Amended in Senate April 15, 2013

Amended in Senate April 4, 2013

Senate Bill No. 364

Introduced by Senator Steinberg

February 20, 2013

An act to amend Sections 5001, 5008, 5150, and 5151 of, to add Sections 5013 and 5121 to, and to repeal Sections 5150.3, 5156, and 5157 of, the Welfare and Institutions Code, relating to mental health.

LEGISLATIVE COUNSEL’S DIGEST

SB 364, as amended, 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 provide consistent standards for protection of the personal rights of persons who are subject to involuntary detention and to provide services in the least restrictive setting appropriate to the needs of the person, as well as making technical changes.

This bill would encourage each county mental health department to post on its Internet Web site a current list, to be updated at least annually, of ambulatory services and other resources for persons with mental health disorders and substance abuse in the county that may be accessed by providers and consumers of mental health services.

Under existing law, when a person, as a result of mental disorder, is a danger to others, or to himself or herself, or gravely disabled, he or she may, upon probable cause, be taken into custody by a peace officer, member of the attending staff of an evaluation facility, designated members of a mobile crisis team, or other designated professional person, and placed in a facility designated by the county and approved by the State Department of Social Services as a facility for 72-hour treatment and evaluation. Existing law specifies advisements that are to be given to the person prior to involuntary commitment.

This bill would authorize a county health director to develop procedures for the county’s designation and training of professionals who will be designated to perform functions relating to the 72-hour treatment and evaluation. The bill would require the facilities for 72-hour treatment and evaluation to be licensed or certified as mental health treatment facilities by the State Department of Health Care Services or the State Department of Public Health. The bill would also authorize a professional person in charge of an evaluation facility to take custody of a person for this purpose, but would remove that ability for a designated member of a mobile crisis team. The bill would make prescribed changes to the advisements given when the person is taken into custody and when the person is admitted to the facility.

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 persons with severe mental health disorders,
developmental disabilities, and chronic alcoholism, and to eliminate
legal disabilities.

(b) To provide prompt evaluation and treatment of persons with
mental health disorders or impaired by chronic alcoholism.

(c) To guarantee and protect public safety.

(d) To safeguard individual rights through judicial review.

(e) To provide individualized treatment, supervision, and
placement services by a conservatorship program for persons who
are gravely disabled.

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

(g) To protect persons with mental health disorders and
developmental disabilities from criminal acts.

(h) To provide consistent standards for protection of the personal
rights of persons receiving services under this part and under Part
1.5 (commencing with Section 5585).

(i) To provide services in the least restrictive setting appropriate
to the needs of each person receiving services under this part and
under Part 1.5 (commencing with Section 5585).

SEC. 2.  

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 face to face or telehealth 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
agency or individual 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 agency or individual to whom the
person has been referred accepts responsibility for providing the
necessary services. All persons shall be advised of available precare
services that prevent initial recourse to hospital treatment or
aftercare services that support adjustment to community living
following hospital treatment. These services may be provided
through county mental health departments, State Department of
State Hospitals, Short-Doyle programs, 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. The interview or interviews may include
family members, significant support persons, providers, or other
entities or individuals, as appropriate and as authorized by law.
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 a mental health
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 health
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 person 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 a mental health 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 persons with
intellectual disabilities by reason of that disability 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. 3.  

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
is encouraged to include a current list of ambulatory services and
other resources for persons with mental health disorders and
substance abuse in the county that may be accessed by providers
and consumers of mental health services. The list of services on
the Internet Web site should be updated at least annually by the
county.

SEC. 4.  

Section 5121 is added to the Welfare and Institutions
Code, to read:

5121.  

The county mental health director may develop
procedures for the county’s designation and training of
professionals who will be designated to perform functions under
Section 5150. These procedures may include, but are not limited
to, the following:

(a) The license types, practice disciplines, and clinical
experience of professionals eligible to be designated by the county.

(b) The initial and ongoing training and testing requirements
for professionals eligible to be designated by the county.

(c) The application and approval processes for professionals
seeking to be designated by the county, including the timeframe
for initial designation and procedures for renewal of the
designation.

(d) The county’s process for monitoring and reviewing
professionals designated by the county to ensure appropriate
compliance with state law, regulations, and county procedures.

