AB 1300, as amended, Ridley-Thomas. Mental health: involuntary commitment.
Under existing law, when a person, as a result of mental disorder, is a danger to others, or to himself or herself, or gravely disabled, he or she may, upon probable cause, be taken into custody by a peace officer, member of the attending staff of an evaluation facility, designated members of a mobile crisis team, or other designated professional person, and placed in a facility designated by the county and approved by the State Department of Health Care Services as a facility for 72-hour treatment and evaluation.
This bill would authorize counties to designate one or more persons to act as a local or regional liaison to assist a person who is a patient in an emergency department of a defined nondesignated hospital and who has been detained, or who may require detention, for evaluation and treatment, as specified. The bill would reorganize and make changes to the provisions relating to the detention for evaluation and treatment of a person who may be subject to the above provisions, including specifying procedures for delivery of those individuals to various facilities; evaluation of the person for probable cause for detention for evaluation and treatment; terms and length of detention, where appropriate, in various types of facilities; and criteria for release from defined designated facilities and nondesignated hospitals. The bill would authorize a provider of ambulance services to transfer a person who is voluntarily transferring to a designated facility for evaluation and treatment. The bill would also make changes to the methods by which law enforcement is notified of the release of a person detained for evaluation and treatment.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 5001 of the Welfare and Institutions Code
2 is amended to read:
The provisions of this part and Part 1.5 (commencing
4with Section 5585) shall be construed to promote the legislative
5intent as follows:
6(a) To end the inappropriate, indefinite, and involuntary
7commitment of persons with mental health disorders,
8developmental disabilities, and chronic alcoholism, and to eliminate
9legal disabilities.
10(b) To provide prompt evaluation and treatment of persons with
11mental health disorders or impaired by chronic alcoholism.
12(c) To guarantee and protect public safety.
13(d) To safeguard individual rights through judicial review.
14(e) To provide individualized treatment, supervision, and
15placement services by a conservatorship program for persons who
16are gravely disabled.
17(f) To encourage the full use of all existing agencies,
18professional personnel, and public funds to accomplish these
19objectives and to prevent duplication of services and unnecessary
20expenditures.
21(g) To protect persons with mental health disorders and
22developmental disabilities from criminal acts.
P3 1(h) To provide consistent standards for protection of the personal
2rights of persons receiving services under this part and under Part
31.5 (commencing with Section 5585).
4(i) To provide services in the least restrictive setting appropriate
5to the needs of each
person receiving services under this part and
6under Part 1.5 (commencing with Section 5585).
7(j) To ensure that persons receive services from facilities and
8providers that are qualified and best suited to provide the services,
9and that persons are not detained in settings that are not therapeutic
10or not designed to meet their needs.
11(k) To affirm that no person may be presumed to be incompetent
12because he or she has been evaluated or treated forbegin insert aend insert mentalbegin insert health end insert
13disorder or chronic alcoholism, regardless of whether that
14evaluation or treatment was voluntarily or involuntarily received.
Section 5001.5 is added to the Welfare and Institutions
16Code, to read:
It is the intent of the Legislature that each county shall
18have the responsibility to ensure that all persons with mentalbegin insert healthend insert
19 disorders who are subject to detention under this part or under Part
201.5 (commencing with Section 5585) receive prompt evaluation
21and treatment in accordance with this part and Part 1.5
22(commencing with Section 5585), including prompt assessment
23of the need for evaluation and treatment. It is the intent of the
24Legislature that each county establish and maintain a mental health
25service system that has sufficient capacity to ensure the provision
26of services under this Part and Part 1.5 (commencing with Section
275585), including, at a minimum, the services required under
28paragraph (2) of subdivision
(a) of Section 5651.
Section 5008 of the Welfare and Institutions Code is
30amended to read:
Unless the context otherwise requires, the following
32definitions shall govern the construction of this part:
33(a) “Antipsychotic medication” means medication customarily
34prescribed for the treatment of symptoms of psychoses and other
35severe mental and emotional disorders.
36(b) “Application for detention for evaluation and treatment”
37means the written application set forth in Section 5150.3.
38(c) (1) “Assessment” means the determination, as described in
39subdivision (b) of Section 5150 and Section 5151, of the following:
P4 1(A) Whether the person meets the criteria for detention for
2
evaluation and treatment.
3(B) Whether the person is in need of evaluation and treatment
4and, if so, what services are needed for the person.
5(C) Whether the person can be properly served without being
6detained, in which case the services shall be provided on a
7voluntary basis.
8(2) “Assessment” includes, but is not limited to, mental status
9determination, analysis of clinical and social history, analysis of
10relevant cultural issues and history, diagnosis, and the use of testing
11procedures.
12(d) “Authorized professional” means any of the following:
13(1) Abegin delete personend deletebegin insert
mental health professionalend insert or category ofbegin delete personsend delete
14begin insert mental health professionalsend insert, excluding peace officers, who are
15authorized in writing by a county to provide services described inbegin delete16 Article 1 (commencing with Section 5150) of Chapter 2, including
17a probable cause determination for the detention of a person for
18evaluation and treatment under Section
5150 and the release of a
19person from detention for evaluation and treatment under Section
205150.15end delete
21appropriate training in mental health disorders and determination
22of probable cause, and shall have relevant experience in providing
23services to persons with mental health disorders.end insert
24(2) An authorizedbegin delete member of theend delete professionalbegin insert as described in
25paragraph (1) who is a member of theend insert staff of abegin insert
designatedend insert facility
26begin insert and who is authorized by the facility to provide services described
27in this subdivisionend insert.
28(3) begin deleteAn authorized end deletebegin insertA end insertmember of a mobile crisis teambegin insert who is
29authorized in writing by a county to provide services described in
30this subdivisionend insert.
31(e) “Conservatorship investigation” means an investigation, by
32an agency appointed or designated by the governing body, of cases
33in which conservatorship is recommended pursuant to Chapter 3
34
(commencing with Section 5350).
35(f) “Court,” unless otherwise specified, means a court of record.
36(g) “Court-ordered evaluation” means an evaluation ordered by
37a superior court pursuant to Article 2 (commencing with Section
385200) or by a superior court pursuant to Article 3 (commencing
39with Section 5225) of Chapter 2.
P5 1(h) “Crisis intervention” consists of an interview or series of
2interviews within a brief period of time, conducted by qualified
3professionals, and designed to alleviate personal or family
4situations which present a serious and imminent threat to the health
5or stability of the person or the family. The interview or interviews
6may be conducted in the home of the person or family, or on an
7inpatient or outpatient basis with such therapy, or other services,
8as may be appropriate. The interview or
interviews may include
9family members, significant support persons, providers, or other
10entities or individuals, as appropriate and as authorized by law.
11Crisis intervention may, as appropriate, include suicide prevention,
12psychiatric, welfare, psychological, legal, or other social services.
13(i) “Crisis stabilization service or unit” means an ambulatory
14service that provides probable cause determinations and
15assessments, collateral services, and therapy within the scope of
16its designation under this part.
17(j) “Department” means the State Department of Health Care
18Services.
19(k) (1) “Designated facility” means a facility or a specific unit
20or part of a facility that is licensed or certified as a mental health
21evaluation facility, a mental health treatment facility, or a mental
22health evaluation
and treatment facility. A designated facility may
23be an inpatient facility or an ambulatory facility.
24(2) “Inpatient facility” means a health facility, or an inpatient
25unit of a health facility, as defined in Chapter 2 (commencing with
26Section 1250) of Division 2 of the Health and Safety Code, that
27is licensedbegin delete andend deletebegin insert by the State of California,end insert has the capability to
28admit and treat persons on an inpatient basis subject to the
29requirements of thisbegin delete part.end deletebegin insert
part, and is designated by a county
30pursuant to Section 5023. Inpatient facility also includes a hospital
31or the inpatient unit of a hospital operated by the United States
32government that has the capability to admit and treat persons on
33an inpatient basis, subject to the requirements of this part, and
34that is designated by the county pursuant to Section 5023.end insert A
35designated inpatient facility includes any of the following:
36(A) A general acute care hospital, as defined in subdivision (a)
37of Section 1250 of the Health and Safety Code.
38(B) An acute psychiatric hospital, as defined in subdivision (b)
39of Section 1250 of the Health and Safety Code.
P6 1(C) A psychiatric health facility, as defined in Section 1250.2
2of the Health and Safety Code.
3(D) A correctional treatment center, as defined in Section 1250
4of the Health and Safety Code, operated by a county, city, or city
5and county law enforcement agency. The department may approve
6an unlicensed correctional treatment center that is in existence as
7of January 1, 2016, if the correctional treatment center meets all
8of the licensing requirements except those that are structurally
9impracticable.
10(3) “Ambulatory facility” means a facilitybegin delete or other providerend delete
11 designated by a county under Section 5023 that provides
12psychiatric services lasting less than 24 hours in accordance with
13applicable law and within the scope of the designation. An
14ambulatory facility may include an outpatient hospital department,
15clinic, crisis stabilizationbegin delete serviceend deletebegin insert
facilityend insert or unit,begin insert
facility of aend insert
16 medical group, facility of a provider organization other than a
17medical group, or other facility that meets the requirements
18established by the department in accordance with Section 5023.
19(l) “Detained for evaluation and treatment” and “detention for
20evaluation and treatment” mean the taking into custody and
21detention of a person in accordance with Section 5150.
