BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



           ----------------------------------------------------------------- 
          |SENATE RULES COMMITTEE            |                        SB 364|
          |Office of Senate Floor Analyses   |                              |
          |1020 N Street, Suite 524          |                              |
          |(916) 651-1520         Fax: (916) |                              |
          |327-4478                          |                              |
           ----------------------------------------------------------------- 
           
                                           
                                    THIRD READING


          Bill No:  SB 364
          Author:   Steinberg (D)
          Amended:  5/7/13
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  7-1, 4/24/13
          AYES:  Hernandez, Beall, De Le�n, DeSaulnier, Nielsen, Pavley,  
            Wolk
          NOES:  Anderson
          NO VOTE RECORDED:  Monning

           SENATE JUDICIARY COMMITTEE  :  6-1, 4/30/13
          AYES:  Evans, Walters, Corbett, Jackson, Leno, Monning
          NOES:  Anderson

           SENATE APPROPRIATIONS COMMITTEE  :  6-0, 5/20/13
          AYES:  De Le�n, Walters, Gaines, Hill, Padilla, Steinberg
          NO VOTE RECORDED:  Lara


           SUBJECT  :    Mental health

           SOURCE :     Author


           DIGEST  :    This bill broadens the types of facilities that can  
          be used for purposes of a 72-hour treatment and evaluation under  
          Welfare and Institutions Code Section 5150 of the  
          Lanterman-Petris-Short Act (LPS Act) for individuals with a  
          mental health disorder to include facilities licensed or  
          certified as mental health treatment facilities by the  
          Department of Health Care Services (DHCS) or the Department of  
                                                                CONTINUED





                                                                     SB 364
                                                                     Page  
          2

          Public Health (DPH).  Permits county mental health directors to  
          develop procedures for the designation and training of  
          professionals who will be designated to perform functions under  
          Section 5150.

           ANALYSIS  :    

          Existing law:

          1. Provides, under the LPS Act, for the involuntary commitment  
             and treatment of individuals with specified mental disorders  
             and for the protection of committed individuals.

          2. States legislative intent regarding the LPS Act, which  
             includes ending inappropriate, indefinite, and involuntary  
             commitment of mentally disordered persons, developmentally  
             disabled persons, and persons impaired by chronic alcoholism,  
             and eliminating legal disabilities and protecting mentally  
             disordered persons and developmentally disabled persons.

          3. Authorizes, under Section 5150 of the LPS Act, 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/herself, a danger to others, or who is gravely  
             disabled, into custody and place him/her in a facility  
             designated by the county and approved as a facility for  
             72-hour treatment and evaluation.

          4. Requires a person who is taking into custody for a 72-hour  
             treatment and evaluation to be provided specified information  
             orally, and requires a person who is admitted for a 72-hour  
             evaluation and treatment to be provided specified  
             information.

          This bill:

          1. Broadens existing legislative intent language in the LPS Act  
             to provide prompt evaluation and treatment of persons with  
             mental health disorders.

          2. Adds to existing legislative intent regarding the LPS Act.


                                                                CONTINUED





                                                                     SB 364
                                                                     Page  
          3

          3. Updates definitions within the LPS Act, as specified.

          4. States legislative intent that referrals between facilities,  
             providers, and other organizations be in accordance with  
             applicable federal and state laws requiring confidentiality  
             of information and records.

          5. Encourages each county mental health department's Internet  
             Web site to include a current list of ambulatory services and  
             other resources for persons with mental health disorders and  
             substance abuse.  Encourages the list of services to be  
             updated at least annually.

          6. Permits the county mental health director to develop  
             procedures for the county's designation and training of  
             professionals who will be designated to perform functions  
             under Section 5150. 

          7. Clarifies that when a person, as a result of a mental health  
             disorder, is a danger to others, or to himself/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,  
             designated members of a mobile crisis team, 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/her in a facility designated by the county as a facility  
             for 72-hour evaluation and treatment.

          8. Permits a person with a mental health disorder to be taken  
             into custody for assessment evaluation and treatment or  
             placed in a facility.

          9. Requires the facility, for purposes of a 72-hour treatment  
             and evaluation, to be licensed or certified as mental health  
             treatment facility or hospital, by DHCS or DPH.

          10.Requires, if probable cause for detaining a person is based  
             on a statement of a person other than a 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 to be documented in  
             the application, and requires a copy of the application to be  

                                                                CONTINUED





                                                                     SB 364
                                                                     Page  
          4

             provided to the person being detained.

