BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1194
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|AUTHOR: |Eggman |
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|VERSION: |May 6, 2015 |
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|HEARING DATE: |June 24, 2015 | | |
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|CONSULTANT: |Reyes Diaz |
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SUBJECT : Mental health: involuntary commitment.
SUMMARY : Requires an authorized person, when determining if a person is
a danger to him- or herself or others because of a mental health
disorder, to consider available information related to the
person's historical course of his or her mental health disorder,
as specified. Requires, when a person is determined to need
detainment, an admitting facility to require a written
application that records whether information about the person's
historical course, as specified, was considered.
Existing law:
1)Establishes the Lanterman-Petris-Short Act (LPS Act), which
authorizes a person to be involuntarily detained for a period
of up to 72 hours for assessment, evaluation, and crisis
intervention, when, as a result of a mental health disorder,
the person is a danger to him- or herself or to others, or is
gravely disabled. Defines "gravely disabled" to mean a
condition in which a person, as a result of a mental health
disorder, is unable to provide for his or her basic personal
needs for food, clothing, or shelter.
2)Requires, when determining if probable cause exists to take,
or cause a person to be taken, into custody, relevant
information about the historical course of the person's mental
health disorder be considered, if an authorized person
determines that the information has a reasonable bearing on
the determination of a person's mental condition.
3)Specifies that "information about the historical course of the
person's mental disorder" includes evidence presented by:
a) the person who has provided or is providing
AB 1194 (Eggman) Page 2 of ?
mental health or related support services to a person
subject to a determination;
b) one or more members of the family of a person
subject to a determination; or,
c) a person subject to a determination or anyone
designated by that person.
4)Requires, when a person cannot be properly served without
being detained, an admitting facility to require an
application in writing stating the circumstances under which a
person's mental condition was called to the attention of an
authorized person and that there was probable cause to believe
that a person was a danger to him- or herself or others, or
was gravely disabled, due to a mental health disorder.
5)Specifies that an "authorized person" includes a:
a) Peace officer;
b) Professional person in charge of a facility
designated by the county for evaluation and treatment;
c) Member of the attending staff of a facility
designated by the county for evaluation and treatment;
d) Designated members of a mobile crisis team;
or,
e) Professional person designated by the county.
This bill:
1)Requires an authorized person, in determining if a person is a
danger to him- or herself or others as a result of a mental
health disorder, to consider available relevant "information
about the historical course," as specified in 3) above, of a
person's mental health disorder if the authorized person
concludes that the information has a reasonable bearing on the
determination of a person's mental condition. Specifies that
"danger" is not limited to danger of imminent harm.
2)Requires the application, required in 4) above, to also record
whether the historical course of a person's mental health
disorder was considered when making a determination of
probable cause.
FISCAL
EFFECT : According to the Assembly Appropriations Committee,
this bill has negligible state fiscal effect.
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PRIOR
VOTES :
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|Assembly Floor: |79 - 0 |
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|Assembly Appropriations Committee: |17 - 0 |
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|Assembly Health Committee: |16 - 0 |
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COMMENTS :
1)Author's statement. According to the author, current law does
not make clear what constitutes danger when a person, as a
result of a mental health disorder, is a danger to him- or
herself or others, and requires law enforcement or other
qualified individuals to respond as according to provisions in
the Welfare and Institutions Code Section 5150 ("5150"). This
lack of clarity results in an uneven application during a 5150
incident in the event where a person in question is not
presenting an immediate or imminent safety risk when a peace
officer or other qualified person responds. AB 1194 simply
clarifies that when a person with a mental health disorder is
a danger to him- or herself or others, the term "danger" is
not limited to imminent or immediate risk of harm to him- or
herself or others. Rather, "danger" constitutes a present risk
or harm that requires consideration of the historical course
of a person's mental health disorder. The purpose of this bill
is to ensure that those who are a danger to themselves or
others receive the appropriate care during a 5150 incident.