22(m) “Emergency” means abegin delete situation in whichend deletebegin insert sudden marked
23change in the person’s condition such thatend insert action to impose
24treatment over the person’s objection is immediately necessary
25for the preservation of life or the prevention of serious bodily harm
26to the patient or others, and it
is impracticable to first gain consent.
27It is not necessary for harm to take place or become unavoidable
28prior to treatment.
29(n) “Emergency transport provider” means a provider of
30ambulance services licensed by the Department of the California
31Highway Patrol or operated by a public safety agency and includes
32the authorized personnel of an emergency transport provider who
33are certified or licensed under Sections 1797.56, 1797.80, 1797.82,
34and 1797.84 of the Health and Safety Code.
35(o) “Evaluation” means a multidisciplinary professional analyses
36of a person’s medical, psychological, educational, social, financial,
37and legal conditions as may appear to constitute a problem. Persons
38providing evaluation services shall be properly qualified
39professionals and may be full-time employeesbegin insert, part-time
40
employees,end insert or independent contractors of a county, designated
P7 1facility, or other agency providing face-to-face evaluationbegin delete services, begin insert services. Face-to-end insertbegin insertface evaluation servicesend insert includes
2whichend delete
3begin insert face-to-face evaluation by means ofend insert telehealth.
4(p) (1) For purposes of Article 1 (commencing with Section
55150), Article 2 (commencing with Section 5200), and Article 4
6(commencing with Section 5250) of Chapter 2, and for the purposes
7of Chapter 3 (commencing with Section 5350), “gravely disabled”
8means either
of the following:
9(A) A condition in which a person, as a result of a mental health
10disorder, is unable to provide for his or her basic personal needs
11for food, clothing, or shelter.
12(B) A condition in which a person, has been found mentally
13incompetent under Section 1370 of the Penal Code and all of the
14following facts exist:
15(i) The indictment or information pending against the person at
16the time of commitment charges a felony involving death, great
17bodily harm, or a serious threat to the physical well-being of
18another person.
19(ii) The indictment or information has not been dismissed.
20(iii) As a result of a mental health disorder, the person is unable
21to understand the nature and purpose
of the proceedings taken
22against him or her and to assist counsel in the conduct of his or
23her defense in a rational manner.
24(2) For purposes of Article 3 (commencing with Section 5225)
25and Article 4 (commencing with Section 5250), of Chapter 2, and
26for the purposes of Chapter 3 (commencing with Section 5350),
27“gravely disabled” means a condition in which a person, as a result
28of impairment by chronic alcoholism, is unable to provide for his
29or her basic personal needs for food, clothing, or shelter.
30(3) The term “gravely disabled” does not include persons with
31intellectual disabilities by reason of that disability alone.
32(q) “Intensive treatment” consists of hospital and other services
33as may be indicated. Intensive treatment shall be provided by
34properly qualified professionals and carried out in facilities
35
qualifying for reimbursement under the California Medical
36Assistance Program (Medi-Cal) set forth in Chapter 7 (commencing
37with Section 14000) of Part 3 of Division 9, or under Title XVIII
38of the federal Social Security Act and regulations thereunder.
39Intensive treatment may be provided in hospitals of the United
40States government by properly qualified professionals. Nothing
P8 1in this part shall be construed to prohibit an intensive treatment
2facility from also providing 72-hour evaluation and treatment.
3(r) “Local or regional liaison” means a person or persons
4authorized by a county, or by two or more counties acting jointly,
5under Section 5024.
6(s) “Mobile crisis team” means a team comprised of one or more
7professionals, and which may also include peer counselors, who
8are authorized by a county to provide probable cause
9determinations and other services under this part.
10(t) “Peace officer” means a duly sworn peace officer as that
11term is defined in Chapter 4.5 (commencing with Section 830) of
12Title 3 of Part 2 of the Penal Code who has completed the basic
13training course established by the Commission on Peace Officer
14Standards and Training, or any parole officer or probation officer
15specified in Section 830.5 of the Penal Code when acting in relation
16to cases for which he or she has a legally mandated responsibility.
17(u) “Postcertification treatment” means an additional period of
18treatment pursuant to Article 6 (commencing with Section 5300)
19of Chapter 2.
20(v) “Prepetition screening” is a screening of all petitions for
21court-ordered evaluation as provided in Article 2 (commencing
22with Section 5200) of Chapter 2, consisting of a professional
23review of the petition; an interview with the
petitioner and,
24whenever possible, the person alleged, as a result of a mental health
25disorder, to be a danger to others, or to himself or herself, or to be
26gravely disabled, to assess the problem and explain the petition;
27and when indicated, efforts to persuade the person to receive, on
28a voluntary basis, comprehensive evaluation, crisis intervention,
29referral, and other services specified in this part.
30(w) “Probable cause determination” means a determination
31whether there is probable cause for the detention of a person for
32evaluation and treatment.begin insert A probable cause determination shall
33be based solely on the criteria for detaining a person for evaluation
34and treatment pursuant to Section 5150. The probable cause
35determination shall not consider the availability of beds or services
36at designated facilities within or outside of the county.end insert
37(x) “Professional person in charge of a facility” means the
38licensed person authorized by a designated facility who is
39responsible for the clinical direction of the designated facility.
P9 1(y) “Professional staff” means the medical staff or other
2organized professional staff of an inpatient facility.
3(z) “Referral” means referral of persons by each facility,
4provider, or other organization providing assessment, evaluation,
5crisis intervention, or treatment services to other facilities,
6providers, or agencies in accordance with Section 5013 and Part
71.5 (commencing with Section 5585).
8(aa) “Telehealth” means the telehealth services, as defined in
9paragraph (6) of subdivision (a) of Section 2290.5 of the Business
10and Professions Code, for the purpose of
providing services under
11this part, including a probable cause determination, the release of
12a person from detention for evaluation and treatment under Section
135150.15, assessment or evaluation, and treatment. For purposes
14of this part, telehealth services may be used by any licensed
15professional, including a psychologist, clinical social worker, and
16other mental health professional, acting within the scope of his or
17her profession for providing evaluation, treatment, consultation,
18or other mental health services under this part.
Section 5013 of the Welfare and Institutions Code is
20amended to read:
(a) The purpose of a referral shall be to provide for
22continuity of carebegin insert and servicesend insert. A referral may include, but need
23not be limited to, informing the person of available services,
24making appointments on the person’s behalf, communication with
25the agency or individual to which the person has been referred,
26appraising the outcome of referrals, and arranging for escort,
27transportation, or both, when necessary.begin delete A referral shall be All persons shall be advised of available precare
28considered complete when the agency or individual to whom the
29person has been referred accepts responsibility for providing the
30necessary services.end delete
31services that
prevent initial recourse to hospital treatment or
32aftercare services that support adjustment to community living
33following hospital treatment. These services may be provided
34through county or city mental health departments, state hospitals
35under the jurisdiction of the State Department of State Hospitals,
36regional centers under contract with the State Department of
37Developmental Services, or other public or private entities.
38(b) It is the intent of the Legislature that referrals between
39facilities, providers, and other organizations shall be facilitated by
P10 1the sharing of information and records in accordance with Section
25328 and applicable federal and state laws.
3(c) Each city or county behavioral health department is
4encouraged to include on its Internet Web site a current list of
5ambulatory behavioral health services and other resources for
6persons with behavioral health
disorders and substance use
7disorders in the city or county that may be accessed by providers
8and consumers of behavioral health services. The list of services
9on the Internet Web site should be updated at least annually by the
10city or county behavioral health department.
Section 5022 is added to the Welfare and Institutions
12Code, to read:
The department shall promote the consistent statewide
14application of this part in order to ensure protection of the personal
15rights of all persons who are subject to this part and Part 1.5
16(commencing with Section 5585). The department shall provide
17oversight of the statewide application of this part and facilitate
18discussion among the organizations listed in subdivision (a) of
19Section 5400, law enforcement agencies, hospitals, mental health
20professionals, county patients’ rights advocates,begin insert the California
21Office of Patientsend insertbegin insert’ Rights,end insert and other stakeholders as may be
22necessary or desirable to achieve the legislative intent
of consistent
23statewide application. These discussions shall include situations
24where persons are certified for additional intensive treatment in a
25county authorizing that treatment under Article 4.7 (commencing
26with Section 5270.10) of Chapter 2 who are then transferred to a
27facility during the course of additional intensive treatment in a
28county that has not authorized additional intensive treatment.
Section 5023 is added to the Welfare and Institutions
30Code, to read:
(a) Each county may designatebegin insert inpatient and ambulatoryend insert
32 facilities within the county, with the approvalbegin delete byend deletebegin insert ofend insert the department,
33that meet the applicable requirements established by the department
34by regulation.begin insert An outpatient or emergency department of a
35nondesignated inpatient facility may be designated as an
36ambulatory facility if it meets all the requirements for certification
37as an ambulatory facility.end insert
38(b) (1) Each county may designate ambulatory facilities within
39the county that meet the behavioral health needs of persons within
40the requirements of applicable law and the scope of their
P11 1designation. The department shall encourage counties to use
2appropriate ambulatory facilities for the evaluation and treatment
3of persons pursuant to this part.
4(2) Counties, mental health professionals, providers, and other
5organizations, with the support of the department, are encouraged
6to establish crisis stabilization services and other ambulatory
7facilities that are designated by a county to provide probable cause
8determinations and assessments, and, as applicable, evaluation and
9treatment services and crisis stabilization services, in settings that
10are appropriate to the needs of persons with severe mental illness
11and less restrictive than inpatient health
facilities.
