Amended in Assembly April 30, 2015

California Legislature—2015–16 Regular Session

Assembly BillNo. 1193


Introduced by Assembly Member Eggman

February 27, 2015


An act to amend Sections 5346, 5348, 5349, 5349.1, and 5349.5 of the Welfare and Institutions Code, relating to mental health.

LEGISLATIVE COUNSEL’S DIGEST

AB 1193, as amended, Eggman. 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, authorizes each county tobegin delete electend deletebegin insert elect, through a resolution adopted by the county board of supervisors or through the county budget process and along with a finding that specified mental health programs may not be reduced as a result of participation,end insert to offer certain assisted outpatient treatment services for their residents. Existing law authorizes participating counties to pay for the services provided from moneys distributed to the counties from various continuously appropriated funds, including the Mental Health Services Fund when included in a county plan, as specified.

This bill would delete thebegin delete provisionsend deletebegin insert requirementend insert thatbegin delete authorize a county to elect to participate in the program, and instead would require each county to implement the provisions of Laura’s Law unlessend delete thebegin insert board of supervisors of aend insert countybegin insert thatend insert electsbegin delete notend delete to participate in the programbegin delete by enacting a resolution passed by the county board of supervisors.end deletebegin insert make the finding described above. The bill instead would require a county that has not held a specified public hearing by January 1, 2017, to hold a hearing by January 1, 2018, and would require the board of supervisors to consider both whether specified programs may be reduced as a result of participation and options for providing services other than court-ordered outpatient treatment, thereby imposing a state-mandated local program.end insert The bill would extend the January 1, 2017, repeal date of those provisions until January 1, 2022.

Existing law authorizes various persons to request the county mental health director to file a petition in the superior court for an order for assisted outpatient treatment for a person who meets specified criteria. Existing law requires the county mental health director to investigate the appropriateness of filing a petition.

This bill would additionally authorize a judge in a superiorbegin delete courtend deletebegin insert court’s mental health court, reentry court, or other collaborative justice court available for improving the mental health of the defendant, or a probate court, as specified,end insert to request a petition for that order to be filed for a person who appears before the judge.begin delete By imposing additional duties on county mental health directors, this bill would impose a state-mandated local program.end delete The bill would make additional conforming changes.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

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

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

P2    1

SECTION 1.  

Section 5346 of the Welfare and Institutions Code
2 is amended to read:

3

5346.  

(a) In any county in which services are available as
4provided in Section 5348, a court may order a person who is the
5subject of a petition filed pursuant to this section to obtain assisted
6outpatient treatment if the court finds, by clear and convincing
7evidence, that the facts stated in the verified petition filed in
8accordance with this section are true and establish that all of the
9requisite criteria set forth in this section are met, including, but
10not limited to, each of the following:

P3    1(1) The person is 18 years of age or older.

2(2) The person is suffering from a mental illness as defined in
3paragraphs (2) and (3) of subdivision (b) of Section 5600.3.

4(3) There has been a clinical determination that the person is
5unlikely to survive safely in the community without supervision.

6(4) The person has a history of lack of compliance with
7treatment for his or her mental illness, in that at least one of the
8following is true:

9(A) The person’s mental illness has, at least twice within the
10last 36 months, been a substantial factor in necessitating
11hospitalization, or receipt of services in a forensic or other mental
12health unit of a state correctional facility or local correctional
13facility, not including any period during which the person was
14hospitalized or incarcerated immediately preceding the filing of
15the petition.

16(B) The person’s mental illness has resulted in one or more acts
17of serious and violent behavior toward himself or herself or
18another, or threats, or attempts to cause serious physical harm to
19himself or herself or another within the last 48 months, not
20including any period in which the person was hospitalized or
21incarcerated immediately preceding the filing of the petition.

22(5) The person has been offered an opportunity to participate
23in a treatment plan by the director of the local mental health
24department, or his or her designee, provided the treatment plan
25includes all of the services described in Section 5348, and the
26person continues to fail to engage in treatment.

27(6) The person’s condition is substantially deteriorating.

