Amended in Assembly January 6, 2016

Amended in Assembly January 4, 2016

Amended in Assembly April 20, 2015

Amended in Assembly April 6, 2015

Amended in Assembly March 9, 2015

California Legislature—2015–16 Regular Session

Assembly BillNo. 59


Introduced by Assembly Member Waldron

begin delete(Coauthor: Assembly Memberend deletebegin insert (Coauthors: Assembly Members Gallagher, Kim, Lackey, Mathis, andend insert Olsen)

(Coauthors: Senatorsbegin delete Hallend deletebegin insert Anderson, Hall,end insert and Huff)

December 9, 2014


An act to amendbegin delete Sectionend deletebegin insert Sections 5348 andend insert 5349.5 of the Welfare and Institutions Code, relating to mental healthbegin delete services.end deletebegin insert services, and making an appropriation thereof.end insert

LEGISLATIVE COUNSEL’S DIGEST

AB 59, as amended, Waldron. Mental health services: assisted outpatient treatment.

Existing law, the Assisted Outpatient Treatment Demonstration Project Act of 2002, known as Laura’s Law, until January 1, 2017, grants each county the authority to offer certain assisted outpatient treatment services for their residents by adoption of a resolution or through the county budget process and by making a finding that no mental health program, as specified, may be reduced as a result of implementation. Under that law, participating counties are required to provide prescribed assisted outpatient services, including a service planning and delivery process, that are client-directed and employ psychosocial rehabilitation and recovery principles. Existing law authorizes participating counties to pay for the services provided from moneys distributed to the counties from various continuously appropriated funds, including the Local Revenue Fund and the Mental Health Services Fund when included in a county plan, as specified.begin insert Existing law requires the State Department of Health Care Services to submit a report and evaluation of all counties implementing any component of these provisions to the Governor and the Legislature by July 1, 2015.end insert

This bill wouldbegin delete delete the January 1, 2017, repeal date of those provisions, thereby extending the program indefinitely.end deletebegin insert extend the operation of the program until January 1, 2022, and would delete that reporting requirement. By extending the authorization to pay for the services using moneys from various continuously appropriated funds, the bill would make an appropriation.end insert

begin insert

Existing law requires a county that operates an assisted outpatient treatment program pursuant to these provisions to provide data to the department, and requires the department to report to the Legislature on or before May 1 of each year based on that data, as specified.

end insert
begin insert

This bill would additionally require the department to report that information to the Governor.

end insert

Vote: majority. Appropriation: begin deleteno end deletebegin insertyesend insert. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P2    1begin insert

begin insertSECTION 1.end insert  

end insert

begin insertSection 5348 of the end insertbegin insertWelfare and Institutions Codeend insert
2begin insert is amended to read:end insert

3

5348.  

(a) For purposes of subdivision (e) of Section 5346, a
4county that chooses to provide assisted outpatient treatment
5services pursuant to this article shall offer assisted outpatient
6treatment services including, but not limited to, all of the following:

7(1) Community-based, mobile, multidisciplinary, highly trained
8mental health teams that use high staff-to-client ratios of no more
9than 10 clients per team member for those subject to court-ordered
10services pursuant to Section 5346.

11(2) A service planning and delivery process that includes the
12following:

P3    1(A) Determination of the numbers of persons to be served and
2the programs and services that will be provided to meet their needs.
3The local director of mental health shall consult with the sheriff,
4the police chief, the probation officer, the mental health board,
5contract agencies, and family, client, ethnic, and citizen
6constituency groups as determined by the director.

7(B) Plans for services, including outreach to families whose
8severely mentally ill adult is living with them, design of mental
9health services, coordination and access to medications, psychiatric
10and psychological services, substance abuse services, supportive
11housing or other housing assistance, vocational rehabilitation, and
12veterans’ services. Plans shall also contain evaluation strategies,
13which shall consider cultural, linguistic, gender, age, and special
14needs of minorities and those based on any characteristic listed or
15defined in Section 11135 of the Government Code in the target
16populations. Provision shall be made for staff with the cultural
17 background and linguistic skills necessary to remove barriers to
18mental health services as a result of having
19limited-English-speaking ability and cultural differences.
20Recipients of outreach services may include families, the public,
21primary care physicians, and others who are likely to come into
22contact with individuals who may be suffering from an untreated
23severe mental illness who would be likely to become homeless if
24the illness continued to be untreated for a substantial period of
25time. Outreach to adults may include adults voluntarily or
26involuntarily hospitalized as a result of a severe mental illness.

27(C) Provision for services to meet the needs of persons who are
28physically disabled.

29(D) Provision for services to meet the special needs of older
30adults.

31(E) Provision for family support and consultation services,
32parenting support and consultation services, and peer support or
33self-help group support,begin delete whereend deletebegin insert ifend insert appropriate.

34(F) Provision for services to be client-directed and that employ
35psychosocial rehabilitation and recovery principles.

36(G) Provision for psychiatric and psychological services that
37are integrated with other services and for psychiatric and
38psychological collaboration in overall service planning.

39(H) Provision for services specifically directed to seriously
40mentally ill young adults 25 years of age or younger who are
P4    1homeless or at significant risk of becoming homeless. These
2provisions may include continuation of services that still would
3be received through other funds had eligibility not been terminated
4as a result of age.

