346 of the Welfare and Institutions Code is
amended to read:
5346. (a) In any county in which services are available
as provided in Section 5348, a A court may order
a person who is the subject of a petition filed pursuant to this
section to obtain assisted outpatient treatment if the court finds,
by clear and convincing evidence, that the facts stated in the
verified petition filed in accordance with this section are true and
establish that all of the requisite criteria set forth in this
section are met, including, but not limited to, each of the
following:
(1) The person is 18 years of age or older.
(2) The person is suffering from a mental illness as defined in
paragraphs (2) and (3) of subdivision (b) of Section 5600.3.
(3) There has been a clinical determination that the person is
unlikely to survive safely in the community without supervision.
(4) The person has a history of lack of compliance with treatment
for his or her mental illness, in that at least one of the following
is true:
(A) The person's mental illness has, at least twice within the
last 36 months, been a substantial factor in necessitating
hospitalization, or receipt of services in a forensic or other mental
health unit of a state correctional facility or local correctional
facility, not including any period during which the person was
hospitalized or incarcerated immediately preceding the filing of the
petition.
(B) The person's mental illness has resulted in one or more acts
of serious and violent behavior toward himself or herself or another,
or threats, or attempts to cause serious physical harm to himself or
herself or another within the last 48 months, not including any
period in which the person was hospitalized or incarcerated
immediately preceding the filing of the petition.
(5) The person has been offered an opportunity to participate in
a treatment plan by the director of the local mental health
department, or his or her designee, provided the treatment plan
includes all of the services described in Section 5348, and the
person , but continues to fail to engage in
, treatment.
(6) The person's condition is substantially deteriorating.
(7) Participation in the assisted outpatient treatment program
would be the least restrictive placement necessary to ensure the
person's recovery and stability.
(8) In view of the person's treatment history and current
behavior, the person is in need of assisted outpatient treatment in
order to prevent a relapse or deterioration that would be likely to
result in grave disability or serious harm to himself or herself, or
to others, as defined in Section 5150.
(9) It is likely that the person will benefit from assisted
outpatient treatment.
(b) (1) A petition for an order authorizing assisted outpatient
treatment may be filed by the county mental health director, or his
or her designee, in the superior court in the county in which the
person who is the subject of the petition is present or reasonably
believed to be present.
(2) A request may be made only by any of the following persons to
the county mental health department for the filing of a petition to
obtain an order authorizing assisted outpatient treatment:
(A) Any person 18 years of age or older with whom the person who
is the subject of the petition resides.
(B) Any person who is the parent, spouse, or sibling or child 18
years of age or older of the person who is the subject of the
petition.
(C) The director of any public or private agency, treatment
facility, charitable organization, or licensed residential care
facility providing mental health services to the person who is the
subject of the petition and in whose institution the
subject of the petition resides.
(D) The director of a hospital in which the person who is the
subject of the petition is hospitalized.
(E) A licensed mental health treatment provider who is either
supervising the treatment of, or treating for a mental illness, the
person who is the subject of the petition.
(F) A peace officer, parole officer, or probation officer assigned
to supervise the person who is the subject of the petition.
(G) A court-appointed commissioner or referee, or a certified
review hearing officer pursuant to Section 5256.1.
(3) Upon receiving a request pursuant to paragraph (2), the county
mental health director shall conduct an investigation into the
appropriateness of the filing of the petition. The director shall
file the petition only if he or she determines that there is a
reasonable likelihood that all the necessary elements to sustain the
petition can be proven in a court of law by clear and convincing
evidence. The director or his or her designee may file the
petition only if he or she reasonably believes that mental
health services that will improve or stabilize the person subject to
the petition are available.
(4) The petition shall state all of the following:
(A) Each of the criteria for assisted outpatient treatment as set
forth in subdivision (a).
(B) Facts that support the petitioner's belief that the person who
is the subject of the petition meets each criterion ,
provided that the hearing on the petition shall be limited to the
stated facts in the verified petition, and the petition contains all
the grounds on which the petition is based, in order to ensure
adequate notice to the person who is the subject of the petition and
his or her counsel .