28(7) Participation in the assisted outpatient treatment program
29would be the least restrictive placement necessary to ensure the
30person’s recovery and stability.

31(8) In view of the person’s treatment history and current
32behavior, the person is in need of assisted outpatient treatment in
33order to prevent a relapse or deterioration that would be likely to
34result in grave disability or serious harm to himself or herself, or
35to others, as defined in Section 5150.

36(9) It is likely that the person will benefit from assisted
37outpatient treatment.

38(b) (1) A petition for an order authorizing assisted outpatient
39treatment may be filed by the county mental health director, or his
40or her designee, in the superior court in the county in which the
P4    1person who is the subject of the petition is present or reasonably
2believed to be present.

3(2) A request may be made only by any of the following persons
4to the county mental health department for the filing of a petition
5to obtain an order authorizing assisted outpatient treatment:

6(A) Any person 18 years of age or older with whom the person
7who is the subject of the petition resides.

8(B) Any person who is the parent, spouse, or sibling or child
918 years of age or older of the person who is the subject of the
10petition.

11(C) The director of any public or private agency, treatment
12facility, charitable organization, or licensed residential care facility
13providing mental health services to the person who is the subject
14of the petition in whose institution the subject of the petition
15resides.

16(D) The director of a hospital in which the person who is the
17subject of the petition is hospitalized.

18(E) A licensed mental health treatment provider who is either
19supervising the treatment of, or treating for a mental illness, the
20person who is the subject of the petition.

21(F) A peace officer, parole officer, or probation officer assigned
22to supervise the person who is the subject of the petition.

23(G) A judge of a superiorbegin delete courtend deletebegin insert court’s mental health court,
24reentry court, or other collaborative justice court available for
25improving the mental health of the defendantend insert
begin insert, or a probate courtend insert
26 before whom the personbegin delete who is the subject of the petition appears.end delete
27begin insert appears as the subject of a proceeding pursuant to Section 5352.end insert

28(3) Upon receiving a request pursuant to paragraph (2), the
29county mental health director shall conduct an investigation into
30the appropriateness of filing the petition. The director shall file
31the petition only if he or she determines that there is a reasonable
32 likelihood that all the necessary elements to sustain the petition
33can be proven in a court of law by clear and convincing evidence.

34(4) The petition shall state all of the following:

35(A) Each of the criteria for assisted outpatient treatment as set
36forth in subdivision (a).

37(B) Facts that support the petitioner’s belief that the person who
38is the subject of the petition meets each criterion, provided that
39the hearing on the petition shall be limited to the stated facts in
40the verified petition, and the petition contains all the grounds on
P5    1which the petition is based, in order to ensure adequate notice to
2the person who is the subject of the petition and his or her counsel.

3(C) That the person who is the subject of the petition is present,
4or is reasonably believed to be present, within the county where
5the petition is filed.

6(D) That the person who is the subject of the petition has the
7right to be represented by counsel in all stages of the proceeding
8under the petition, in accordance with subdivision (c).

9(5) The petition shall be accompanied by an affidavit of a
10licensed mental health treatment provider designated by the local
11mental health director who shall state, if applicable, either of the
12following:

13(A) That the licensed mental health treatment provider has
14personally examined the person who is the subject of the petition
15no more than 10 days prior to the submission of the petition, the
16facts and reasons why the person who is the subject of the petition
17meets the criteria in subdivision (a), that the licensed mental health
18treatment provider recommends assisted outpatient treatment for
19the person who is the subject of the petition, and that the licensed
20mental health treatment provider is willing and able to testify at
21the hearing on the petition.

22(B) That no more than 10 days prior to the filing of the petition,
23the licensed mental health treatment provider, or his or her
24designee, has made appropriate attempts to elicit the cooperation
25of the person who is the subject of the petition, but has not been
26successful in persuading that person to submit to an examination,
27that the licensed mental health treatment provider has reason to
28believe that the person who is the subject of the petition meets the
29criteria for assisted outpatient treatment, and that the licensed
30mental health treatment provider is willing and able to examine
31the person who is the subject of the petition and testify at the
32hearing on the petition.

