BILL ANALYSIS Ó
AB 193
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB
193 (Maienschein)
As Amended September 2, 2015
Majority vote
--------------------------------------------------------------------
|ASSEMBLY: |77-0 |(June 2, 2015) |SENATE: |39-0 |(September 8, |
| | | | | |2015) |
| | | | | | |
| | | | | | |
--------------------------------------------------------------------
Original Committee Reference: HEALTH
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.
The Senate amendments clarify that a potential LPS conservatee
must be represented by counsel when petitioning the court for a
recommendation for an LPS conservatorship, clarify that the
Probate Court has the authority to order an investigation when
making a recommendation for an LPS conservatorship, replace
references to "probate court recommendations" with
"conservatorship investigation order" and make additional
technical, non-substantive changes.
AB 193
Page 2
FISCAL EFFECT: According to the Senate Appropriations
Committee, potential non-reimbursable local costs in the mid to
high hundreds of thousands of dollars annually for county public
guardians to conduct a greater number of conservatorship
investigations and reports; potential increases in
non-reimbursable local costs to county behavioral health and
mental health departments for additional LPS placements,
services, and treatment; and, potential cost increases to
counties for LPS conservatorship placements into Department of
State Hospital facilities.
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.
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,
AB 193
Page 3
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.
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
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
AB 193
Page 4
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. 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 current probate code 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 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.
Analysis Prepared by: Paula Villescaz /
HEALTH / (916) 319-2097 FN: 0002093
AB 193
Page 5