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.
P3 1(g) To protect persons with mental health disorders and
2developmental disabilities from criminal acts.
3(h) To provide consistent standards for protection of the personal
4rights of persons receiving services under this part and under Part
51.5 (commencing with Section 5585).
6(i) To provide services in the least restrictive setting appropriate
7to the needs of each person receiving services under this part and
8under Part 1.5 (commencing with Section 5585).
9(j) To ensure that persons receive services from facilities and
10providers that are qualified and best suited to provide the services,
11and that persons are not detained in settings that are not therapeutic
12or not designed to meet their needs.
13(k) To affirm that no person may be presumed to be incompetent
14because he or she has been evaluated or treated for a mental health
15disorder or chronic alcoholism, regardless of whether that
16evaluation or treatment was voluntarily or involuntarily received.
Section 5001.5 is added to the Welfare and Institutions
18Code, to read:
It is the intent of the Legislature that each county shall
20have the responsibility to ensure that all persons with mental health
21disorders who are subject to detention under this part or under Part
221.5 (commencing with Section 5585) receive prompt evaluation
23and treatment in accordance with this part and Part 1.5
24(commencing with Section 5585), including prompt assessment
25of the need for evaluation and treatment. It is the intent of the
26Legislature that each county establish and maintain a mental health
27service system that has sufficient capacity to ensure the provision
28of services under thisbegin delete Partend deletebegin insert
partend insert and Part 1.5 (commencing with
29Section 5585), including, at a minimum, the services required
30under paragraph (2) of subdivision (a) of Section 5651.
Section 5008 of the Welfare and Institutions Code is
32amended to read:
Unless the context otherwise requires, the following
34definitions shall govern the construction of this part:
35(a) “Antipsychotic medication” means medication customarily
36prescribed for the treatment of symptoms of psychoses and other
37severe mental and emotional disorders.
38(b) “Application for detention for evaluation and treatment”
39means the written application set forth in Section 5150.3.
P4 1(c) (1) “Assessment” means the determination, as described in
2subdivision (b) of Section 5150 and Section 5151, of the following:
3(A) Whether the person meets the criteria for detention for
4
evaluation and treatment.
5(B) Whether the person is in need of evaluation and treatment
6and, if so, what services are needed for the person.
7(C) Whether the person can be properly served without being
8detained, in which case the services shall be provided on a
9voluntary basis.
10(2) “Assessment” includes, but is not limited to, mental status
11determination, analysis of clinical and social history, analysis of
12relevant cultural issues and history, diagnosis, and the use of testing
13procedures.
14(d) “Authorized professional” means any of the following:
15(1) A mental health professional or category of
mental health
16professionals, excluding peace officers, who are authorized in
17writing by a county to provide services described in this
18subdivision. An authorized professional shall have appropriate
19training in mental health disorders and determination of probable
20cause, and shall have relevant experience in providing services to
21persons with mental health disorders.
22(2) An authorized professional as described in paragraph (1)
23who is a member of the staff of a designated facility and who is
24authorized by the facility to provide services described in this
25subdivision.
26(3) A member of a mobile crisis team who is authorized in
27writing by a county to provide services described in this
28subdivision.
29(e) “Conservatorship investigation” means an investigation, by
30an agency appointed or designated by the governing body, of cases
31in which conservatorship is recommended pursuant to Chapter 3
32
(commencing with Section 5350).
33(f) “Court,” unless otherwise specified, means a court of record.
34(g) “Court-ordered evaluation” means an evaluation ordered by
35a superior court pursuant to Article 2 (commencing with Section
365200) or by a superior court pursuant to Article 3 (commencing
37with Section 5225) of Chapter 2.
38(h) “Crisis intervention” consists of an interview or series of
39interviews within a brief period of time, conducted by qualified
40professionals, and designed to alleviate personal or family
P5 1situations which present a serious and imminent threat to the health
2or stability of the person or the family. The interview or interviews
3may be conducted in the home of the person or family, or on an
4inpatient
or outpatient basis with such therapy, or other services,
5as may be appropriate. The interview or interviews may include
6family members, significant support persons, providers, or other
7entities or individuals, as appropriate and as authorized by law.
8Crisis intervention may, as appropriate, include suicide prevention,
9psychiatric, welfare, psychological, legal, or other social services.
10(i) “Crisis stabilization service or unit” means an ambulatory
11service that provides probable cause determinations and
12assessments, collateral services, and therapy within the scope of
13its designation under this part.
14(j) “Department” means the State Department of Health Care
15Services.
16(k) (1) “Designated facility”
means a facility or a specific unit
17or part of a facility that is licensed or certified as a mental health
18evaluation facility, a mental health treatment facility, or a mental
19health evaluation and treatment facility. A designated facility may
20be an inpatient facility or an ambulatory facility.
21(2) “Inpatient facility” means a health facility, or an inpatient
22unit of a health facility, as defined in Chapter 2 (commencing with
23Section 1250) of Division 2 of the Health and Safety Code, that
24is licensed by the State of California, has the capability to admit
25and treat persons on an inpatient basis subject to the requirements
26of this part, and is designated by a county pursuant to Section 5023.
27Inpatient facility also includes a hospital or the inpatient unit of a
28hospital operated by the United States government that has the
29capability to admit
and treat persons on an inpatient basis, subject
30to the requirements of this part, and that is designated by the county
31pursuant to Section 5023. A designated inpatient facility includes
32any of the following:
33(A) A general acute care hospital, as defined in subdivision (a)
34of Section 1250 of the Health and Safety Code.
35(B) An acute psychiatric hospital, as defined in subdivision (b)
36of Section 1250 of the Health and Safety Code.
37(C) A psychiatric health facility, as defined in Section 1250.2
38of the Health and Safety Code.
39(D) A correctional treatment center, as defined in Section 1250
40of the Health and Safety Code, operated by a county, city, or city
P6 1and
county law enforcement agency. The department may approve
2an unlicensed correctional treatment center that is in existence as
3of January 1, 2016, if the correctional treatment center meets all
4of the licensing requirements except those that are structurally
5impracticable.
6(3) “Ambulatory facility” means a facility designated by a
7county under Section 5023 that provides psychiatric services lasting
8less than 24 hours in accordance with applicable law and within
9the scope of the designation. An ambulatory facility may include
10an outpatient hospital department, clinic, crisis stabilization facility
11or unit, facility of a medical group, facility of a provider
12organization other than a medical group, or other facility that meets
13the requirements established by the department in accordance with
14Section 5023.
15(l) “Detained for evaluation and treatment” and “detention for
16evaluation and treatment” mean the taking into custody and
17detention of a person in accordance with Section 5150.
18(m) “Emergency” means a sudden marked change in the
19person’s condition such that action to impose treatment over the
20person’s objection is immediately necessary for the preservation
21of life or the prevention of serious bodily harm to the patient or
22others, and it is impracticable to first gain consent. It is not
23necessary for harm to take place or become unavoidable prior to
24treatment.
25(n) “Emergency transport provider” means a provider of
26ambulance services licensed by the Department of the California
27Highway Patrol or operated by a public safety agency and includes
28the authorized personnel
of an emergency transport provider who
29are certified or licensed under Sections 1797.56, 1797.80, 1797.82,
30and 1797.84 of the Health and Safety Code.
31(o) “Evaluation” means a multidisciplinary professional analyses
32of a person’s medical, psychological, educational, social, financial,
33and legal conditions as may appear to constitute a problem. Persons
34providing evaluation services shall be properly qualified
35professionals and may be full-time employees, part-time
36
employees, or independent contractors of a county, designated
37facility, or other agency providing face-to-face evaluation services.
38Face-to-face evaluation services includes face-to-face evaluation
39by means of telehealth.
P7 1(p) (1) For purposes of Article 1 (commencing with Section
25150), Article 2 (commencing with Section 5200), and Article 4
3(commencing with Section 5250) of Chapter 2, and for the purposes
4of Chapter 3 (commencing with Section 5350), “gravely disabled”
5means either of the following:
6(A) A condition in which a person, as a result of a mental health
7disorder, is unable to provide for his or her basic personal needs
8for food, clothing, or shelter.
