BILL ANALYSIS �
SENATE JUDICIARY COMMITTEE
Senator Noreen Evans, Chair
2013-2014 Regular Session
SB 364 (Steinberg)
As Amended April 15, 2013
Hearing Date: April 30, 2013
Fiscal: Yes
Urgency: No
NR
SUBJECT
Mental Health
DESCRIPTION
Existing law enacted the Lanterman-Petris-Short (LPS) Act to end
the inappropriate, indefinite, and involuntary commitment of
persons with mental health disorders and provide for the prompt
evaluation and treatment of persons with serious mental
disorders. Among other provisions, the LPS Act authorizes the
temporary involuntary detainment of a person for mental health
evaluation and treatment.
This bill would expand the types of facilities a county may
designate for the purpose of a 72-hour treatment and evaluation
under the LPS Act, to include facilities licensed or certified
as mental health treatment facilities by the Department of
Health Care Services or the Department of Public Health. This
bill would also authorize county mental health directors to
develop procedures for the designation and training of
professionals who perform functions under the LPS Act.
This bill would also require that the advisement orally provided
to a person when first taken into custody be in a language or
modality accessible to that person, and would require that
voluntary services be offered if a patient may be properly
served without being detained, as specified. This bill would
additionally clarify that in a "crisis intervention" interview,
family members, significant support persons, providers, or other
entities or individuals may be included. This bill would also
expand the definition of "responsible relative," to include a
domestic partner, grandparent, or grandchild as that term
applies to safeguarding a person's personal property when they
(more)
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are taken into custody.
Finally, this bill would recast and restructure several
provisions to more accurately reflect the process of events when
a person is detained, and make other clarifying and technical
changes.
BACKGROUND
The Lanterman-Petris-Short (LPS) Act was enacted in the 1960s to
develop a statutory process under which individuals could be
involuntarily held and treated in a mental health facility in a
manner that safeguarded their constitutional rights. The LPS
Act was intended to balance the goals of maintaining the
constitutional right to personal liberty and choice in mental
health treatment, with the goal of safety when an individual may
be a danger to oneself or others, or is gravely disabled.
At the time of its enactment, the LPS Act was considered
progressive because it afforded the mentally disordered more
legal rights than most other states. Since its passage in 1967
the law in the field of mental health has continues to evolve
toward even greater legal rights for mentally disordered
persons.
This bill seeks to make focused changes to the LPS Act to
address both the needs and rights of patients and the ability of
counties to adequately serve those patients. Specifically, this
bill would update outmoded language related to mental health and
clarify rights of patients by better defining what information
and services must be afforded to them. This bill would also
authorize county mental health directors to develop procedures
for the training of professionals who perform specified mental
health procedures and expand the types of facilities available
for LPS Act services. This bill would additionally make other
clarifying and technical changes.
CHANGES TO EXISTING LAW
1.Existing law provides, among other things, that the
Legislative intent of the LPS Act, is to end inappropriate,
indefinite, and involuntary commitment of mentally disordered
persons, developmentally disabled persons, and persons
impaired by chronic alcoholism. Existing law also establishes
that the LPS Act is intended to eliminate legal disabilities
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and protect mentally disordered and developmentally disabled
persons. (Welf. & Inst. Code Sec. 5001.)
This bill would revise the above provisions to eliminate the
terms "mentally disordered persons and developmentally
disabled persons" and would add "persons with severe mental
health disorders, developmental disabilities." This bill
would also state the Legislative intent to:
provide consistent standards for protection of the
personal rights of persons receiving services under the LPS
Act and under the Children's Civil Commitment and Mental
Health Treatment Act;
provide services in the least restrictive setting
appropriate to the needs of each person receiving services
under those two bodies of law; and
ensure that referrals between facilities, providers, and
other organizations be facilitated by the sharing of
information and records in accordance with applicable
federal and state laws.
1.Existing law authorizes a peace officer, member of the
attending staff of an evaluation facility designated by the
county, or other professional person designated by the county,
upon probable cause, to take a person with a mental disorder
who is a danger to himself or others, or who is gravely
disabled, into custody and place him in a facility designated
by the county and approved as a facility for 72-hour treatment
and evaluation. (Welf. & Inst. Code Sec. 5150.)
This bill would clarify that a professional person in charge
of an evaluation facility designated by the county may take,
as specified, a person with a mental disorder into custody for
a 72-hour treatment and evaluation.
2.Existing law requires facilities, for the purposes of a
72-hour treatment and evaluation, to be approved by the
Department of Social Services as a facility for 72-hour
treatment and evaluation. (Welf. & Inst. Code Sec. 5150.)
This bill would instead require a facility, for the purposes
of a 72-hour treatment and evaluation, to be licensed or
certified as a mental health treatment facility by the
Department of Health Care Services or the Department of Public
Health.