33(c) The person who is the subject of the petition shall have the
34right to be represented by counsel at all stages of a proceeding
35commenced under this section. If the person so elects, the court
36shall immediately appoint the public defender or other attorney to
37assist the person in all stages of the proceedings. The person shall
38pay the cost of the legal services if he or she is able.

39(d) (1) Upon receipt by the court of a petition submitted
40pursuant to subdivision (b), the court shall fix the date for a hearing
P6    1at a time not later than five days from the date the petition is
2received by the court, excluding Saturdays, Sundays, and holidays.
3The petitioner shall promptly cause service of a copy of the
4petition, together with written notice of the hearing date, to be
5made personally on the person who is the subject of the petition,
6and shall send a copy of the petition and notice to the county office
7of patient rights, and to the current health care provider appointed
8for the person who is the subject of the petition, if that provider is
9known to the petitioner. Continuances shall be permitted only for
10good cause shown. In granting continuances, the court shall
11consider the need for further examination by a physician or the
12potential need to provide expeditiously assisted outpatient
13treatment. Upon the hearing date, or upon any other date or dates
14to which the proceeding may be continued, the court shall hear
15testimony. If it is deemed advisable by the court, and if the person
16who is the subject of the petition is available and has received
17notice pursuant to this section, the court may examine in or out of
18court the person who is the subject of the petition who is alleged
19to be in need of assisted outpatient treatment. If the person who is
20the subject of the petition does not appear at the hearing, and
21appropriate attempts to elicit the attendance of the person have
22failed, the court may conduct the hearing in the person’s absence.
23If the hearing is conducted without the person present, the court
24shall set forth the factual basis for conducting the hearing without
25the person’s presence.

26(2) The court shall not order assisted outpatient treatment unless
27an examining licensed mental health treatment provider, who has
28personally examined, and has reviewed the available treatment
29history of, the person who is the subject of the petition within the
30time period commencing 10 days before the filing of the petition,
31testifies in person at the hearing.

32(3) If the person who is the subject of the petition has refused
33to be examined by a licensed mental health treatment provider,
34the court may request that the person consent to an examination
35by a licensed mental health treatment provider appointed by the
36court. If the person who is the subject of the petition does not
37consent and the court finds reasonable cause to believe that the
38allegations in the petition are true, the court may order any person
39designated under Section 5150 to take into custody the person who
40is the subject of the petition and transport him or her, or cause him
P7    1or her to be transported, to a hospital for examination by a licensed
2mental health treatment provider as soon as is practicable.
3Detention of the person who is the subject of the petition under
4the order may not exceed 72 hours. If the examination is performed
5by another licensed mental health treatment provider, the
6examining licensed mental health treatment provider may consult
7with the licensed mental health treatment provider whose
8affirmation or affidavit accompanied the petition regarding the
9issues of whether the allegations in the petition are true and whether
10the person meets the criteria for assisted outpatient treatment.

11(4) The person who is the subject of the petition shall have all
12of the following rights:

13(A) To adequate notice of the hearings to the person who is the
14subject of the petition, as well as to parties designated by the person
15who is the subject of the petition.

16(B) To receive a copy of the court-ordered evaluation.

17(C) To counsel. If the person has not retained counsel, the court
18shall appoint a public defender.

19(D) To be informed of his or her right to judicial review by
20habeas corpus.

21(E) To be present at the hearing unless he or she waives the
22right to be present.

23(F) To present evidence.

24(G) To call witnesses on his or her behalf.

25(H) To cross-examine witnesses.

26(I) To appeal decisions, and to be informed of his or her right
27to appeal.

28(5) (A) If after hearing all relevant evidence, the court finds
29that the person who is the subject of the petition does not meet the
30criteria for assisted outpatient treatment, the court shall dismiss
31the petition.