9(B) A condition in
which a person, has been found mentally
10incompetent under Section 1370 of the Penal Code and all of the
11following facts exist:
12(i) The indictment or information pending against the person at
13the time of commitment charges a felony involving death, great
14bodily harm, or a serious threat to the physical well-being of
15another person.
16(ii) The indictment or information has not been dismissed.
17(iii) As a result of a mental health disorder, the person is unable
18to understand the nature and purpose of the proceedings taken
19against him or her and to assist counsel in the conduct of his or
20her defense in a rational manner.
21(2) For purposes of Article 3 (commencing
with Section 5225)
22and Article 4 (commencing with Section 5250), of Chapter 2, and
23for the purposes of Chapter 3 (commencing with Section 5350),
24“gravely disabled” means a condition in which a person, as a result
25of impairment by chronic alcoholism, is unable to provide for his
26or her basic personal needs for food, clothing, or shelter.
27(3) The term “gravely disabled” does not include persons with
28intellectual disabilities by reason of that disability alone.
29(q) “Intensive treatment” consists of hospital and other services
30as may be indicated. Intensive treatment shall be provided by
31properly qualified professionals and carried out in facilities
32
qualifying for reimbursement under the California Medical
33Assistance Program (Medi-Cal) set forth in Chapter 7 (commencing
34with Section 14000) of Part 3 of Division 9, or under Title XVIII
35of the federal Social Security Act and regulations thereunder.
36Intensive treatment may be provided in hospitals of the United
37States government by properly qualified professionals. Nothing
38in this part shall be construed to prohibit an intensive treatment
39facility from also providing 72-hour evaluation and treatment.
P8 1(r) “Local or regional liaison” means a person or persons
2authorized by a county, or by two or more counties acting jointly,
3under Section 5024.
4(s) “Mobile crisis team” means a team comprised of one or more
5professionals, and which may also include peer counselors, who
6are
authorized by a county to provide probable cause
7determinations and other services under this part.
8(t) “Peace officer” means a duly sworn peace officer as that
9term is defined in Chapter 4.5 (commencing with Section 830) of
10Title 3 of Part 2 of the Penal Code who has completed the basic
11training course established by the Commission on Peace Officer
12Standards and Training, or any parole officer or probation officer
13specified in Section 830.5 of the Penal Code when acting in relation
14to cases for which he or she has a legally mandated responsibility.
15(u) “Postcertification treatment” means an additional period of
16treatment pursuant to Article 6 (commencing with Section 5300)
17of Chapter 2.
18(v) “Prepetition screening” is a
screening of all petitions for
19court-ordered evaluation as provided in Article 2 (commencing
20with Section 5200) of Chapter 2, consisting of a professional
21review of the petition; an interview with the petitioner and,
22whenever possible, the person alleged, as a result of a mental health
23disorder, to be a danger to others, or to himself or herself, or to be
24gravely disabled, to assess the problem and explain the petition;
25and when indicated, efforts to persuade the person to receive, on
26a voluntary basis, comprehensive evaluation, crisis intervention,
27referral, and other services specified in this part.
28(w) “Probable cause determination” means a determination
29whether there is probable cause for the detention of a person for
30evaluation and treatment. A probable cause determination shall be
31based solely on the criteria for detaining a person for
evaluation
32and treatment pursuant to Section 5150. The probable cause
33determination shall not consider the availability of beds or services
34at designated facilities within or outside of the county.
35(x) “Professional person in charge of a facility” means the
36licensed person authorized by a designated facility who is
37responsible for the clinical direction of the designated facility.
38(y) “Professional staff” means the medical staff or other
39organized professional staff of an inpatient facility.
P9 1(z) “Referral” means referral of persons by each facility,
2provider, or other organization providing assessment, evaluation,
3crisis intervention, or treatment services to other facilities,
4providers, or agencies in accordance with
Section 5013 and Part
51.5 (commencing with Section 5585).
6(aa) “Telehealth” means the telehealth services, as defined in
7paragraph (6) of subdivision (a) of Section 2290.5 of the Business
8and Professions Code, for the purpose of providing services under
9this part, including a probable cause determination, the release of
10a person from detention for evaluation and treatment under Section
115150.15, assessment or evaluation, and treatment. For purposes
12of this part, telehealth services may be used by any licensed
13professional, including a psychologist, clinical social worker, and
14other mental health professional, acting within the scope of his or
15her profession for providing evaluation, treatment, consultation,
16or other mental health services under this part.
Section 5013 of the Welfare and Institutions Code is
18amended to read:
(a) The purpose of a referral shall be to provide for
20continuity of care and services. A referral may include, but need
21not be limited to, informing the person of available services,
22making appointments on the person’s behalf, communication with
23the agency or individual to which the person has been referred,
24appraising the outcome of referrals, and arranging for escort,
25transportation, or both, when necessary. All persons shall be
26advised of available precare services that prevent initial recourse
27to hospital treatment or aftercare services that support adjustment
28to community living following hospital treatment. These services
29may be provided through county or city mental health departments,
30state hospitals under the jurisdiction of the
State Department of
31State Hospitals, regional centers under contract with the State
32Department of Developmental Services, or other public or private
33entities.
34(b) It is the intent of the Legislature that referrals between
35facilities, providers, and other organizations shall be facilitated by
36the sharing of information and records in accordance with Section
375328 and applicable federal and state laws.
38(c) Each city or county behavioral health department is
39encouraged to include on its Internet Web site a current list of
40ambulatory behavioral health services and other resources for
P10 1persons with behavioral health disorders and substance use
2disorders in the city or county that may be accessed by providers
3and consumers of behavioral health services. The list of services
4on the
Internet Web site should be updated at least annually by the
5city or county behavioral health department.
Section 5022 is added to the Welfare and Institutions
7Code, to read:
The department shall promote the consistent statewide
9application of this part in order to ensure protection of the personal
10rights of all persons who are subject to this part and Part 1.5
11(commencing with Section 5585). The department shall provide
12oversight of the statewide application of this part and facilitate
13discussion among the organizations listed in subdivision (a) of
14Section 5400, law enforcement agencies, hospitals, mental health
15professionals, county patients’ rights advocates, the California
16Office of Patients’ Rights, and other stakeholders as may be
17necessary or desirable to achieve the legislative intent of consistent
18statewide application. These discussions shall include situations
19where persons are certified for additional
intensive treatment in a
20county authorizing that treatment under Article 4.7 (commencing
21with Section 5270.10) of Chapter 2 who are then transferred to a
22facility during the course of additional intensive treatment in a
23county that has not authorized additional intensive treatment.
Section 5023 is added to the Welfare and Institutions
25Code, to read:
(a) Each county may designate inpatient and ambulatory
27facilities within the county, with the approval of the department,
28that meet the applicable requirements established by the department
29by regulation. An outpatient or emergency department of a
30nondesignated inpatient facility may be designated as an
31ambulatory facility if it meets all the requirements for certification
32as an ambulatory facility.
33(b) (1) Each county may designate ambulatory facilities within
34the county that meet the behavioral health needs of persons within
35the requirements of applicable law and the scope of their
36designation. The department shall encourage counties to use
37
appropriate ambulatory facilities for the evaluation and treatment
38of persons pursuant to this part.
39(2) Counties, mental health professionals, providers, and other
40organizations, with the support of the department, are encouraged
P11 1to establish crisis stabilization services and other ambulatory
2facilities that are designated by a county to provide probable cause
3determinations and assessments, and, as applicable, evaluation and
4treatment services and crisis stabilization services, in settings that
5are appropriate to the needs of persons with severe mental illness
6and less restrictive than inpatient health facilities.
7(3) Nothing in this subdivision shall preclude the designation
8of an ambulatory facility that is an outpatient clinic of a licensed
9health facility.
10(4) An ambulatory facility shall provide services within the
11scope of its designation to all persons regardless of their place of
12residence.
13(c) Regulations adopted pursuant to this part establishing staffing
14standards for designated facilities shall be consistent with
15applicable licensing regulations for the type of facility. If there are
16no licensing regulations for the type of designated facility, or for
17certain categories of professional personnel providing services in
18a type of designated facility, the regulations adopted pursuant to
19this part for staffing standards may differentiate between the types
20of designated facilities, including ambulatory facilities.begin delete On January
211, 2016, the existing regulations establishing staffing standards
22for designated facilities set forth in Section 663 of Title 9 of the
23California Code of Regulations are repealed and nullified. end delete
24(d) A county shall not charge or assess a fee for the designation
25of a facility or an authorized professional.