3.Existing law requires that a person who is taken into custody
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for a 72-hour treatment and evaluation be provided an oral
advisement that informs the person of:
the name of the officer or mental health professional
authorizing custody;
the fact that the person is not under criminal arrest,
but under a mental health examination;
where the evaluation will take place;
that he or she may take a few personal items; and
that he or she may make a phone call or leave a note to
inform family and friends where he or she has been taken.
(Welf. & Inst. Code Sec. 5157.)
Existing law further requires that a person who is admitted
for a 72-hour evaluation and treatment be provided with the
following information in writing:
that he or she is being placed in the psychiatric unit
because he or she may hurt himself or herself, or others,
or be unable to take care of himself or herself, as
specified;
a listing of the facts upon which the above allegation
is based;
that he or she will be held for a period of up to 72
hours, and when that period will begin;
that he or she may be held for a longer period of time;
and
his or her right to a lawyer, as specified. (Welf. &
Inst. Code Sec. 5157.)
This bill would require the above oral advisement to be
provided in a language or modality accessible to the person.
This bill would further require that if the person cannot
understand the oral advisement, the information must be
provided to him or her in writing, and that the facility keep
a record of the language or modality used to communicate the
advisement.
This bill would require an evaluation, crisis intervention,
and/or other patient services to be conducted on a voluntary
basis if the person can be properly served without being
detained, as specified.
This bill would require, that if probable cause for detaining
a person is based on the statement of a person other than a
peace officer, member of the attending staff, or professional
person, the documentation of the identity of the person and
his or her statement relevant to the determination of probable
cause, be included in the application, and a copy of the
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application be provided to the person being detained.
1.This bill would authorize the county mental health director to
develop procedures for the county's designation and training
of professionals who would perform LPS Act functions
including:
license types, practice disciplines, and clinical
experience of professionals;
initial and ongoing training and testing requirements
for professionals;
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; and
the county's process for monitoring and reviewing these
professionals to ensure appropriate compliance with state
law, regulations, and county procedures.
This bill would expand the definition of "responsible
relative" for the purpose of who may take possession of the
property of the detained person to include a domestic partner,
grandparent, or grandchild.
This bill would require that a person admitted to a designated
facility, be informed that he or she may request to be treated
at a facility and/or provider of his or her choice, as
specified.
This bill would update definitions within the LPS Act by: (1)
clarifying that "telehealth" is included within the definition
of "evaluation;" and (2) clarifying that interviews conducted
as part of crisis intervention may include family members,
significant support persons, providers, or other entities or
individuals, as appropriate and as authorized by law.
This bill would encourage county mental health departments to
include on their Internet Web sites a current list, as
specified, of ambulatory services and other resources for
persons with mental health disorders and substance abuse that
may be accessed by providers and consumers of mental health
services.
This bill would reorganize existing LPS statutes and make
other clarifying and technical changes.
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COMMENT
1.Stated need for the bill
According to the author:
Unfortunately, Section 5150 of Welfare and Institutions Code
has become part of a modern day vernacular that implies an
individual is being locked-up, and put away. SB 364 is
intended to change this construct by making focused changes to
this section of the landmark LPS Act which was, and remains to
this day, a civil rights act for persons with mental health
disorders to ensure their personal rights.
2.Clarifies rights of persons involuntarily detained for
treatment and evaluation
Existing law, under the Lanterman-Petris-Short Act, authorizes
peace officers, members of the attending staff of an evaluation
facility designated by the county, or other professional persons
designated by the county to take an individual into custody if
they believe that, due to a mental disorder, a person is: (1) a
danger to himself or herself; (2) a danger to others; or (3)
gravely disabled, meaning unable to provide for his or her basic
needs for food, clothing, and shelter.
The person taking an individual into custody must take
reasonable precautions to safeguard his or her property, advise
the individual that he or she is not under criminal arrest,
allow the individual to gather a few personal belongings, and
allow the individual to make a phone call or leave a note
indicating to family or friends where he or she is being taken.
The individual may then be detained for up to 72 hours if an
appropriate member of the staff at an approved facility finds
that the individual is a danger or gravely disabled, as listed
above.
When an individual is thus detained, he or she must then be
given a written advisement containing various information
including: (1) why he or she is being detained, as specified;
(2) that he or she will be held for up to 72 hours, and when
that 72-hour period begins; and (3) that he or she will be
evaluated and may receive treatment.
This bill would add clarification to this process in a number of
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ways, and add various protections to ensure that individuals
taken into custody are informed of their rights and treated with
respect. These goals would be further reflected in Legislative
intent language, which expresses the intent to provide
consistent standards for protection of the personal rights of
persons receiving services, and to provide services in the least
restrictive setting appropriate.
