BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 1300


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          Date of Hearing:   April 28, 2015


                           ASSEMBLY COMMITTEE ON JUDICIARY


                                  Mark Stone, Chair


          AB 1300  
          (Ridley-Thomas) - As Amended April 23, 2015


                              As Proposed to be Amended


          SUBJECT:  MENTAL HEALTH: INVOLUNTARY COMMITMENT


          KEY ISSUE:  SHOULD NON-DESIGNATED HOSPITALS AND THE PHYSICIANS,  
          AND PROFESSIONAL STAFF WHO WORK IN THOSE HOSPITALS, BE GIVEN  
          QUALIFIED IMMUNITY FOR THEIR DECISIONS RELATED TO THE EVALUATION  
          OF WHETHER A PERSON IS A DANGER TO SELF OR OTHERS AND THEREFORE  
          APPROPRIATELY DETAINED FOR A 72-HOUR MENTAL HEALTH HOLD TO  
          PROTECT NON-DESIGNATED HOSPITALS AND THEIR PROFESSIONAL STAFF  
          FROM ORDINARY NEGLIGENCE, BUT NOT FROM GROSS NEGLIGENCE OR  
          WANTON OR WILLFULL MISCONDUCT?

                                      SYNOPSIS


          This bill, co-sponsored by the California Hospital Association,  
          California Chapter of the American College of Emergency  
          Physicians, and California Emergency Nurses Association, makes a  
          number of changes, most of which are technical, to the law  
          governing involuntary commitment to mental health facilities  
          pursuant to Welfare and Institutions Code Sections 5150 and  
          5152.  Many of the bill's technical aspects were addressed in  
          the analysis of the Assembly Health Committee, which recently  








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          approved the bill by an 18-0 vote (with one abstention).  There  
          are two main issues before this Committee.  First, should the  
          72-hour detention period for the hold pursuant to Section 5150  
          of the Welfare and Institutions Code start when the person is  
          detained by a peace officer, or when the person is admitted to a  
          designated facility for treatment?  Second (and more  
          significantly), is it appropriate to provide qualified immunity  
          to non-designated hospitals (those which are not specifically  
          designated by the county (and therefore "designated facilities")  
          for evaluation of whether a person is a danger to self or  
          others, or is greatly disabled, and therefore appropriately  
          detained in the facility for a 72-hour hold for acute mental  
          health treatment?  While existing law provides immunity to  
          public agencies (which includes public hospitals) and their  
          employees for the involuntary detention of persons, including  
          the enforcement and release of detainment to the extent that the  
          facility or employee acts in accordance with requirements of the  
          Lanterman-Petris-Short (LPS) Act in detaining a person, and  
          enforcing or releasing the detention (Government Code Section  
          856), no such immunity is provided to non-designated facilities  
          or their employees.  The author and sponsors contend that the  
          immunity provisions for designated hospitals were drafted at a  
          time when the state hospital system was used for acute mental  
          health treatment and persons in mental health crisis were not  
          often seen in non-designated facilities.  The situation has  
          changed in the past 52 years, according to the author, so that  
          non-designated facilities routinely encounter these patients and  
          need to make decisions about whether to request detention by law  
          enforcement, or release the patients.  The bill originally  
          proposed that non-designated hospitals, physicians, and all  
          staff at the hospitals would be granted complete immunity from  
          liability in dealing with these patients.  Opponents, including  
          the Consumer Attorneys of California and NAMI California,  
          reasonably observed that this is extremely broad immunity that  
          would immunize even grossly negligent acts from any civil  
          liability.  With these concerns in mind, the author has agreed  
          to amend the bill to provide qualified immunity to  
          non-designated hospitals and certain personnel who encounter  
          persons who are in acute mental health crisis.  The bill is  








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          supported by numerous hospitals and medical organizations.  It  
          is opposed by Consumer Attorneys of California and NAMI  
          California and the California State Association of Counties and  
          the County Behavioral Health Directors Association have  
          expressed concerns about the bill.  This analysis reflects the  
          bill as it is proposed to be amended.  


