BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  SB 364
                                                                  Page  1

          Date of Hearing:   August 14, 2013

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                  SB 364 (Steinberg) - As Amended:  August 5, 2013 

          Policy Committee:                             HealthVote:19-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  

          As proposed to be amended, this bill revises numerous provisions  
          of the Lanterman-Petris-Short (LPS) Act related to 72-hour  
          involuntary detention for mental health evaluation and treatment  
          (so-called "5150 holds," as defined in Section 5150 of the  
          Welfare and Institutions Code).  Specifically, key provisions of  
          this bill:

          1)Broaden the types of facilities counties may designate for  
            purposes of 72-hour evaluation and treatment.  

          2)Authorize 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.

          3)Recast Section 5150 by adding and modifying other existing  
            provisions related to the required sequencing of events.

          4)Make numerous other clarifying, technical, and minor  
            substantive changes to Section 5150 and related provisions.   

           FISCAL EFFECT  

          Negligible state fiscal effect. 

           COMMENTS  

           1)Rationale  . This bill is intended make focused changes to the  
            landmark LPS Act, which the author states comprise a civil  
            rights act for persons with mental health disorders to ensure  
            their personal rights. 








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          The author writes that this bill broadens the types of  
            facilities a county can designate for 5150 purposes in order  
            to provide counties with more options for assisting  
            individuals.  Provisions authorizing county mental health  
            directors to develop procedures for the county designation of  
            LPS facilities and the training of professionals are intended  
            to improve consistency across counties, transparency, and  
            quality improvement in the 5150 process. In addition, the  
            author indicates this bill restructures and recasts several  
            provisions to more clearly articulate the sequencing of events  
            in the 5150 process.  Finally, the bill modifies legislative  
            intent language, updates terminology, and emphasizes that  
            services need to be provided in the least restrictive  
            settings, as appropriate.  

            In support, the California Mental Health Directors Association  
            (CMHDA) writes that this bill provides helpful clarifications  
            to the LPS Act while upholding the original intent of these  
            landmark civil rights statutes.  Disability Rights California,  
            also in support, believes this bill will help ensure people  
            with mental health disabilities are treated appropriately and  
            in the least restrictive environments.

           2)Related Legislation  . 

             a)   AB 110 (Blumenfield), Chapter 20, Statutes of 2013,  
               enacts the 2013-14 Budget Act, which includes, among other  
               provisions, $206 million ($143 million one-time GF) for a  
               major investment in mental health services, including  
               additional residential treatment capacity, crisis treatment  
               teams, and triage personnel. AB 110 also designates  
               $400,000 for the development of consensus guidelines for  
               involuntary assessment and discharge regarding Section 5150  
               and related statutes, and training as appropriate,  
               including for peace officers.

             b)   SB 585 (Steinberg), also being heard today, clarifies  
               that Mental Health Services Act funds and various other  
               local funds may be used to provide mental health services  
               under the Assisted Outpatient Treatment Demonstration  
               Project Act of 2002, or Laura's Law, and allows counties to  
               opt to implement Laura's Law through the county budget  
               process.









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          1)Concern  . The California American College of Emergency  
            Physicians (ACEP/CA) is opposed to a provision of the bill  
            that de-links requirements previously placed on "designated  
            facilities" and applies them to designated persons.  ACEP/CA  
            requests an amendment to clarify that designated facilities  
            must provide certain services on a voluntary basis, instead of  
            providing the person a right to receive such services.  The  
            Citizen's Commission on Human Rights is opposed to this bill  
            based on opposition to the current provisions of Section 5150  
            and to involuntary treatment broadly. 

          2)Amendments.  Amendments reinstate the current law requirement  
            that DHCS approve designated facilities, clarify the 72-hour  
            limit also applies to circumstances where an individual is  
            taken into custody for assessment and evaluation without  
            necessarily being admitted to a designated facility, and  
            clarify one usage of the word "facility" refers to the  
            "admitting facility."  

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081