(C) That the person who is the subject of the petition is present,
or is reasonably believed to be present, within the county where the
petition is filed.
(D) That the person who is the subject of the petition has the
right to be represented by counsel in all stages of the proceeding
under the petition, in accordance with subdivision (c).
(5) The petition shall be accompanied by an affidavit of a
licensed mental health treatment provider designated by the local
mental health director who shall state, if applicable, either of the
following:
(A) That the licensed mental health treatment provider has
personally examined the person who is the subject of the petition no
more than 10 days prior to the submission of the petition, the facts
and reasons why the person who is the subject of the petition
meets meet the criteria in subdivision
(a), that the licensed mental health treatment provider recommends
assisted outpatient treatment for the person who is the subject of
the petition, and that the licensed mental health treatment provider
is willing and able to testify at the hearing on the petition.
(B) That no more than 10 days prior to the filing of the petition,
the licensed mental health treatment provider, or his or her
designee, has made appropriate attempts to elicit the cooperation of
the person who is the subject of the petition, but has not been
successful in persuading that person to submit to an examination,
that the licensed mental health treatment provider has reason to
believe that the person who is the subject of the petition meets the
criteria for assisted outpatient treatment, and that the licensed
mental health treatment provider is willing and able to examine the
person who is the subject of the petition and testify at the hearing
on the petition.
(c) The person who is the subject of the petition shall have the
right to be represented by counsel at all stages of a proceeding
commenced under this section. If the person so elects, the court
shall immediately appoint the public defender or other attorney to
assist the person in all stages of the proceedings. The person shall
pay the cost of the legal services if he or she is able.
(d) (1) Upon receipt by the court of a petition submitted pursuant
to subdivision (b), the court shall fix the date for a hearing at a
time not later than five days from the date the petition is received
by the court, excluding Saturdays, Sundays, and holidays. The
petitioner shall promptly cause service of a copy of the petition,
together with written notice of the hearing date, to be made
personally on the person who is the subject of the petition, and
shall send a copy of the petition and notice to the county office of
patient rights, and to the current health care provider appointed for
the person who is the subject of the petition, if any such
current health care provider is known to the
petitioner. Continuances shall be permitted only for good cause
shown. In granting continuances, the court shall consider the need
for further examination by a physician or the potential need to
provide expeditiously assisted outpatient treatment. Upon the hearing
date, or upon any other date or dates to which the proceeding may be
continued, the court shall hear testimony. If it is deemed advisable
by the court, and if the person who is the subject of the petition
is available and has received notice pursuant to this section, the
court may examine , in or out of court , the
person who is the subject of the petition who is alleged to be in
need of assisted outpatient treatment. If the person who is the
subject of the petition does not appear at the hearing, and
appropriate attempts to elicit the attendance of the person have
failed, the court may conduct the hearing in the person's absence. If
the hearing is conducted without the person present, the court shall
set forth the factual basis for conducting the hearing without the
person's presence.
(2) The court shall not order assisted outpatient treatment unless
an examining licensed mental health treatment provider, who has
personally examined, and has reviewed the available treatment history
of, the person who is the subject of the petition within the time
period commencing 10 days before the filing of the petition,
testifies in person at the hearing.
(3) If the person who is the subject of the petition has refused
to be examined by a licensed mental health treatment provider, the
court may request that the person consent to an examination by a
licensed mental health treatment provider appointed by the court. If
the person who is the subject of the petition does not consent and
the court finds reasonable cause to believe that the allegations in
the petition are true, the court may order any person designated
under Section 5150 to take into custody the person who is the subject
of the petition and transport him or her, or cause him or her to be
transported, to a hospital for examination by a licensed mental
health treatment provider as soon as is practicable. Detention of the
person who is the subject of the petition under the order may not
exceed 72 hours. If the examination is performed by another licensed
mental health treatment provider, the examining licensed mental
health treatment provider may consult with the licensed mental health
treatment provider whose affirmation or affidavit accompanied the
petition regarding the issues of whether the allegations in the
petition are true and whether the person meets the criteria for
assisted outpatient treatment.