12(3) Nothing in this subdivision shall preclude the designation
13of an ambulatory facility that is an outpatient clinic of a licensed
14health facility.
15(4) An ambulatory facility shall provide services within the
16scope of its designation to all persons regardless of their place of
17residence.
18(c) Regulations adopted pursuant to this part establishing staffing
19standards for designated facilities shall be consistent with
20applicable licensing regulations for the type of facility. If there are
21no licensing regulations for the type of designated facility, or for
22certain categories of professional personnel providing services in
23a type of designated facility, the regulations adopted pursuant to
24this part for staffing standards may differentiate between the types
25of designated facilities, including ambulatory
facilities. On January
261, 2016, the existing regulations establishing staffing standards
27for designated facilities set forth in Section 663 of Title 9 of the
28California Code of Regulations are repealed and nullified.
29(d) A county may contract with a facility or other provider in
30an
adjacent state that, within the discretion and oversight of the
31county, will meet the needs of county residents under this part and
32that has agreed in writing to meet the terms and conditions
33established by the county for the scope of services to be performed
34by the facility or other provider. The terms and conditions shall
35include the protection of a person’s rights under Article 7
36(commencing with Section 5325) of Chapter 2 and access to
37persons placed in the facility by patients’ right advocates of the
38contracting county.
34 39(e)
end delete
P12 1begin insert(d)end insert A county shall not charge or assess a fee for the designation
2ofbegin delete an ambulatoryend deletebegin insert
aend insert facility orbegin delete the approval ofend delete an authorized
3professional.
37 4(f)
end delete
5begin insert(e)end insert Each designated facility shall accept, within its clinical
6capability and capacity, all categories of persons for whom it is
7designated, without regard to insurance or financial status. If a
8person presents to a designated facility with a psychiatric
9emergency medical condition, as defined in subdivision (f) of
10Section 5150.10, that is beyond its capability, the facility shall
11assist the person in obtaining emergency services and care at an
12appropriate facility.
13(g)
end delete
14begin insert(f)end insert In order to provide access by members of the public to
15information about designated facilities, each county department
16responsible for mental health services shall maintain on its Internet
17Web site the locations of all designated facilities within the county,
18including address, the types of services available at each designated
19facility, and the hours of operation for ambulatory facilities. The
20Internet Web site shall be updated if there are changes to the
21information.
13 22(h)
end delete
23begin insert(g)end insert Each county
shall report to the department, on at least an
24annual basis, a current list of designated facilities within the county,
25including the name and address of each facility and its facility
26type. The department shall maintain a list of designated facilities,
27by county and facility licensure type, on its Internet Web site, and
28update the list not less than annually. The department Internet Web
29site shall also contain links to each county Internet Web site
30required by subdivisionbegin delete (g).end deletebegin insert (f).end insert
21 31(i)
end delete
32begin insert(h)end insert Counties are encouraged to share information with adjacent
33and other counties with respect to its roster of authorized
34professionals. An authorized professional shall not be required to
35obtain approval from another county to be an authorized
36professional in that county in order to take action under this part.
Section 5024 is added to the Welfare and Institutions
38Code, to read:
(a) Each county may authorize one or more qualified
40persons to act as a local or regional liaison to assist nondesignated
P13 1hospitals in the county in accordance with this section and Article
21.1 (commencing with Section 5150.10) of Chapter 2. Two or
3more counties may enter into anbegin delete inter-countyend deletebegin insert intercountyend insert
4 arrangement under which the participating counties agree to
5authorize one or more persons to act as a local or regional liaison
6to assist nondesignated hospitals in the participating counties in
7accordance with this section and Article 1.1 (commencing with
8Section 5150.10) of Chapter 2.
9(b) The role of the local or regional liaison is to assist a person
10who is a patient in an emergency department of a nondesignated
11hospital and who has been detained, or may require detention, for
12evaluation and treatment. The assistance may include any of the
13following:
14(1) Arranging for an authorized professional to provide a prompt
15probable cause determination under Section 5150.13.
16(2) Arranging for an authorized professional to determine
17whether the detention for evaluation and treatment of a person
18shall be released under Section 5150.15.
19(3) Arranging for the placement of a person detained for
20evaluation and treatment whobegin delete isend deletebegin insert
has beenend insert medicallybegin delete clearend deletebegin insert
stabilizedend insert
21 for transfer or discharge to a designated facility.
22(c) A local or regional liaison may be employed by, or may
23contract with, a county or counties and may include personnel of
24one or more designated facilities within the county or counties.
25The role of the local or regional liaison may be rotated among the
26categories of persons described in this subdivision.
27(d) A local or regional liaison shall be available 24 hours a day,
28including weekends and holidays, to provide assistance under this
29section.
30(e) Each county, or counties acting jointly under this section,
31shall provide the nondesignated hospitals in the county or counties
32with the contact information for a local or regional liaison. The
33means of contact may be a designated telephone number, email,
34text-messaging
or other electronic means, or any combination of
35the foregoing, so long as the local or regional liaison has immediate
36access to the means of contact. The contact information provided
37to nondesignated hospitals shall be updated as necessary.
38(f) This section shall not apply to a county that has not
39authorized a local or regional liaison.
Section 5025 is added to the Welfare and Institutions
2Code, to read:
(a) A designated facility or nondesignated hospital, as
4defined in subdivision (e) of Section 5150.10, or a physician,
5employee, or other staff person acting within the scope of his or
6her official duties or employment for the designated facility or
7nondesignated hospital shall not be liable for any injury resulting
8from determining any of the following:
9(1) Whether to detain a person for a mental healthbegin delete disorder or begin insert disorder, inebriation, chronic alcoholism, or the use of
10addiction,end delete
11narcotics or a restricted dangerous drugend insert
in accordance with this
12part.
13(2) The terms, conditions, and enforcement of detention for a
14person with a mental healthbegin delete disorder or addiction,end deletebegin insert disorder,
15inebriation, chronic alcoholism, or the use of narcotics or a
16restricted dangerous drugend insert in accordance with this part.
17(3) Whether to release a person detained for a mentalbegin delete health begin insert disorder, inebriation, chronic alcoholism,
18disorder or addiction,end delete
19or the use of narcotics or a restricted dangerous drugend insert
in
20accordance with this part.
21(b) A physician, employee, or other staff person acting within
22the scope of his or her official duties or employment for a
23designated facility or nondesignated hospital shallbegin delete beend delete notbegin insert beend insert liable
24for carrying out a determination described in subdivision (a) so
25long as he or she uses due care.
26(c) Nothing in this section shall exonerate a physician, employee,
27or other staff person acting within the scope of his or her official
28duties or employment for a designated facility or nondesignated
29hospital from liability for injury proximately caused by his or her
30negligent or wrongful act or omission in carrying out or failing to
31carry
out any of the following:
32(1) A determination to detain or not to detain a person for a
33mental health disorder or addiction, in accordance with this part.
34(2) The terms or conditions of detention of a person for a mental
35health disorder or addiction, in accordance with this part.
36(3) A determination to release a person detained for a mental
37health disorder or addiction, in accordance with this part.
Section 5026 is added to the Welfare and Institutions
39Code, to read:
(a) A designated facility or nondesignated hospital, as
2defined in subdivision (e) of Section 5150.10, or a physician,
3employee, or other staff person acting within the scope of his or
4her official duties or employment for the designated facility or
5nondesignated hospital shall not be liable for any of the following:
6(1) An injury caused by an eloping or eloped person who has
7been detained for a mental health disorder or addiction.
8(2) An injury to, or the wrongful death of, an eloping or eloped
9person who has been detained for a mental health disorder or
10addiction.
11(b) Nothing in this section shall exonerate a
physician,
12employee, or other staff person acting within the scope of his or
13her official duties or employment for a designated facility or
14nondesignated hospital from liabilitybegin delete in either of the following begin insert if he or she acted or failed to act because of actual
15situations:end delete
16fraud, corruption, or actual malice.end insert
17(1) If he or she acted or failed to act because of actual fraud,
18corruption, or actual malice.
19(2) For injuries inflicted as a result of his or her own negligent
20or wrongful act or omission on an eloping or eloped person who
21has been detained for a mental health disorder or addiction under
22this part, in an effort to enforce the detention.
Section 5150 of the Welfare and Institutions Code is
24amended to read:
(a) When a person, as a result of a mental health
26disorder, is a danger to others, or to himself or herself, or gravely
27disabled, a peace officer or an authorized professional acting within
28the scope of his or her authorization may, upon probable cause,
29take, or cause to be taken, the person into custody for a period of
30up to 72 hours for assessment, evaluation, and crisis intervention,
31or placement for evaluation and treatment in a facility designated
32by the county for evaluation and treatment and approved by the
33department. At a minimum, assessment, as defined in subdivision
34(c) of Section 5008, and evaluation, as defined in subdivision (n)
35of Section 5008, shall be conducted and provided on an ongoing
36basis. Crisis intervention, as defined in subdivision (g) of Section
375008, may be provided concurrently with assessment,
evaluation,
38or any other service. The period of 72-hour detention for evaluation
39and treatment shall begin at the time that the person is initially
40detained pursuant to this section.
