Amended in Assembly August 5, 2013

Amended in Assembly June 26, 2013

Amended in Assembly June 24, 2013

Amended in Senate May 7, 2013

Amended in Senate April 15, 2013

Amended in Senate April 4, 2013

Senate BillNo. 364


Introduced by Senator Steinberg

February 20, 2013


An act to amend Sections 5001, 5008, 5150, 5151, and 5259.3 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, 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, among other things.

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 city or 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 and substance use disorders in the city or 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 forbegin delete 72-hourend delete 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.begin insert The bill would require assessment and evaluation, as defined, to be provided on an ongoing basis and would authorize crisis intervention to be provided concurrently with assessment, evaluation, or any other service.end insert The bill would also authorize a professional person in charge of a facility for evaluation and treatment to take custody of a person for this purpose. 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, and would require that the facility keep a record of the advisement. By requiring local mental health facilities to provide and maintain this additional information, 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:

P3    1

SECTION 1.  

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

3

5001.  

The provisions of this part and Part 1.5 (commencing
4with Section 5585) shall be construed to promote the legislative
5intent as follows:

6(a) To end the inappropriate, indefinite, and involuntary
7commitment of persons with mental health disorders,
8developmental disabilities, and chronic alcoholism, and to eliminate
9legal disabilities.

10(b) To provide prompt evaluation and treatment of persons with
11mental health disorders or impaired by chronic alcoholism.

12(c) To guarantee and protect public safety.

13(d) To safeguard individual rights through judicial review.

14(e) To provide individualized treatment, supervision, and
15placement services by a conservatorship program for persons who
16are gravely disabled.

17(f) To encourage the full use of all existing agencies,
18professional personnel, and public funds to accomplish these
19objectives and to prevent duplication of services and unnecessary
20expenditures.

21(g) To protect persons with mental health disorders and
22developmental disabilities from criminal acts.

23(h) To provide consistent standards for protection of the personal
24rights of persons receiving services under this part and under Part
251.5 (commencing with Section 5585).

26(i) To provide services in the least restrictive setting appropriate
27to the needs of each person receiving services under this part and
28under Part 1.5 (commencing with Section 5585).

29

SEC. 2.  

Section 5008 of the Welfare and Institutions Code is
30amended to read:

P4    1

5008.  

Unless the context otherwise requires, the following
2definitions shall govern the construction of this part:

3(a) “Evaluation” consists of multidisciplinary professional
4analyses of a person’s medical, psychological, educational, social,
5financial, and legal conditions as may appear to constitute a
6problem. Persons providing evaluation services shall be properly
7qualified professionals and may be full-time employees of an
8agency providing face-to-face, which includes telehealth,
9evaluation services or may be part-time employees or may be
10employed on a contractual basis.

11(b) “Court-ordered evaluation” means an evaluation ordered by
12a superior court pursuant to Article 2 (commencing with Section
135200) or by a superior court pursuant to Article 3 (commencing
14with Section 5225) of Chapter 2.

15(c) “Intensive treatment” consists of such hospital and other
16services as may be indicated. Intensive treatment shall be provided
17by properly qualified professionals and carried out in facilities
18qualifying for reimbursement under the California Medical
19Assistance Program (Medi-Cal) set forth in Chapter 7 (commencing
20with Section 14000) of Part 3 of Division 9, or under Title XVIII
21of the federal Social Security Act and regulations thereunder.
22Intensive treatment may be provided in hospitals of the United
23States government by properly qualified professionals. Nothing
24in this part shall be construed to prohibit an intensive treatment
25facility from also providing 72-hour evaluation and treatment.

26(d) “Referral” is referral of persons by each agency or facility
27providing assessment, evaluation, crisis intervention, or treatment
28services to other agencies or individuals. The purpose of referral
29shall be to provide for continuity of care, and may include, but
30need not be limited to, informing the person of available services,
31making appointments on the person’s behalf, discussing the
32person’s problem with the agency or individual to which the person
33has been referred, appraising the outcome of referrals, and
34arranging for personal escort and transportation when necessary.
35Referral shall be considered complete when the agency or
36individual to whom the person has been referred accepts
37responsibility for providing the necessary services. All persons
38shall be advised of available precare services that prevent initial
39recourse to hospital treatment or aftercare services that support
40adjustment to community living following hospital treatment.
P5    1These services may be provided through county or city mental
2health departments, state hospitals under the jurisdiction of the
3State Department of State Hospitals, regional centers under contract
4with the State Department of Developmental Services, or other
5public or private entities.