          SUMMARY:  Makes numerous changes to the provisions regarding  
          evaluation procedures, terms and lengths of detention, and  
          criteria for release and transfer protocol related to the  
          involuntary detention of individuals and enacts a number of  
          provisions providing qualified immunity to a physician,  
          employee, or other staff person acting within the scope of his  
          or her official duties or employment for a designated facility  
          or nondesignated hospital from civil and criminal liability.   
          Among other things, this bill:  


          1)Defines "authorized professional" as a mental health  
            professional who is authorized in writing by a county to  
            provide services related to the evaluation, treatment, or  
            transfer of an individual who is a danger to himself, herself,  
            or others or who is gravely disabled. 


          2)Requires an authorized professional to have appropriate  
            training in mental health disorders and determination of  
            probable cause, and in providing services to persons with  
            mental health disorders.


          3)Defines a "designated facility" as a facility or a specific  
            unit or part of a facility that is licensed or certified as a  
            mental health evaluation facility, a mental health treatment  
            facility, or a mental health evaluation and treatment  
            facility. 










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          4)Requires persons providing evaluation services to be properly  
            qualified professionals and may be full-time employees,  
            part-time employees, or independent contractors of a county,  
            designated facility, or other agency providing face-to-face  
            evaluation services. 


          5)Defines "probable cause determination" to mean a determination  
            of whether there is probable cause for the detention of a  
            person and requires that a probable cause determination be  
            based solely on the criteria for detaining a person for  
            evaluation and treatment when a person, as a result of a  
            mental health disorder, is a danger to others, or him or  
            herself, or gravely disabled. 


          6)Prohibits a probable cause determination from considering the  
            availability of beds or services at designated facilities  
            within or outside of the county.


          7)Specifies that the period of 72-hour detention for evaluation  
            and treatment begins at the time that the person is initially  
            detained.


          8)Requires that when an individual is detained and taken to a  
            designated facility for evaluation and treatment, the  
            individual shall be assessed to determine whether he or she  
            can be properly served without being detained. 


          9)Requires a person to be provided evaluation, crisis  
            intervention, or other inpatient or outpatient services on a  
            voluntary basis if it is determined that he or she can be  
            served without being detained.


          10)Specifies that if a detained individual is first taken to the  








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            emergency department (ED) of a non-designated hospital, the  
            person should be detained only for the time necessary to  
            ensure the patient is medically stable.


          11)Prohibits mental health personnel from instructing a peace  
            officer or authorized professional employee of an emergency  
            transport provider acting at the direction of a peace officer  
            seeking to transport a person to a designated facility for  
            assessment to take the person to a jail solely because of the  
            unavailability of an acute bed.


          12)Prohibits a peace officer or other authorized professional  
            employee of an emergency transport provider from being  
            detained any longer than the time necessary to complete  
            documentation of the factual basis of the detention for  
            evaluation and safely complete the transfer of physical  
            custody of the person.


          13)Requires a peace officer, or an authorized professional who  
            takes a person into custody, to complete and sign an  
            application for detention for evaluation and treatment,  
            stating the circumstances under which the person's condition  
            was called to the attention of the peace officer or authorized  
            professional, and stating that the peace officer or authorized  
            professional has probable cause to believe that the person is,  
            as a result of a mental health disorder, a danger to others,  
            or to himself or herself, or gravely disabled.


          14)Requires the presentation of the application to a designated  
            facility or nondesignated hospital as a condition of  
            continuation of the detention for evaluation and treatment; if  
            the application is not presented to the designated facility or  
            nondesignated hospital, as applicable, the person must be  
            immediately released from detention for evaluation and  
            treatment.








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          15)Requires that, in the case that a person detained by a peace  
            officer or authorized professional is in a location other than  
            a designated facility or nondesignated hospital, the original  
            or copy of the application for detention for evaluation and  
            treatment be presented to the designated facility where the  
            individual is transported.