32(B) If after hearing all relevant evidence, the court finds that
33the person who is the subject of the petition meets the criteria for
34assisted outpatient treatment, and there is no appropriate and
35feasible less restrictive alternative, the court may order the person
36who is the subject of the petition to receive assisted outpatient
37treatment for an initial period not to exceed six months. In
38fashioning the order, the court shall specify that the proposed
39treatment is the least restrictive treatment appropriate and feasible
40for the person who is the subject of the petition. The order shall
P8    1state the categories of assisted outpatient treatment, as set forth in
2Section 5348, that the person who is the subject of the petition is
3to receive, and the court may not order treatment that has not been
4recommended by the examining licensed mental health treatment
5provider and included in the written treatment plan for assisted
6outpatient treatment as required by subdivision (e). If the person
7has executed an advance health care directive pursuant to Chapter
82 (commencing with Section 4650) of Part 1 of Division 4.7 of
9the Probate Code, any directions included in the advance health
10care directive shall be considered in formulating the written
11treatment plan.

12(6) If the person who is the subject of a petition for an order for
13assisted outpatient treatment pursuant to subparagraph (B) of
14paragraph (5) refuses to participate in the assisted outpatient
15treatment program, the court may order the person to meet with
16the assisted outpatient treatment team designated by the director
17of the assisted outpatient treatment program. The treatment team
18shall attempt to gain the person’s cooperation with treatment
19ordered by the court. The person may be subject to a 72-hour hold
20pursuant to subdivision (f) only after the treatment team has
21attempted to gain the person’s cooperation with treatment ordered
22by the court, and has been unable to do so.

23(e) Assisted outpatient treatment shall not be ordered unless the
24licensed mental health treatment provider recommending assisted
25outpatient treatment to the court has submitted to the court a written
26treatment plan that includes services as set forth in Section 5348,
27and the court finds, in consultation with the county mental health
28director, or his or her designee, all of the following:

29(1) That the services are available from the county, or a provider
30approved by the county, for the duration of the court order.

31(2) That the services have been offered to the person by the
32local director of mental health, or his or her designee, and the
33person has been given an opportunity to participate on a voluntary
34basis, and the person has failed to engage in, or has refused,
35treatment.

36(3) That all of the elements of the petition required by this article
37have been met.

38(4) That the treatment plan will be delivered to the county
39director of mental health, or to his or her appropriate designee.

P9    1(f) If, in the clinical judgment of a licensed mental health
2treatment provider, the person who is the subject of the petition
3has failed or has refused to comply with the treatment ordered by
4the court, and, in the clinical judgment of the licensed mental health
5treatment provider, efforts were made to solicit compliance, and,
6in the clinical judgment of the licensed mental health treatment
7provider, the person may be in need of involuntary admission to
8a hospital for evaluation, the provider may request that persons
9designated under Section 5150 take into custody the person who
10is the subject of the petition and transport him or her, or cause him
11or her to be transported, to a hospital, to be held up to 72 hours for
12examination by a licensed mental health treatment provider to
13determine if the person is in need of treatment pursuant to Section
145150. Any continued involuntary retention in a hospital beyond
15the initial 72-hour period shall be pursuant to Section 5150. If at
16any time during the 72-hour period the person is determined not
17to meet the criteria of Section 5150, and does not agree to stay in
18the hospital as a voluntary patient, he or she shall be released and
19any subsequent involuntary detention in a hospital shall be pursuant
20to Section 5150. Failure to comply with an order of assisted
21outpatient treatment alone may not be grounds for involuntary
22civil commitment or a finding that the person who is the subject
23of the petition is in contempt of court.

24(g) If the director of the assisted outpatient treatment program
25determines that the condition of the patient requires further assisted
26outpatient treatment, the director shall apply to the court, prior to
27the expiration of the period of the initial assisted outpatient
28treatment order, for an order authorizing continued assisted
29outpatient treatment for a period not to exceed 180 days from the
30date of the order. The procedures for obtaining an order pursuant
31to this subdivision shall be in accordance with subdivisions (a) to
32(f), inclusive. The period for further involuntary outpatient
33treatment authorized by a subsequent order under this subdivision
34may not exceed 180 days from the date of the order.