6Each agency or facility providing evaluation services shall
7maintain a current and comprehensive file of all community
8services, both public and private. These files shall contain current
9agreements with agencies or individuals accepting referrals, as
10well as appraisals of the results of past referrals.

11(e) “Crisis intervention” consists of an interview or series of
12interviews within a brief period of time, conducted by qualified
13professionals, and designed to alleviate personal or family
14situations which present a serious and imminent threat to the health
15or stability of the person or the family. The interview or interviews
16may be conducted in the home of the person or family, or on an
17inpatient or outpatient basis with such therapy, or other services,
18as may be appropriate. The interview or interviews may include
19family members, significant support persons, providers, or other
20entities or individuals, as appropriate and as authorized by law.
21Crisis intervention may, as appropriate, include suicide prevention,
22psychiatric, welfare, psychological, legal, or other social services.

23(f) “Prepetition screening” is a screening of all petitions for
24court-ordered evaluation as provided in Article 2 (commencing
25with Section 5200) of Chapter 2, consisting of a professional
26review of all petitions; an interview with the petitioner and,
27whenever possible, the person alleged, as a result of a mental health
28disorder, to be a danger to others, or to himself or herself, or to be
29gravely disabled, to assess the problem and explain the petition;
30when indicated, efforts to persuade the person to receive, on a
31voluntary basis, comprehensive evaluation, crisis intervention,
32referral, and other services specified in this part.

33(g) “Conservatorship investigation” means investigation by an
34agency appointed or designated by the governing body of cases in
35which conservatorship is recommended pursuant to Chapter 3
36(commencing with Section 5350).

37(h) (1) For purposes of Article 1 (commencing with Section
385150), Article 2 (commencing with Section 5200), and Article 4
39(commencing with Section 5250) of Chapter 2, and for the purposes
P6    1of Chapter 3 (commencing with Section 5350), “gravely disabled”
2means either of the following:

3(A) A condition in which a person, as a result of a mental health
4disorder, is unable to provide for his or her basic personal needs
5for food, clothing, or shelter.

6(B) A condition in which a person, has been found mentally
7incompetent under Section 1370 of the Penal Code and all of the
8following facts exist:

9(i) The indictment or information pending against the person at
10the time of commitment charges a felony involving death, great
11bodily harm, or a serious threat to the physical well-being of
12another person.

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

14(iii) As a result of a mental health disorder, the person is unable
15to understand the nature and purpose of the proceedings taken
16against him or her and to assist counsel in the conduct of his or
17her defense in a rational manner.

18(2) For purposes of Article 3 (commencing with Section 5225)
19and Article 4 (commencing with Section 5250), of Chapter 2, and
20for the purposes of Chapter 3 (commencing with Section 5350),
21“gravely disabled” means a condition in which a person, as a result
22of impairment by chronic alcoholism, is unable to provide for his
23or her basic personal needs for food, clothing, or shelter.

24(3) The term “gravely disabled” does not include persons with
25intellectual disabilities by reason of that disability alone.

26(i) “Peace officer” means a duly sworn peace officer as that
27term is defined in Chapter 4.5 (commencing with Section 830) of
28Title 3 of Part 2 of the Penal Code who has completed the basic
29training course established by the Commission on Peace Officer
30Standards and Training, or any parole officer or probation officer
31specified in Section 830.5 of the Penal Code when acting in relation
32to cases for which he or she has a legally mandated responsibility.

33(j) “Postcertification treatment” means an additional period of
34treatment pursuant to Article 6 (commencing with Section 5300)
35of Chapter 2.

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

37(l) “Antipsychotic medication” means any medication
38customarily prescribed for the treatment of symptoms of psychoses
39and other severe mental and emotional disorders.

