BILL ANALYSIS Ó
AB 193
Page 1
ASSEMBLY THIRD READING
AB
193 (Maienschein)
As Amended May 28, 2015
Majority vote
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|Committee |Votes |Ayes |Noes |
| | | | |
| | | | |
|----------------+------+--------------------+----------------------|
|Health |16-0 |Bonta, Maienschein, | |
| | |Burke, Chávez, | |
| | |Chiu, Gomez, | |
| | |Lackey, Nazarian, | |
| | |Patterson, | |
| | |Ridley-Thomas, | |
| | |Rodriguez, | |
| | |Santiago, | |
| | |Steinorth, | |
| | |Thurmond, Waldron, | |
| | |Wood | |
| | | | |
|----------------+------+--------------------+----------------------|
|Judiciary |10-0 |Mark Stone, Wagner, | |
| | |Alejo, Chau, Chiu, | |
| | |Gallagher, Cristina | |
| | |Garcia, Holden, | |
| | |Maienschein, | |
| | |O'Donnell | |
| | | | |
|----------------+------+--------------------+----------------------|
AB 193
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|Appropriations |17-0 |Gomez, Bigelow, | |
| | |Bonta, Calderon, | |
| | |Chang, Daly, | |
| | |Eggman, Gallagher, | |
| | | | |
| | | | |
| | |Eduardo Garcia, | |
| | |Gordon, Holden, | |
| | |Jones, Quirk, | |
| | |Rendon, Wagner, | |
| | |Weber, Wood | |
| | | | |
| | | | |
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SUMMARY: Permits a judge presiding over a probate conservatorship
to recommend to the county investigating officer the establishment
of a Lanterman-Petris-Short (LPS) conservatorship when there is
evidence of grave disability as a result of a mental disorder or
impairment by chronic alcoholism. Specifically, this bill:
1)Allows a Probate Court to recommend a conservatorship to the
officer providing conservatorship investigation of the person's
county of residence if the court, in a proceeding under the
Probate Code, determines that a person for whom a
conservatorship has been established under the Probate Code and
may be gravely disabled as a result of a mental disorder or
impairment by chronic alcoholism, to provide individualized
treatment, supervision, and placement.
2)Requires, if the recommendation for conservatorship was made by
the court, the existing probate conservator to disclose any
records or information that may facilitate the investigation.
FISCAL EFFECT: According to the Assembly Appropriations
Committee:
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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: According to the author, probate courts today are
hampered in their ability to ensure proper care and treatment of
conservatees who suffer from a mental illness, and there currently
are a significant number of people who are not getting the care
and treatment they need. Under the LPS Act, the individuals
authorized to initiate conservatorship proceedings do not include
probate judges or family members. The author contends that some
counties are becoming more and more reluctant to initiate
necessary conservatorship proceedings. This becomes an even
greater issue with gravely disabled homeless persons who have no
additional help or anyone to be a proponent for their well-being.
They are continually dependent on other services that have limited
availability for their survival and are unable to receive the
assistance they really need.
The author contends that this creates a gap in treatment
availability, making it harder for individuals who are not already
hospitalized but whose problems stem from mental illness,
alcoholism, or drug abuse, and thus cannot qualify for treatment
under the Probate Code. By allowing probate judges to initiate
LPS conservatorship proceedings, this bill is intended to remove
obstacles to treatment for these individuals.
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1)LPS conservatorship process. The LPS Act creates a series of
processes for the involuntary treatment of individuals who are
unwilling or unable to accept necessary mental health treatment,
generally conditional upon the person being gravely disabled or
posing a danger to self or others. An LPS conservatorship,
which lasts for a year before it must be reinitiated and
reapproved, is typically sought after an individual has received
72-hour evaluation and treatment and 14-day intensive treatment
and continues to be gravely disabled. The process begins when
the professional staff of the psychiatric facility, after having
evaluated and treated the individual, makes a recommendation of
conservatorship to the county conservatorship investigator
(typically designated as an office in the county, such as the
Public Guardian's Office or the Office of the Public
Conservator). The county conservatorship investigator is then
required to conduct a comprehensive investigation and file a
petition for conservatorship only if, after considering all
available alternatives to conservatorship, there are no suitable
alternatives available.
2)Probate conservatorships. Conservatorships governed by the
Probate Code are the most common type of conservatorship.
Probate conservatorships can be established for adults who are
unable to provide properly for their personal needs for physical
health, food, clothing, or shelter. These conservatees are
often elderly people, but can also be seriously impaired younger
people. A petition for probate conservatorship can be filed by
a spouse, domestic partner, or family member of the proposed
conservatee, any interested state or local agency, the
conservatee himself or herself, or any other interested person
or friend. Current law contains provisions related to
conservatees who are unable to give informed consent for medical
treatment and gives the conservator the exclusive authority to
make health care decisions for the conservatee, including
requiring the conservatee to receive health care, whether or not
the conservatee objects. For conservatees with dementia,
current law allows the conservator to place the conservatee in a
locked nursing or residential care facility and authorize the
administration of medications to treat dementia, provided that
the court makes specified findings. However, current law does
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not contain provisions that allow a probate conservator to place
a conservatee in a locked facility for any reason other than
dementia.
The sponsors of this bill, Conference of California Bar
Associations, state that this bill would allow a judge presiding
over a probate conservatorship to recommend to the county
investigating officer that a LPS conservatorship be established
when there is medical evidence that an individual is suffering
from a grave disability as a result of a mental disorder or
impairment by chronic alcoholism. This provision fills a gap in
the law.
The sponsor argues that currently, one of the few persons who can
recommend to the conservatorship investigator that a LPS
conservatorship be established are the professional from the
agency or facility providing intensive treatment or evaluation
services. If an individual is not receiving such intensive
treatment or evaluation services, however, no such recommendation
can be made, and no LPS conservatorship may be contemplated. At
the same time, Probate Code Section 2356.5, governing traditional
probate conservatorships, only allows for a conservatee to be
treated in a secured facility or to be administered psychotropic
medications when the conservatee has a diagnosis of dementia and
not for any other mental health diagnosis or issue relating to
alcohol abuse. The sponsor concludes this creates a "gap" in
treatment availability for individuals who are not already
hospitalized, and thus can't be recommended, but whose problems
stem from mental illness, alcoholism or drug abuse, and thus
cannot qualify for treatment under the Probate Code.
The California Association of Counties, the County Behavioral
Health Directors Association of California, and the Urban Counties
Caucus state in opposition that counties are primarily concerned
about the potential costs, workload levels, and overall erosion of
county authority in conservatorship investigations associated with
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authorizing the Probate Court to recommend a LPS conservatorship
to a county conservatorship officer and compel that officer to
submit a report to the Probate Court within 30 days.
The opposition notes that currently, only a county conservatorship
officer or such designation official of the county can conduct LPS
conservatorship investigations to determine whether a person meets
the statutory definition of gravely disabled. The opposition
states that in compelling the conservatorship officer to conduct
an investigation and report back to the Probate Court their
findings, this bill is contrary to current law, and will increase
the number of LPS conservatorship referrals, thereby increasing
county costs. The opposition argues that should the mandate in
this bill become law, counties not only anticipate a significant
increase in workload and county costs for conservatorship
investigations, but will also face increased costs due to the
arbitrary and unrealistic 30-day mandated timeline for the
investigation and submission of a report to the court.
Analysis Prepared by: Paula Villescaz /
HEALTH / (916) 319-2097
FN: 0000849