(4) The person who is the subject of the petition shall have all
of the following rights:
(A) To adequate notice of the hearings to the person who is the
subject of the petition, as well as to parties designated by the
person who is the subject of the petition.
(B) To receive a copy of the court-ordered evaluation.
(C) To counsel. If the person has not retained counsel, the court
shall appoint a public defender.
(D) To be informed of his or her right to judicial review by
habeas corpus.
(E) To be present at the hearing unless he or she waives the right
to be present.
(F) To present evidence.
(G) To call witnesses on his or her behalf.
(H) To cross-examine witnesses.
(I) To appeal decisions, and to be informed of his or her right to
appeal.
(5) (A) If , after hearing all relevant evidence, the
court finds that the person who is the subject of the petition does
not meet the criteria for assisted outpatient treatment, the court
shall dismiss the petition.
(B) If , after hearing all relevant evidence, the court
finds that the person who is the subject of the petition meets the
criteria for assisted outpatient treatment, and there is no
appropriate and feasible less restrictive alternative, the court may
order the person who is the subject of the petition to receive
assisted outpatient treatment for an initial period not to exceed six
months. In fashioning the order, the court shall specify that the
proposed treatment is the least restrictive treatment appropriate and
feasible for the person who is the subject of the petition. The
order shall state the categories of assisted outpatient treatment, as
set forth in Section 5348, that the person who is the subject of the
petition is to receive, and the court may not order treatment that
has not been recommended by the examining licensed mental health
treatment provider and or included in
the written treatment plan for assisted outpatient treatment as
required by subdivision (e). If the person has executed an advance
health care directive pursuant to Chapter 2 (commencing with Section
4650) of Part 1 of Division 4.7 of the Probate Code, any directions
included in the advance health care directive shall be considered in
formulating the written treatment plan.
(6) If the person who is the subject of a petition for an order
for assisted outpatient treatment pursuant to subparagraph (B) of
paragraph (5) of subdivision (d) refuses to participate in the
assisted outpatient treatment program, the court may order the person
to meet with the assisted outpatient treatment team designated by
the director of the assisted outpatient treatment program. The
treatment team shall attempt to gain the person's cooperation with
treatment ordered by the court. The person may be subject to a
72-hour hold pursuant to subdivision (f) only after the treatment
team has attempted to gain the person's cooperation with treatment
ordered by the court, and has been unable to do so.
(e) Assisted outpatient treatment shall not be ordered unless the
licensed mental health treatment provider recommending assisted
outpatient treatment to the court has submitted to the court a
written treatment plan that includes services as set forth in Section
5348, and the court finds, in consultation with the county mental
health director , or his or her designee, all of
the following:
(1) That the sufficient services are
available from the county, or a provider approved by the county
, for the duration of the court order .
(2) That the services have been offered to the person by
the local director of mental health, or his or her designee, and the
person has been given an opportunity to participate on a voluntary
basis, and the person has failed to engage in, or has refused,
treatment. That the person has been offered
an opportunity to participate in treatment and has continuously
failed to engage in treatment.
(3) That all of the elements of the petition required by this
article have been met.
(4) That the treatment plan will be delivered to the county
director of mental health, or to his or her appropriate designee.
(f) If, in the clinical judgment of a licensed mental health
treatment provider, the person who is the subject of the petition has
failed or has refused to comply with the treatment ordered by the
court, and, in the clinical judgment of the licensed mental health
treatment provider, efforts were made to solicit compliance, and, in
the clinical judgment of the licensed mental health treatment
provider, the person may be in need of involuntary admission to a
hospital for evaluation, the provider may request that persons
designated under Section 5150 take into custody the person who is the
subject of the petition and transport him or her, or cause him or
her to be transported, to a hospital, to be held up to 72 hours for
examination by a licensed mental health treatment provider to
determine if the person is in need of treatment pursuant to Section
5150. Any continued involuntary retention in a hospital beyond the
initial 72-hour period shall be pursuant to Section 5150. If at any
time during the 72-hour period the person is determined not to meet
the criteria of Section 5150, and does not agree to stay in the
hospital as a voluntary patient, he or she shall be released and any
subsequent involuntary detention in a hospital shall be pursuant to
Section 5150. Failure to comply with an order of assisted outpatient
treatment alone may not be grounds for involuntary civil commitment
or a finding that the person who is the subject of the petition is in
contempt of court.