          16)Allows a treating emergency professional to initiate a  
            follow-up probable cause determination if the emergency  
            professional determines that there is no longer probable cause  
            to continue the detention for evaluation and treatment.


          17)Requires that the determination to release a person from  
            detention for evaluation and treatment be based solely on  
            whether there is probable cause to continue the detention for  
            evaluation and treatment. 


          18)Prohibits the determination to continue the detention or to  
            release the person from detention from being based on the  
            availability of beds or services at designated facilities  
            within or outside of the county, or on anything other than  
            whether there is probable cause for detention.


          19)Requires each county to establish disposition procedures and  
            guidelines with local law enforcement agencies for the safe  
            and orderly transfer of persons detained for evaluation and  
            treatment by a peace officer.  


          20)Requires the determination of probable cause to detain a  
            person for evaluation and treatment to be independent of a  
            determination as to whether the person has a psychiatric  
            emergency medical condition requiring emergency services and  








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            care.


          21)Prohibits a determination of probable cause to detain a  
            person for evaluation and treatment by a peace officer or an  
            authorized professional from being deemed a psychiatric  
            emergency medical condition unless a health care professional  
            has determined that the person has a psychiatric emergency  
            medical condition.


          22)Prohibits a determination by a treating emergency  
            professional or a psychiatric professional that an individual  
            has a psychiatric emergency medical condition from being the  
            only reason to establish probable cause and therefore consider  
            an individual eligible to be detained for evaluation and  
            treatment.


          23)Prohibits a determination by a treating emergency  
            professional or a psychiatric professional that a person  
            detained for evaluation and treatment does not have a  
            psychiatric emergency medical condition, or that the person's  
            psychiatric emergency medical condition is stabilized, from  
            being the only reason a person is eligible for release from  
            detention for evaluation and treatment.  


          24)Provides qualified immunity to a designated facility or  
            nondesignated hospital or a physician, employee, or other  
            staff person from civil or criminal liability for any injury  
            resulting from evaluation or providing services with care, as  
            specified. 


          25)Provides qualified immunity to a nondesignated hospital and  
            the professional staff of the nondesignated hospital from  
            civil or criminal liability for the transfer of a person  
            detained for evaluation and treatment to a designated  








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            facility.


          26)Provides qualified immunity to an emergency transport  
            provider from civil or criminal liability for the continuation  
            of the detention for evaluation and treatment while  
            transporting the person to a designated facility at the  
            direction of a peace officer who detained the person for  
            evaluation and treatment, as specified. 


          27)Provides qualified immunity to a peace officer or authorized  
            professional responsible for the detention of the person who  
            transfers the custody of the person from civil or criminal  
            liability for the continuation of detention during the  
            person's stay in the ED prior to the discharge of the person  
            from the hospital or the release of the person from detention.


          28)Provides qualified immunity to the professional person in  
            charge of the facility providing intensive treatment, the  
            medical director of the facility, the psychiatrist directly  
            responsible for the person's treatment, or the psychologist  
            from civil or criminal liability for any action by a person  
            prematurely released from detention. 


          29)Provides qualified immunity to the attorney or advocate  
            representing the person, the court-appointed commissioner or  
            referee, the certification review hearing officer conducting  
            the certification review hearing, and the peace officer  
            responsible for detaining the person from civil or criminal  
            liability for any action by a person released at or before the  
            end of 30 days pursuant to this article.


          30)Provides qualified immunity to a provider of ambulance  
            services licensed by the Department of the California Highway  
            Patrol or operated by a public safety agency, to transport a  








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            person who is in a hospital or facility on a voluntary basis  
            to a designated facility for psychiatric treatment. 


          31)Prohibits a person from being detained for evaluation and  
            treatment solely for the purpose of transporting the person,  
            or transferring the person by a provider of ambulance  
            services, to a designated facility or an ED of a nondesignated  
            hospital.