2)Background. According to National Alliance on Mental Illness
(NAMI) California's Web site, the LPS act ended the
inappropriate, indefinite, and involuntary commitment of
mentally disordered persons to institutions and encouraged the
full use of existing agencies, personnel, and funds to provide
treatment, supervision, and placement of gravely disabled
persons. The authors of the LPS act envisioned an expanded
system of community based mental health centers providing
appropriate and timely support to those in need at a reduced
cost to the state.
The LPS Act requires authorized people making a determination
if a person is a danger to him- or herself or others, or
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gravely disabled, to assess whether or not the person can be
properly served without being detained. If a person can be
properly served without being detained, he or she is entitled
to receive an evaluation, crisis intervention, or other
inpatient or outpatient services on a voluntary basis.
Some anecdotal data provided by the author shows that 5150
situations are not always handled uniformly. Some law
enforcement departments and mental health agencies interpret
the term "danger to him- or herself or others" to apply only
in situations where a person poses an immediate danger. The
word "danger" is not defined in current law, which has created
a challenge in applying Section 5150 in certain cases.
3)Related legislation. AB 193 (Maienschein), permits a judge
presiding over a probate conservatorship to recommend to the
county investigating officer the establishment of an LPS
conservatorship when there is evidence of grave disability as
a result of a mental health disorder or impairment by chronic
alcoholism. AB 193 is set for hearing in the Senate Judiciary
Committee on June 30, 2015.
4)Prior legislation. AB 110 (Blumenfield, Chapter 20, Statutes
of 2013), enacted the 2013-14 Budget Act, which included,
among its other provisions, $206 million ($142 million General
Fund one-time) for a major investment in mental health
services, including additional residential treatment capacity,
crisis treatment teams, and triage personnel.
AB 1424 (Thomson, Chapter 506, Statutes of 2001), made various
changes to the LPS Act to: increase the involvement of family
members in commitment hearings for the mentally ill; require
more use of a patient's medical and psychiatric records in
these hearings; and prohibit health plans and insurers from
using the commitment status of a mentally ill person to
determine eligibility for claim reimbursement.
SB 665 (Petris, Chapter 681, Statutes of 1991), established
the right, under the LPS Act, to refuse antipsychotic
medication and established hearing procedures to determine a
person's capacity to refuse treatment with antipsychotic
medication.
5)Support. Supporters of this bill, comprising medical
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professionals, law enforcement, and mental health advocates,
argue that this bill will provide more timely access to
treatment for people in psychiatric crises who, without
treatment, may harm themselves or others. They state that this
bill could prevent certain situations from escalating into
overt acts of violence. Supporters further state that current
law is unclear whether the term "danger" is limited to danger
of imminent harm, and this bill will allow a more consistent
interpretation and determination of an individual's level of
dangerousness.
6)Opposition. Disability Rights California (DRC) states that a
present risk of harm, as defined in this bill, is too broad
and most anything could be considered dangerous, resulting in
involuntary detention for anyone with a history of mental
health disability. DRC states that the proposed definition has
the potential to cause more problems than it solved, and if
people are not likely to harm themselves or others at the
present time, they should not be subject to involuntary
detention.
7)Technical amendments. The author may wish to consider the
following technical amendments:
a. On page 4, line 12, strike out "subdivision (b)" and
insert:
subdivision (c)
b. On page 6, line 5, strike out "subdivision (f)" and
insert:
subdivision (g)
SUPPORT AND OPPOSITION :
Support: California Psychiatric Association (sponsor)
California Association of Marriage and Family
Therapists
California Chapter of the American College of
Emergency Physicians
California Hospital Association
California Medical Association
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California Police Chiefs Association
California Probation, Parole and Correctional
Association
California State Sheriffs' Association
California Treatment Advocacy Coalition
Contra Costa Mental Health Community Coalition
Latino Coalition for a Healthy California
NAMI California
NAMI Contra Costa
NAMI Orange County
St. Joseph's Behavioral Health Center
Treatment Advocacy Center
Numerous individuals
Oppose: Disability Rights California
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