(g) If the director of the assisted outpatient treatment program
determines that the condition of the patient requires further
assisted outpatient treatment, the director shall apply to the court,
prior to the expiration of the period of the initial assisted
outpatient treatment order, for an order authorizing continued
assisted outpatient treatment for a period not to exceed 180
360 days from the date of the order. The
procedures for obtaining any order pursuant to this subdivision shall
be in accordance with subdivisions (a) to (f), inclusive. The period
for further involuntary outpatient treatment authorized by any
subsequent order under this
subdivision may not exceed 180 360
days from the date of the order. If the final
administrative disposition of the petition does not occur before the
expiration of the current order, the current order shall remain in
effect until final disposition.
(h) At intervals of not less than 60 days during an assisted
outpatient treatment order, the director of the outpatient treatment
program shall file an affidavit with the court that ordered the
outpatient treatment affirming that the person who is the subject of
the order continues to meet the criteria for assisted outpatient
treatment. At these times, the person who is the subject of the order
shall have the right to a hearing on whether or not he or she still
meets the criteria for assisted outpatient treatment if he or she
disagrees with the director's affidavit. The burden of proof shall be
on the director.
(i) During each 60-day period specified in subdivision (h), if
(h) If the person who is the
subject of the order believes that he or she is being wrongfully
retained in the assisted outpatient treatment program against his or
her wishes, he or she may file a petition for a writ of habeas
corpus, thus requiring the director of the assisted outpatient
treatment program to prove that the person who is the subject of the
order continues to meet the criteria for assisted outpatient
treatment.
(j)
(i) Any person ordered to undergo assisted outpatient
treatment pursuant to this article, who was not present at the
hearing at which the order was issued, may immediately petition the
court for a writ of habeas corpus. Treatment under the order for
assisted outpatient treatment may not commence until the resolution
of that petition.
SEC. 5. Section 5347 of the Welfare and Institutions Code is
amended to read:
5347. (a) In any county in which services are available
pursuant to Section 5348, any Any person who is
determined by the court to be subject to subdivision (a) of Section
5346 may voluntarily enter into an agreement for services under this
section.
(b) (1) After a petition for an order for assisted
outpatient treatment is filed, but before the conclusion of the
hearing on the petition, the A person
who is the subject of the a petition
for assisted outpatient treatment , or the person's legal
counsel with the person's consent, may waive the right to an assisted
outpatient treatment hearing for the purpose of obtaining treatment
under a settlement agreement, provided that an examining licensed
mental health treatment provider states that the person can survive
safely in the community. The A
settlement agreement for an initial period of
assisted outpatient treatment may not exceed 180 days in
duration and shall be agreed to by all parties. A settlement
agreement for continued assisted outpatient treatment shall not
exceed 360 days.
(2) The settlement agreement shall be in writing, shall be
approved by the court, and shall include a treatment plan developed
by the community-based program that will provide services that
provide treatment in the least restrictive manner consistent with the
needs of the person who is the subject of the petition.
(3) Either party may request that the court modify the treatment
plan at any time during the 180-day period .
(4) The court shall designate the appropriate county department to
monitor the person's treatment under, and compliance with, the
settlement agreement. If the person fails to comply with the
treatment according to the agreement, the designated county
department shall notify the counsel designated by the county and the
person's counsel of the person's noncompliance.
(5) A settlement agreement approved by the court pursuant to this
section shall have the same force and effect as an order for assisted
outpatient treatment pursuant to Section 5346.