5(I) Services reflecting special needs of women from diverse
6cultural backgrounds, including supportive housing that accepts
7children, personal services coordinator therapeutic treatment, and
8substance treatment programs that address gender-specific trauma
9and abuse in the lives of persons with mental illness, and vocational
10rehabilitation programs that offer job training programs free of
11gender bias and sensitive to the needs of women.

12(J) Provision for housing for clients that is immediate,
13transitional, permanent, or all of these.

14(K) Provision for clients who have been suffering from an
15untreated severe mental illness for less than one year, and who do
16not require the full range of services, but are at risk of becoming
17homeless unless a comprehensive individual and family support
18services plan is implemented. These clients shall be served in a
19manner that is designed to meet their needs.

20(3) Each client shall have a clearly designated mental health
21personal services coordinator who may be part of a
22multidisciplinary treatment team who is responsible for providing
23or assuring needed services. Responsibilities include complete
24assessment of the client’s needs, development of the client’s
25personal services plan, linkage with all appropriate community
26services, monitoring of the quality and followthrough of services,
27and necessary advocacy to ensure each client receives those
28services that are agreed to in the personal services plan. Each client
29shall participate in the development of his or her personal services
30plan, and responsible staff shall consult with the designated
31conservator, if one has been appointed, and, with the consent of
32the client, shall consult with the family and other significant
33persons as appropriate.

34(4) The individual personal services plan shall ensure that
35persons subject to assisted outpatient treatment programs receive
36 age-appropriate, gender-appropriate, and culturally appropriate
37services, to the extent feasible, that are designed to enable
38recipients to:

39(A) Live in the most independent, least restrictive housing
40feasible in the local community, and, for clients with children, to
P5    1live in a supportive housing environment that strives for
2reunification with their children or assists clients in maintaining
3custody of their children as is appropriate.

4(B) Engage in the highest level of work or productive activity
5appropriate to their abilities and experience.

6(C) Create and maintain a support system consisting of friends,
7family, and participation in community activities.

8(D) Access an appropriate level of academic education or
9vocational training.

10(E) Obtain an adequate income.

11(F) Self-manage their illnesses and exert as much control as
12possible over both the day-to-day and long-term decisions that
13affect their lives.

14(G) Access necessary physical health care and maintain the best
15possible physical health.

16(H) Reduce or eliminate serious antisocial or criminal behavior,
17and thereby reduce or eliminate their contact with the criminal
18justice system.

19(I) Reduce or eliminate the distress caused by the symptoms of
20mental illness.

21(J) Have freedom from dangerous addictive substances.

22(5) The individual personal services plan shall describe the
23service array that meets the requirements of paragraph (4), and to
24the extent applicable to the individual, the requirements of
25paragraph (2).

26(b) A county that provides assisted outpatient treatment services
27pursuant to this article also shall offer the same services on a
28voluntary basis.

29(c) Involuntary medication shall not be allowed absent a separate
30order by the court pursuant to Sections 5332 to 5336, inclusive.

31(d) A county that operates an assisted outpatient treatment
32program pursuant to this article shall provide data to the State
33Department of Health Care Services and, based on the data, the
34department shall report to thebegin insert Governor and theend insert Legislature on or
35before May 1 of each yearbegin delete in which the county providesend deletebegin insert regarding
36theend insert
servicesbegin insert the county providesend insert pursuant to this article. The report
37shall include, at a minimum, an evaluation of the effectiveness of
38the strategies employed by each program operated pursuant to this
39article in reducing homelessness and hospitalization of persons in
40the program and in reducing involvement with local law
P6    1enforcement by persons in the program. The evaluation and report
2shall also include any other measures identified by the department
3regarding persons in the program and all of the following, based
4on information that is available:

5(1) The number of persons served by the program and, of those,
6the number who are able to maintain housing and the number who
7maintain contact with the treatment system.

8(2) The number of persons in the program with contacts with
9local law enforcement, and the extent to which local and state
10incarceration of persons in the program has been reduced or
11avoided.

12(3) The number of persons in the program participating in
13employment services programs, including competitive employment.

14(4) The days of hospitalization of persons in the program that
15have been reduced or avoided.

16(5) Adherence to prescribed treatment by persons in the program.

17(6) Other indicators of successful engagement, if any, by persons
18in the program.

19(7) Victimization of persons in the program.

20(8) Violent behavior of persons in the program.

21(9) Substance abuse by persons in the program.

22(10) Type, intensity, and frequency of treatment of persons in
23the program.

24(11) Extent to which enforcement mechanisms are used by the
25program, when applicable.

26(12) Social functioning of persons in the program.

27(13) Skills in independent living of persons in the program.

28(14) Satisfaction with program services both by those receiving
29them and by their families, when relevant.

30

begin deleteSECTION 1.end delete
31begin insertSEC. 2.end insert  

Section 5349.5 of the Welfare and Institutions Code
32 is amended to read:

begin delete
33

5349.5.  

The State Department of Health Care Services shall
34submit a report and evaluation of all counties implementing any
35component of this article to the Governor and to the Legislature
36by July 1, 2015. The evaluation shall include data described in
37subdivision (d) of Section 5348.

end delete
38begin insert

begin insert5349.5.end insert  

end insert
begin insert

This article shall remain in effect only until January
391, 2022, and as of that date is repealed, unless a later enacted
P7    1statute, that is enacted before January 1, 2022, deletes or extends
2that date.

end insert


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