          32)Prohibits an individual from being subject to detention for  
            the purpose of authorizing or providing evaluation, treatment,  
            or admission to a facility, or as a condition for providing or  
            paying for medical services, care, or treatment, unless there  
            is probable cause to detain the person for evaluation and  
            treatment and the person cannot be properly served on a  
            voluntary basis.


          EXISTING LAW:  


          1)Declares the intent of the Legislature to end the  
            inappropriate, indefinite, and involuntary commitment of  
            persons with mental health disorders, developmental  
            disabilities, and chronic alcoholism, and to eliminate legal  
            disabilities.  (Welfare and Institutions Code Section 5100.   
            All further statutory references are to the California Welfare  
            and Institutions Code, unless otherwise indicated.)


          2)Authorizes a peace officer, member of the attending staff of  
            an evaluation facility designated by the county for evaluation  
            and treatment ("designated facility"), member of the attending  
            staff, as defined by regulation, of a facility designated by  
            the county for evaluation and treatment, or other professional  
            person designated by the county, upon probable cause, to take  
            a person with a mental disorder who is a danger to himself or  








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            others, or who is gravely disabled, into custody and place him  
            in a facility designated by the county.  (Section 5150(a).)


          3)Requires facilities, for the purposes of a 72-hour treatment  
            and evaluation, to be designated by the county for evaluation  
            and treatment and approved by the State Department of Health  
            Care Services.  (Section 5150(a).)


          4)Requires that a person who is taken into custody for a 72-hour  
            treatment and evaluation be provided an oral advisement that  
            informs the person of: 


             a)   The name of the officer or mental health professional  
               authorizing custody;
             b)   The fact that the person is not under criminal arrest,  
               but under a mental health examination;
             c)   Where the evaluation will take place;
             d)   That he or she may take a few personal items; and
             e)   That he or she may make a phone call or leave a note to  
               inform family and friends where he or she has been taken.   
               (Section 5157.)


          1)Requires that a person who is admitted for a 72-hour  
            evaluation and treatment be provided with the following  
            information in writing:


             a)   That he or she is being placed in the psychiatric unit  
               because he or she may hurt himself or herself, or others,  
               or be unable to take care of himself or herself, as  
               specified;
             b)   A listing of the facts upon which the above allegation  
               is based; 
             c)   That he or she will be held for a period of up to 72  
               hours, and when that period will begin;








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             d)   That he or she may be held for a longer period of time;  
               and
             e)   His or her right to a lawyer, as specified.  (Section  
               5157.)


          2)Authorizes the county mental health director to develop  
            procedures for the county's designation and training of  
            professionals who would perform LPS Act functions including:


             a)   License types, practice disciplines, and clinical  
               experience of professionals;
             b)   Initial and ongoing training and testing requirements  
               for professionals;
             c)   The application and approval processes for professionals  
               seeking to be designated by the county, including the  
               timeframe for initial designation and procedures for  
               renewal of the designation; and
             d)   The county's process for monitoring and reviewing these  
               professionals to ensure appropriate compliance with state  
               law, regulations, and county procedures.  (Section 5121.)


          1)Provides immunity to public agencies (which includes public  
            hospitals) and their employees for the involuntary detention  
            of persons, including the enforcement and release of  
            detainment to the extent that the facility or employee acts in  
            accordance with requirements of LPS in detaining a person, and  
            enforcing or releasing the detention.  (Government Code  
            Section 856.)  




          FISCAL EFFECT:  As currently in print this bill is keyed fiscal.
          COMMENTS:  The Lanterman-Petris-Short (LPS) Act was enacted in  
          the 1960s to develop a statutory process under which individuals  
          could be involuntarily held and treated in a mental health  








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          facility in a manner that safeguarded their constitutional  
          rights.  The LPS Act was intended to balance the goals of  
          maintaining the constitutional right to personal liberty and  
          choice in mental health treatment, with the goal of safety when  
          an individual may be a danger to oneself or others, or is  
          gravely disabled.


          At the time of its enactment, the LPS Act was considered  
          progressive because it afforded the mentally disordered more  
          legal rights than most other states.  Since its passage in 1967  
          the law in the field of mental health has continues to evolve  
          toward even greater legal rights for mentally disordered  
          persons.  


