BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1194|
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THIRD READING
Bill No: AB 1194
Author: Eggman (D)
Amended: 9/2/15 in Senate
Vote: 21
SENATE HEALTH COMMITTEE: 7-0, 7/1/15
AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Pan, Roth
NO VOTE RECORDED: Nielsen, Wolk
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
ASSEMBLY FLOOR: 79-0, 6/1/15 - See last page for vote
SUBJECT: Mental health: involuntary commitment
SOURCE: California Psychiatric Association
DIGEST: This bill requires a person who determines that an
individual should be taken into custody, because he or she is a
danger to him- or herself or others, to consider available
information related to the historical course of the individual's
mental health disorder, as specified. This bill 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.
Senate Floor Amendments of 9/2/15 specify that a determination
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about whether an individual should be taken into custody should
not be limited to the consideration of the danger of imminent
harm.
ANALYSIS:
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 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
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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 the relevant information about
the historical course of an individual's mental health
disorder. Prohibits the determination from being limited to
the consideration of the 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.
Comments
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
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ensure that those who are a danger to themselves or others
receive the appropriate care during a 5150 incident.
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 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.
Related/Prior Legislation
AB 193 (Maienschein - 2015) 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
currently pending on the Senate Floor.
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
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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; required
more use of a patient's medical and psychiatric records in these
hearings; and prohibited 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.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: Yes
SUPPORT: (Verified9/2/15)
California Psychiatric Association (source)
American Federation of State, County and Municipal Employees
California Association of Marriage and Family Therapists
California Chapter of the American College of Emergency
Physicians
California Hospital Association
California Medical Association
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
OPPOSITION: (Verified9/2/15)
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Department of Health Care Services
Disability Rights California
ARGUMENTS IN SUPPORT: Supporters of this bill, comprising
medical 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.
ARGUMENTS IN 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. The Department of Health Care Services
argues that this bill lowers the standard for placing an
individual on a 5150 hold, as the additional language adds a
broad and vague standard that is not specific enough to ensure
appropriate application of involuntary detainments for mental
health treatment.
ASSEMBLY FLOOR: 79-0, 6/1/15
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,
Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang,
Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle,
Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina
Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez,
Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden,
Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder,
Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina,
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Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen,
Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez,
Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting,
Waldron, Weber, Wilk, Williams, Wood, Atkins
NO VOTE RECORDED: Wagner
Prepared by:Reyes Diaz / HEALTH /
9/3/15 15:32:01
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