BILL ANALYSIS �
AB 2134
Page 1
ASSEMBLY THIRD READING
AB 2134 (Chesbro)
As Amended May 3, 2012
Majority vote
HEALTH 12-5
-----------------------------------------------------------------
|Ayes:|Monning, Ammiano, Atkins, | | |
| |Bonilla, Eng, Gordon, | | |
| |Hayashi, | | |
| |Bonnie Lowenthal, | | |
| |Mitchell, | | |
| |V. Manuel P�rez, Smyth, | | |
| |Williams | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Logue, Garrick, Mansoor, | | |
| |Nestande, Silva | | |
| | | | |
-----------------------------------------------------------------
SUMMARY : Requires a county that elects to implement a
court-ordered assisted outpatient treatment (AOT) program for
mentally ill persons, pursuant to current law, to develop best
practices and provide services for mental health crisis response,
including, but not limited to, utilization of crisis intervention
teams, mobile crisis teams, or psychiatric emergency response
teams. Exempts a county providing AOT services as of January 1,
2012, from the requirements of this bill.
EXISTING LAW :
1)Establishes, pursuant to AB 1421 (Thomson), Chapter 1017,
Statutes of 2002, the AOT Demonstration Project Act of 2002
(Act) to permit counties to provide AOT services for people
with serious mental illnesses when a court finds that a
person's recent history of hospitalizations or violent
behavior, and noncompliance with voluntary treatment, indicates
the person is likely to become dangerous or gravely disabled
without the court-ordered outpatient treatment.
2)Requires a county that chooses to provide AOT services pursuant
to the Act to do so by a resolution of the county Board of
Supervisors that authorizes implementation and makes a finding
that no voluntary mental health program serving adults, and no
AB 2134
Page 2
children's mental health program, may be reduced as a result of
implementation.
3)Requires a participating county that provides AOT services
pursuant to the Act to also offer the same services on a
voluntary basis.
4)Sunsets the Act on January 1, 2013, and requires the Department
of Mental Health to submit a report and evaluation to the
Legislature of all counties implementing an AOT program by July
31, 2011.
FISCAL EFFECT : None
COMMENTS : The author asserts that, as counties face increasing
pressure to implement AB 1421 from newspaper editorials across
the state and self-appointed entities, such as the
Lanterman-Petris-Short Reform Task Force, it is critical to
require counties to have appropriate best practices in place for
psychiatric crisis response as a condition of implementation.
The author states that a county that chooses to pursue
implementation of a court-ordered involuntary treatment program
should have policies and best practices, similar to crisis
intervention teams, mobile crisis teams, or psychiatric emergency
response teams, in place beforehand in order to appropriately
respond to a mentally ill person in crisis. The author maintains
that if a county that is considering an AOT program has first
responders experienced in cultural competency, peer support, and
other important de-escalation techniques to diffuse dangerous and
difficult situations and provide mental health clients and
consumers who are in crisis with dignity and compassion, then it
will not need to take, what the author contends, is a drastic and
unnecessary step of implementing a forced involuntary treatment
program.
AB 1421 is also known as Laura's Law, in memory of Laura Wilcox,
a 19-year-old college student who was killed by a severely
mentally ill man who was not adhering to prescribed mental health
treatment. Laura's Law provides counties with the option to
implement intensive AOT programs for individuals who have
difficulty maintaining their mental health stability in the
community and have frequent hospitalizations and contact with law
enforcement related to untreated or undertreated mental illness.
AB 2134
Page 3
Generally, mental health crisis response teams are composed of
mental health practitioners, law enforcement officers, social
services personnel, and other professionals who can effectively
and appropriately intervene in a mental health crisis. These
professionals can meet face-to-face with the person in crisis at
home, school, work, or wherever a crisis occurs, to assess and
de-escalate the situation. Additional services can include
stabilization for a certain period of time, rapid access to
psychiatrists, health care navigators, mental health crisis beds,
and referrals to community mental health providers. Teams can
also contact emergency services when necessary. Additionally,
teams can provide longer-term support by helping loved ones and
caregivers develop "crisis plans" to better prepare for future
crises.
According to the California Mental Health Directors Association
(CMHDA), which represents county mental health departments, all
counties in California are required to have 24/7 access lines and
to respond to crises and psychiatric emergencies, regardless of
whether they are considering adopting an AOT program. However,
CMHDA notes that not all counties have mobile support teams and
some, but not all, provide training to law enforcement on crisis
intervention with individuals with mental illness.
The California Psychological Association (CPA) writes in support
that this bill strikes a fair balance between providing mental
health services, protecting the public, and ordering people into
treatment, when necessary. CPA adds that this bill is sensitive
to the civil rights and efficacy of court-ordered treatment and
seeks to ensure counties establish a wide variety of voluntary
services, including crisis response teams, to offer to
individuals before they decompensate and become a danger to
themselves or others. Disability Rights California supports this
bill as a positive first step to protect client rights.
The California Psychiatric Association objects to this bill,
stating that there is no policy reason to bring this bill forward
because there is no identified problem that it would solve in
relation to AB 1421. The California Medical Association adds in
opposition that all counties have suffered funding cuts to their
mental health budgets in recent years and this bill would place
another impediment in the way of counties that have expressed
interest in implementing an AOT program.
Analysis Prepared by : Cassie Royce / HEALTH / (916) 319-2097
AB 2134
Page 4
FN:
0003526