          Need for the bill.  Co-sponsor of the bill, the California  
          Chapter of the American College of Emergency Physicians, state  
          in support of the bill that district hospitals see the results  
          of the variance in application of the LPS Act across the state -  
          which results in individuals with mental illness languishing for  
          hours, days and weeks awaiting psychiatric assessment and  
          treatment in their hospitals.  Supporters note that this measure  
          increases the emphasis on the prompt provision of services in  
          both LPS-designated and non-LPS designated facilities.  


          The California Medical Association adds in support that the  
          current system is failing psychiatric patients by forcing them  
          through a fragmented medical delivery system that is inefficient  
          and wastes valuable ED resources.  No one benefits when a  
          patient waits for days in an ED waiting for treatment.  This  
          bill will remedy this situation, resulting in benefits to  
          patients in need of psychiatric treatment and to our state's  
          EDs.


          Commencement of the 72-hour clock start for detention.  This  
          bill indicates that that the period of 72-hour detention for  








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          evaluation and treatment shall begin at the time that the person  
          is initially detained.  While it is possible that the person may  
          not receive a full 72 hours of medical care because some of that  
          time will be taken up between the time when the person is taken  
          into custody by a peace officer or other authorized individual  
          and the time when the person is actually treated, it would be  
          inappropriate to not start the clock until the person is  
          assessed at a treatment facility.  Balancing the desire to  
          ensure the most appropriate care for individuals, while  
          protecting their civil liberties, it seems appropriate to start  
          the clock when the individual is taken into the custody of a  
                                             peace officer.  This method of calculating the total time  
          allowed for the person's detention also incentivizes timely  
          transport of the person to the treatment facility.  It is also  
          consistent with the Legislature's intent to "provide prompt  
          evaluation and treatment of persons with mental health  
          disorders."  (Section 5001(b).)


          Qualified immunity provisions are logical and consistent with  
          other California statutes.  Explaining the need for qualified  
          immunity for medical professionals working in or with  
          non-designated hospitals, the bill's co-sponsor, the California  
          Hospital Association, writes:


               The purpose of the immunity statutes is to protect the  
               discretionary nature of the evaluation so that the  
               professionals can be guided by their medical judgment and  
               not the fear of liability.  To do so, the statute must  
               protect those who decide to involuntarily commit a patient  
               as well as those who decide not to involuntarily commit a  
               patient and to release an individual.


               Recognizing that psychiatry is not an exact science, the  
               United States Supreme Court has recognized that "the  
               subtleties and nuances of psychiatric diagnoses render  
               certainties virtually beyond reach in most situations."   








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               Unlike other health care providers, whose diagnoses can be  
               verified at the outset by a CAT scan, MRI, x-ray, blood  
               tests, palpation and surgery, psychiatric and mental health  
               professionals cannot verify their diagnoses, treatment or  
               discretionary judgment, except through hindsight.


          Co-sponsor, the California Chapter of the American College of  
          Emergency Physicians (California ACEP), adds:


               When enacted, the LPS Act granted immunity to psychiatrists  
               in designated facilities.  Extending the qualified immunity  
               to emergency physicians modernizes the Act, given that most  
               patients with mental health conditions are now receiving  
               care in emergency departments in non-designated facilities.


          Like so many other state approaches, this bill immunizes certain  
          hospital personnel who provide services in conjunction with the  
          detention process pursuant to Section 5150 et seq. from  
          negligent actions when seeking to assist others in peril, but it  
          logically does not immunize actions that are grossly negligent  
          or outright reckless.  This balanced approach, which encourages  
          assistance to individuals in crisis by shielding staff on the  
          Section 5150 response team from liability for ordinary  
          negligence, but not from either gross negligence, or willful or  
          wanton conduct, is reflective of the approach taken by many  
          other statutes in state law.  For example, a Good Samaritan who  
          pulls an accident victim from an automobile is shielded from  
          liability for inadvertently, but negligently causing physical  
          injury to the injured person.  (Health and Safety Code, Section  
          1799.102(b)(2).)  On the other hand, if that person then  
          attempted to choke or strike the injured person, the Good  
          Samaritan would not be completely free from potential  
          responsibility for the harm he or she caused.  