          11.Expands the definition of "responsible relative." 

          12.Requires the oral advisements currently required to be given  
             to a person when he/she is first taken into custody be  
             provided in a language or modality accessible to the person.   
             Requires, when a person is admitted to a designated facility,  
             accommodations for other disabilities that may impact  
             communication to be made.

          13.Requires, when a person is admitted to a designated facility,  
             that the individual can request to be treated at a facility  
             of their choice, and that the person will be given a choice  
             of providers but that no guarantee of treatment by a specific  
             facility or provider can be made.  Requires the person be  
             told he/she can contact the county's Patients' Rights  
             Advocates if they have questions about their legal rights.

          14.Requires, for each patient admitted for a 72-hour evaluation  
             and treatment, the facility to keep in the patient's record  
             the language or modality used to communicate.

          15.Clarifies that the professional person, as defined, providing  
             treatment or the attorney or advocate representing the person  
             will not be held civilly or criminally liable for any action  
             by a person released before the end of 14 days.  

          16.Clarifies that nothing in this bill should be construed to  
             revise or expand the scope of practice of psychologists, as  
             defined.  

          17.Updates language in the LPS Act, rearranges provisions of the  
             LPS Act to have the statute align with the sequence of  
             events, and moves provisions dealing with voluntary treatment  
             to earlier in the statute.

           Background
           
           5150 of the LPS Act  .  Section 5150 law allows 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, an individual is:

                                                                CONTINUED





                                                                     SB 364
                                                                     Page  
          5


          A.   A danger to himself/herself;
          B.   A danger to others; or
          C.   Gravely disabled.

          Under existing law, the person taking an individual into custody  
          must take reasonable precautions to safeguard their property,  
          advise the individual that this is not a criminal arrest, allow  
          the individual to gather some personal things to bring with  
          them, and make a phone call.  The professional staff of the  
          county designated facility may detain the individual for up to  
          72 hours if the staff finds that the individual meets the 5150  
          criteria.  The individual must be given written notice of why  
          he/she is being held, and must be evaluated.  The evaluation  
          consists of a multidisciplinary analysis of the individual's  
          medical, psychological, educational, social, financial and legal  
          situation.

           FISCAL EFFECT :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  Yes

          According to the Senate Appropriations Committee:

             Minor local costs, not likely to be reimbursed (local  
             funds/General Fund).  

             Minor cost savings to the Department of Social Services, as  
             the Department will no longer be required to approve county  
             facilities for use as a 72-hour evaluation and treatment  
             facility (General Fund).


           ARGUMENTS IN SUPPORT  :    According to the author's office,  
          unfortunately, Section 5150 has become part of a modern day  
          vernacular that implies an individual is being locked-up and put  
          away.  The author's office states this bill 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.  The author's office claims this  
          bill makes several fundamental changes.  First, it broadens the  
          types of facilities a county can designate for 5150 purposes.   
          This will provide counties with more options for assisting  
          clients with significant and grave needs, can assist in  

                                                                CONTINUED





                                                                     SB 364
                                                                     Page  
          6

          alleviating emergency room wait times for this client  
          population, and most importantly, and can offer a less  
          restrictive environment for a client to receive necessary  
          assistance.  

          Second, this bill authorizes county mental health directors to  
          develop procedures for the county designation of LPS facilities  
          and the training of professionals who perform the functions of  
          Section 5150.  This change will improve consistency across  
          counties for the application of 5150 protocols as well as serve  
          as a quality improvement tool for professionals to be  
          specifically trained in the 5150 process.

          According to Disability Rights California, this bill clarifies  
          provisions of the LPS Act, ensures people have access to  
          services in the most appropriate setting and protects clients'  
          rights.  It makes changes to the legislative intent portions of  
          the LPS Act related to consistent treatment and least  
          restrictive environment.  It encourages counties to serve people  
          on a voluntary basis, even after being placed on a custodial  
          hold.  It encourages counties to develop training programs for  
          designated staff about the LPS Act, which will help ensure  
          people with mental health disabilities are treated appropriately  
          and in least restrictive environments.  It further updates and  
          strengthens advisements given to clients, including ensuring  
          children and property is safeguarded when a person is taken into  
          a custodial hold.


          JL:k  5/21/13   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  NONE RECEIVED

                                   ****  END  ****











                                                                CONTINUED