Specifically, this bill would require that the oral advisement
which is given to a person when he or she is first taken into
custody, be provided in a language or modality that he or she
understands. This is consistent with existing law, which
requires that the written advisement provided to a patient when
he or she is admitted for up to 72 hours be in a language or
modality that the patient understands. This bill would also
require that a patient is advised that he or she may be treated
at a facility or by a provider of his or her choice, and that
current facility will try to honor that request. Recognizing
the importance of each patient's autonomy, this bill would
require that evaluation, crisis intervention, and/or other
patient services be conducted on a voluntary basis, outpatient
if necessary, if the person can be properly served without being
detained.
Further, this bill would incorporate into the 72-hour evaluation
and treatment process a patient's family, and the support family
members may offer, in a meaningful way. It would expand the
definition of "responsible relative" to include a domestic
partner, grandparent, or grandchild for the purpose of
safeguarding an individual's property when he or she is admitted
for evaluation and treatment. This bill would also clarify that
interviews conducted as part of crisis intervention may include
family members, significant support persons, providers, or other
entities and individuals, as appropriate and as authorized by
law.
3.Authorizes county mental health directors to designate
facilities and implement training standards
Under existing law, the State Department of Social Services
approves particular facilities, designated by the county, for
72-hour treatment and evaluation under the LPS Act. This bill
would instead authorize these facilities to be licensed or
certified as mental health treatment facilities by the State
Department Health Care Services or the State Department of
Public Health. This provision will expand the type and number
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of facilities that are available to serve individuals. Thus,
under this bill, facilities such as psychiatric hospitals,
free-standing acute psychiatric hospitals, and psychiatric units
in general hospitals, as well as certified facilities such as
crisis stabilization units, will be able to serve the needs of
persons with mental health disorders.
This bill would also authorize county mental health directors to
develop procedures for the training of professionals who perform
the functions under the LPS Act. Under this bill, directors
would be encouraged to consider specified factors in the
training of their county professionals, but would not be subject
to mandatory considerations or criteria. Among the factors that
would be suggested for consideration regarding mental health
professionals are: (1) the license types, practice disciplines,
and clinical experience; (2) initial and ongoing training and
testing requirements; (3) the application processes; and (4) the
county's process for monitoring and reviewing these
professionals to ensure appropriate compliance with state law,
regulations, and county procedures.
Arguably, authorizing counties to exercise more independence
over their mental health facilities and professionals will allow
them the flexibility needed to address the needs of each unique
county population. To this end, the author notes that these
changes "will improve consistency across counties for the
application of the [72-hour evaluation and treatment]? protocols
as well as serve as a quality improvement tool for professionals
to be specifically trained in the 5150 process."
4.Author's amendments
The following amendment was accepted by the author in the Senate
Health Committee:
On page 11, strike line 8 and insert "by a facility or
provider of your choice. You will be given a choice of
treatment providers. However, while we make an effort to
honor such requests, we cannot guarantee that you will be
treated by a specific facility or provider."
The following technical and clarifying amendments are offered by
the author:
1.On page 3, in line 2, strike "severe"
2.On page 7, in line 28, after "county," insert "designated
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members of a mobile crisis team"
3.On page 7, in line 32, after "for" insert "72-hour"
4.On page 7, in line 33, after "facilities" insert "or hospitals
(as defined in Section 1250(a) and 1250(b) of Health and
Safety Code)"
5.On page 12, after line 33 insert:
Section 5259.3. of the Welfare and Institutions Code is
amended to read:
(a) Notwithstanding Section 5113, if the provisions of Section
5257 have been met, the professional person in charge of the
facility providing intensive treatment, his or her designee,
the professional person designated by the county, the medical
director of the facility or his or her designee described in
Section 5257, the psychiatrist directly responsible for the
person's treatment, or the psychologist shall not be held
civilly or criminally liable for any action by a person
released before the end of 14 days pursuant to this article.
(b) The professional person in charge of the facility
providing intensive treatment, his or her designee, the
professional person designated by the county, the medical
director of the facility or his or her designee described in
Section 5257, the psychiatrist directly responsible for the
person's treatment, or the psychologist shall not be held
civilly or criminally liable for any action by a person
released at the end of the 14 days pursuant to this article.
Support : California Mental Health Directors Association;
National Alliance on Mental Illness
Opposition : None Known
HISTORY
Source : Author
Related Pending Legislation : None Known
Prior Legislation : SB 677(Lanterman, Petris, Short, Ch. 1667,
Stats. 1967) expressed Legislative intent to end the
inappropriate, indefinite, and involuntary commitment of persons
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with mental health disorders and provide for the prompt
evaluation and treatment of persons with serious mental
disorders.
Prior Vote : Senate Committee on Health (Ayes 7, Noes 1)
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