          The "gross negligence or willful and wanton conduct" proviso in  








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          the bill also appears to be completely consistent with other  
          existing California statutes that grant qualified immunity to  
          various professionals who render emergency care voluntarily,  
          without expectation of compensation, and outside of the scope of  
          their employment.  (See, e.g., Bus. & Prof. Code sections 2727.5  
          and 2861.5 [emergency care rendered by nurses outside the scope  
          of their employment]; Bus & Prof. Code section 3503.5 [emergency  
          care rendered by physicians' assistants outside the scope of  
          their employment]; Health and Safety Code, Section 1799.102  
          [person who renders emergency medical or nonmedical care at the  
          scene of an emergency].)


          As originally in print, the bill provided virtually complete  
          immunity from liability to hospital and emergency personnel who  
          provide services in conjunction with the detention process  
          pursuant to Section 5150 et seq. at private hospitals.  With the  
          addition of language that is standard in other qualified  
          immunity statutes, "Nothing in this section shall exonerate from  
          liability a person described in this section who acted with  
          gross negligence or willful or wanton misconduct," these  
          individuals are immunized from liability for ordinary  
          negligence, but not from either gross negligence, or willful or  
          wanton conduct.


          Regarding the bill's original immunity provisions, the Consumer  
          Attorneys of California wrote: 


               While we support the goal of consistent statewide  
               practices, we must oppose the broad immunity provisions as  
               they undermine public safety.


               AB 1300 provides immunity for the transportation and  
               elopement of detained individuals. The National Institute  
               for Elopement Prevention defines elopement as follows,  
               "When a patient or resident who is cognitively, physically,  








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               mentally, emotionally, and/or chemically impaired; wanders  
               away, walks away, runs away, escapes, or otherwise leaves a  
               caregiving facility or environment unsupervised, unnoticed,  
               and/or prior to their scheduled discharge."   Facilities  
               who care for these detained, high risk individuals must  
               take the appropriate precautions to prevent this from  
               occurring.  These facilities should not be immune from  
               negligent, gross negligent or even intentional acts that  
               can place detained mentally ill individuals in danger.


               Once you take someone's liberty, even for good cause, you  
               must be required to provide reasonable care for their  
               safety.


          NAMI California expressed similar concerns with the immunity  
          provisions, stating that, "By removing liability from hospitals,  
          an individual, or family of an individual, harmed by the actions  
          of a facility will have no recourse, and significant incentives  
          to provide quality care to patients experiencing psychiatric  
          crises are removed." 




          These concerns should be significantly mitigated by the author's  
          agreement to limit the immunity provisions in the bill.  


          Because the intent of the bill is to provide qualified immunity  
          to certain hospital and emergency personnel who provide certain  
          services in conjunction with Section 5150 detention process at  
          private hospitals and it is intent of the Legislature to  
          "provide prompt evaluation and treatment of persons with mental  
          health disorders" (Section 5001(b)) and to "encourage the full  
          use of all existing agencies, professional personnel, and public  
          funds to accomplish these objectives and to prevent duplication  
          of services and unnecessary expenditures" (Section 5001 (f)), it  








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          is appropriate to provide these individuals with qualified  
          immunity from liability.  
          Prior similar legislation.  SB 364 (Steinberg), Chapter 567,  
          Statutes of 2013 - revised the law related to 72-hour treatment  
          and evaluation for individuals with a mental health disorder by  
          adding to the types of facilities that a county is allowed to  
          designate to provide services and allowing county mental health  
          directors to develop procedures for the designation and training  
          of professionals who can perform functions of detention,  
          evaluation, and treatment of persons subject to Section 5150.  