35(h) At intervals of not less than 60 days during an assisted
36outpatient treatment order, the director of the outpatient treatment
37program shall file an affidavit with the court that ordered the
38outpatient treatment affirming that the person who is the subject
39of the order continues to meet the criteria for assisted outpatient
40treatment. At these times, the person who is the subject of the order
P10   1shall have the right to a hearing on whether or not he or she still
2meets the criteria for assisted outpatient treatment if he or she
3disagrees with the director’s affidavit. The burden of proof shall
4be on the director.

5(i) During each 60-day period specified in subdivision (h), if
6the person who is the subject of the order believes that he or she
7is being wrongfully retained in the assisted outpatient treatment
8program against his or her wishes, he or she may file a petition for
9a writ of habeas corpus, thus requiring the director of the assisted
10outpatient treatment program to prove that the person who is the
11subject of the order continues to meet the criteria for assisted
12outpatient treatment.

13(j) Any person ordered to undergo assisted outpatient treatment
14pursuant to this article, who was not present at the hearing at which
15the order was issued, may immediately petition the court for a writ
16of habeas corpus. Treatment under the order for assisted outpatient
17treatment may not commence until the resolution of that petition.

18

SEC. 2.  

Section 5348 of the Welfare and Institutions Code is
19amended to read:

20

5348.  

(a) For purposes of subdivision (e) of Section 5346, a
21county that provides assisted outpatient treatment services pursuant
22to this article shall offer assisted outpatient treatment services
23including, but not limited to, all of the following:

24(1) Community-based, mobile, multidisciplinary, highly trained
25mental health teams that use high staff-to-client ratios of no more
26than 10 clients per team member for those subject to court-ordered
27services pursuant to Section 5346.

28(2) A service planning and delivery process that includes the
29following:

30(A) Determination of the numbers of persons to be served and
31the programs and services that will be provided to meet their needs.
32The local director of mental health shall consult with the sheriff,
33the police chief, the probation officer, the mental health board,
34contract agencies, and family, client, ethnic, and citizen
35constituency groups as determined by the director.

36(B) Plans for services, including outreach to families whose
37severely mentally ill adult is living with them, design of mental
38health services, coordination and access to medications, psychiatric
39and psychological services, substance abuse services, supportive
40housing or other housing assistance, vocational rehabilitation, and
P11   1veterans’ services. Plans shall also contain evaluation strategies,
2which shall consider cultural, linguistic, gender, age, and special
3 needs of minorities and those based on any characteristic listed or
4defined in Section 11135 of the Government Code in the target
5populations. Provision shall be made for staff with the cultural
6background and linguistic skills necessary to remove barriers to
7mental health services as a result of having
8limited-English-speaking ability and cultural differences.
9Recipients of outreach services may include families, the public,
10primary care physicians, and others who are likely to come into
11contact with individuals who may be suffering from an untreated
12severe mental illness who would be likely to become homeless if
13the illness continued to be untreated for a substantial period of
14time. Outreach to adults may include adults voluntarily or
15involuntarily hospitalized as a result of a severe mental illness.

16(C) Provision for services to meet the needs of persons who are
17physically disabled.

18(D) Provision for services to meet the special needs of older
19adults.

20(E) Provision for family support and consultation services,
21parenting support and consultation services, and peer support or
22self-help group support, where appropriate.

23(F) Provision for services to be client-directed and that employ
24psychosocial rehabilitation and recovery principles.

25(G) Provision for psychiatric and psychological services that
26are integrated with other services and for psychiatric and
27psychological collaboration in overall service planning.

28(H) Provision for services specifically directed to seriously
29mentally ill young adults 25 years of age or younger who are
30homeless or at significant risk of becoming homeless. These
31provisions may include continuation of services that still would
32be received through other funds had eligibility not been terminated
33as a result of age.

34(I) Services reflecting special needs of women from diverse
35cultural backgrounds, including supportive housing that accepts
36children, personal services coordinator therapeutic treatment, and
37substance treatment programs that address gender-specific trauma
38and abuse in the lives of persons with mental illness, and vocational
39rehabilitation programs that offer job training programs free of
40gender bias and sensitive to the needs of women.