P16 1(b) (1) When an individual detained pursuant to subdivision
2(a) is taken to a designated facility for evaluation and treatment,
3the professional person in charge, a member of the attending staff
4of the designated facility, or an authorized professional acting
5within the scope of his or her authorization by the county, shall
6assess the person to determine whether he or she can be properly
7served without being detained.begin delete The assessment under this
8subdivision may be performed by an authorized professional in a
9designated ambulatory facility or
any other setting in accordance
10with paragraph (2) of this subdivision and Section 5151.end delete
11assessment shall be performed based on the clinical condition and
12needs of a person detained for evaluation and treatment. This
13section shall not be construed to prevent an authorized professional
14from providing consultation or other professional assistance by
15telehealth.end insert If in the judgment of the authorized professional, the
16person can be properly served without being detained, he or she
17shall be provided evaluation, crisis intervention, or other inpatient
18or outpatient services on a voluntary basis.
19(2) If the person detained for evaluation and treatment is taken
20to a designated ambulatory facility that is authorized by the county
21to conduct an assessment, the assessment shall be conducted by
22the professional person in charge of the
designated ambulatory
23facility or his or her designee acting within the scope of his or her
24licensed profession. The assessment in a designated ambulatory
25facility may be performed by or in consultation with an authorized
26member of the professional staff of a designated inpatient facility
27using telehealth if the designated inpatient facility has agreed to
28admit the person in accordance with subdivision (a) upon a
29determination that an involuntary admission is appropriate.
30(3) begin deleteNothing in this end deletebegin insertThis end insertsection shallbegin insert notend insert bebegin delete interpretedend deletebegin insert
construedend insert
31 to prevent a peace officer, or an authorized professional employee
32of an emergency transport provider acting at the direction of the
33peace officer, from delivering individuals to a designated facility
34for an assessment under this section. Furthermore, the assessment
35requirement of this section shall not bebegin delete interpretedend deletebegin insert construedend insert to
36require peace officers or authorized professional employees of
37emergency transport providers acting at the direction of the peace
38officer to perform any additional duties other than those specified
39in Sections 5150.1 and 5150.2.
P17 1(4) If an individual detained under subdivision (a) isbegin insert
firstend insert taken
2to an emergency department of a nondesignated hospital, as defined
3in subdivision (e) of Section 5150.10, the provisions of Article 1.1
4(commencing with Section 5150.10) shall apply to the individual
5during his or her stay in the emergency department of a
6nondesignated hospital. This section does not require the peace
7officer or authorized professional who detained the individual
8pursuant to subdivision (a) to take or causebegin delete to takeend delete the individual
9begin insert to be takenend insert to an emergency department of a nondesignated
10hospital.
11(5) The assessment may be performed, based on the clinical
12condition and needs of a person detained for evaluation and
13treatment, in either a designated inpatient facility, a designated
14ambulatory
facility, or any other setting. Nothing in this section
15shall be construed to prevent an authorized member of the
16professional staff of a designated inpatient facility from providing
17consultation or other professional assistance by telehealth for a
18person detained for evaluation and treatment in a designated
19ambulatory facility or other setting.
14 20(6)
end delete
21begin insert(5)end insert Notwithstanding paragraph (2) of subdivision (j) of Section
225008, or any regulation, if a person detained for evaluation and
23treatment presents or is transferred to a designated ambulatory
24facility, andbegin insert
following a new determination of probable cause,end insert the
25professional person in charge of the designated ambulatory facility
26or his or her designee determines that the personbegin insert continues to meet
27the criteria for detention under Section 5150 andend insert should be
28admitted to a designated inpatient facility for further evaluation
29and treatment, the designated ambulatory facility shall makebegin insert and
30documentend insert good faith efforts to arrange placement for the person
31in a designated inpatient facility.begin delete Ifend deletebegin insert Subject to the requirements of
32subdivision (a), ifend insert
the designated ambulatory facility has been
33unable to arrange placement for the person in a designated inpatient
34facility within 24 hours, the designated ambulatory facility shall
35continue to provide evaluation and treatment for the person beyond
3624 hours in order to arrange for placement and transfer of the
37person to a designated inpatient facility, provided the designated
38ambulatory facilitybegin insert, prior to the expiration of the 24 hours,end insert notifies
39the county in which it is located and the mental healthbegin insert patients’
40rightsend insert advocate for the county that it is continuing to detain the
P18 1person beyond 24 hours. The designated ambulatory facility shall
2not transfer or send a person to an emergency department of a
3nondesignated hospitalbegin delete except ifend deletebegin insert
unlessend insert the person requires
4examination or treatment for a medical condition that is beyond
5the capability of the designated ambulatory facility.
6(c) Whenever a person is evaluated by an authorized professional
7and is found to be in need of mental health services, but is not
8admitted to the facility, all available alternative services provided
9pursuant to subdivision (b) shall be offered as determined by the
10county mental health director.
11(d) If, in the judgment of the authorized professional, the person
12cannot be properly served without being detained, the admitting
13facility shall require an application in writing pursuant to Section
145150.3.
15(e) At the time a person is taken into custody for evaluation, or
16within a reasonable time thereafter, unless a responsible relative
17or the guardian or
conservator of the person is in possession of the
18person’s personal property, the person taking him or her into
19custody shall take reasonable precautions to preserve and safeguard
20the personal property in the possession of or on the premises
21occupied by the person. The person taking him or her into custody
22shall then furnish to the court a report generally describing the
23person’s property so preserved and safeguarded and its disposition,
24in substantially the form set forth in Section 5211, except that if
25a responsible relative or the guardian or conservator of the person
26is in possession of the person’s property, the report shall include
27only the name of the relative or guardian or conservator and the
28location of the property, whereupon responsibility of the person
29taking him or her into custody for that property shall terminate.
30As used in this section, “responsible relative” includes the spouse,
31parent, adult child, domestic partner, grandparent, grandchild, or
32adult brother or sister of the person.
33(f) (1) Each person, at the time he or she is first taken into
34custody under this section, shall be provided, by the person who
35takes him or her into custody, the following information orally in
36a language or modality accessible to the person. If the person
37cannot understand an oral advisement, the information shall be
38provided in writing. The information shall be in substantially the
39following form:
My name is .
You are not under criminal arrest, but I am taking you for an examination by mental health professionals at .
You will be told your rights by the mental health staff. |
12(2) If taken into custody at his or her own residence, the person
13shall also be provided the following information:
15You may bring a few personal items with you, which I will have
16to approve. Please inform me if you need assistance turning off
17any appliance or water. You may make a phone call and leave a
18note to tell your friends or family where you have
been taken.
20(g) The designated facility shall keep, for each patient evaluated,
21a record of the advisement given pursuant to subdivision (f) which
22shall include all of the following:
23(1) The name of the person detained for evaluation.
24(2) The name and position of the peace officer or mental health
25professional taking the person into custody.
26(3) The date the advisement was completed.
27(4) Whether the advisement was completed.
28(5) The language or modality used to give the advisement.
29(6) If the advisement was not
completed, a statement of good
30cause, as defined by regulations of the State Department of Health
31Care Services.
32(h) begin delete(1)end deletebegin delete end deleteEach person admitted to a facility designated by the
33county for evaluation and treatment shall be given the following
34information by admission staff of the facility. The information
35shall be given orally and in writing and in a language or modality
36accessible to the person. The written information shall be available
37to the person in English and in the language that is the person’s
38primary means of communication. Accommodations for other
P20 1disabilities that may affect communication shall also be provided.
2The information shall be in substantially the following form:
My name is . |
||||
My position here is . |
||||
You are being placed into this psychiatric facility because it is our professional opinion that, as a result of a mental health disorder, you are likely to (check applicable): |
||||
â—» Harm yourself. |
||||
|
||||
(list of the facts upon which the allegation of dangerous |
||||
You will be held for a period up to 72 hours. During the 72 hours you may also be transferred to another facility. You may request to be evaluated or treated at a facility of your choice. You may request to be evaluated or treated by a mental health professional of your choice. We cannot guarantee the facility or mental health professional you choose will be available, but we will honor your choice if we can. |
||||
During these 72 hours you will be evaluated by the facility staff, and you may be given treatment, including medications. It is possible for you to be released before the end of the 72 hours. But if the staff decides that you need continued treatment you can be held for a longer period of time. If you are held longer than 72 hours, you have the right to a lawyer and a qualified interpreter and a hearing before a judge. If you are unable to pay for the lawyer, then one will be provided to you free of charge. |
||||
|
38(2) If the notice is given in a county where weekends and
39holidays are excluded from the 72-hour period, the patient shall
40be informed of this fact.
P21 1(i) For each patient admitted for evaluation and treatment, the
2facility shall keep with the patient’s medical record a record of the
3advisement given pursuant to subdivision (h), which shall include
4all of the following:
5(1) The name of the person performing the advisement.
6(2) The date of the advisement.
7(3) Whether the advisement was completed.
8(4) The language or modality used to communicate the
9advisement.
10(5) If the advisement was not completed, a statement of good
11cause.
Section 5150.05 of the Welfare and Institutions Code
13 is amended to read:
(a) When determining if probable cause exists to
15take a person into custody, or cause a person to be taken into
16custody, pursuant to Section 5150, a person who is authorized to
17take that person, or cause that person to be taken, into custody
18pursuant to that section shall consider available relevant
19information about the historical course of the person’s mental
20disorder if the authorized person determines that the information
21has a reasonable bearing on the determination as to whether the
22person is a danger to others, or to himself or herself, or is gravely
23disabled as a result of the mental disorder.