26(e) Each designated facility shall accept, within its clinical
27capability and capacity, all categories of persons for whom it is
28designated, without regard to insurance or financial status. If a
29person presents to a designated facility with a psychiatric
30emergency medical condition, as defined in subdivision (f) of
31Section 5150.10, that is beyond its capability, the facility shall
32assist the person in obtaining emergency services and care at an
33appropriate facility.
34(f) In order to provide access by members of the public to
35information about designated facilities, each county department
36responsible
for mental health services shall maintain on its Internet
37Web site the locations of all designated facilities within the county,
38including address, the types of services available at each designated
39facility, and the hours of operation for ambulatory facilities. The
P12 1Internet Web site shall be updated if there are changes to the
2information.
3(g) Each county shall report to the department, on at least an
4annual basis, a current list of designated facilities within the county,
5including the name and address of each facility and its facility
6type. The department shall maintain a list of designated facilities,
7by county and facility licensure type, on its Internet Web site, and
8update the list not less than annually. The department Internet Web
9site shall also contain links to each county Internet Web site
10required by subdivision (f).
11(h) Counties are encouraged to share information with adjacent
12and other counties with respect to its roster of authorized
13professionals. An authorized professional shall not be required to
14obtain approval from another county to be an authorized
15professional in that county in order to take action under this part.
Section 5024 is added to the Welfare and Institutions
17Code, to read:
(a) Each county may authorize one or more qualified
19persons to act as a local or regional liaison to assist nondesignated
20hospitals in the county in accordance with this section and Article
211.1 (commencing with Section 5150.10) of Chapter 2. Two or
22more counties may enter into an intercounty arrangement under
23which the participating counties agree to authorize one or more
24persons to act as a local or regional liaison to assist nondesignated
25hospitals in the participating counties in accordance with this
26section and Article 1.1 (commencing with Section 5150.10) of
27Chapter 2.
28(b) The role of the local or regional liaison is to assist a person
29who is a patient in an
emergency department of a nondesignated
30hospital and who has been detained, or may require detention, for
31evaluation and treatment. The assistance may include any of the
32following:
33(1) Arranging for an authorized professional to provide a prompt
34probable cause determination under Section 5150.13.
35(2) Arranging for an authorized professional to determine
36whether the detention for evaluation and treatment of a person
37shall be released under Section 5150.15.
38(3) Arranging for the placement of a person detained for
39evaluation and treatment who has been medically stabilized for
40transfer or discharge to a designated facility.
P13 1(c) A local or regional liaison may be
employed by, or may
2contract with, a county or counties and may include personnel of
3one or more designated facilities within the county or counties.
4The role of the local or regional liaison may be rotated among the
5categories of persons described in this subdivision.
6(d) A local or regional liaison shall be available 24 hours a day,
7including weekends and holidays, to provide assistance under this
8section.
9(e) Each county, or counties acting jointly under this section,
10shall provide the nondesignated hospitals in the county or counties
11with the contact information for a local or regional liaison. The
12means of contact may be a designated telephone number, email,
13text-messaging or other electronic means, or any combination of
14the foregoing, so long as the local or regional
liaison has immediate
15access to the means of contact. The contact information provided
16to nondesignated hospitals shall be updated as necessary.
17(f) This section shall not apply to a county that has not
18authorized a local or regional liaison.
Section 5025 is added to the Welfare and Institutions
20Code, to read:
(a) A designated facility or nondesignated hospital, as
22defined in subdivision (e) of Section 5150.10, or a physician,
23employee, or other staff person acting within the scope of his or
24her official duties or employment for the designated facility or
25nondesignated hospital shall not be liable for any injury resulting
26from determining any of the following:
27(1) Whether to detain a person for a mental health disorder,
28inebriation, chronic alcoholism, or the use of narcotics or a
29restricted dangerous drug in accordance with this part.
30(2) The terms, conditions, and enforcement of detention for a
31person with a
mental health disorder, inebriation, chronic
32alcoholism, or the use of narcotics or a restricted dangerous drug
33in accordance with this part.
34(3) Whether to release a person detained for a mental disorder,
35inebriation, chronic alcoholism, or the use of narcotics or a
36restricted dangerous drug in accordance with this part.
37(b) A physician, employee, or other staff person acting within
38the scope of his or her official duties or employment for a
39designated facility or nondesignated hospital shall not be liable
P14 1for carrying out a determination described in subdivision (a) so
2long as he or she uses due care.
Section 5026 is added to the Welfare and Institutions
4Code, to read:
(a) A designated facility or nondesignated hospital, as
6defined in subdivision (e) of Section 5150.10, or a physician,
7employee, or other staff person acting within the scope of his or
8her official duties or employment for the designated facility or
9nondesignated hospital shall not be liable for any of the following:
10(1) An injury caused by an eloping or eloped person who has
11been detained for a mental health disorder or addiction.
12(2) An injury to, or the wrongful death of, an eloping or eloped
13person who has been detained for a mental health disorder or
14addiction.
15(b) Nothing in this section shall exonerate a physician,
16employee, or other staff person acting within the scope of his or
17her official duties or employment for a designated facility or
18nondesignated hospital from liability if he or she acted or failed
19to act because of actual fraud, corruption, or actual malice.
Section 5150 of the Welfare and Institutions Code is
21amended to read:
(a) When a person, as a result of a mental health
23disorder, is a danger to others, or to himself or herself, or gravely
24disabled, a peace officer or an authorized professional acting within
25the scope of his or her authorization may, upon probable cause,
26take, or cause to be taken, the person into custody for a period of
27up to 72 hours for assessment, evaluation, and crisis intervention,
28or placement for evaluation and treatment in a facility designated
29by the county for evaluation and treatment and approved by the
30department. At a minimum, assessment, as defined in subdivision
31(c) of Section 5008, and evaluation, as defined in subdivision (n)
32of Section 5008, shall be conducted and provided on an ongoing
33basis. Crisis intervention, as defined in
subdivision (g) of Section
345008, may be provided concurrently with assessment, evaluation,
35or any other service. The period of 72-hour detention for evaluation
36and treatment shall begin at the time that the person is initially
37detained pursuant to this section.
38(b) (1) When an individual detained pursuant to subdivision
39(a) is taken to a designated facility for evaluation and treatment,
40the professional person in charge, a member of the attending staff
P15 1of the designated facility, or an authorized professional acting
2within the scope of his or her authorization by the county, shall
3assess the person to determine whether he or she can be properly
4served without being detained. The assessment shall be performed
5based on the clinical condition and needs of a person detained for
6evaluation and treatment. This section
shall not be construed to
7prevent an authorized professional from providing consultation or
8other professional assistance by telehealth. If in the judgment of
9the authorized professional, the person can be properly served
10without being detained, he or she shall be provided evaluation,
11crisis intervention, or other inpatient or outpatient services on a
12voluntary basis.
13(2) If the person detained for evaluation and treatment is taken
14to a designated ambulatory facility that is authorized by the county
15to conduct an assessment, the assessment shall be conducted by
16the professional person in charge of the designated ambulatory
17facility or his or her designee acting within the scope of his or her
18licensed profession. The assessment in a designated ambulatory
19facility may be performed by or in consultation with an authorized
20member of the
professional staff of a designated inpatient facility
21using telehealth if the designated inpatient facility has agreed to
22admit the person in accordance with subdivision (a) upon a
23determination that an involuntary admission is appropriate.
24(3) This section shall not be construed to prevent a peace officer,
25or an authorized professional employee of an emergency transport
26provider acting at the direction of the peace officer, from delivering
27individuals to a designated facility for an assessment under this
28section. Furthermore, the assessment requirement of this section
29shall not be construed to require peace officers or authorized
30professional employees of emergency transport providers acting
31at the direction of the peace officer to perform any additional duties
32other than those specified in Sections 5150.1 and 5150.2.