P7    1(m) “Emergency” means a situation in which action to impose
2treatment over the person’s objection is immediately necessary
3for the preservation of life or the prevention of serious bodily harm
4to the patient or others, and it is impracticable to first gain consent.
5It is not necessary for harm to take place or become unavoidable
6prior to treatment.

begin insert

7(n) “Designated facility” or “facility designated by the county
8for evaluation and treatment” means a facility that is licensed or
9certified as a mental health treatment facility or a hospital, as
10defined in subdivision (a) or (b) of Section 1250 of the Health and
11Safety Code, by the State Department of Public Health, and may
12include, but is not limited to, a licensed psychiatric hospital, a
13licensed psychiatric health facility, and a certified crisis
14stabilization unit.

end insert
15

SEC. 3.  

Section 5013 is added to the Welfare and Institutions
16Code
, to read:

17

5013.  

(a) It is the intent of the Legislature that referrals
18between facilities, providers, and other organizations shall be
19facilitated by the sharing of information and records in accordance
20with Section 5328 and applicable federal and state laws.

21(b) Each city or county mental health department is encouraged
22to include on its Internet Web site a current list of ambulatory
23services and other resources for persons with mental health
24disorders and substance use disorders in the city or county that
25may be accessed by providers and consumers of mental health
26services. The list of services on the Internet Web site should be
27updated at least annually by the city or county mental health
28department.

29

SEC. 4.  

Section 5121 is added to the Welfare and Institutions
30Code
, to read:

31

5121.  

The county mental health director may develop
32procedures for the county’s designation and training of
33professionals who will be designated to perform functions under
34Section 5150. These procedures may include, but are not limited
35to, the following:

36(a) The license types, practice disciplines, and clinical
37experience of professionals eligible to be designated by the county.

38(b) The initial and ongoing training and testing requirements
39for professionals eligible to be designated by the county.

P8    1(c) The application and approval processes for professionals
2seeking to be designated by the county, including the timeframe
3for initial designation and procedures for renewal of the
4designation.

5(d) The county’s process for monitoring and reviewing
6professionals designated by the county to ensure appropriate
7compliance with state law, regulations, and county procedures.

8

SEC. 5.  

Section 5150 of the Welfare and Institutions Code is
9amended to read:

10

5150.  

(a) When a person, as a result of a mental health
11disorder, is a danger to others, or to himself or herself, or gravely
12disabled, a peace officer, professional person in charge of a facility
13designated by the county for evaluation and treatment, member of
14the attending staff, as defined by regulation, of a facility designated
15by the county for evaluation and treatment, designated members
16of a mobile crisis team, or professional person designated by the
17county may, upon probable cause, take, or cause to be taken, the
18person into custody for assessment, evaluation, and crisis
19intervention, orbegin delete place him or herend deletebegin insert placementend insert for evaluation and
20treatment in a facility designated by the county forbegin delete 72-hourend delete
21 evaluation and treatment. begin delete These facilities shall be licensed or
22certified as mental health treatment facilities or hospitals, as defined
23in subdivision (a) or (b) of Section 1250 of the Health and Safety
24Code, by the State Department of Health Care Services or the State
25Department of Public Health, and may include, but are not limited
26to, licensed psychiatric hospitals, licensed psychiatric health
27facilities, and certified crisis stabilization units. Assessment, as
28defined in Section 5150.4, evaluation, as defined in subdivision
29(a) of Section 5008, and crisis intervention, as defined in
30subdivision (e) of Section 5008, may be provided by a professional
31person in charge of a facility designated by the county for
32evaluation and treatment, a member of the attending staff, or by a
33professional person designated by the county.end delete
begin insert At a minimum,end insert
34begin insert assessment, as defined in Section 5150.4, andend insertbegin insert evaluation, as
35defined in subdivision (a) of Section 5008, shall be conducted and
36provided on an ongoing basis. Crisis intervention, as defined in
37subdivision (e) of Section 5008, may be provided concurrently
38with assessment, evaluation, or any other service.end insert

39(b) The professional person in charge of a facility designated
40by the county for evaluation and treatment, member of the
P9    1attending staff, or professional person designated by the county
2shall assess the person to determine whether he or she can be
3properly served without being detained. If in the judgment of the
4professional person in charge of the facility designated by the
5county for evaluation and treatment, member of the attending staff,
6or professional person designated by the county, the person can
7be properly served without being detained, he or she shall be
8provided evaluation, crisis intervention, or other inpatient or
9outpatient services on a voluntary basis. Nothing in this subdivision
10shall be interpreted to prevent a peace officer from delivering
11individuals to a designated facility for assessment under this
12section. Furthermore, the assessment requirement of this
13subdivision shall not be interpreted to require peace officers to
14perform any additional duties other than those specified in Sections
155150.1 and 5150.2.