24(b) For purposes of this section, “information about the historical
25course of the person’s mental disorder” includes
evidence presented
26by the person who has provided or is providing mental health or
27related support services to the person subject to a determination
28described in subdivision (a), evidence presented by one or more
29members of the family of that person, and evidence presented by
30the person subject to a determination described in subdivision (a)
31or anyone designated by that person.
32(c) If the probable cause in subdivision (a) is based on the
33statement of a person other than one authorized to take the person
34into custody pursuant to Section 5150, the person making the
35statement shall be liable in a civil action for intentionally giving
36a statement that he or she knows to be false.
37(d) This section shall not be applied to limit the application of
38Section 5328.
Section 5150.1 of the Welfare and Institutions Code
40 is amended to read:
(a) A peace officer or authorized professional
2employee of an emergency transport provider acting at the direction
3of a peace officer, seeking to transport, or having transported, a
4person to a designated facility for assessment pursuant to
5begin insert subdivision (a) of Section 5150 orend insert Section 5151, shall not be
6instructed by mental health personnel to take the person to, or keep
7the person at, a jail solely because of the unavailability of an acute
8bed. The peace officer or the authorized professional employee of
9an emergency transport provider acting at the direction of the peace
10officer, shall not be forbidden to transport the person directly to
11the designated facility. No mental health
employee from any
12county, state, city, or any private agency providing psychiatric
13emergency services shall interfere with a peace officer or an
14authorized professional employee of an emergency transport
15provider acting at the direction of a peace officer performing duties
16under Section 5150 by preventing the peace officer from detaining
17a person for evaluation and treatment or preventing the peace
18officer or an authorized professional employee of an emergency
19transport provider acting at the direction of a peace officer from
20entering a designated facility with the person for an assessment.
21An employee of a facility shall not require the peace officer or an
22authorized professional employee of an emergency transport
23provider acting at the direction of a peace officer to remove the
24person without an assessment as a condition of allowing the peace
25officer or an authorized professional employee of an emergency
26transport provider acting at the direction of a peace officer to
27depart.
28(b) An emergency transport provider, or any certified or licensed
29personnel of an emergency transport provider, shall not be civilly
30or criminally liable for any of the following that may be applicable
31to the transport of a person who has been detained for evaluation
32and treatment:
33(1) The continuation of the detention for evaluation and
34treatment while transporting the person to a designated facility or
35an emergency department of a nondesignated hospital at the
36direction of a peace officer or authorized professional who detained
37the person for evaluation and treatment.
38(2) The continuation of the detention for evaluation and
39treatment while transporting the person detained for evaluation
40and treatment to a designated facility or an emergency department
P23 1of a nondesignated hospital at the direction of the treating
2
emergency professional in an emergency department of a
3nondesignated hospital for an assessment or other service under
4Section 5151.
5(c) For purposes of this section, “peace officer” means a peace
6officer as defined in Chapter 4.5 (commencing with Section 830)
7of Title 3 of Part 2 of the Penal Code and also includes a jailer
8seeking to transport or transporting a person in custody to a
9designated facility for an assessment consistent with Section 4011.6
10or 4011.8 of the Penal Code and Section 5150.
Section 5150.2 of the Welfare and Institutions Code
12 is amended to read:
In each county, whenever a peace officer or the
14authorized professional employee of an emergency transport
15provider acting at the direction of the peace officer has transported
16a person to a designated facility for an assessment, the officer or
17professional employee of an emergency transporter shall be
18detained no longer than the time necessary to complete
19documentation of the factual basis of the detention for evaluation
20and treatment and effectuate a prompt, safe, and orderly transfer
21of physical custody of the person.
Section 5150.3 is added to the Welfare and
23Institutions Code, to read:
(a) (1) The peacebegin delete officer,end deletebegin insert officerend insert or an authorized
25professionalbegin delete acting within the scope of his or her authorization by begin insert who takes a person into custody or otherwise initially
26the county,end delete
27detains a person pursuant to Section 5150end insert shall complete and sign
28an application for detention for evaluation and treatment, in the
29form prescribed by subdivision (g), stating the circumstances under
30which the person’s
condition was called to the attention of the
31peace officer or authorized professional, and stating that the peace
32officer or authorized professional has probable cause to believe
33that the person is, as a result of a mental health disorder, a danger
34to others, or to himself or herself, or gravely disabled.
35(2) The documentation shall include detailed information
36regarding the factual circumstances and observations constituting
37probable cause for the peace officer or authorized professional to
38believe that the person should be detained for evaluation and
39treatment in accordance with Section 5150. If the probable cause
40is based on the statement of a person other than the peace officer
P24 1or authorized professional, the person shall be liable in a civil
2action for intentionally giving a statement that he or she knows is
3false.
4(3) A designated facility or nondesignated hospital shall
require
5presentation of the application as a condition of continuation of
6the detention for evaluation and treatment. If the application is not
7presented to the designated facility or nondesignated hospital, as
8applicable, the person shall be immediately released from detention
9for evaluation and treatment.
10(4) An application for detention for evaluation and treatment
11shall be valid in all counties to which the person may be taken to
12a designated facility.
13(b) (1) If the person detained by a peace officer or authorized
14professional is in a location other than a designated facility or
15nondesignated hospital, the original or copy of the application for
16detention for evaluation and treatment shall be presented to the
17designated facility under paragraph (2) or the nondesignated
18hospital under paragraph (3).
19(2) If after detention under Section 5150, the person is first taken
20to a designated facility, the original or a copy of the signed
21application for detention for evaluation and treatment shall be
22presented to the designated facility.
23(3) If after detention under Section 5150, the person is first taken
24to a nondesignated hospital, the original or a copy of the signed
25application for detention for evaluation and treatment shall be
26presented to the nondesignated hospital. If the person is
27subsequently transferred to a designated facility, the nondesignated
28hospital shall deliver the original or a copy of the signed application
29for detention for evaluation and treatment to the designated facility.
30If the person is discharged from the nondesignated hospital under
31Section 5150.15 or 5150.16, without a transfer to a designated
32facility, the nondesignated hospital shall maintain the original or
33a copy of the original signed application for
detention for
34evaluation and treatment.
35(c) If a person detained for evaluation and treatment is
36subsequently released from detention for evaluation and treatment
37pursuant to Section 5150.15 or 5151, the application for detention
38for evaluation and treatment in the possession of a designated
39facility or nondesignated hospital shall be retained for the period
P25 1of time required by the medical records retention policy of the
2designated facility or nondesignated hospital.
3(d) The determination of a peace officer or authorized
4professional to detain a person under Section 5150 and complete
5and sign an application for detention for evaluation and treatment,
6shall be based solely on whether the person meets the criteria for
7detention for evaluation and treatment as set forth inbegin delete Sections 5150 begin insert
Section 5150.end insert The determination shall not be delayed,
8and 5150.05.end delete
9denied, or refused based on the availability of beds or services at
10designated facilities to which a person may be taken under this
11article.
12(e) If a person detained for evaluation and treatment under
13Section 5150 is transported by a professional employee of an
14emergency transport provider to a designated facility or
15nondesignated hospital at the request of a peace officer or an
16authorized professional, the peace officer or authorized professional
17shall give the application for detention for evaluation and treatment
18to the professional employee of the emergency transport provider
19if the peace officer or authorized professional does not accompany
20the person to the designated facility or nondesignated hospital.
21(f) A copy of the application for detention for evaluation and
22treatment shall be given to an
emergency transport provider if the
23person detained for evaluation and treatment is transported from
24a nondesignated hospital to a designated facility or from a
25designated facility to another designated facility.
26(g) Not later than July 1, 2016, the department shall adopt and
27make available a standardized form of the application for detention
28for evaluation and treatment that shall be used by peace officers
29and authorized professionals to apply for detention of a person for
30evaluation and treatment under Section 5150 and by authorized
31professionals to release a person from detention for evaluation and
32treatment pursuant to Section 5150.15 or 5151. In developing the
33form, the department shall request comments from stakeholders
34including the organizations described in subdivision (b) of Section
355400. The form of the application for detention for evaluation and
36treatment shall, at a minimum, provide all of the following:
37(1) A description of the person’s behavior and other relevant
38facts that provide the basis for probable cause under Sections 5150
39and 5150.05 of the person’s detainment for evaluation and
40treatment.
P26 1(2) For persons detained for evaluation and treatment who are
2first taken to an emergency department of a nondesignated hospital,
3documentation of the facts and conclusions that provide the basis
4for the determination of medical clearance, excluding a psychiatric
5emergency medical condition, by the emergency professional
6treating the person in the emergency department to transfer the
7person to a designated facility.
8(3) Documentation of the facts and conclusions that provide the
9basis for the determination by an authorized professional authorized
10to perform an assessment that the person should be admitted for
11involuntary
evaluation and treatment under Section 5152.
12(4) Determination of the facts and conclusions that support the
13determination by an authorized professional authorized to release
14a person from detention in accordance with Section 5150.14 or
155151.
16(5) Request by a peace officer under Section 5152.1 for
17notification of the person’s release or discharge by a designated
18facility or nondesignated hospital.
19(6) All of the information required by subdivision (f) of Section
205150.
Section 5150.4 of the Welfare and Institutions Code
22 is repealed.