          AB 110 (Blumenfield), Chapter 20, Statutes of 2013 - enacted the  
          2013-14 Budget Act, which includes, among its other provisions,  
          $206 million ($142 million General Fund one-time) for a major  
          investment in mental health services, including additional  
          residential treatment capacity, crisis treatment teams, and  
          triage personnel. 


          SB 585 (Steinberg), Chapter 288, Statutes of 2013 - clarified  
          that Mental Health Services Act funds and various County  
          Realignment accounts may be used to provide mental health  
          services under the Assisted Outpatient Treatment Demonstration  
          Project Act of 2002, or Laura's Law, and allows counties to opt  
          to implement Laura's Law through the county budget process.


          SB 1381 (Pavley), Chapter 457, Statutes of 2012 - deleted in  
          state law references to "mental retardation" or a "mentally  
          retarded person" and instead replaces them with "intellectual  
          disability" or "a person with an intellectual disability."


          SB 665 (Petris), Chapter 681, Statutes of 1991 - established the  
          right, under the LPS Act, to refuse antipsychotic medication and  
          establishes hearing procedures to determine a person's capacity  
          to refuse treatment with antipsychotic medication.









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          AB 2541 (Bronzan and Mojonnier), Chapter 1286, Statutes of 1985  
          - authorized county mental health programs to initiate services  
          to various target populations, requires various studies and  
          planning activities, and prohibits mental health personnel from  
          instructing law enforcement personnel to take individuals  
          detained for mental health evaluations to jail solely due to the  
          unavailability of a mental health facility bed.


          AB 1424 (Thomson), Chapter 506, Statutes of 2001- made various  
          changes to the LPS Act to:  increase the involvement of family  
          members in commitment hearings for the mentally ill; require  
          more use of a patient's medical and psychiatric records in these  
          hearings; and prohibit health plans and insurers from using the  
          commitment status of a mentally ill person to determine  
          eligibility for claim reimbursement.


          SB 677 (Lanterman, Petris, and Short), Chapter 1667, Statutes of  
          1967 - enacted the LPS Act, which governs involuntary civil  
          commitment for individuals with mental illness, with the intent  
          to end inappropriate, indefinite, and involuntary commitment and  
          provide for prompt evaluation and treatment.


          








          REGISTERED SUPPORT / OPPOSITION:











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          Support


          California Hospital Association (co-sponsor)


          California Chapter of the American College of Emergency  
          Physicians (co-sponsor)


          California Emergency Nurses Association (co-sponsor)


          Alameda Health System


          Antelope Valley Hospital


          Association of California Healthcare Districts


          Aurora Vista del Mar Hospital


          California Medical Association


          Citrus Valley Health Partners


          Cottage Health System


          Dignity Health


          District Hospital Association








                                                                    AB 1300


                                                                    Page  20







          El Camino Hospital


          Emergency Nurses Association


          Fremont Hospital


          Good Samaritan Hospital - Bakersfield


          Good Samaritan Hospital, San Jose


          Henry Mayo Newhall Hospital


          John Muir Health


          Long Beach Memorial Hospital


          Mad River Community Hospital


          Madera Community Hospital


          Mammoth Hospital


          Miller Children's & Women's Hospital Long Beach


          Mission Community Hospital








                                                                    AB 1300


                                                                    Page  21







          O'Connor Hospital Parkview Community Hospital Medical Center


          Pomona Valley Hospital


          Redlands Community Hospital


          Ridgecrest Regional Hospital


          Saint Louise Regional Hospital


          San Gorgonio Memorial Hospital


          Sharp HealthCare


          Sierra View Medical Center


          Southwest Healthcare System


          Stanford Health Care


          White Memorial Medical Center




          Opposition









                                                                    AB 1300


                                                                    Page  22






          Consumer Attorneys of California


          NAMI California (Oppose unless amended)


          Concerns


          California State Association of Counties


          County Behavioral Health Directors Association




          Analysis Prepared by:Alison Merrilees / JUD. / (916) 319-2334