(6) At a hearing on the issue of noncompliance with the agreement,
the written statement of noncompliance submitted shall be prima
facie evidence that a violation of the conditions of the agreement
has occurred. If the person who is the subject of the petition denies
any of the facts as stated in the statement, he or she has the
burden of proving by a preponderance of the evidence that the alleged
facts are false.
SEC. 6. Section 5348 of the Welfare and Institutions Code is
amended to read:
5348. (a) For purposes of subdivision (e) of Section
5346, any county that chooses to provide assisted outpatient
treatment services pursuant to this article shall offer assisted
outpatient treatment services including, but not limited to, all of
the following: The treatment plan shall state that, to
the best of the knowledge of the licensed mental health treatment
provider who developed the plan, the services specified in the plan
are available from the county or a provider approved by the county.
(1) Community-based, mobile, multidisciplinary, highly trained
mental health teams that use high staff-to-client ratios of no more
than 10 clients per team member for those subject to court-ordered
services pursuant to Section 5346.
(2) A service planning and delivery process that includes the
following:
(A) Determination of the numbers of persons to be served and the
programs and services that will be provided to meet their needs. The
local director of mental health shall consult with the sheriff, the
police chief, the probation officer, the mental health board,
contract agencies, and family, client, ethnic, and citizen
constituency groups as determined by the director.
(B) Plans for services, including outreach to families whose
severely mentally ill adult is living with them, design of mental
health services, coordination and access to medications, psychiatric
and psychological services, substance abuse services, supportive
housing or other housing assistance, vocational rehabilitation, and
veterans' services. Plans shall also contain evaluation strategies,
that shall consider cultural, linguistic, gender, age, and special
needs of minorities and those based on any characteristic listed or
defined in Section 11135 of the Government Code in the target
populations. Provision shall be made for staff with the cultural
background and linguistic skills necessary to remove barriers to
mental health services as a result of having limited-English-speaking
ability and cultural differences. Recipients of outreach services
may include families, the public, primary care physicians, and others
who are likely to come into contact with individuals who may be
suffering from an untreated severe mental illness who would be likely
to become homeless if the illness continued to be untreated for a
substantial period of time. Outreach to adults may include adults
voluntarily or involuntarily hospitalized as a result of a severe
mental illness.
(C) Provisions for services to meet the needs of persons who are
physically disabled.
(D) Provision for services to meet the special needs of older
adults.
(E) Provision for family support and consultation services,
parenting support and consultation services, and peer support or
self-help group support, where appropriate.
(F) Provision for services to be client-directed and that employ
psychosocial rehabilitation and recovery principles.
(G) Provision for psychiatric and psychological services that are
integrated with other services and for psychiatric and psychological
collaboration in overall service planning.
(H) Provision for services specifically directed to seriously
mentally ill young adults 25 years of age or younger who are homeless
or at significant risk of becoming homeless. These provisions may
include continuation of services that would still be received through
other funds had eligibility not been terminated as a result of age.
(I) Services reflecting special needs of women from diverse
cultural backgrounds, including supportive housing that accepts
children, personal services coordinator therapeutic treatment, and
substance treatment programs that address gender specific trauma and
abuse in the lives of persons with mental illness, and vocational
rehabilitation programs that offer job training programs free of
gender bias and sensitive to the needs of women.
(J) Provision for housing for clients that is immediate,
transitional, permanent, or all of these.
(K) Provision for clients who have been suffering from an
untreated severe mental illness for less than one year, and who do
not require the full range of services, but are at risk of becoming
homeless unless a comprehensive individual and family support
services plan is implemented. These clients shall be served in a
manner that is designed to meet their needs.
(3) Each client shall have a clearly designated mental health
personal services coordinator who may be part of a multidisciplinary
treatment team who is responsible for providing or assuring needed
services. Responsibilities include complete assessment of the client'
s needs, development of the client's personal services plan, linkage
with all appropriate community services, monitoring of the quality
and follow through of services, and necessary advocacy to ensure each
client receives those services which are agreed to in the personal
services plan. Each client shall participate in the development of
his or her personal services plan, and responsible staff shall
consult with the designated conservator, if one has been appointed,
and, with the consent of the client, shall consult with the family
and other significant persons as appropriate.