Article 1.1 (commencing with Section 5150.10) is
24added to Chapter 2 of Part 1 of Division 5 of the Welfare and
25Institutions Code, to read:
26
Unless the context otherwise requires, the following
30definitions shall govern the construction of this article:
31(a) “Emergency department of a nondesignated hospital” means
32a basic, comprehensive, or standby emergency medical service
33that is approved by the State Department of Public Health as a
34special or supplemental service of a nondesignated hospital. For
35purposes of this part, an emergency department of a nondesignated
36hospital shall include an observation or similar unit of the hospital
37that meets both of the following criteria:
38(1) The unit is operated under the direction and policies of the
39emergency department.
P27 1(2) The unit
provides continuing emergency services and care
2to patients prior to an inpatient admission, transfer, or discharge.
3(b) “Emergency professional” means either of the following:
4(1) A physician and surgeon who is board certified or pursuing
5board certification in emergency medicine, or a qualified licensed
6person, as defined in subdivision (g), during any scheduled period
7that he or she is on duty to provide medical screening and treatment
8of patients in an emergency department of a nondesignated hospital.
9(2) A physician and surgeon, or a qualified licensed person, as
10defined in subdivision (g), during any scheduled period that he or
11she is on duty to provide medical screening and treatment of
12patients in the emergency department of a nondesignated hospital
13that is a critical access hospital within the meaning of
Section
141250.7 of the Health and Safety Code. A physician and surgeon
15on duty under this paragraph shall include a physician and surgeon
16on call for a standby emergency medical service who is responsible
17to provide professional coverage for the emergency department.
18A physician and surgeon on duty under this paragraph does not
19include a physician and surgeon who is providing on-call specialty
20coverage services to the emergency department of a nondesignated
21hospital, unless the physician and surgeon is an emergency
22professional under paragraph (1).
23(c) “Emergency services and care” has the same meaning as in
24subdivision (a) of Section 1317.1 of the Health and Safety Code.
25(d) “EMTALA” means the Emergency Medical Treatment and
26Labor Act, and regulations adopted pursuant thereto, as defined
27in Section 1395dd of Title 42 of the United States Code.
28(e) “Nondesignated hospital” means a general acute care
29hospital, as defined in subdivision (a) of Section 1250 of the Health
30and Safety Code or an acute psychiatric hospital, as defined in
31subdivision (b) of Section 1250 of the Health and Safety Code,
32that is not a designated facility.
33(f) “Psychiatric emergency medical condition” has the same
34meaningbegin insert asend insert in subdivision (k) of Section 1317.1 of the Health and
35Safety Code.
36(g) “Psychiatric professional” means a physician and surgeon
37who is board certified or pursuing board certification in psychiatry
38and who is providing specialty services to the emergency
39department of a
nondesignated hospital.
21 40(g)
end delete
P28 1begin insert(h)end insert “Qualified licensed person” means a licensed person
2designated by the medical staff and governing body of a
3nondesignated hospital to provide emergency services and care,
4to the extent permitted by applicable law, in an emergency
5department of the nondesignated hospital under the supervision
6of a physician and surgeon.
27 7(h)
end delete
8begin insert(i)end insert “Stabilized” has the same meaning as in subdivision (j) of
9Section 1317.1 of the Health and Safety Code.
(a) The Legislature finds and declares all of the
11following:
12(1) A person who has been detained for evaluation and treatment
13pursuant to Section 5150 should be taken to a designated facility
14rather than an emergency department of a nondesignated hospital.
15(2) A person who has been detained for evaluation and treatment
16pursuant to Section 5150 should be detained in an emergency
17department of a nondesignated hospital only for the time necessary
18to provide required emergency services and care and obtain medical
19clearance, unless the person requires an admission for inpatient
20services.
21(3) A person who has been
detained for evaluation and treatment
22pursuant to Section 5150 has the right to receive a prompt
23assessment to determine the appropriateness of the detention and
24the need for evaluation and treatment at a designated facility.
25(b) It is also the intent of the Legislature that nothing in this
26chapter shall be construed to require a peace officer or any other
27authorized professional to take a person detained for evaluation
28and treatment to an emergency department of a nondesignated
29hospital instead of taking the person to a designated facility, unless
30the peace officer or authorized professional reasonably determines
31that the person is in need of emergency care and services that
32should be provided at an emergency department of a nondesignated
33hospital before the person is transported to a designated facility.
(a) This section shall apply to a person who has been
35detained for evaluation and treatment by a peace officer or an
36authorized professional and is taken to an emergency department
37of a nondesignated hospital for emergency services and care.
38(b) While the person is in the emergency department of the
39nondesignated hospital, the detention of the person for evaluation
P29 1and treatment shall continue, unless the person is released from
2detention pursuant to Section 5150.15 or 5150.16.
(a) This section shall apply if, during a person’s
4examination or treatment in an emergency department, there is a
5need for abegin insert determination ofend insert probable causebegin delete determination thatend deletebegin insert for
6the detention ofend insert the personbegin delete should be detainedend delete for evaluation and
7treatment.
8(b) If a person who has not been detained for evaluation and
9treatment has signs or symptoms, in the judgment
of the treating
10emergency professional, that indicate probable cause for detention
11for evaluation and treatment, the person shall have the right to a
12prompt probable cause determination in accordance with any of
13the following:
14(1) The hospital may contact the county to arrange for a probable
15cause determination by an authorized professional, including, but
16not limited to, a member of a mobile crisis team.
17(2) (A) If the county in which the nondesignated hospital is
18located has a local or regional liaison, the hospital may contact the
19local or regional liaison to arrange for an authorized professional
20to provide a prompt probable cause determination of the person.
21(B) The local or regional liaison shall advise the nondesignated
22hospital within 30 minutes of the time of the initial contact whether
23
an authorized professional can perform the probable cause
24determination within two hours from the time of the initial contact
25with the local or regional liaison.
26(C) The probable cause determination shall be based solely on
27the criteria for detaining a person for evaluation and treatment.
28The probable cause determination shall not consider the availability
29of beds or services at designated facilities within or outside of the
30county.
31(D) The probable cause determination may be conducted by an
32authorized professional utilizing telehealth.
33(3) The treating emergency professional may conduct a probable
34cause determination and, upon a finding of probable cause, detain
35the person for evaluation and treatment in accordance with Sections
365150 and 5150.3.
37(c) If
the person is detained for evaluation and treatment
38pursuant to this section, the detention shall continue during his or
39her stay in the emergency department of a nondesignated hospital,
40unless the person is released from detention pursuant to Section
P30 15150.15begin insert or 5150.16 or the detention ends by reason of the
2expiration of 72 hours pursuant to subdivision (a) of Section 5150end insert.
(a) This section shall apply to a person who isbegin insert firstend insert
4 detained pursuant to Section 5150 for evaluation and treatment in
5a nondesignated hospital emergency department or has been
6detained pursuant to Section 5150 for evaluation and treatmentbegin delete by andbegin insert firstend insert taken to an emergency department of a
7a peace officerend delete
8nondesignated hospital.
9(b) (1) Except as provided in subdivision (e), the nondesignated
10hospital shall notify the county
in which the nondesignated hospital
11is located of the person’s detentionbegin delete statusend delete.
12(2) If the person was detained for evaluation and treatment and
13taken to the emergency department of the nondesignated hospital
14pursuant to Section 5150.12, the notification shall occur after the
15hospital has performed an initial medical screening of the person
16in accordance with paragraphs (1) and (2) of subdivision (a) of
17Section 1317.1 of the Health and Safety Code.
18(3) If the person is first detained for evaluation and treatment
19in the emergency department of the nondesignated hospital
20pursuant to Section 5150.13, the notification shall occur when the
21probable cause determination has been completed.
22(c) The notification to the county shall be made
using the
2324-hour toll-free telephone number established by the county’s
24mental health program for psychiatric emergency services and
25crisis stabilization if the county’s mental health program has a
2624-hour toll-free telephone number in operation on January 1,
272016, for this purpose. The notification shall be documented in
28the patient’s medical record.
29(d) The nondesignated hospital shall advise the county of all of
30the following:
31(1) The time when the 72-hour detention period for evaluation
32and treatment expires.
33(2) An estimate of the time when the person will be medically
34stable for transfer to a designated facility.
35(3) The county in which the person resides, if known.
36(e) The
notification to the county under this section shall not
37be required if the treating emergency professional determines that
38the person will be admitted, pursuant to Section 5150.16, to an
39acute care bed of a nondesignated hospital for the primary purpose
P31 1of receiving acute inpatient services for a medical condition that
2is in addition to the person’s psychiatric condition.
(a) This section shall establish a process for releasing
4begin insert from detentionend insert a personbegin delete from detention for evaluation and treatment begin insert who has been detained for evaluation and
5during the period ofend delete
6treatment during theend insert time that the person isbegin delete receiving emergency begin insert detainedend insert in the emergency department of a
7services and careend delete
8nondesignated
hospital.
9(b) If the treating emergency professional determines that there
10is no longer probable cause to continue the detention for evaluation
11and treatment, the treating emergency professional may initiate a
12followup probable cause determination to determine whether the
13person may be released from detention for evaluation and
14treatment. The followup probable cause determination shall be
15made in accordance with either of the following:
16(1) The hospital may contact the county, or a local or regional
17liaison if authorized by the county, to arrange for an authorized
18professional to perform a followup probable cause determination
19to determine whether the person may be released from detention
20for evaluation and treatment. If a county or a local or regional
21liaison cannot arrange for an authorized professional to make the
22determination within two hours of the initial call to the county
or
23the local or regional liaisonbegin insert and there is no probable cause for
24detentionend insert, the treating emergency professional may perform a
25followup probable cause determination to determine whether the
26person may be released from detention for evaluation and
27treatment.