SEC. 5.  

Section 5150 of the Welfare and Institutions Code is
amended to read:

5150.  

(a) When a person, as a result of a mental health
disorder, is a danger to others, or to himself or herself, or gravely
disabled, a peace officer, professional person in charge of an
evaluation facility designated by the county, member of the
attending staff, as defined by regulation, of an evaluation facility
designated by the county , or professional person designated by
the county may, upon probable cause, take, or cause to be taken,
the person into custody for assessment, evaluation, and crisis
intervention, or place him or her in a facility designated by the
county as a facility for evaluation and treatment. These facilities
shall be licensed or certified as mental health treatment facilities
by the State Department of Health Care Services or the State
Department of Public Health. Assessment, as defined in Section
5150.4, and evaluation and crisis intervention, as defined in
subdivisions (a) and (e) of Section 5008, may be provided by a
professional person in charge of an evaluation facility designated
by the county, or by a professional person designated by the county.

(b) If in the judgment of the professional person designated by
the county or professional person in charge of the facility
designated by the county providing evaluation and treatment, or
his or her designee, the person can be properly served without
being detained, he or she shall be provided evaluation, crisis
intervention, or other inpatient or outpatient services on a voluntary
basis. Nothing in this subdivision shall be interpreted to prevent
a peace officer from delivering individuals to a designated facility
for assessment under this section. Furthermore, the assessment
requirement of this section shall not be interpreted to require peace
officers to perform any additional duties other than those specified
in Sections 5150.1 and 5150.2.

(c) Whenever a person is evaluated by a professional person
designated by the county or a professional person in charge of a
facility designated by the county and is found to be in need of
mental health services, but is not admitted to the facility, all
available alternative services provided for pursuant to Section 5151
shall be offered as determined by the county mental health director.

(d) If, in the judgment of the peace officer, member of the
attending staff, the professional person designated by the county,
or the professional person in charge of a designated facility, the
person cannot be properly served without being detained, the
facility shall require an application in writing stating the
circumstances under which the person’s condition was called to
the attention of the peace officer, member of the attending staff,
or professional person, and stating that the peace officer, member
of the attending staff, or professional person has probable cause
to believe that the person is, as a result of a mental health disorder,
a danger to others, or to himself or herself, or gravely disabled. If
the probable cause is based on the statement of a person other than
the peace officer, member of the attending staff, or professional
person, the identity of the person and portions of the person’s
statement relevant to the determination of probable cause shall be
documented in the application and the person giving the statement
shall be liable in a civil action for intentionally giving a statement
which he or she knows to be false. A copy of the application shall
be provided to the person being detained.

(e) At the time a person is taken into custody for evaluation, or
within a reasonable time thereafter, unless a responsible relative
or the guardian or conservator of the person is in possession of the
person’s personal property, the person taking him or her into
custody shall take reasonable precautions to preserve and safeguard
the personal property in the possession of or on the premises
occupied by the person. The person taking him or her into custody
shall then furnish to the court a report generally describing the
person’s property so preserved and safeguarded and its disposition,
in substantially the form set forth in Section 5211, except that if
a responsible relative or the guardian or conservator of the person
is in possession of the person’s property, the report shall include
only the name of the relative or guardian or conservator and the
location of the property, whereupon responsibility of the person
taking him or her into custody for that property shall terminate.
As used in this section, “responsible relative” includes the spouse,
parent, adult child, domestic partner, grandparent, grandchild, or
adult brother or sister of the person begin delete , except that it does not include
the person who applied for the petition under this article end delete .

(f) (1) Each person, at the time he or she is first taken into
custody under this section, shall be provided, by the person who
takes him or her into custody, the following information orally in
a language or modality accessible to the person. If the person
cannot understand an oral advisement, the information shall be
provided in writing. The information shall be in substantially the
following form:

 

My name is     . I am a     . (peace officer/mental health professional) with     . (name of agency) You are not under criminal arrest, but I am taking you for an examination by mental health professionals at     .     (name of facility) You will be told your rights by the mental health staff.

