BILL ANALYSIS Ó
SB 938
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Date of Hearing: August 3, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
SB 938
(Jackson) - As Amended June 29, 2016
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Urgency: No State Mandated Local Program: NoReimbursable: No
SUMMARY: This bill requires additional oversight before
psychotropic medication can be prescribed to a conservatee with
a major neurocognitive disorder (MNCD), generally dementia.
Specifically, this bill:
1)Clarifies a conservator's authority to place a conservatee
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with a MNCD in a secured perimeter residential facility for
the elderly (as opposed to a locked facility), provided it is
the least restrictive placement appropriate for the
conservatee's needs. Deletes the prohibition against
placement of a conservatee in a mental health rehabilitation
center or institution for mental disease, as specified.
2)Requires that before a conservator can authorize the
administration of psychotropic medication to a conservatee, a
court must make certain specified findings, already in
existing law, by clear and convincing evidence. Requires that
the physician's supporting declaration, required for the
conservator's petition requesting authority to administer
psychotropic medication in existing law, must contain
additional information, as specified.
3)Provides that, if a court has granted a conservator the power
to administer psychotropic medication to a conservatee, the
conservator may, consistent with the authority granted by the
court, change or adjust the psychotropic medications without
further notice or approval by the court, provided the
conservator has received information about the risks, benefits
and alternatives before making the change.
4)Provides that, if a court has granted a conservator the power
to administer psychotropic medication, the court must review
the authority when periodically reviewing the conservatorship
as required by law.
5)Requires, on or before July 1, 2017, the Judicial Council to
adopt rules of court and develop appropriate forms for the
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implementation of this bill.
6)Provides that the requirements of this bill do not apply to
conservatees who are prescribed psychotropic medication by a
physician in an acute care hospital or for purposes of
diagnostic or therapeutic treatment not directly related to
the MNCD.
FISCAL EFFECT:
1)Minor one-time costs to the Judicial Council for additional
workload likely in the range of $50,000 to $70,000 (GF) to
adopt rules of court, develop appropriate forms, and provide
the specified guidance on how to evaluate requests for
authorization.
2)Unknown potential increase in court workload (GF) for
additional petitions to the court requesting authorization for
the administration of medications under the category of
"psychotropic medications" for the expanded population of
conservatees with major NCDs.
COMMENTS:
1)Purpose. This bill, sponsored by California Advocates for
Nursing Home Reform (CANHR), seeks to update 20-year old rules
and provide better guidance to courts when determining whether
to authorize a conservator to give psychotropic medication to
a conservatee with dementia. To provide better guidance, the
bill requires additional information to be provided in a
physician declaration filed in support of the conservator's
petition to authorize the administration of psychotropic
medication, and requires Judicial Council to update rules and
forms to better assist with the reporting. The bill also
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revises existing law to reflect the various dementia disorders
that fall under the new, broader diagnostic category of major
neurocognitive disorders and make various conforming changes.
2)Background. If a person is unable to adequately provide for
his or her personal needs or incapable of managing his or her
assets, a probate court can establish a conservatorship.
Because of concerns of mistreatment and misuse of potent
psychotropic medication on those with dementia, the
Legislature created special judicial oversight to protect
conservatees with dementia from being unnecessarily
overmedicated. Psychotropic medications, including
antipsychotics, antidepressants and psychostimulants, alter
chemical levels in the brain which impact mood and behavior.
SB 1481 (Mello), Chapter 910, Statutes of 1996, established
protections to provide, within the scheme of a probate
conservatorship, the authority to place a person with dementia
in a secure facility and to authorize the administration of
dementia medications. This bill seeks to update those
protections.
3)Prior Legislation. SB 238 (Mitchell and Beall), Chapter 534,
Statutes of 2015, among its provisions, revised and enhanced
the existing requirements for court authorization for the
administration of psychotropic medication to minor placed in
foster care.
Analysis Prepared by:Jennifer Swenson / APPR. / (916)
319-2081
SB 938
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