BILL ANALYSIS �
AB 1725
Page 1
Date of Hearing: May 14, 2014
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
AB 1725 (Maienschein) - As Amended: April 30, 2014
Policy Committee: HealthVote:16-0
Judiciary Vote: 9-1
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill allows a probate court to recommend a
Lanterman-Petris-Short (LPS) conservatorship for an individual
for whom a conservatorship has been established under the
Probate Code, subject to a hearing attended by the proposed
conservatee or the proposed conservatee's counsel, as specified.
It also requires the officer providing conservatorship
investigation to file a copy of his or her report with the court
making the recommendation in the probate conservatorship within
30 days of the recommendation.
FISCAL EFFECT
1)Potential state-reimbursable mandate costs, in excess of
$500,000 annually, as this bill would likely compel a greater
number of conservatorship investigations and reports.
2)In addition, counties could incur significant costs in the
range of $5 million statewide associated with a larger number
of conservatees. These costs are not likely to be
reimbursable.
COMMENTS
1)Purpose . According to the author, many seriously mentally ill
persons who might benefit from an LPS conservatorship cannot
obtain it because their condition does not rise to the level
of creating a "danger to themselves or others," as is required
to trigger the "5150" and the eventual LPS process. This
bill, therefore, would create an additional means by which an
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LPS conservatorship may be recommended to the county
conservatorship investigator.
2)Background . California has two types of conservatorships.
Probate conservatorships - established under the Probate Code
- are established for adults who cannot adequately care for
basic personal needs. Most probate conservatee are elderly
persons, but can also include younger adults with severe
developmental disabilities. Conservatorships established
under the Lanterman-Petris-Short (LPS) Act, on the other hand,
are for persons who are gravely disabled by mental illness or
who pose a threat to themselves or others. LPS
conservatorships are created when a psychiatric facility in
which the prospective conservatee is held makes a
recommendation to the county conservatorship investigator, who
in turn may petition a superior court for the conservatorship.
A probate conservatorship does not allow the conservator to
compel medical treatment on behalf of the conservatee if the
conservatee refuses. The LPS conservator, on the other hand,
may, if the court order so provides, compel psychiatric
treatment and placement in a locked facility for a conservatee
who is unwilling to accept voluntary treatment.
Individuals can only enter an LPS conservatorship through a
the "5150 hold" process, specified in Welfare and Institutions
Code 5150, whereby an officer or clinician may involuntarily
detain a person suspected to have a mental disorder that makes
him or her a danger to self, a danger to others, and/or is
gravely disabled. An individual enters into an LPS
conservatorship via an initial 72-hour 5150 hold for
assessment, evaluation, and crisis intervention, which is then
extended for a period of 14 or 30 days. After this period, if
warranted, an authorized individual may recommend that the
county conservatorship investigator petition the superior
court for a year-long LPS conservatorship. This bill would
bypass the requirement for a 5150 hold and associated
statutory protections by allowing a probate court to directly
recommend an LPS conservatorship to the county conservatorship
investigator.
It is important to note this bill does not permit the court to
establish an LPS conservatorship on its own motion; rather,
this bill permits the court to make a recommendation, based on
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medical evidence, to the county conservatorship investigator.
It would still be up to the investigator, if he or she concurs
with the court, to act on that recommendation and petition a
superior court for an LPS conservatorship.
3)Opposition . The California State Association of Counties
(CSAC) and the California Mental Health Directors Association
(CMHDA), and the California State Association of Public
Administrators, Public Guardians, and Public Conservators
(Public Conservators) oppose this bill, citing workload and
cost burdens on an overburdened public guardian system, as
well as policy concerns with allowing a judge who likely lacks
mental health training to order an LPS investigation. The
Public Conservators believe the probate court authority to
compel investigations will be used liberally and lead to many
more unnecessary and inappropriate investigations. CSAC notes
that under existing law that a county conservatorship
investigation must be based a recommendation from a medical or
psychological professional.
4)Prior Legislation .
a) SB 364 (Steinberg), Chapter 567, Statutes of 2013,
broadens the types of facilities that can be used for
purposes of a 72-hour treatment and evaluation under the
LPS Act and permits county mental health directors to
develop procedures for the designation and training of
professionals that carry out functions related to 72-hour
holds.
b) AB 2266 (Waldron) would increase the maximum period of
imposed treatment under Laura's Law from six months to one
year and allows professional staff of 72-hour and 14-day
treatment facilities to request that an individual be
subject to Laura's Law treatment. This bill failed passage
in the Assembly Judiciary Committee but was granted
reconsideration.
1)Staff Comment . The current pathway to an LPS conservatorship
is narrow. The provisions governing "5150 holds" are rigorous
and well-established: a person must be judged gravely disabled
or a danger to self or others. Then, after a 5150 hold is
established, a mental health professional must recommend an
LPS conservatorship. A 5150 hold, as well as an LPS
conservatorship, may require an individual to be confined to a
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locked facility and compel an individual to be medicated
against their will.
Allowing a judge, who often will lack formal mental health
training, to recommend a mental health conservatorship
significantly lowers the bar for such a recommendation, given
that it sidesteps the requirement that a person is initially
judged gravely disabled or a danger to self or others, as well
as the requirement that a recommendation be made by a mental
health professional. This will likely lead to additional
costs to county systems, some of which reportedly have
difficulty meeting current county needs at current resource
levels, and may subject more people who may never have met the
current criteria to involuntary detention and treatment.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081