(4)
(b) The individual personal services
treatment plan shall include, at a minimum, case
management services and ensure that persons subject to assisted
outpatient treatment programs receive
age age- , gender gender-
, and culturally appropriate services, to the extent feasible,
that are designed to enable recipients to:
(A)
(1) Live in the most independent, least restrictive
housing feasible in the local community, and, for clients with
children, to live in a supportive housing environment that strives
for reunification with their children or assists clients in
maintaining custody of their children , as is appropriate.
(B)
(2) Engage in the highest level of work or productive
activity appropriate to their abilities and experience.
(C)
(3) Create and maintain a support system consisting of
friends, family, and participation in community activities.
(D)
(4) Access an appropriate level of academic education
or vocational training.
(E)
(5) Obtain an adequate income.
(F)
(6) Self-manage their illnesses and exert as much
control as possible over both the day-to-day and long-term decisions
that affect their lives.
(G)
(7) Access necessary physical health care and maintain
the best possible physical health.
(H)
(8) Reduce or eliminate serious antisocial or criminal
behavior, and thereby reduce or eliminate their contact with the
criminal justice system.
(I)
(9) Reduce or eliminate the distress caused by the
symptoms of mental illness.
(J)
(10) Have freedom from dangerous addictive substances.
(5) The individual personal services plan shall describe the
service array that meets the requirements of paragraph (4), and to
the extent applicable to the individual, the requirements of
paragraph (2).
(b) Any county that provides assisted outpatient treatment
services pursuant to this article also shall offer the same services
on a voluntary basis.
(c) Involuntary medication allowed
Medication may be ordered but shall not be administered
over objection absent a separate order by the court pursuant to
Sections 5332 to 5336, inclusive.
(d) Each county that operates an assisted outpatient
treatment program pursuant to this article shall provide
data to the State Department of Mental Health and, based on the data,
the department shall report to the Legislature on or before May 1 of
each year in which the county provides services pursuant to
this article . The report shall include, at a minimum, an
evaluation of the effectiveness of the strategies employed by each
program operated pursuant to this article in reducing homelessness
and hospitalization of persons in the program and in reducing
involvement with local law enforcement by persons in the program. The
evaluation and report shall also include any other measures
identified by the department regarding persons in the program and all
of the following, based on information that is available:
(1) The number of persons served by the program and, of those, the
number who are able to maintain housing and the number who maintain
contact with the treatment system.
(2) The number of persons in the program with contacts with local
law enforcement, and the extent to which local and state
incarceration of persons in the program has been reduced or avoided.
(3) The number of persons in the program participating in
employment services programs, including competitive employment.
(4) The days of hospitalization of persons in the program that
have been reduced or avoided.
(5) Adherence to prescribed treatment by persons in the program.
(6) Other indicators of successful engagement, if any, by persons
in the program.
(7) Victimization of persons in the program.
(8) Violent behavior of persons in the program.
(9) Substance abuse by persons in the program.
(10) Type, intensity, and frequency of treatment of persons in the
program.
(11) Extent to which enforcement mechanisms are used by the
program, when applicable.
(12) Social functioning of persons in the program.
(13) Skills in independent living of persons in the program.
(14) Satisfaction with program services both by those receiving
them and by their families, when relevant.
SEC. 7. Section 5349 of the Welfare and Institutions Code is
repealed.
5349. This article shall be operative in those counties in which
the county board of supervisors, by resolution, authorizes its
application and makes a finding that no voluntary mental health
program serving adults, and no children's mental health program, may
be reduced as a result of the implementation of this article.
Compliance with this section shall be monitored by the State
Department of Mental Health as part of its review and approval of
county Short-Doyle plans.
SEC. 8. If the Commission on State Mandates determines that this
act contains costs mandated by the state, reimbursement to local
agencies and school districts for those costs shall be made pursuant
to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of
the Government Code.