BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     AB 193


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          Date of Hearing:  May 6, 2015


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                                 Jimmy Gomez, Chair


          AB  
          193 (Maienschein) - As Amended April 14, 2015


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          Urgency:  No  State Mandated Local Program:  YesReimbursable:   
          Yes


          SUMMARY:


          This bill allows a probate court to recommend a  
          Lanterman-Petris-Short (LPS) conservatorship for an individual  
          for whom a conservatorship has been established under the  








                                                                     AB 193


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          Probate Code, subject to a hearing attended by the proposed  
          conservatee or the proposed conservatee's counsel, as specified.

          It also requires the officer providing conservatorship  
          investigation to file a copy of his or her report with the court  
          making the recommendation in the probate conservatorship within  
          30 days of the recommendation. 

          FISCAL EFFECT:





          1)Potential state-reimbursable mandate costs, conservatively in  
            the hundreds of thousands of dollars annually, as this bill is  
            likely to compel a greater number of conservatorship  
            investigations and reports.  These costs are likely to be  
            state-reimbursable.  

          2)In addition, counties could incur significant unknown costs  
            associated with a larger number of conservatees, potentially  
            resulting in cost shifting from one segment of local  
            government to another.  These costs are not state-  
            reimbursable.  
          


          COMMENTS:





          1)Purpose. According to the author, many seriously mentally ill  
            persons who might benefit from an LPS conservatorship cannot  
            obtain it because their condition does not rise to the level  
            of creating a "danger to themselves or others," as is required  
            to trigger the "5150" and the eventual LPS process.  This  








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            bill, therefore, would create an additional means by which an  
            LPS conservatorship may be recommended to the county  
            conservatorship investigator.



          2)Background. California has two types of conservatorships.   
            Probate conservatorships - established under the Probate Code  
            - are established for adults who cannot adequately care for  
            basic personal needs.  Most probate conservatee are elderly  
            persons, but can also include younger adults with severe  
            developmental disabilities.  Conservatorships established  
            under the Lanterman-Petris-Short (LPS) Act, on the other hand,  
            are for persons who are gravely disabled by mental illness or  
            who pose a threat to themselves or others.  LPS  
            conservatorships are created when a psychiatric facility in  
            which the prospective conservatee is held makes a  
            recommendation to the county conservatorship investigator, who  
            in turn may petition a superior court for the conservatorship.  
             



            A probate conservatorship does not allow the conservator to  
            compel medical treatment on behalf of the conservatee if the  
            conservatee refuses.  The LPS conservator, on the other hand,  
            may, if the court order so provides, compel psychiatric  
            treatment and placement in a locked facility for a conservatee  
            who is unwilling to accept voluntary treatment.  





            Individuals can only enter an LPS conservatorship through a  
            the "5150 hold" process, specified in Welfare and Institutions  
            Code 5150, whereby an officer or clinician may involuntarily  
            detain a person suspected to have a mental disorder that makes  
            him or her a danger to self, a danger to others, and/or is  








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            gravely disabled.  An individual enters into an LPS  
            conservatorship via an initial 72-hour 5150 hold for  
            assessment, evaluation, and crisis intervention, which is then  
            extended for a period of 14 or 30 days.  After this period, if  
            warranted, an authorized individual may recommend that the  
            county conservatorship investigator petition the superior  
            court for a year-long LPS conservatorship.  This bill would  
            bypass the requirement for a 5150 hold and associated  
            statutory protections by allowing a probate court to directly  
            recommend an LPS conservatorship to the county conservatorship  
            investigator, for someone already in a probate  
            conservatorship.





            It is important to note this bill does not permit the court to  
            establish an LPS conservatorship on its own motion; rather,  
            this bill permits the court to make a recommendation, based on  
            medical evidence, to the county conservatorship investigator.   
            It would still be up to the investigator, if he or she concurs  
            with the court, to act on that recommendation and petition a  
            superior court for an LPS conservatorship.   





          3)Opposition.  The California State Association of Counties  
            (CSAC) and the California Behavioral Health Directors  
            Association (CBHDA), and the Urban Counties Caucus oppose this  
            bill, citing primarily workload and cost burdens on an  
            overburdened public guardian system.  Opposition believes the  
            probate court authority to compel investigations will be used  
            liberally and lead to many more unnecessary and inappropriate  
            investigations.  










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          4)Prior Legislation. AB 1725 (Maienschein) of 2014 was similar  
            to this bill. It was held on the Suspense File of this  
            committee.
          


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