16(c) Whenever a person is evaluated by a professional person in
17charge of a facility designated by the county for evaluation or
18treatment, member of the attending staff, or professional person
19designated by the county and is found to be in need of mental
20health services, but is not admitted to the facility, all available
21alternative services provided pursuant to subdivision (b) shall be
22offered as determined by the county mental health director.

23(d) If, in the judgment of thebegin delete peace officer,end delete professional person
24in charge of the facility designated by the county for evaluation
25and treatment, member of the attending staff, or the professional
26person designated by the county, the person cannot be properly
27served without being detained, the facility shall require an
28application in writing stating the circumstances under which the
29person’s condition was called to the attention of the peace officer,
30professional person in charge of the facility designated by the
31county for evaluation and treatment, member of the attending staff,
32or professional person designated by the county, and stating that
33the peace officer, professional person in charge of the facility
34designated by the county for evaluation and treatment, member of
35the attending staff, or professional person designated by the county
36has probable cause to believe that the person is, as a result of a
37mental health disorder, a danger to others, or to himself or herself,
38or gravely disabled. If the probable cause is based on the statement
39of a person other than the peace officer, professional person in
40charge of the facility designated by the county for evaluation and
P10   1treatment, member of the attending staff, or professional person
2designated by the county, the person shall be liable in a civil action
3for intentionally giving a statement which he or she knows to be
4false.

5(e) At the time a person is taken into custody for evaluation, or
6within a reasonable time thereafter, unless a responsible relative
7or the guardian or conservator of the person is in possession of the
8person’s personal property, the person taking him or her into
9custody shall take reasonable precautions to preserve and safeguard
10the personal property in the possession of or on the premises
11occupied by the person. The person taking him or her into custody
12shall then furnish to the court a report generally describing the
13person’s property so preserved and safeguarded and its disposition,
14in substantially the form set forth in Section 5211, except that if
15a responsible relative or the guardian or conservator of the person
16is in possession of the person’s property, the report shall include
17only the name of the relative or guardian or conservator and the
18location of the property, whereupon responsibility of the person
19taking him or her into custody for that property shall terminate.
20As used in this section, “responsible relative” includes the spouse,
21parent, adult child, domestic partner, grandparent, grandchild, or
22adult brother or sister of the person.

23(f) (1) Each person, at the time he or she is first taken into
24custody under this section, shall be provided, by the person who
25takes him or her into custody, the following information orally in
26a language or modality accessible to the person. If the person
27cannot understand an oral advisement, the information shall be
28provided in writing. The information shall be in substantially the
29following form:


30

 

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.

3031

 

P11   1(2) If taken into custody at his or her own residence, the person
2shall also be provided the following information:


4You may bring a few personal items with you, which I will have
5to approve. Please inform me if you need assistance turning off
6any appliance or water. You may make a phone call and leave a
7note to tell your friends or family where you have been taken.


9(g) The designated facility shall keep, for each patient evaluated,
10a record of the advisement given pursuant to subdivision (f) which
11 shall include all of the following:

12(1) The name of the person detained for evaluation.

13(2) The name and position of the peace officer or mental health
14professional taking the person into custody.

15(3) The date the advisement was completed.

16(4) Whether the advisement was completed.

17(5) The language or modality used to give the advisement.

18(6) If the advisement was not completed, a statement of good
19cause, as defined by regulations of the State Department of Health
20Care Services.

21(h) (1) Each person admitted to a facility designated by the
22county for evaluation and treatment shall be given the following
23information by admission staff of the facility. The information
24shall be given orally and in writing and in a language or modality
25accessible to the person. The written information shall be available
26to the person in English and in the language that is the person’s
27primary means of communication. Accommodations for other
28disabilities that may affect communication shall also be provided.
29The information shall be in substantially the following form:

 

My name is    .