P12   1(J) Provision for housing for clients that is immediate,
2transitional, permanent, or all of these.

3(K) Provision for clients who have been suffering from an
4untreated severe mental illness for less than one year, and who do
5not require the full range of services, but are at risk of becoming
6homeless unless a comprehensive individual and family support
7services plan is implemented. These clients shall be served in a
8manner that is designed to meet their needs.

9(3) Each client shall have a clearly designated mental health
10personal services coordinator who may be part of a
11multidisciplinary treatment team who is responsible for providing
12or assuring needed services. Responsibilities include complete
13assessment of the client’s needs, development of the client’s
14personal services plan, linkage with all appropriate community
15services, monitoring of the quality and follow through of services,
16and necessary advocacy to ensure each client receives those
17services that are agreed to in the personal services plan. Each client
18shall participate in the development of his or her personal services
19plan, and responsible staff shall consult with the designated
20conservator, if one has been appointed, and, with the consent of
21the client, shall consult with the family and other significant
22persons as appropriate.

23(4) The individual personal services plan shall ensure that
24persons subject to assisted outpatient treatment programs receive
25age-appropriate, gender-appropriate, and culturally appropriate
26services, to the extent feasible, that are designed to enable
27recipients to:

28(A) Live in the most independent, least restrictive housing
29feasible in the local community, and, for clients with children, to
30live in a supportive housing environment that strives for
31reunification with their children or assists clients in maintaining
32custody of their children as is appropriate.

33(B) Engage in the highest level of work or productive activity
34appropriate to their abilities and experience.

35(C) Create and maintain a support system consisting of friends,
36family, and participation in community activities.

37(D) Access an appropriate level of academic education or
38vocational training.

39(E) Obtain an adequate income.

P13   1(F) Self-manage their illnesses and exert as much control as
2possible over both the day-to-day and long-term decisions that
3affect their lives.

4(G) Access necessary physical health care and maintain the best
5possible physical health.

6(H) Reduce or eliminate serious antisocial or criminal behavior,
7and thereby reduce or eliminate their contact with the criminal
8justice system.

9(I) Reduce or eliminate the distress caused by the symptoms of
10mental illness.

11(J) Have freedom from dangerous addictive substances.

12(5) The individual personal services plan shall describe the
13service array that meets the requirements of paragraph (4), and to
14the extent applicable to the individual, the requirements of
15paragraph (2).

16(b) A county that provides assisted outpatient treatment services
17pursuant to this article also shall offer the same services on a
18voluntary basis.

19(c) Involuntary medication shall not be allowed absent a separate
20order by the court pursuant to Sections 5332 to 5336, inclusive.

21(d) A county that operates an assisted outpatient treatment
22program pursuant to this article shall provide data to the State
23Department of Health Care Services and, based on the data, the
24department shall report to the Legislature on or before May 1 of
25each year in which the county provides services pursuant to this
26article. The report shall include, at a minimum, an evaluation of
27the effectiveness of the strategies employed by each program
28operated pursuant to this article in reducing homelessness and
29hospitalization of persons in the program and in reducing
30involvement with local law enforcement by persons in the program.
31The evaluation and report shall also include any other measures
32identified by the department regarding persons in the program and
33all of the following, based on information that is available:

34(1) The number of persons served by the program and, of those,
35the number who are able to maintain housing and the number who
36maintain contact with the treatment system.

37(2) The number of persons in the program with contacts with
38local law enforcement, and the extent to which local and state
39incarceration of persons in the program has been reduced or
40avoided.

P14   1(3) The number of persons in the program participating in
2employment services programs, including competitive employment.

3(4) The days of hospitalization of persons in the program that
4have been reduced or avoided.

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

6(6) Other indicators of successful engagement, if any, by persons
7in the program.

8(7) Victimization of persons in the program.

9(8) Violent behavior of persons in the program.

10(9) Substance abuse by persons in the program.

11(10) Type, intensity, and frequency of treatment of persons in
12the program.

13(11) Extent to which enforcement mechanisms are used by the
14program, when applicable.

