Amended in Senate March 28, 2016

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 Bill No. 59

Introduced by Assembly Member Waldron

(Coauthors: Assembly Members begin insert Eggman, end insert Gallagher, begin insert Harper, end insert Kim, Lackey, Mathis, begin delete and Olsen end delete begin insert Olsen, and Steinorth end insert )

(Coauthors: Senators Anderson, begin insert Bates, Cannella, end insert Hall, and Huff)

December 9, 2014

An act to amend Sections 5348 and 5349.5 of the Welfare and Institutions Code, relating to mental health services, and making an appropriation begin delete thereof. end delete begin insert therefor. 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. 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.

This bill would 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.

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.

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

Vote: majority. Appropriation: yes. Fiscal committee: yes. State-mandated local program: no.

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

SECTION 1.  

Section 5348 of the Welfare and Institutions Code
is amended to read:

5348.  

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

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

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

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

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

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

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

(E) Provision for family support and consultation services,
parenting support and consultation services, and peer support or
self-help group support, if appropriate.

(F) Provision for services to be client-directed and begin delete that end delete begin insert to end insert employ
psychosocial rehabilitation and recovery principles.

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

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

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

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

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

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

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

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

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

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

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

(E) Obtain an adequate income.

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

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

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

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

(J) Have freedom from dangerous addictive substances.

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

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

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

(d) A county that operates an assisted outpatient treatment
program pursuant to this article shall provide data to the State
Department of Health Care Services and, based on the data, the
department shall report to the Governor and the Legislature on or
before May 1 of each year regarding the services the county
provides pursuant to this article. The report shall include, at a
minimum, an evaluation of the effectiveness of the strategies
employed by each program operated pursuant to this article in
reducing homelessness and hospitalization of persons in the
program and in reducing involvement with local law enforcement
by persons in the program. The evaluation and report shall also
include any other measures identified by the department regarding
persons in the program and all of the following, based on
information that is available:

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

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

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

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

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

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

(7) Victimization of persons in the program.

(8) Violent behavior of persons in the program.

(9) Substance abuse by persons in the program.

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

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

(12) Social functioning of persons in the program.

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

(14) Satisfaction with program services both by those receiving
begin delete them end delete begin insert them, end insert and by their families, when relevant.

SEC. 2.  

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

5349.5.  

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