33(4) If an individual detained under subdivision (a) is first taken
34to an emergency department of a nondesignated hospital, as defined
35in subdivision (e) of Section 5150.10, the provisions of Article 1.1
36(commencing with Section 5150.10) shall apply to the individual
37during his or her stay in the emergency department of a
38nondesignated hospital. This section does not require the peace
39officer or authorized professional who detained the individual
P16 1pursuant to subdivision (a) to take or cause the individual to be
2taken to an emergency department of a nondesignated hospital.
3(5) Notwithstanding paragraph (2) of subdivision (j) of Section
45008, or any regulation, if a person detained for evaluation and
5treatment presents or is transferred to a designated ambulatory
6facility, and
following a new determination of probable cause, the
7professional person in charge of the designated ambulatory facility
8or his or her designee determines that the person continues to meet
9the criteria for detention under Section 5150 and should be admitted
10to a designated inpatient facility for further evaluation and
11treatment, the designated ambulatory facility shall make and
12document good faith efforts to arrange placement for the person
13in a designated inpatient facility. Subject to the requirements of
14subdivision (a), if the designated ambulatory facility has been
15unable to arrange placement for the person in a designated inpatient
16facility within 24 hours, the designated ambulatory facility shall
17continue to provide evaluation and treatment for the person beyond
1824 hours in order to arrange for placement and transfer of the
19person to a designated inpatient facility, provided the designated
20ambulatory
facility, prior to the expiration of the 24 hours, notifies
21the county in which it is located and the mental health patients’
22rights advocate for the county that it is continuing to detain the
23person beyond 24 hours. The designated ambulatory facility shall
24not transfer or send a person to an emergency department of a
25nondesignated hospital unless the person requires examination or
26treatment for a medical condition that is beyond the capability of
27the designated ambulatory facility.
28(c) Whenever a person is evaluated by an authorized professional
29and is found to be in need of mental health services, but is not
30admitted to the facility, all available alternative services provided
31pursuant to subdivision (b) shall be offered as determined by the
32county mental health director.
33(d) If, in the judgment of the authorized professional, the person
34cannot be properly served without being detained, the admitting
35facility shall require an application in writing pursuant to Section
365150.3.
37(e) At the time a person is taken into custody for evaluation, or
38within a reasonable time thereafter, unless a responsible relative
39or the guardian or conservator of the person is in possession of the
40person’s personal property, the person taking him or her into
P17 1custody shall take reasonable precautions to preserve and safeguard
2the personal property in the possession of or on the premises
3occupied by the person. The person taking him or her into custody
4shall then furnish to the court a report generally describing the
5person’s property so preserved and safeguarded and its disposition,
6in substantially the form set forth in
Section 5211, except that if
7a responsible relative or the guardian or conservator of the person
8is in possession of the person’s property, the report shall include
9only the name of the relative or guardian or conservator and the
10location of the property, whereupon responsibility of the person
11taking him or her into custody for that property shall terminate.
12As used in this section, “responsible relative” includes the spouse,
13parent, adult child, domestic partner, grandparent, grandchild, or
14adult brother or sister of the person.
15(f) (1) Each person, at the time he or she is first taken into
16custody under this section, shall be provided, by the person who
17takes him or her into custody, the following information orally in
18a language or modality accessible to the person. If the person
19cannot understand an oral advisement,
the information shall be
20provided in writing. The information shall be in substantially the
21following 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. |
34(2) If taken into custody at his or her own residence, the person
35shall also be provided the following information:
37You may bring a few personal items with you, which I will have
38to approve. Please inform me if you need assistance turning off
P18 1any appliance or water. You may make a phone call and leave a
2note to tell your friends or family where you have been taken.
4(g) The designated facility shall keep, for each
patient evaluated,
5a record of the advisement given pursuant to subdivision (f) which
6shall include all of the following:
7(1) The name of the person detained for evaluation.
8(2) The name and position of the peace officer or mental health
9professional taking the person into custody.
10(3) The date the advisement was completed.
11(4) Whether the advisement was completed.
12(5) The language or modality used to give the advisement.
13(6) If the advisement was not completed, a statement of good
14cause, as defined by regulations of the State Department of Health
15
Care Services.
16(h) Each person admitted to a facility designated by the county
17for evaluation and treatment shall be given the following
18information by admission staff of the facility. The information
19shall be given orally and in writing and in a language or modality
20accessible to the person. The written information shall be available
21to the person in English and in the language that is the person’s
22primary means of communication. Accommodations for other
23disabilities that may affect communication shall also be provided.
24The 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. |
||||
|
22(i) For each patient admitted for evaluation and treatment, the
23facility shall keep with the patient’s medical record a record of the
24advisement given pursuant to subdivision (h), which shall include
25all of the following:
26(1) The name of the person performing the advisement.
27(2) The date of the advisement.
28(3) Whether the advisement was completed.
29(4) The language or modality used to communicate the
30advisement.
31(5) If the advisement was not completed, a statement of good
32cause.
Section 5150.05 of the Welfare and Institutions Code
34 is amended to read:
(a) When determining if probable cause exists to
36take a person into custody, or cause a person to be taken into
37custody, pursuant to Section 5150, a person who is authorized to
38take that person, or cause that person to be taken, into custody
39pursuant to that section shall consider available relevant
40information about the historical course of the person’s mental
P20 1disorder if the authorized person determines that the information
2has a reasonable bearing on the determination as to whether the
3person is a danger to others, or to himself or herself, or is gravely
4disabled as a result of the mental disorder.
5(b) For purposes of this section, “information
about the historical
6course of the person’s mental disorder” includes evidence presented
7by the person who has provided or is providing mental health or
8related support services to the person subject to a determination
9described in subdivision (a), evidence presented by one or more
10members of the family of that person, and evidence presented by
11the person subject to a determination described in subdivision (a)
12or anyone designated by that person.
13(c) If the probable cause in subdivision (a) is based on the
14statement of a person other than one authorized to take the person
15into custody pursuant to Section 5150, the person making the
16statement shall be liable in a civil action for intentionally giving
17a statement that he or she knows to be false.
18(d) This section shall not be
applied to limit the application of
19Section 5328.
Section 5150.1 of the Welfare and Institutions Code
21 is amended to read:
(a) A peace officer or authorized professional
23employee of an emergency transport provider acting at the direction
24of a peace officer, seeking to transport, or having transported, a
25person to a designated facility for assessment pursuant to
26subdivision (a) of Section 5150 or Section 5151, shall not be
27instructed by mental health personnel to take the person to, or keep
28the person at, a jail solely because of the unavailability of an acute
29bed. The peace officer or the authorized professional employee of
30an emergency transport provider acting at the direction of the peace
31officer, shall not be forbidden to transport the person directly to
32the designated facility. No mental health employee from any
33county,
state, city, or any private agency providing psychiatric
34emergency services shall interfere with a peace officer or an
35authorized professional employee of an emergency transport
36provider acting at the direction of a peace officer performing duties
37under Section 5150 by preventing the peace officer from detaining
38a person for evaluation and treatment or preventing the peace
39officer or an authorized professional employee of an emergency
40transport provider acting at the direction of a peace officer from
P21 1entering a designated facility with the person for an assessment.
2An employee of a facility shall not require the peace officer or an
3authorized professional employee of an emergency transport
4provider acting at the direction of a peace officer to remove the
5person without an assessment as a condition of allowing the peace
6officer or an authorized professional employee of an emergency
7transport
provider acting at the direction of a peace officer to
8depart.
9(b) An emergency transport provider, or any certified or licensed
10personnel of an emergency transport provider, shall not be civilly
11or criminally liable for any of the following that may be applicable
12to the transport of a person who has been detained for evaluation
13and treatment:
14(1) The continuation of the detention for evaluation and
15treatment while transporting the person to a designated facility or
16an emergency department of a nondesignated hospital at the
17direction of a peace officer or authorized professional who detained
18the person for evaluation and treatment.
19(2) The continuation of the detention for evaluation and
20treatment while
transporting the person detained for evaluation
21and treatment to a designated facility or an emergency department
22of a nondesignated hospital at the direction of the treating
23
emergency professional in an emergency department of a
24nondesignated hospital for an assessment or other service under
25Section 5151.