15(12) Social functioning of persons in the program.

16(13) Skills in independent living of persons in the program.

17(14) Satisfaction with program services both by those receiving
18them and by their families, when relevant.

19

SEC. 3.  

Section 5349 of the Welfare and Institutions Code is
20amended to read:

begin delete
21

5349.  

A county that does not wish to implement this article
22may opt out of the requirements of this article by a resolution
23passed by the county board of supervisors that states the reasons
24for opting out and any facts or circumstances relied on in making
25that decision. To

end delete
26begin insert

begin insert5349.end insert  

end insert
begin insert

(a) This article shall be operative in those counties in
27which the county board of supervisors, by resolution or through
28the county budget process, authorizes application of this article.

end insert
begin insert

29(b) Any county that has not held a public hearing by January
301, 2017, to determine whether this article shall be operative shall
31hold that hearing by January 1, 2018. At the hearing, the board
32of supervisors shall consider the options available in the county
33for providing services to persons whose recent history of
34hospitalization or violent behavior, and noncompliance with
35voluntary treatment, indicate that he or she may be likely to become
36dangerous or gravely disabled, including, but not limited to, both
37of the following:

end insert
begin insert

38(1) Options for providing services other than court-ordered
39outpatient treatment.

end insert
begin insert

P15   1(2) Whether any voluntary mental health program serving
2adults, or any children’s mental health program, may be reduced
3as a result of the implementation of this article.

end insert

4begin insert(c)end insertbegin insertend insertbegin insertToend insert the extent otherwise permitted under state and federal
5law, counties that implement this article may pay for the provision
6of services under Sections 5347 and 5348 using funds distributed
7to the counties from the Mental Health Subaccount, the Mental
8Health Equity Subaccount, and the Vehicle License Collection
9Account of the Local Revenue Fund, funds from the Mental Health
10Account and the Behavioral Health Subaccount within the Support
11Services Account of the Local Revenue Fund 2011, funds from
12the Mental Health Services Fund when included in county plans
13pursuant to Section 5847, and any other funds from which the
14Controller makes distributions to the counties for those purposes.
15Compliance with this section shall be monitored by the State
16Department of Health Care Services as part of its review and
17approval of county performance contracts.

18

SEC. 4.  

Section 5349.1 of the Welfare and Institutions Code
19 is amended to read:

20

5349.1.  

(a) Counties that implement this article, shall, in
21consultation with the State Department of Health Care Services,
22client and family advocacy organizations, and other stakeholders,
23develop a training and education program for purposes of
24improving the delivery of services to mentally ill individuals who
25are, or who are at risk of being, involuntarily committed under this
26part. This training shall be provided to mental health treatment
27providers contracting with participating counties and to other
28individuals, including, but not limited to, mental health
29professionals, law enforcement officials, and certification hearing
30officers involved in making treatment and involuntary commitment
31decisions.

32(b) The training shall include both of the following:

33(1) Information relative to legal requirements for detaining a
34person for involuntary inpatient and outpatient treatment, including
35criteria to be considered with respect to determining if a person is
36considered to be gravely disabled.

37(2) Methods for ensuring that decisions regarding involuntary
38treatment as provided for in this part direct patients toward the
39most effective treatment. Training shall include an emphasis on
40each patient’s right to provide informed consent to assistance.

P16   1

SEC. 5.  

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

3

5349.5.  

(a) This article shall remain in effect only until January
41, 2022, and as of that date is repealed, unless a later enacted statute
5that is enacted on or before January 1, 2022, deletes or extends
6that date.

7(b) The State Department of Health Care Services shall submit
8a report and evaluation of all counties implementing any
9component of this article to the Governor and to the Legislature
10by July 1, 2015. The evaluation shall include data described in
11subdivision (d) of Section 5348.

12

SEC. 6.  

If the Commission on State Mandates determines that
13this act contains costs mandated by the state, reimbursement to
14local agencies and school districts for those costs shall be made
15pursuant to Part 7 (commencing with Section 17500) of Division
164 of Title 2 of the Government Code.



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