Senate Bill No. 364

Introduced by Senator Steinberg

February 20, 2013

An act to amend Sections 5001 and 5008 of, and to add Sections 5001.5 and 5013 to, the Welfare and Institutions Code, relating to mental health.

LEGISLATIVE COUNSEL’S DIGEST

SB 364, as introduced, Steinberg. Mental health.

Existing law, the Lanterman-Petris-Short Act, provides for the involuntary commitment and treatment of persons with specified mental disorders and for the protection of the persons so committed. Existing law states the intent of the Legislature, with regard to this act, including to end inappropriate, indefinite, and involuntary commitment of mentally disordered persons, developmentally disabled persons, and persons impaired by chronic alcoholism, and to eliminate legal disabilities and to protect mentally disordered persons and developmentally disabled persons.

This bill would state the intent of the Legislature, additionally, to ensure equal protection for all persons who are subject to involuntary detention and to provide services in the least restrictive setting consistent with the needs and stability of the person, as well as making technical changes. The bill would require counties to ensure that persons with severe mental illness who are on custodial hold receive prompt assessment, evaluation, and treatment, regardless of insurance status, economic status, or ability to pay for treatment.

This bill would require each county mental health department to post on its Internet Web site a current list, to be updated at lease annually, of ambulatory services and other resources for persons with severe mental illness and substance use in the county that may be accessed by providers and consumers of mental health services. By imposing these additional requirements on counties, this bill would impose a state-mandated local program.

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 5001 of the Welfare and Institutions Code
is amended to read:

5001.  

The provisions of this part shall be construed to promote
the legislative intent as follows:

(a) To end the inappropriate, indefinite, and involuntary
commitment of begin delete mentally disordered persons, developmentally
disabled persons, and persons impaired by end delete begin insert persons with severe
mental illness, developmental disabilities, and end insert chronic alcoholism,
and to eliminate legal begin delete disabilities; end delete begin insert disabilities. end insert

(b) To provide prompt evaluation and treatment of persons with
begin delete serious end delete begin insert severe end insert mental begin delete disorders end delete begin insert illness end insert or impaired by chronic
begin delete alcoholism; end delete begin insert alcoholism. end insert

(c) To guarantee and protect public begin delete safety; end delete begin insert safety. end insert

(d) To safeguard individual rights through judicial begin delete review; end delete
begin insert review. end insert

(e) To provide individualized treatment, supervision, and
placement services by a conservatorship program for gravely
disabled begin delete persons; end delete begin insert persons. end insert

(f) To encourage the full use of all existing agencies,
professional personnel begin insert , end insert and public funds to accomplish these
objectives and to prevent duplication of services and unnecessary
begin delete expenditures; end delete begin insert expenditures. end insert

(g) To protect begin delete mentally disordered persons and developmentally
disabled persons end delete begin insert persons with severe mental illness and
developmental disabilities end insert from criminal acts.

begin insert

(h) To promote consistent statewide application of this part in
order to ensure equal protection for all persons who are subject
to involuntary detention, including preadmission assessment and
evaluation and treatment pursuant to this part.

end insert begin insert

(i) To provide services in the least restrictive setting consistent
with the needs and stability of the persons subject to this part.

end insert

SEC. 2.  

Section 5001.5 is added to the Welfare and Institutions
Code, to read:

5001.5.  

In furtherance of subdivision (b) of Section 5001, each
county shall have the responsibility, in accordance with this part,
to ensure that all persons with severe mental illness who are on a
custodial hold receive prompt assessment, evaluation, and
treatment, regardless of insurance status, economic status, or ability
to pay for services.

SEC. 3.  

Section 5008 of the Welfare and Institutions Code is
amended to read:

5008.  

Unless the context otherwise requires, the following
definitions shall govern the construction of this part:

(a) “Evaluation” consists of multidisciplinary professional
analyses of a person’s medical, psychological, educational, social,
financial, and legal conditions as may appear to constitute a
problem. Persons providing evaluation services shall be properly
qualified professionals and may be full-time employees of an
agency providing evaluation services or may be part-time
employees or may be employed on a contractual basis.

(b) “Court-ordered evaluation” means an evaluation ordered by
a superior court pursuant to Article 2 (commencing with Section
5200) or by a court pursuant to Article 3 (commencing with Section
5225) of Chapter 2.

(c) “Intensive treatment” consists of such hospital and other
services as may be indicated. Intensive treatment shall be provided
by properly qualified professionals and carried out in facilities
qualifying for reimbursement under the California Medical
Assistance Program (Medi-Cal) set forth in Chapter 7 (commencing
with Section 14000) of Part 3 of Division 9, or under Title XVIII
of the federal Social Security Act and regulations thereunder.
Intensive treatment may be provided in hospitals of the United
States government by properly qualified professionals. Nothing
in this part shall be construed to prohibit an intensive treatment
facility from also providing 72-hour treatment and evaluation.

