BILL NUMBER: SB 743	ENROLLED
	BILL TEXT

	PASSED THE SENATE  AUGUST 17, 2009
	PASSED THE ASSEMBLY  JUNE 30, 2009
	AMENDED IN ASSEMBLY  JUNE 1, 2009

INTRODUCED BY   Committee on Health (Senators Alquist (Chair),
Aanestad, Cedillo, Cox, DeSaulnier, Leno, Maldonado, Negrete McLeod,
Pavley, Strickland, and Wolk)

                        FEBRUARY 27, 2009

   An act to amend Section 1799.111 of the Health and Safety Code,
relating to mental health.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 743, Committee on Health. Health facilities: psychiatric
patient release.
   Existing law allows for the detention, for a 72-hour evaluation,
of any person who, as a result of a mental disorder, is a danger to
others, or to himself or herself, or is gravely disabled, as defined.
Existing law provides immunity from civil and criminal liability for
specified licensed general acute care hospitals, licensed acute
psychiatric hospitals, licensed professional staff at those
hospitals, or any physician and surgeon providing emergency medical
services in any department of those hospitals for the detention of a
person who is subject to a 72-hour evaluation as provided above.
Immunity is also provided, under specified circumstances, for the
actions of a person after release who was detained up to 24 hours
pursuant to their qualification for a 72-hour evaluation.
   This bill would extend the immunity from civil and criminal
liability to the specified facilities and staff for the detention of
any person who meets specified criteria, whether or not they qualify
for a 72-hour evaluation, and for the actions after release of a
person who was detained up to 24 hours and who meets specified
criteria.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 1799.111 of the Health and Safety Code is
amended to read:
   1799.111.  (a) Subject to subdivision (b), a licensed general
acute care hospital, as defined in subdivision (a) of Section 1250,
that is not a county-designated facility pursuant to Section 5150 of
the Welfare and Institutions Code, a licensed acute psychiatric
hospital, as defined in subdivision (b) of Section 1250, that is not
a county-designated facility pursuant to Section 5150 of the Welfare
and Institutions Code, licensed professional staff of those
hospitals, or any physician and surgeon, providing emergency medical
services in any department of those hospitals to a person at the
hospital shall not be civilly or criminally liable for detaining a
person if all of the following conditions exist during the detention:

   (1) The person cannot be safely released from the hospital
because, in the opinion of the treating physician and surgeon, or a
clinical psychologist with the medical staff privileges, clinical
privileges, or professional responsibilities provided in Section
1316.5, the person, as a result of a mental disorder, presents a
danger to himself or herself, or others, or is gravely disabled. For
purposes of this paragraph, "gravely disabled" means an inability to
provide for his or her basic personal needs for food, clothing, or
shelter.
   (2) The hospital staff, treating physician and surgeon, or
appropriate licensed mental health professional, have made, and
documented, repeated unsuccessful efforts to find appropriate mental
health treatment for the person.
   (A) Telephone calls or other contacts required pursuant to this
paragraph shall commence at the earliest possible time when the
treating physician and surgeon has determined the time at which the
person will be medically stable for transfer.
   (B) In no case shall the contacts required pursuant to this
paragraph begin after the time when the person becomes medically
stable for transfer.
   (3) The person is not detained beyond 24 hours.
   (4) There is probable cause for the detention.
   (b) If the person is detained pursuant to subdivision (a) beyond
eight hours, but less than 24 hours, both of the following additional
conditions shall be met:
   (1) A discharge or transfer for appropriate evaluation or
treatment for the person has been delayed because of the need for
continuous and ongoing care, observation, or treatment that the
hospital is providing.
   (2) In the opinion of the treating physician and surgeon, or a
clinical psychologist with the medical staff privileges or
professional responsibilities provided for in Section 1316.5, the
person, as a result of a mental disorder, is still a danger to
himself or herself, or others, or is gravely disabled, as defined in
paragraph (1) of subdivision (a).
   (c) In addition to the immunities set forth in subdivision (a), a
licensed general acute care hospital, as defined in subdivision (a)
of Section 1250 that is not a county-designated facility pursuant to
Section 5150 of the Welfare and Institutions Code, a licensed acute
psychiatric hospital as defined by subdivision (b) of Section 1250
that is not a county-designated facility pursuant to Section 5150 of
the Welfare and Institutions Code, licensed professional staff of
those hospitals, or any physician and surgeon, providing emergency
medical services in any department of those hospitals to a person at
the hospital shall not be civilly or criminally liable for the
actions of a person detained up to 24 hours in those hospitals who is
subject to detention pursuant to subdivision (a) after that person's
release from the detention at the hospital, if all of the following
conditions exist during the detention:
   (1) The person has not been admitted to a licensed general acute
care hospital or a licensed acute psychiatric hospital for evaluation
and treatment pursuant to Section 5150 of the Welfare and
Institutions Code.
   (2) The release from the licensed general acute care hospital or
the licensed acute psychiatric hospital is authorized by a physician
and surgeon or a clinical psychologist with the medical staff
privileges or professional responsibilities provided for in Section
1316.5, who determines, based on a face-to-face examination of the
person detained, that the person does not present a danger to himself
or herself or others and is not gravely disabled, as defined in
paragraph (1) of subdivision (a). In order for this paragraph to
apply to a clinical psychologist, the clinical psychologist shall
have a collaborative treatment relationship with the physician and
surgeon. The clinical psychologist may authorize the release of the
person from the detention, but only after he or she has consulted
with the physician and surgeon. In the event of a clinical or
professional disagreement regarding the release of a person subject
to the detention, the detention shall be maintained unless the
hospital's medical director overrules the decision of the physician
and surgeon opposing the release. Both the physician and surgeon and
the clinical psychologist shall enter their findings, concerns, or
objections in the person's medical record.
   (d) Nothing in this section shall affect the responsibility of a
general acute care hospital or an acute psychiatric hospital to
comply with all state laws and regulations pertaining to the use of
seclusion and restraint and psychiatric medications for psychiatric
patients. Persons detained under this section shall retain their
legal rights regarding consent for medical treatment.
   (e) A person detained under this section shall be credited for the
time detained, up to 24 hours, in the event he or she is placed on a
subsequent 72-hour hold pursuant to Section 5150 of the Welfare and
Institutions Code.
   (f) The amendments to this section made by the act adding this
subdivision shall not be construed to limit any existing duties for
psychotherapists contained in Section 43.92 of the Civil Code.
   (g) Nothing in this section is intended to expand the scope of
licensure of clinical psychologists.