BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                 UNFINISHED BUSINESS


          Bill No:  SB 364
          Author:   Steinberg (D)
          Amended:  8/15/13
          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

           SENATE FLOOR  :  39-0, 5/28/13
          AYES:  Anderson, Beall, Berryhill, Block, Calderon, Cannella,  
            Corbett, Correa, De Le�n, DeSaulnier, Emmerson, Evans, Fuller,  
            Gaines, Galgiani, Hancock, Hernandez, Hill, Hueso, Huff,  
            Jackson, Knight, Lara, Leno, Lieu, Liu, Monning, Nielsen,  
            Padilla, Pavley, Price, Roth, Steinberg, Torres, Walters,  
            Wolk, Wright, Wyland, Yee
          NO VOTE RECORDED:  Vacancy

           ASSEMBLY FLOOR  :  77-0, 9/3/13 - See last page for vote


           SUBJECT  :    Mental health
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           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  
          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.

           Assembly Amendments  make numerous clarifying and technical  
          changes including adding the definition of "designated facility"  
          and "facility designated by the county for evaluation and  
          treatment."

           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  

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             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. Allows a county mental health director to develop procedures  
             for the designation and training of professionals who perform  
             5150 functions, including license types, practice  
             disciplines, clinical experience, training and testing  
             requirements, application and approval processes, and  
             monitoring and reviewing processes. 

           2. Requires 5150-designated facilities to be licensed or  
             certified as mental health treatment facilities or hospitals,  
             as defined, and specifies that 5150-designated facilities may  
             include, but are not limited to, licensed psychiatric  
             hospitals, licensed psychiatric health facilities, and  
             certified crisis stabilization units. 

           3. Creates the option, in addition to placement for evaluation  
             and treatment in a designated facility, for a person who is a  
             danger to self or others or gravely disabled to be taken into  
             custody for up to 72 hours for assessment, evaluation, and  
             crisis intervention.  Requires assessment and evaluation to  
             be conducted and provided on an ongoing basis and specifies  
             that crisis intervention may be provided concurrently with  
             other services.

           4. Requires individuals to be provided evaluation, crisis  
             intervention, or other inpatient or outpatient services on a  
             voluntary basis if an assessment yields a determination that  
             a person can be properly served without being detained.

           5. Requires a person, at the time he/she takes another person  
             into custody under the 5150 process, to provide currently  
             required oral advisements in a language or modality  
             accessible to the person and record documentation of that  
             language or modality and makes other minor changes to  
             required oral advisements. 

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           6. Requires the information given upon 72-hour admission to  
             include various advisements:  a person may request a facility  
             or treating professional of his/her choice; a person can  
             contact the county's Patients' Rights Advocate if they have  
             questions about their legal rights; and a statement if  
             weekends and holidays will be excluded from the 72-hour  
             period.

           7. Requires the professional person in charge of a facility  
             designated by the county for evaluation and treatment, member  
             of the attending staff, or professional person designated by  
             the county to assess the person to determine whether he/she  
             can be properly served without being detained.

           8. Encourages each city or county mental health department to  
             include on its Web site a current list, updated annually, of  
             local ambulatory services and other resources for persons  
             with mental health disorders and substance use disorders. 

           9. Makes numerous minor, clarifying, technical, and  
             terminological changes.

           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:

          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  

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          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 Assembly Appropriations Committee, negligible  
          state fiscal effect.

           SUPPORT  :   (Verified  9/3/13)

          California Mental Health Directors Association
          Disabilities Rights California  
          National Alliance on Mental Illness California
          Superior Court of California of the Counties of Santa Clara, San  
            Francisco and Kern  
          Urban Counties Caucus

           OPPOSITION  :    (Verified  9/3/13)

          California American College of Emergency Physicians
          California Psychiatric Association
          Citizens Commission on Human Rights

           ARGUMENTS IN SUPPORT  :    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.  

           ASSEMBLY FLOOR  :  77-0, 9/3/13
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,  
            Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian  
            Calderon, Campos, Chau, Ch�vez, Chesbro, Conway, Cooley,  
            Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox, Frazier,  
            Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell,  
            Gray, Grove, Hagman, Harkey, Roger Hern�ndez, Holden, Jones,  

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            Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein,  
            Mansoor, Medina, Melendez, Mitchell, Morrell, Mullin,  
            Muratsuchi, Nazarian, Nestande, Olsen, Pan, Patterson, Perea,  
            V. Manuel P�rez, Quirk, Quirk-Silva, Rendon, Salas, Skinner,  
            Stone, Ting, Wagner, Waldron, Weber, Wieckowski, Wilk,  
            Williams, Yamada, John A. P�rez
          NO VOTE RECORDED:  Hall, Vacancy, Vacancy


          JL:k  9/3/13   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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