26(c) For purposes of this section, “peace officer” means a peace
27officer as defined in Chapter 4.5 (commencing with Section 830)
28of Title 3 of Part 2 of the Penal Code and also includes a jailer
29seeking to transport or transporting a person in custody to a
30designated facility for an assessment consistent with Section 4011.6
31or 4011.8 of the Penal Code and Section 5150.
Section 5150.2 of the Welfare and Institutions Code
33 is amended to read:
In each county, whenever a peace officer or the
35authorized professional employee of an emergency transport
36provider acting at the direction of the peace officer has transported
37a person to a designated facility for an assessment, the officer or
38professional employee of an emergency transporter shall be
39detained no longer than the time necessary to complete
40documentation of the factual basis of the detention for evaluation
P22 1and treatment and effectuate a prompt, safe, and orderly transfer
2of physical custody of the person.
Section 5150.3 is added to the Welfare and
4Institutions Code, to read:
(a) (1) The peace officer or an authorized professional
6who takes a person into custody or otherwise initially detains a
7person pursuant to Section 5150 shall complete and sign an
8application for detention for evaluation and treatment, in the form
9prescribed by subdivision (g), stating the circumstances under
10which the person’s condition was called to the attention of the
11peace officer or authorized professional, and stating that the peace
12officer or authorized professional has probable cause to believe
13that the person is, as a result of a mental health disorder, a danger
14to others, or to himself or herself, or gravely disabled.
15(2) The
documentation shall include detailed information
16regarding the factual circumstances and observations constituting
17probable cause for the peace officer or authorized professional to
18believe that the person should be detained for evaluation and
19treatment in accordance with Section 5150. If the probable cause
20is based on the statement of a person other than the peace officer
21or authorized professional, the person shall be liable in a civil
22action for intentionally giving a statement that he or she knows is
23false.
24(3) A designated facility or nondesignated hospital shall require
25presentation of the application as a condition of continuation of
26the detention for evaluation and treatment. If the application is not
27presented to the designated facility or nondesignated hospital, as
28applicable, the person shall be immediately released from detention
29for
evaluation and treatment.
30(4) An application for detention for evaluation and treatment
31shall be valid in all counties to which the person may be taken to
32a designated facility.
33(b) (1) If the person detained by a peace officer or authorized
34professional is in a location other than a designated facility or
35nondesignated hospital, the original or copy of the application for
36detention for evaluation and treatment shall be presented to the
37designated facility under paragraph (2) or the nondesignated
38hospital under paragraph (3).
39(2) If after detention under Section 5150, the person is first taken
40to a designated facility, the original or a copy of the signed
P23 1application for detention for evaluation and
treatment shall be
2presented to the designated facility.
3(3) If after detention under Section 5150, the person is first taken
4to a nondesignated hospital, the original or a copy of the signed
5application for detention for evaluation and treatment shall be
6presented to the nondesignated hospital. If the person is
7subsequently transferred to a designated facility, the nondesignated
8hospital shall deliver the original or a copy of the signed application
9for detention for evaluation and treatment to the designated facility.
10If the person is discharged from the nondesignated hospital under
11Section 5150.15 or 5150.16, without a transfer to a designated
12facility, the nondesignated hospital shall maintain the original or
13a copy of the original signed application for detention for
14evaluation and treatment.
15(c) If a person detained for evaluation and treatment is
16subsequently released from detention for evaluation and treatment
17pursuant to Section 5150.15 or 5151, the application for detention
18for evaluation and treatment in the possession of a designated
19facility or nondesignated hospital shall be retained for the period
20of time required by the medical records retention policy of the
21designated facility or nondesignated hospital.
22(d) The determination of a peace officer or authorized
23professional to detain a person under Section 5150 and complete
24and sign an application for detention for evaluation and treatment,
25shall be based solely on whether the person meets the criteria for
26detention for evaluation and treatment as set forth in
Section 5150.
27The determination shall not be delayed, denied, or refused based
28on the availability of beds or services at designated facilities to
29which a person may be taken under this article.
30(e) If a person detained for evaluation and treatment under
31Section 5150 is transported by a professional employee of an
32emergency transport provider to a designated facility or
33nondesignated hospital at the request of a peace officer or an
34authorized professional, the peace officer or authorized professional
35shall give the application for detention for evaluation and treatment
36to the professional employee of the emergency transport provider
37if the peace officer or authorized professional does not accompany
38the person to the designated facility or nondesignated hospital.
39(f) A copy of the application for detention for evaluation and
40treatment shall be given to an emergency transport provider if the
P24 1person detained for evaluation and treatment is transported from
2a nondesignated hospital to a designated facility or from a
3designated facility to another designated facility.
4(g) Not later than July 1, 2016, the department shall adopt and
5make available a standardized form of the application for detention
6for evaluation and treatment that shall be used by peace officers
7and authorized professionals to apply for detention of a person for
8evaluation and treatment under Section 5150 and by authorized
9professionals to release a person from detention for evaluation and
10treatment pursuant to Section 5150.15 or 5151. In developing the
11form, the department shall request comments from stakeholders
12including
the organizations described in subdivision (b) of Section
135400. The form of the application for detention for evaluation and
14treatment shall, at a minimum, provide all of the following:
15(1) A description of the person’s behavior and other relevant
16facts that provide the basis for probable cause under Sections 5150
17and 5150.05 of the person’s detainment for evaluation and
18treatment.
19(2) For persons detained for evaluation and treatment who are
20first taken to an emergency department of a nondesignated hospital,
21documentation of the facts and conclusions that provide the basis
22for the determination of medical clearance, excluding a psychiatric
23emergency medical condition, by the emergency professional
24treating the person in the emergency department to transfer the
25person to a
designated facility.
26(3) Documentation of the facts and conclusions that provide the
27basis for the determination by an authorized professional authorized
28to perform an assessment that the person should be admitted for
29involuntary evaluation and treatment under Section 5152.
30(4) Determination of the facts and conclusions that support the
31determination by an authorized professional authorized to release
32a person from detention in accordance with Section 5150.14 or
335151.
34(5) Request by a peace officer under Section 5152.1 for
35notification of the person’s release or discharge by a designated
36facility or nondesignated hospital.
37(6) All of the information required by
subdivision (f) of Section
385150.
Section 5150.4 of the Welfare and Institutions Code
40 is repealed.
Article 1.1 (commencing with Section 5150.10) is
2added to Chapter 2 of Part 1 of Division 5 of the Welfare and
3Institutions Code, to read:
4
Unless the context otherwise requires, the following
8definitions shall govern the construction of this article:
9(a) “Emergency department of a nondesignated hospital” means
10a basic, comprehensive, or standby emergency medical service
11that is approved by the State Department of Public Health as a
12special or supplemental service of a nondesignated hospital. For
13purposes of this part, an emergency department of a nondesignated
14hospital shall include an observation or similar unit of the hospital
15that meets both of the following criteria:
16(1) The unit is operated under the direction and policies of the
17emergency department.
18(2) The unit provides continuing emergency services and care
19to patients prior to an inpatient admission, transfer, or discharge.
20(b) “Emergency professional” means either of the following:
21(1) A physician and surgeon who is board certified or pursuing
22board certification in emergency medicine, or a qualified licensed
23person, as defined in subdivision (g), during any scheduled period
24that he or she is on duty to provide medical screening and treatment
25of patients in an emergency department of a nondesignated hospital.
26(2) A physician and surgeon, or a qualified licensed person, as
27defined in subdivision (g), during any scheduled period that he or
28she is on duty to
provide medical screening and treatment of
29patients in the emergency department of a nondesignated hospital
30that is a critical access hospital within the meaning of Section
311250.7 of the Health and Safety Code. A physician and surgeon
32on duty under this paragraph shall include a physician and surgeon
33on call for a standby emergency medical service who is responsible
34to provide professional coverage for the emergency department.
35A physician and surgeon on duty under this paragraph does not
36include a physician and surgeon who is providing on-call specialty
37coverage services to the emergency department of a nondesignated
38hospital, unless the physician and surgeon is an emergency
39professional under paragraph (1).
P26 1(c) “Emergency services and care” has the same meaning as in
2subdivision (a) of Section 1317.1 of the Health and Safety Code.