28(2) The treating emergency professional, without first contacting
29the county or a local or regional liaison, may perform a followup
30probable cause determination to determine whether the person
31may be released from detention for evaluation and treatment.
32(c) The determination under this section to release a person from
33detention for evaluation and treatment shall be basedbegin insert solelyend insert on
34whether there is probable cause
to continue the detention for
35evaluation and treatment. The determination to continuebegin insert the
36detentionend insert orbegin insert toend insert release the person from detention shall not be based
37on the availability of beds or services at designated facilities within
38or outside of the countybegin insert, or on anything other than whether there
39is probable cause for detentionend insert.
P32 1(d) The followup probable cause determination under this section
2may be conducted by an authorized professional utilizing
3telehealth.
4(e) The followup
probable cause determination under this
5section may be conducted by a psychiatric professional.
(a) This section shall apply to a person detained for
7evaluation and treatment who is admitted to abegin insert nonpsychiatric unit
8of aend insert general acute care hospitalbegin delete bedend delete for acute medical services.
9This section shall apply to all general acute care hospitals,
10including general acute care hospitals that are designated facilities.
11(b) If the person detained for evaluation and treatment is
12admitted to abegin insert nonpsychiatric unit of aend insert
general acute care hospital
13begin delete bedend delete for the primary purpose of receiving acute inpatient services
14for a medical condition that is in addition to the person’s
15psychiatric condition, the effect on the detention for evaluation
16and treatment while receiving acute medical services shall be as
17follows:
18(1) If the hospital offers to provide assessment, evaluation, and
19crisis intervention services and the person consents to the services
20on a voluntary basis in addition to acute medicalbegin delete services, the begin insert services,
21detention for evaluation and treatment shall be releasedend delete
22the person shall be released from detentionend insert.
23(2) If the hospital offers to provide assessment, evaluation, and
24crisis intervention services and the person refusesbegin insert or is unableend insert to
25consent to the services on a voluntary basis in addition to acute
26medical services, the detention for evaluation and treatment shall
27continue in effect during the acute hospital staybegin insert, for so long as
28there continues to be probable cause for the detentionend insert.
29(3) If the hospital does not have the capability to provide
30assessment, evaluation, and crisis intervention services, thebegin insert person
31shall be released from end insertdetention for evaluation and treatmentbegin delete shall
32be
releasedend delete
33(c) The release of the person from detention for evaluation and
34treatment shall be communicated to the person and documented
35in the person’s medical record.
36(d) This section shall not apply to a person detained for
37evaluation and treatment who meets both of the following:
38(1) The person does not require acute inpatient services for a
39medical condition.
P33 1(2) The person is awaiting a transfer to a designated facility and
2is placed in an acute bed of the nondesignated hospital for the
3purpose of securing the protection of the person or other persons,
4or both, in the nondesignated hospital pending the transfer of the
5person to a designated facility.
6(e) In all cases
described in subdivision (b), if the discharge
7plan for the patient provides for followup evaluation and treatment
8at a psychiatric facility, the patient shall be advised of the
9recommended need for the followup evaluation and treatment.
10(f) If the person is not able or willing to accept treatment on a
11voluntary basis, or to accept the referral or transfer to a psychiatric
12facility, the hospital shall obtain a new probable cause
13determination for detention for evaluation and treatment pursuant
14to Section 5150 in order to take or cause the person to be taken to
15a designated facility. Upon request by the hospital, a county shall
16arrange for an authorized professional to conduct a probable cause
17determination in a timely manner, which may be performed by the
18authorized professional utilizing telehealth.
(a) This section, together with Sections 5150.18 and
205150.19, shall apply to the placementbegin delete withend deletebegin insert inend insert a designated facility
21of a person in a nondesignated hospital emergency department
22who has been detained for evaluation and treatment.
23(b) The person may be placedbegin delete withend deletebegin insert inend insert any designated facility
24that has the capability to meet the needs of the person, including
25a
designated ambulatory facility.
26(c) begin deleteIf end deletebegin insertPrior to end insertplacementbegin delete is made withend deletebegin insert inend insert a designated
27ambulatory facility, personnel at the designated ambulatory facility
28shall confirm whether the facility can meet the needs of the person
29within the scope of its designation and capability.
(a) This section shall apply to the placementbegin delete withend deletebegin insert inend insert
31 a designated facility for a person described in Section 5150.17 if
32the person has a psychiatric emergency medical condition.
33(b) If a person, in the judgment of the treating emergency
34professional, has a psychiatric emergency medical condition, the
35placementbegin delete withend deletebegin insert inend insert a designated facility shall be made as
follows:
36(1) The placement may bebegin delete withend deletebegin insert inend insert any designated facility that
37has the capability and capacity to provide evaluation and treatment
38for the person, whether that designated facility is located within
39or outside of the county of the hospital.
P34 1(2) The treating emergency professional shall determine the
2mode of transportation, including personnel and equipment, that
3are appropriate for the transport of the person to the designated
4facility.
5(3) In the event of a disagreement as to whether the person under
6this section has a psychiatric emergency medical condition, the
7judgment of the treating emergency professional shall
prevail.
8(4) The placement of a person described in this subdivision shall
9take precedence over provider networks.
10(c) If the person, in the judgment of the treating emergency
11professional, does not have a psychiatric emergency medical
12condition, the placement of the personbegin delete withend deletebegin insert inend insert a designated facility
13for evaluation and treatment shall be deemed to be made for a
14medical reason within the meaning of Section 1317.2 of the Health
15and Safety Code.
16(d) This section shall also apply to a person whobegin delete isend deletebegin insert
has beenend insert
17 medicallybegin delete clearend deletebegin insert
stabilizedend insert, but is being held in an inpatient unit of
18the nondesignated hospital for the purposes of ensuring the safety
19and security of the person or other persons, pending placement of
20the personbegin delete withend deletebegin insert inend insert a designated facility for evaluation and
21treatment.
22(e) If a person detained for evaluation and treatment is in the
23emergency department of a nondesignated hospital, or in a bed
24not licensed for psychiatric care, the nondesignated hospital shall
25make good faith efforts to arrange placement for the person in a
26designated facility and, pending placement, shall provide further
27screening, treatment, and monitoring consistent with the
needs of
28the patient and within the capacity of the hospital.
(a) This section describes assistance that may be
30available to an emergency department of a nondesignated hospital
31for the placementbegin delete withend deletebegin insert inend insert a designated facility of a person described
32in Section 5150.17.
33(b) If a person has been taken to or detained by a
34county-authorized professional in the emergency department of
35the nondesignated hospital, the authorized professional shall assist
36the nondesignated hospital in arranging for the placement of the
37person with an appropriate designated facility.
38(c) If a person is detained for evaluation and treatment by a
39peace officer or a treating emergency professional in the emergency
40department of the nondesignated hospital, the hospital may contact
P35 1the local or regional liaison, if authorized for the county in which
2the nondesignated hospital is located, to assist the hospital in
3arranging for the placement of the personbegin delete withend deletebegin insert inend insert a designated
4facility, as follows:
5(1) Contact with the local or regional liaison may be initiated
6when the treating emergency professional hasbegin delete determined that the
medically
7person isend deletebegin delete clearend deletebegin insert stabilized the personend insert for placementbegin delete withend delete
8begin insert inend insert a designated facility.
9(2) The hospital shall inform thebegin insert county or theend insert localbegin delete andend deletebegin insert orend insert
10 regional liaison whether the person has a psychiatric emergency
11medical condition that requires a transport of the
person in
12accordance with the EMTALA obligations for making an
13appropriate transfer.
14(d) A nondesignated hospitalbegin delete may pursueend deletebegin insert shall makeend insert efforts to
15obtain placement of the personbegin insert in a designated facilityend insert without
16first contacting thebegin insert county or theend insert local or regional liaison under
17this section or in addition to requesting assistance that may be
18provided by thebegin insert county or theend insert
local or regional liaison.
(a) The determination of probable cause to detain a
20person for evaluation and treatment shall be independent of a
21determination as to whether the person has a psychiatric emergency
22medical condition for the provision of emergency services and
23care.
24(b) A determination of probable cause to detain a person for
25evaluation and treatment, whether by a peace officer or an
26authorized professional, shall not be deemed to constitute a
27psychiatric emergency medical condition unless a treating
28emergency professionalbegin insert or psychiatric professionalend insert has determined
29that the person has a psychiatric emergency medical condition.
30(c) A determination by a treating emergency professionalbegin insert or a
31psychiatric professionalend insert that a person has a psychiatric emergency
32medical condition shall not be deemed to constitute probable cause
33under Section 5150 that the person may be detained for evaluation
34and treatment.
35(d) A determination by a treating emergency professionalbegin insert or a
36psychiatric professionalend insert that a person detained for evaluation and
37treatment does not have a psychiatric emergency medical condition,
38or that the person’s psychiatric emergency medical condition is
39stabilized, shall not be deemed to constitute a release of the person
40from detention for evaluation and
treatment.