My position here is    .

 You are being placed into this psychiatric facility 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 believe this is true because

   

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

 You will be held for a period up to 72 hours. During the 72 hours you may also be transferred to another facility. You may request to be evaluated or treated at a facility of your choice. You may request to be evaluated or treated by a mental health professional of your choice. We cannot guarantee the facility or mental health professional you choose will be available, but we will honor your choice if we can.

 During these 72 hours you will be evaluated by the facility 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)

Your 72-hour period began    .

(date/time)

 

26(2) If the notice is given in a county where weekends and
27holidays are excluded from the 72-hour period, the patient shall
28be informed of this fact.

29(i) For each patient admitted forbegin delete 72-hourend delete evaluation and
30treatment, the facility shall keep with the patient’s medical record
31a record of the advisement given pursuant to subdivision (h), which
32shall include all of the following:

33(1) The name of the person performing the advisement.

34(2) The date of the advisement.

35(3) Whether the advisement was completed.

36(4) The language or modality used to communicate the
37advisement.

38(5) If the advisement was not completed, a statement of good
39cause.

P13   1

SEC. 6.  

Section 5150.3 of the Welfare and Institutions Code
2 is repealed.

3

SEC. 7.  

Section 5151 of the Welfare and Institutions Code is
4amended to read:

5

5151.  

If the facility designated by the county for evaluation
6and treatment admits the person, it may detain him or her for
7evaluation and treatment for a period not to exceed 72 hours.
8Saturdays, Sundays, and holidays may be excluded from the
9begin delete 72-hourend delete period if the State Department of Health Care Services
10certifies for each facility that evaluation and treatment services
11cannot reasonably be made available on those days. The
12certification by the department is subject to renewal every two
13years. The department shall adopt regulations defining criteria for
14determining whether a facility can reasonably be expected to make
15evaluation and treatment services available on Saturdays, Sundays,
16and holidays.

17Prior to admitting a person to the facility forbegin delete 72-hourend delete treatment
18and evaluation pursuant to Section 5150, the professional person
19in charge of the facility or his or her designee shall assess the
20individual in person to determine the appropriateness of the
21involuntary detention.

22

SEC. 8.  

Section 5156 of the Welfare and Institutions Code is
23repealed.

24

SEC. 9.  

Section 5157 of the Welfare and Institutions Code is
25repealed.

26

SEC. 10.  

Section 5259.3 of the Welfare and Institutions Code
27 is amended to read:

28

5259.3.  

(a) Notwithstanding Section 5113, if the provisions
29of Section 5257 have been met, the professional person in charge
30of the facility providing intensive treatment, his or her designee,
31the professional person designated by the county, the medical
32director of the facility or his or her designee described in Section
335257, the psychiatrist directly responsible for the person’s
34treatment, or the psychologist shall not be held civilly or criminally
35liable for any action by a person released before the end of 14 days
36pursuant to this article.

37(b) The professional person in charge of the facility providing
38intensive treatment, his or her designee, the professional person
39designated by the county, the medical director of the facility or
40his or her designee described in Section 5257, the psychiatrist
P14   1directly responsible for the person’s treatment, or the psychologist
2shall not be held civilly or criminally liable for any action by a
3person released at the end of the 14 days pursuant to this article.

4(c) The attorney or advocate representing the person, the
5court-appointed commissioner or referee, the certification review
6hearing officer conducting the certification review hearing, and
7the peace officer responsible for the detainment of the person shall
8not be civilly or criminally liable for any action by a person
9released at or before the end of 14 days pursuant to this article.

10(d) The amendments to this section made by Assembly Bill 348
11 of the 2003-04 Regular Session shall not be construed to revise
12or expand the scope of practice of psychologists, as defined in
13Chapter 6.6 (commencing with Section 2900) of Division 2 of the
14Business and Professions Code.

15

SEC. 11.  

If the Commission on State Mandates determines
16that this act contains costs mandated by the state, reimbursement
17to local agencies and school districts for those costs shall be made
18pursuant to Part 7 (commencing with Section 17500) of Division
194 of Title 2 of the Government Code.



O

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