3(d) “EMTALA” means the Emergency Medical Treatment and
4Labor Act, and regulations adopted pursuant thereto, as defined
5in Section 1395dd of Title 42 of the United States Code.
6(e) “Nondesignated hospital” means a general acute care
7hospital, as defined in subdivision (a) of Section 1250 of the Health
8and Safety Code or an acute psychiatric hospital, as defined in
9subdivision (b) of Section 1250 of the Health and Safety Code,
10that is not a designated facility.
11(f) “Psychiatric emergency medical condition” has the same
12meaning as in subdivision (k) of Section 1317.1 of the Health and
13Safety Code.
14(g) “Psychiatric professional” means a physician and surgeon
15who
is board certified or pursuing board certification in psychiatry
16and who is providing specialty services to the emergency
17department of a nondesignated hospital.
18(h) “Qualified licensed person” means a licensed person
19designated by the medical staff and governing body of a
20nondesignated hospital to provide emergency services and care,
21to the extent permitted by applicable law, in an emergency
22department of the nondesignated hospital under the supervision
23of a physician and surgeon.
24(i) “Stabilized” has the same meaning as in subdivision (j) of
25Section 1317.1 of the Health and Safety Code.
(a) The Legislature finds and declares all of the
27following:
28(1) A person who has been detained for evaluation and treatment
29pursuant to Section 5150 should be taken to a designated facility
30rather than an emergency department of a nondesignated hospital.
31(2) A person who has been detained for evaluation and treatment
32pursuant to Section 5150 should be detained in an emergency
33department of a nondesignated hospital only for the time necessary
34to provide required emergency services and care and obtain medical
35clearance, unless the person requires an admission for inpatient
36services.
37(3) A person who has been detained for evaluation and treatment
38pursuant to Section 5150 has the right to receive a prompt
39assessment to determine the appropriateness of the detention and
40the need for evaluation and treatment at a designated facility.
P27 1(b) It is also the intent of the Legislature that nothing in this
2chapter shall be construed to require a peace officer or any other
3authorized professional to take a person detained for evaluation
4and treatment to an emergency department of a nondesignated
5hospital instead of taking the person to a designated facility, unless
6the peace officer or authorized professional reasonably determines
7that the person is in need of emergency care and services that
8should be provided at an emergency department of a nondesignated
9hospital before
the person is transported to a designated facility.
(a) This section shall apply to a person who has been
11detained for evaluation and treatment by a peace officer or an
12authorized professional and is taken to an emergency department
13of a nondesignated hospital for emergency services and care.
14(b) While the person is in the emergency department of the
15nondesignated hospital, the detention of the person for evaluation
16and treatment shall continue, unless the person is released from
17detention pursuant to Section 5150.15 or 5150.16.
(a) This section shall apply if, during a person’s
19examination or treatment in an emergency department, there is a
20need for a determination of probable cause for the detention of the
21person for evaluation and treatment.
22(b) If a person who has not been detained for evaluation and
23treatment has signs or symptoms, in the judgment of the treating
24emergency professional, that indicate probable cause for detention
25for evaluation and treatment, the person shall have the right to a
26prompt probable cause determination in accordance with any of
27the following:
28(1) The hospital may contact the county to arrange
for a probable
29cause determination by an authorized professional, including, but
30not limited to, a member of a mobile crisis team.
31(2) (A) If the county in which the nondesignated hospital is
32located has a local or regional liaison, the hospital may contact the
33local or regional liaison to arrange for an authorized professional
34to provide a prompt probable cause determination of the person.
35(B) The local or regional liaison shall advise the nondesignated
36hospital within 30 minutes of the time of the initial contact whether
37
an authorized professional can perform the probable cause
38determination within two hours from the time of the initial contact
39with the local or regional liaison.
P28 1(C) The probable cause determination shall be based solely on
2the criteria for detaining a person for evaluation and treatment.
3The probable cause determination shall not consider the availability
4of beds or services at designated facilities within or outside of the
5county.
6(D) The probable cause determination may be conducted by an
7authorized professional utilizing telehealth.
8(3) The treating emergency professional may conduct a probable
9cause determination and, upon a finding of probable cause, detain
10the person for evaluation and treatment
in accordance with Sections
115150 and 5150.3.
12(c) If the person is detained for evaluation and treatment
13pursuant to this section, the detention shall continue during his or
14her stay in the emergency department of a nondesignated hospital,
15unless the person is released from detention pursuant to Section
165150.15 or 5150.16 or the detention ends by reason of the
17expiration of 72 hours pursuant to subdivision (a) of Section 5150.
(a) This section shall apply to a person who is first
19detained pursuant to Section 5150 for evaluation and treatment in
20a nondesignated hospital emergency department or has been
21detained pursuant to Section 5150 for evaluation and treatment
22and first taken to an emergency department of a nondesignated
23hospital.
24(b) (1) Except as provided in subdivision (e), the nondesignated
25hospital shall notify the county in which the nondesignated hospital
26is located of the person’s detention.
27(2) If the person was detained for evaluation and treatment and
28taken to the emergency department of the
nondesignated hospital
29pursuant to Section 5150.12, the notification shall occur after the
30hospital has performed an initial medical screening of the person
31in accordance with paragraphs (1) and (2) of subdivision (a) of
32Section 1317.1 of the Health and Safety Code.
33(3) If the person is first detained for evaluation and treatment
34in the emergency department of the nondesignated hospital
35pursuant to Section 5150.13, the notification shall occur when the
36probable cause determination has been completed.
37(c) The notification to the county shall be made using the
3824-hour toll-free telephone number established by the county’s
39mental health program for psychiatric emergency services and
40crisis stabilization if the county’s mental health program has a
P29 124-hour toll-free telephone number
in operation on January 1,
22016, for this purpose. The notification shall be documented in
3the patient’s medical record.
4(d) The nondesignated hospital shall advise the county of all of
5the following:
6(1) The time when the 72-hour detention period for evaluation
7and treatment expires.
8(2) An estimate of the time when the person will be medically
9stable for transfer to a designated facility.
10(3) The county in which the person resides, if known.
11(e) The notification to the county under this section shall not
12be required if the treating emergency professional determines that
13the person will be
admitted, pursuant to Section 5150.16, to an
14acute care bed of a nondesignated hospital for the primary purpose
15of receiving acute inpatient services for a medical condition that
16is in addition to the person’s psychiatric condition.
(a) This section shall establish a process for releasing
18from detention a person who has been detained for evaluation and
19treatment during the time that the person is detained in the
20emergency department of a nondesignated hospital.
21(b) If the treating emergency professional determines that there
22is no longer probable cause to continue the detention for evaluation
23and treatment, the treating emergency professional may initiate a
24followup probable cause determination to determine whether the
25person may be released from detention for evaluation and
26treatment. The followup probable cause determination shall be
27made in accordance with either of the following:
28(1) The hospital may contact the county, or a local or regional
29liaison if authorized by the county, to arrange for an authorized
30professional to perform a followup probable cause determination
31to determine whether the person may be released from detention
32for evaluation and treatment. If a county or a local or regional
33liaison cannot arrange for an authorized professional to make the
34determination within two hours of the initial call to the county or
35the local or regional liaison and there is no probable cause for
36detention, the treating emergency professional may perform a
37followup probable cause determination to determine whether the
38person may be released from detention for evaluation and
39treatment.
P30 1(2) The treating emergency professional, without first contacting
2the
county or a local or regional liaison, may perform a followup
3probable cause determination to determine whether the person
4may be released from detention for evaluation and treatment.
5(c) The determination under this section to release a person from
6detention for evaluation and treatment shall be based solely on
7whether there is probable cause to continue the detention for
8evaluation and treatment. The determination to continue the
9detention or to release the person from detention shall not be based
10on the availability of beds or services at designated facilities within
11or outside of the county, or on anything other than whether there
12is probable cause for detention.
13(d) The followup probable cause determination under this section
14may be conducted by an authorized professional
utilizing
15telehealth.
16(e) The followup probable cause determination under this section
17may be conducted by a psychiatric professional.