 

(2) If taken into custody at his or her own residence, the person
shall also be provided the following information:

You may bring a few personal items with you, which I will have
to approve. Please inform me if you need assistance turning off
any appliance or water. You may make a phone call and leave a
note to tell your friends or family where you have been taken.

begin delete

(3) If the advisement was not completed, the mental health
professional at the facility shall complete the advisement.

end delete

(g) The designated facility shall keep, for each patient evaluated,
a record of the advisement given pursuant to subdivision (f) which
shall include all of the following:

(1) The name of the person detained for evaluation.

(2) The name and position of the peace officer or mental health
professional taking the person into custody.

(3) The date the advisement was completed.

(4) Whether the advisement was completed.

(5) The language or modality used to give the advisement.

(6) If the advisement was not completed, a statement of good
cause, as defined by regulations of the State Department of Social
Services.

(h) (1) Each person admitted to a designated facility for
evaluation and treatment shall be given the following information
by admission staff at the evaluation unit. The information shall be
given orally and in writing and in a language or modality accessible
to the person. The written information shall be available to the
person in English and in the language that is the person’s principal
means of communication. Accommodations for other disabilities
that may impact communication shall also be made. The
information shall be in substantially the following form:

 

My name is     .

My position here is     .

You are being placed into the psychiatric unit because it is our professional opinion that, as a result of a mental health disorder, you are likely to (check applicable):

◻ Harm yourself.   ◻ Harm someone else.   ◻ Be unable to take care of your own food, clothing, and housing needs. We feel this is true because

(list of the facts upon which the allegation of dangerous or gravely disabled due to mental disorder is based, including pertinent facts arising from the admission interview).

You will be held begin delete on the ward end delete for a period up to 72 hours. During the 72 hours you may also be transferred to another facility. You may request to be treated at a facility of your choice. You will be given a choice of treatment providers.

During these 72 hours you will be evaluated by the hospital staff, and you may be given treatment, including medications. It is possible for you to be released before the end of the 72 hours. But if the staff decides that you need continued treatment you can be held for a longer period of time. If you are held longer than 72 hours, you have the right to a lawyer and a qualified interpreter and a hearing before a judge. If you are unable to pay for the lawyer, then one will be provided to you free of charge.

If you have questions about your legal rights, you may contact the county Patients’ Rights Advocate at    . (phone number for the county Patients’ Rights Advocacy office)

 

(2) If the notice is given in a county where weekends and
holidays are excluded from the 72-hour period, the patient shall
also be given the following information:

 

The 72-hour period does not include weekends or holidays. Your 72-hour period began    . (date/time)

 

begin delete

(3) If the advisement was not completed at admission, the
advisement process shall be continued on the ward until completed.

end delete

(i) For each patient admitted for 72-hour evaluation and
treatment, the facility shall keep with the patient’s medical record
a record of the advisement given pursuant to subdivision (h), which
shall include all of the following:

(1) The name of the person performing the advisement.

(2) The date of the advisement.

(3) Whether the advisement was completed.

(4) The language or modality used to communicate the
advisement.

(5) If the advisement was not completed, a statement of good
cause.

SEC. 6.  

Section 5150.3 of the Welfare and Institutions Code
is repealed.

SEC. 7.  

Section 5151 of the Welfare and Institutions Code is
amended to read:

5151.  

If the facility for 72-hour treatment and evaluation admits
the person, it may detain him or her for evaluation and treatment
for a period not to exceed 72 hours. Saturdays, Sundays, and
holidays may be excluded from the 72-hour period if the State
Department of Health Care Services certifies for each facility that
evaluation and treatment services cannot reasonably be made
available on those days. The certification by the department is
subject to renewal every two years. The department shall adopt
regulations defining criteria for determining whether a facility can
reasonably be expected to make evaluation and treatment services
available on Saturdays, Sundays, and holidays.

Prior to admitting a person to the facility for 72-hour treatment
and evaluation pursuant to Section 5150, the professional person
in charge of the facility or his or her designee shall assess the
individual in person to determine the appropriateness of the
involuntary detention.

SEC. 8.  

Section 5156 of the Welfare and Institutions Code is
repealed.

SEC. 9.  

Section 5157 of the Welfare and Institutions Code is
repealed.

SEC. 10.  

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.