(a) A nondesignated hospital and the professional
2staff of the nondesignated hospital shall not be civilly or criminally
3liable forbegin delete transferringend deletebegin insert the transfer ofend insert a person detained for
4evaluation and treatment to a designated facility in accordance
5with this article.
6(b) The peace officer or authorized professional responsible for
7the detention of the person for evaluation and treatment who
8transfers the custody of the person to an emergency professional
9of a nondesignated hospital, shall not be civilly or criminally liable
10for any of the following:
11(1) The continuation and enforcement of the detention for
12evaluation and treatment during the person’s stay in the emergency
13department of the nondesignated hospital prior to the discharge of
14the personbegin insert from the hospitalend insert in accordance with this article.
15(2) The release of the person from detention for evaluation and
16treatment in accordance with this article.
17(3) The transfer of the person detained for evaluation and
18treatment to a designated facility in accordance with this article.
Article 1.2 (commencing with Section 5150.30) is
20added to Chapter 2 of Part 1 of Division 5 of the Welfare and
21Institutions Code, to read:
22
(a) A provider of ambulance services licensed by the
26Department of the California Highway Patrol or operated by a
27public safety agency, and the employees of those providers who
28are certified or licensed under Section 1797.56 of the Health and
29Safety Code, shall be authorized to transport a person who is
30begin delete transferringend deletebegin insert in a hospital or facilityend insert on a voluntary basis to a
31designated facility for psychiatric treatment. This section shall
32apply to transfers from any type of facility, including nondesignated
33hospitals and other facilities.
34(b) A person shall not
be detained for evaluation and treatment
35solely for the purpose of transporting the person, or transferring
36the person by a provider of ambulance services, to a designated
37facility or an emergency department of a nondesignated hospital.
38(c) Not later than July 1, 2016, the department shall adopt and
39make available a standardized form that will enable voluntary
40patients to consent to transfer between facilities by a provider of
P37 1ambulance services. The form shall be provided to voluntary
2patients to sign before thebegin delete arrival of the provider of ambulance begin insert transfer of the patientend insert. The form shall be kept in the
3servicesend delete
4patient’s chart. Copies of the form shall be given to the patient and
5the provider of ambulance services.
6(d) This section shall apply to all patients who are on voluntary
7status, regardless of whether the person was previously detained
8for evaluation and treatment at any point during the course of
9treatment at a nondesignated hospital or designated facility prior
10to the transfer.
11(e) No person shall require a person to be subject to detention
12for evaluation and treatment for the purpose of authorizing or
13providing evaluation, treatment, or admission to a facility, or as a
14condition for providing or paying for medical services, care, or
15treatment, including emergency services and care, unless there is
16probable cause under Section 5150 to detain the person for
17evaluation and treatment and the person cannot be properly served
18on a voluntary basis. Nothing in this part shall be construed as
19preventing a person subject to detention for evaluation and
20treatment from receiving evaluation or
treatment on a voluntary
21basis unless there has been an adjudication under this part that the
22person lacks the capacity to do so.
The heading of Article 1.3 (commencing with Section
245151) is added to Chapter 2 of Part 1 of Division 5 of the Welfare
25and Institutions Code, to read:
26
Section 5151 of the Welfare and Institutions Code is
30amended to read:
(a) If a designated facility for evaluation and treatment
32admits the person, it may detain him or her for evaluation and
33treatment for a period not to exceed 72 hours from the time that
34the person was initially detained pursuant to subdivision (a) of
35Section 5150.
36(b) Prior to admitting a person to the facility forbegin delete treatment andend delete
37 evaluationbegin insert and treatmentend insert, the professional person in charge of the
38facility or his or her designee shall conduct an assessment of the
39individual in person to determine the appropriateness of the
40involuntary
detention.
Section 5151.1 is added to the Welfare and
2Institutions Code, to read:
If the assessment results in a determination that the
4person is in need of mental health services, but he or she is not
5admitted to the facility, the designated facility shall provide the
6person with appropriate referrals and a list of alternative services
7and other resources that are appropriate to the needs of the person.
8The alternative services and other resources shall include both of
9the following, as applicable:
10(a) The services described in subdivision (b) of Section 5150.
11(b) The services for persons with severe mental illness and
12substance use disorders posted by a county on its Internet Web
13site pursuant to Section 5013.
Section 5151.2 is added to the Welfare and
15Institutions Code, to read:
(a) Each county shall establish disposition procedures
17and guidelines with local law enforcement agencies for the safe
18and orderly transfer of persons detained for evaluation and
19treatment by a peace officer, who has requested notification under
20Section 5152.1 of the person’s release from detention for evaluation
21and treatment in accordance with Section 5150.15, 5150.16, or
225151. The disposition procedures and guidelines shall include
23persons who are not admitted for evaluation and treatment and
24who decline alternative mental health services and persons who
25have a criminal detention pending.
26(b) The disposition procedures and guidelines should include
27interagency communication between law enforcement agencies
28located within the county, as well
as law enforcement agencies
29located in other counties, that take or arrange to take persons
30detained for evaluation and treatment under Section 5150 to health
31facilities within the county. The disposition procedures and
32guidelines, including updates, shall be disseminated to designated
33facilities and nondesignated hospitals.
Section 5152.1 of the Welfare and Institutions Code
35 is amended to read:
(a) A designated facility or nondesignated hospital
37shall notify the county mental health director, or the director’s
38designee, and the law enforcement agency that employs the peace
39officer who makes the application for detention for 72-hour
40evaluation and treatment pursuant to Section 5150, if the person
P39 1admitted pursuant to Section 5152 will be discharged after a
272-hour inpatient admission, when the person is not admitted by
3the designated facility, when the person discharged before the
4expiration of the 72-hour inpatient admission, when the person
5discharged from detention for evaluation and treatment is released
6under Section 5150.15, 5150.16, or 5151, or if the person elopes
7from a designated facility or nondesignated hospital, if both of the
8following conditions apply:
9(1) The peace officer who made the application for detention
10for evaluation and treatment requests notification of the person’s
11release or discharge at the time he or she makes the application
12for detention for evaluation and treatment and the peace officer
13certified at that time in writing that the person has been detained
14for evaluation and treatment under circumstances which, based
15upon an allegation of facts regarding actions witnessed by the
16officer or another person, would support the filing of a criminal
17complaint. The application for detention for evaluation and
18treatment shall include one or more methods of contacting a person
19at the law enforcement agency who may receive the notification.
20(2) The notice is limited to the person’s name, address, date of
21admission or initial service, and date of release.
22(b) If
a police officer, law enforcement agency, or designee of
23the law enforcement agency, possesses any record of information
24obtained pursuant to the notification requirements of this section,
25the officer, agency, or designee shall destroy that record two years
26after receipt of notification.
27(c) The notice required by this section shall be made prior to
28the release or discharge of the person, if possible. The designated
29facility or nondesignated hospital shall consider the distancebegin delete ofend delete
30begin insert
fromend insert the law enforcement agency to the location of the designated
31facility or nondesignated hospital in giving the notice. The peace
32officer or other representative of the law enforcement agency
33receiving the notice shall promptly advise the designated facility
34or nondesignated hospital whether the peace officer or other law
35enforcement agency representative shall take custody of the person
36upon his or her release or discharge from the designated facility
37or nondesignated hospital and, if so, the time at which the peace
38officer or other law enforcement agency representative will be
39present at the designated facility or nondesignated hospital.
P40 1(d) Nothing in this section shall be construed to require the
2designated facility or nondesignated hospital to delay the discharge
3of a person for purposes of awaiting the arrival of the peace officer
4or another representative of the law enforcement
agency.
Section 5152.2 of the Welfare and Institutions Code
6 is repealed.
Section 5152.2 is added to the Welfare and
8Institutions Code, to read:
In addition to the request for notification set forth in
10the application for detention for evaluation and treatment, each
11law enforcement agency shall arrange with the county mental
12health director for a method for designated facilities and
13nondesignated hospitals to give prompt notification to peace
14officers under Section 5152.1. The methods for notification for
15each county shall be disseminated by the county to the designated
16facilities and nondesignated hospitals located within the county.
Section 5153 of the Welfare and Institutions Code is
18amended to read:
Whenever possible, officers charged with apprehension
20of persons pursuant to this chapter shall dress in plain clothes and
21travel in unmarked vehicles.
Section 5270.50 of the Welfare and Institutions Code
23 is amended to read:
(a) Notwithstanding Section 5113, if the provisions
25of Section 5270.35 have been met, the professional person in
26charge of the facility providing intensive treatment, his or her
27designee, the medical director of the facility or his or her designee
28described in Section 5270.53, the psychiatrist directly responsible
29for the person’s treatment, or the psychologist shall not be held
30civilly or criminally liable for any action by a person released
31before the end of 30 days pursuant to this article.
32(b) The professional person in charge of the facility providing
33intensive treatment or his or her designee, the medical director of
34the facility or his or her designee described in Section 5270.35,
35the psychiatrist directly
responsible for the person’s treatment, or
36the psychologist shall not be held civilly or criminally liable for
37any action by a person released at the end of the 30 days pursuant
38to this article.
39(c) The attorney or advocate representing the person, the
40court-appointed commissioner or referee, the certification review
P41 1hearing officer conducting the certification review hearing, and
2the peace officer responsible for detaining the person shall not be
3civilly or criminally liable for any action by a person released at
4or before the end of 30 days pursuant to this article.
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98