(a) This section shall apply to a person detained for
19evaluation and treatment who is admitted to a nonpsychiatric unit
20of a general acute care hospital for acute medical services. This
21section shall apply to all general acute care hospitals, including
22general acute care hospitals that are designated facilities.
23(b) If the person detained for evaluation and treatment is
24admitted to a nonpsychiatric unit of a general acute care hospital
25for the primary purpose of receiving acute inpatient services for a
26medical condition that is in addition to the person’s psychiatric
27condition, the effect on the detention for evaluation and treatment
28while receiving acute medical services
shall be as follows:
29(1) If the hospital offers to provide assessment, evaluation, and
30crisis intervention services and the person consents to the services
31on a voluntary basis in addition to acute medical services, the
32person shall be released from detention.
33(2) If the hospital offers to provide assessment, evaluation, and
34crisis intervention services and the person refuses or is unable to
35consent to the services on a voluntary basis in addition to acute
36medical services, the detention for evaluation and treatment shall
37continue in effect during the acute hospital stay, for so long as
38there continues to be probable cause for the detention.
P31 1(3) If the hospital does not have the capability to provide
2assessment,
evaluation, and crisis intervention services, the person
3shall be released from detention for evaluation and treatment.
4(c) The release of the person from detention for evaluation and
5treatment shall be communicated to the person and documented
6in the person’s medical record.
7(d) This section shall not apply to a person detained for
8evaluation and treatment who meets both of the following:
9(1) The person does not require acute inpatient services for a
10medical condition.
11(2) The person is awaiting a transfer to a designated facility and
12is placed in an acute bed of the nondesignated hospital for the
13purpose of securing the protection of the person or
other persons,
14or both, in the nondesignated hospital pending the transfer of the
15person to a designated facility.
16(e) In all cases described in subdivision (b), if the discharge
17plan for the patient provides for followup evaluation and treatment
18at a psychiatric facility, the patient shall be advised of the
19recommended need for the followup evaluation and treatment.
20(f) If the person is not able or willing to accept treatment on a
21voluntary basis, or to accept the referral or transfer to a psychiatric
22facility, the hospital shall obtain a new probable cause
23determination for detention for evaluation and treatment pursuant
24to Section 5150 in order to take or cause the person to be taken to
25a designated facility. Upon request by the hospital, a county shall
26arrange for an authorized
professional to conduct a probable cause
27determination in a timely manner, which may be performed by the
28authorized professional utilizing telehealth.
(a) This section, together with Sections 5150.18 and
305150.19, shall apply to the placement in a designated facility of a
31person in a nondesignated hospital emergency department who
32has been detained for evaluation and treatment.
33(b) The person may be placed in any designated facility that has
34the capability to meet the needs of the person, including a
35designated ambulatory facility.
36(c) Prior to placement in a designated ambulatory facility,
37personnel at the designated ambulatory facility shall confirm
38whether the facility can meet the needs of the person within the
39scope of its designation and
capability.
(a) This section shall apply to the placement in a
2designated facility for a person described in Section 5150.17 if the
3person has a psychiatric emergency medical condition.
4(b) If a person, in the judgment of the treating emergency
5professional, has a psychiatric emergency medical condition, the
6placement in a designated facility shall be made as follows:
7(1) The placement may be in any designated facility that has
8the capability and capacity to provide evaluation and treatment for
9the person, whether that designated facility is located within or
10outside of the county of the hospital.
11(2) The treating emergency professional shall determine the
12mode of transportation, including personnel and equipment, that
13are appropriate for the transport of the person to the designated
14facility.
15(3) In the event of a disagreement as to whether the person under
16this section has a psychiatric emergency medical condition, the
17judgment of the treating emergency professional shall prevail.
18(4) The placement of a person described in this subdivision shall
19take precedence over provider networks.
20(c) If the person, in the judgment of the treating emergency
21professional, does not have a psychiatric emergency medical
22condition, the placement of the person in a
designated facility for
23evaluation and treatment shall be deemed to be made for a medical
24reason within the meaning of Section 1317.2 of the Health and
25Safety Code.
26(d) This section shall also apply to a person who has been
27medically stabilized, but is being held in an inpatient unit of the
28nondesignated hospital for the purposes of ensuring the safety and
29security of the person or other persons, pending placement of the
30person in a designated facility for evaluation and treatment.
31(e) If a person detained for evaluation and treatment is in the
32emergency department of a nondesignated hospital, or in a bed not
33licensed for psychiatric care, the nondesignated hospital shall make
34good faith efforts to arrange placement for the person in a
35designated facility and, pending
placement, shall provide further
36screening, treatment, and monitoring consistent with the needs of
37the patient and within the capacity of the hospital.
(a) This section describes assistance that may be
39available to an emergency department of a nondesignated hospital
P33 1for the placement in a designated facility of a person described in
2Section 5150.17.
3(b) If a person has been taken to or detained by a
4county-authorized professional in the emergency department of
5the nondesignated hospital, the authorized professional shall assist
6the nondesignated hospital in arranging for the placement of the
7person with an appropriate designated facility.
8(c) If a person is detained for evaluation and treatment by a
9peace officer or a treating emergency professional in
the emergency
10department of the nondesignated hospital, the hospital may contact
11the local or regional liaison, if authorized for the county in which
12the nondesignated hospital is located, to assist the hospital in
13arranging for the placement of the person in a designated facility,
14as follows:
15(1) Contact with the local or regional liaison may be initiated
16when the treating emergency professional has
medically stabilized
17the person for placement in a designated facility.
18(2) The hospital shall inform the county or the local or regional
19liaison whether the person has a psychiatric emergency medical
20condition that requires a transport of the person in accordance with
21the EMTALA obligations for making an appropriate transfer.
22(d) A nondesignated hospital shall make efforts to obtain
23placement of the person in a designated facility without first
24contacting the county or the local or regional liaison under this
25section or in addition to requesting assistance that may be provided
26by the county or the local or regional liaison.
(a) The determination of probable cause to detain a
28person for evaluation and treatment shall be independent of a
29determination as to whether the person has a psychiatric emergency
30medical condition for the provision of emergency services and
31care.
32(b) A determination of probable cause to detain a person for
33evaluation and treatment, whether by a peace officer or an
34authorized professional, shall not be deemed to constitute a
35psychiatric emergency medical condition unless a treating
36emergency professional or psychiatric professional has determined
37that the person has a psychiatric emergency medical condition.
38(c) A determination by a treating emergency professional or a
39psychiatric professional that a person has a psychiatric emergency
40medical condition shall not be deemed to constitute probable cause
P34 1under Section 5150 that the person may be detained for evaluation
2and treatment.
3(d) A determination by a treating emergency professional or a
4psychiatric professional that a person detained for evaluation and
5treatment does not have a psychiatric emergency medical condition,
6or that the person’s psychiatric emergency medical condition is
7stabilized, shall not be deemed to constitute a release of the person
8from detention for evaluation and treatment.
(a) A nondesignated hospital and the professional
10staff of the nondesignated hospital shall not be civilly or criminally
11liable for the transfer of a person detained for evaluation and
12treatment to a designated facility in accordance with this article.
13(b) The peace officer or authorized professional responsible for
14the detention of the person for evaluation and treatment who
15transfers the custody of the person to an emergency professional
16of a nondesignated hospital, shall not be civilly or criminally liable
17for any of the following:
18(1) The continuation and enforcement of the detention for
19evaluation
and treatment during the person’s stay in the emergency
20department of the nondesignated hospital prior to the discharge of
21the person from the hospital in accordance with this article.
22(2) The release of the person from detention for evaluation and
23treatment in accordance with this article.
24(3) The transfer of the person detained for evaluation and
25treatment to a designated facility in accordance with this article.
begin insertSection 5150.25 is added to the end insertbegin insertWelfare and
27Institutions Codeend insertbegin insert, to read:end insert
Nothing in this chapter supersedes or abrogates the
29provisions governing medical control set forth in Chapter 5
30(commencing with Section 1798) of Division 2.5 of the Health and
31Safety Code.