(d) “Referral” is referral of persons by each agency or facility
providing intensive treatment or evaluation services to other
agencies or individuals. The purpose of referral shall be to provide
for continuity of care, and may include, but need not be limited
to, informing the person of available services, making appointments
on the person’s behalf, discussing the person’s problem with the
begin delete agency or individual end delete begin insert facility, provider, or other organization end insert to
which the person has been referred, appraising the outcome of
referrals, and arranging for personal escort and transportation when
necessary. Referral shall be considered complete when the begin delete agency
or individual end delete begin insert facility, provider, or other organization end insert to whom the
person has been referred accepts responsibility for providing the
necessary services. All persons shall be advised of available precare
services begin delete which end delete begin insert that end insert prevent initial recourse to hospital treatment
or aftercare services begin delete which end delete begin insert that end insert support adjustment to community
living following hospital treatment. These services may be provided
through county begin delete welfare end delete begin insert mental health end insert departments, State
Department of State Hospitals, Short-Doyle programs begin insert , end insert or other
local agencies.

Each agency or facility providing evaluation services shall
maintain a current and comprehensive file of all community
services, both public and private. These files shall contain current
agreements with agencies or individuals accepting referrals, as
well as appraisals of the results of past referrals.

(e) “Crisis intervention” consists of an interview or series of
interviews within a brief period of time, conducted by qualified
professionals, and designed to alleviate personal or family
situations which present a serious and imminent threat to the health
or stability of the person or the family. The interview or interviews
may be conducted in the home of the person or family, or on an
inpatient or outpatient basis with such therapy, or other services,
as may be appropriate. Crisis intervention may, as appropriate,
include suicide prevention, psychiatric, welfare, psychological,
legal, or other social services.

(f) “Prepetition screening” is a screening of all petitions for
court-ordered evaluation as provided in Article 2 (commencing
with Section 5200) of Chapter 2, consisting of a professional
review of all petitions; an interview with the petitioner and,
whenever possible, the person alleged, as a result of mental
disorder, to be a danger to others, or to himself or herself, or to be
gravely disabled, to assess the problem and explain the petition;
when indicated, efforts to persuade the person to receive, on a
voluntary basis, comprehensive evaluation, crisis intervention,
referral, and other services specified in this part.

(g) “Conservatorship investigation” means investigation by an
agency appointed or designated by the governing body of cases in
which conservatorship is recommended pursuant to Chapter 3
(commencing with Section 5350).

(h) (1) For purposes of Article 1 (commencing with Section
5150), Article 2 (commencing with Section 5200), and Article 4
(commencing with Section 5250) of Chapter 2, and for the purposes
of Chapter 3 (commencing with Section 5350), “gravely disabled”
means either of the following:

(A) A condition in which a person, as a result of a mental
disorder, is unable to provide for his or her basic personal needs
for food, clothing, or shelter.

(B) A condition in which a person, has been found mentally
incompetent under Section 1370 of the Penal Code and all of the
following facts exist:

(i) The indictment or information pending against the defendant
at the time of commitment charges a felony involving death, great
bodily harm, or a serious threat to the physical well-being of
another person.

(ii) The indictment or information has not been dismissed.

(iii) As a result of mental disorder, the person is unable to
understand the nature and purpose of the proceedings taken against
him or her and to assist counsel in the conduct of his or her defense
in a rational manner.

(2) For purposes of Article 3 (commencing with Section 5225)
and Article 4 (commencing with Section 5250), of Chapter 2, and
for the purposes of Chapter 3 (commencing with Section 5350),
“gravely disabled” means a condition in which a person, as a result
of impairment by chronic alcoholism, is unable to provide for his
or her basic personal needs for food, clothing, or shelter.

(3) The term “gravely disabled” does not include mentally
retarded persons by reason of being mentally retarded alone.

(i) “Peace officer” means a duly sworn peace officer as that
term is defined in Chapter 4.5 (commencing with Section 830) of
Title 3 of Part 2 of the Penal Code who has completed the basic
training course established by the Commission on Peace Officer
Standards and Training, or any parole officer or probation officer
specified in Section 830.5 of the Penal Code when acting in relation
to cases for which he or she has a legally mandated responsibility.

(j) “Postcertification treatment” means an additional period of
treatment pursuant to Article 6 (commencing with Section 5300)
of Chapter 2.

(k) “Court,” unless otherwise specified, means a court of record.

(l) “Antipsychotic medication” means any medication
customarily prescribed for the treatment of symptoms of psychoses
and other severe mental and emotional disorders.

(m) “Emergency” means a situation in which action to impose
treatment over the person’s objection is immediately necessary
for the preservation of life or the prevention of serious bodily harm
to the patient or others, and it is impracticable to first gain consent.
It is not necessary for harm to take place or become unavoidable
prior to treatment.

SEC. 4.  

Section 5013 is added to the Welfare and Institutions
Code, to read:

5013.  

(a) It is the intent of the Legislature that referrals
between facilities, providers, and other organizations shall be
facilitated by the sharing of information and records in accordance
with Section 5328 and applicable federal and state laws.

(b) Each county mental health department’s Internet Web site
shall include a current list of ambulatory services and other
resources for persons with severe mental illness and substance use
in the county that may be accessed by providers and consumers
of mental health services. The list of services on the Internet Web
site shall be updated at least annually by the county.

SEC. 5.  

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.