Article 1.2 (commencing with Section 5150.30) is
34added to Chapter 2 of Part 1 of Division 5 of the Welfare and
35Institutions Code, to read:
36
(a) A provider of ambulance services licensed by the
40Department of the California Highway Patrol or operated by a
P35 1public safety agency, and the employees of those providers who
2are certified or licensed under Section 1797.56 of the Health and
3Safety Code, shall be authorized to transport a person who is in a
4hospital or facility on a voluntary basis to a designated facility for
5psychiatric treatment. This section shall apply to transfers from
6any type of facility, including nondesignated hospitals and other
7facilities.
8(b) A person shall not be detained for evaluation and treatment
9solely for the purpose of transporting the person, or transferring
10the person
by a provider of ambulance services, to a designated
11facility or an emergency department of a nondesignated hospital.
12(c) Not later than July 1, 2016, the department shall adopt and
13make available a standardized form that will enable voluntary
14patients to consent to transfer between facilities by a provider of
15ambulance services. The form shall be provided to voluntary
16patients to sign before the transfer of the patient. The form shall
17be kept in the patient’sbegin delete chart.end deletebegin insert medical record.end insert Copies of the form
18shall be given to the patient and the provider of ambulance services.
19(d) This section shall apply to all
patients who are on voluntary
20status, regardless of whether the person was previously detained
21for evaluation and treatment at any point during the course of
22treatment at a nondesignated hospital or designated facility prior
23to the transfer.
24(e) No person shall require a person to be subject to detention
25for evaluation and treatment for the purpose of authorizing or
26providing evaluation, treatment, or admission to a facility, or as a
27condition for providing or paying for medical services, care, or
28treatment, including emergency services and care, unless there is
29probable cause under Section 5150 to detain the person for
30evaluation and treatment and the person cannot be properly served
31on a voluntary basis. Nothing in this part shall be construed as
32preventing a person subject to detention for evaluation and
33treatment from receiving
evaluation or treatment on a voluntary
34basis unless there has been an adjudication under this part that the
35person lacks the capacity to do so.
The heading of Article 1.3 (commencing with Section
385151) is added to Chapter 2 of Part 1 of Division 5 of the Welfare
39and Institutions Code, to read:
Section 5151 of the Welfare and Institutions Code is
5amended to read:
(a) If a designated facility for evaluation and treatment
7admits the person, it may detain him or her for evaluation and
8treatment for a period not to exceed 72 hours from the time that
9the person was initially detained pursuant to subdivision (a) of
10Section 5150.
11(b) Prior to admitting a person to the facility for evaluation and
12treatment, the professional person in charge of the facility or his
13or her designee shall conduct an assessment of the individual in
14person to determine the appropriateness of the involuntary
15detention.
Section 5151.1 is added to the Welfare and Institutions
18Code, to read:
If the assessment results in a determination that the
20person is in need of mental health services, but he or she is not
21admitted to the facility, the designated facility shall provide the
22person with appropriate referrals and a list of alternative services
23and other resources that are appropriate to the needs of the person.
24The alternative services and other resources shall include both of
25the following, as applicable:
26(a) The services described in subdivision (b) of Section 5150.
27(b) The services for persons with severe mental illness and
28substance use disorders posted by a county on its Internet Web
29site pursuant to Section
5013.
Section 5151.2 is added to the Welfare and Institutions
32Code, to read:
(a) Each county shall establish disposition procedures
34and guidelines with local law enforcement agencies for the safe
35and orderly transfer of persons detained for evaluation and
36treatment by a peace officer, who has requested notification under
37Section 5152.1 of the person’s release from detention for evaluation
38and treatment in accordance with Section 5150.15, 5150.16, or
395151. The disposition procedures and guidelines shall include
40persons who are not admitted for evaluation and treatment and
P37 1who decline alternative mental health services and persons who
2have a criminal detention pending.
3(b) The disposition procedures and guidelines should include
4interagency
communication between law enforcement agencies
5located within the county, as well as law enforcement agencies
6located in other counties, that take or arrange to take persons
7detained for evaluation and treatment under Section 5150 to health
8facilities within the county. The disposition procedures and
9guidelines, including updates, shall be disseminated to designated
10facilities and nondesignated hospitals.
Section 5152.1 of the Welfare and Institutions Code
13 is amended to read:
(a) A designated facility or nondesignated hospital
15shall notify the county mental health director, or the director’s
16designee, and the law enforcement agency that employs the peace
17officer who makes the application for detention for 72-hour
18evaluation and treatment pursuant to Section 5150, if the person
19admitted pursuant to Section 5152 will be discharged after a
2072-hour inpatient admission, when the person is not admitted by
21the designated facility, when the person discharged before the
22expiration of the 72-hour inpatient admission, when the person
23discharged from detention for evaluation and treatment is released
24under Section 5150.15, 5150.16, or 5151, or if the person elopes
25from a designated facility or nondesignated
hospital, if both of the
26following conditions apply:
27(1) The peace officer who made the application for detention
28for evaluation and treatment requests notification of the person’s
29release or discharge at the time he or she makes the application
30for detention for evaluation and treatment and the peace officer
31certified at that time in writing that the person has been detained
32for evaluation and treatment under circumstances which, based
33upon an allegation of facts regarding actions witnessed by the
34officer or another person, would support the filing of a criminal
35complaint. The application for detention for evaluation and
36treatment shall include one or more methods of contacting a person
37at the law enforcement agency who may receive the notification.
38(2) The notice is limited to
the person’s name, address, date of
39admission or initial service, and date of release.
P38 1(b) If a police officer, law enforcement agency, or designee of
2the law enforcement agency, possesses any record of information
3obtained pursuant to the notification requirements of this section,
4the officer, agency, or designee shall destroy that record two years
5after receipt of notification.
6(c) The notice required by this section shall be made prior to
7the release or discharge of the person, if possible. The designated
8facility or nondesignated hospital shall consider the distance
from
9the law enforcement agency to the location of the designated
10facility or nondesignated hospital in giving the notice. The peace
11officer or other representative of the law enforcement agency
12receiving the notice shall promptly advise the designated facility
13or nondesignated hospital whether the peace officer or other law
14enforcement agency representative shall take custody of the person
15upon his or her release or discharge from the designated facility
16or nondesignated hospital and, if so, the time at which the peace
17officer or other law enforcement agency representative will be
18present at the designated facility or nondesignated hospital.
19(d) Nothing in this section shall be construed to require the
20designated facility or nondesignated hospital to delay the discharge
21of a person for purposes of awaiting the arrival of the
peace officer
22or another representative of the law enforcement agency.
Section 5152.2 of the Welfare and Institutions Code
25 is repealed.
Section 5152.2 is added to the Welfare and Institutions
28Code, to read:
In addition to the request for notification set forth in
30the application for detention for evaluation and treatment, each
31law enforcement agency shall arrange with the county mental
32health director for a method for designated facilities and
33nondesignated hospitals to give prompt notification to peace
34officers under Section 5152.1. The methods for notification for
35each county shall be disseminated by the county to the designated
36facilities and nondesignated hospitals located within the county.
Section 5153 of the Welfare and Institutions Code is
39amended to read:
Whenever possible, officers charged with apprehension
2of persons pursuant to this chapter shall dress in plain clothes and
3travel in unmarked vehicles.
Section 5270.50 of the Welfare and Institutions Code
6 is amended to read:
(a) Notwithstanding Section 5113, if the provisions
8of Section 5270.35 have been met, the professional person in
9charge of the facility providing intensive treatment, his or her
10designee, the medical director of the facility or his or her designee
11described in Section 5270.53, the psychiatrist directly responsible
12for the person’s treatment, or the psychologist shall not be held
13civilly or criminally liable for any action by a person released
14before the end of 30 days pursuant to this article.
15(b) The professional person in charge of the facility providing
16intensive treatment or his or her designee, the medical director of
17the facility or his or
her designee described in Section 5270.35,
18the psychiatrist directly responsible for the person’s treatment, or
19the psychologist shall not be held civilly or criminally liable for
20any action by a person released at the end of the 30 days pursuant
21to this article.
22(c) The attorney or advocate representing the person, the
23court-appointed commissioner or referee, the certification review
24hearing officer conducting the certification review hearing, and
25the peace officer responsible for detaining the person shall not be
26civilly or criminally liable for any action by a person released at
27or before the end of 30 days pursuant to this article.
O
97