BILL ANALYSIS
AB 1800
Page 1
ASSEMBLY THIRD READING
AB 1800 (Thomson)
As Amended May 26, 2000
Majority vote
HEALTH 10-0 JUDICIARY 10-4
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|Ayes:|Bates, Aanestad, Florez, |Ayes:|Kuehl, Ackerman, Bates, |
| |Cox, Kuehl, Runner, | |House, Jackson, Knox, |
| |Thomson, Wayne, Wesson, | |Longville, |
| |Zettel | |Robert Pacheco, Shelley, |
| | | |Wiggins |
|-----+--------------------------+-----+--------------------------|
| | |Nays:|Aroner, Corbett, |
| | | |McClintock, Steinberg |
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APPROPRIATIONS 21-0
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|Ayes:|Migden, Campbell, | | |
| |Ackerman, Alquist, | | |
| |Aroner, Ashburn, Brewer, | | |
| |Cedillo, Corbett, Davis, | | |
| |Kuehl, Maldonado, Papan, | | |
| |Romero, Runner, Shelley, | | |
| |Thomson, Wesson, Wiggins, | | |
| |Wright, Zettel | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Expands the conditions and the length of time for
which a person may be involuntarily detained and treated for
mental illness. Specifically, this bill :
1)Expands the existing law definition of "gravely disabled,"
from indicating a condition in which a person, as a result of
a mental disorder, is unable to provide for his or needs for
food, clothing or shelter, to mean a person who meets these
criteria or who presents, as a result of a mental disorder, an
acute risk of physical or psychiatric harm to the person in
the absence of treatment.
2)Defines "psychiatric harm" as an exacerbation or escalation of
symptoms or behaviors during the 30 days prior to detention
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that render it more likely than not that the person will be
unable to provide for his or her basic needs or become
dangerous to the patient's self or others.
3)Broadens the existing law definition of available family
support that is necessary to exclude a person from being
considered gravely disabled. Provides that a person is not
gravely disabled if that person can survive safely without
involuntary detention with the help of responsible family,
friends, or others who are both willing and able to help
provide for the person's basic personal needs for food,
clothing or shelter, and who are willing and able to assist
the person in meeting his or her medical and psychiatric
needs.
4)Requires a hearing officer to make a finding of probable cause
that the person certified should be involuntarily detained, to
detain that person for involuntary care, protection and
treatment related to the mental disorder or chronic alcoholism
for which the person is detained.
5)Requires, if a person who is certified for involuntary
treatment refuses psychotropic medication, the certification
hearing officer to determine whether the person lacks the
capacity to make an informed refusal of treatment. Permits
the certified person to be treated with medications without
consent during the certification period.
6)Provides the right to judicial review of the detention and
capacity decisions at the patient's request. Requires that
unless good cause is shown to the contrary, all capacity
hearings shall be heard concurrently with the judicial review
of the patient's detention.
7)Requires, if a person is certified for treatment, the treating
agency or facility to acquire the patient's medication
history.
8)Provides that a person may be certified for another 180 days
of community assisted outpatient treatment following initial
detention following a 72-hour hold.
9)Requires persons committed due to grave disability,
dangerousness, or chronic alcoholism to be placed in community
assisted outpatient treatment programs for 180 days if all of
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the following conditions exist:
a) A hearing officer finds the patient requires continuing
treatment and care under supervised conditions and the
person will benefit from community treatment;
b) The person agrees to community outpatient treatment;
c) The person does not present an immediate harm to self or
others; and,
d) A community treatment plan is prepared by the outpatient
treatment team.
10)Specifies the elements required to be included in a community
assisted outpatient treatment program, including a
multidisciplinary provider team and help to obtain other
assistance.
11)Permits an outpatient to be committed to inpatient treatment
for the remaining days of the certification if the patient
does not or cannot abide by the terms of the outpatient
treatment plan, and the person poses an acute risk of physical
or psychiatric deterioration.
12)Eliminates a requirement that a capacity hearing be conducted
by a superior court judge, a court appointed commissioner or
hearing officer, and requires that those hearings be conducted
only by a hearing officer, as specified.
13)Expands the maximum involuntary detention period from 180
days to one year.
14)Provides that the provisions of this bill, including
community assisted outpatient treatment, are contingent upon
an appropriation in the Budget Act for these purposes.
EXISTING LAW :
1)Expresses, under the Lanterman Petris Short Act (LPS Act),
intent to treat persons with mental disorders, to protect
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public safety, to safeguard individual rights, and to end the
inappropriate involuntary commitment of mentally ill persons.
2)Provides that a person may be held for 72 hours of evaluation
and treatment, upon demonstration of probable cause that the
person, as a result of a mental disorder, is a danger to
others or him/her self, or is gravely disabled. Defines
"gravely disabled" as a condition in which a person, as a
result of a mental disorder, is unable to provide for his or
her basic needs for food, clothing or shelter. Provides that
a person is not gravely disabled if that person can survive
safely with help from others who help provide for the person's
needs for food, clothing or shelter.
3)Permits a person to be certified and detained for 14 days of
intensive treatment if the person is a danger to self/others,
or gravely disabled, and is not willing or able to accept
treatment.
4)Grants a detainee the right to a certification review hearing
to determine whether probable cause exists to continue to
detain the person.
5)Requires a person certified for intensive treatment to be
released after 14 days unless the patient agrees to further
treatment, or is certified for treatment due to dangerousness
to self/others, grave disablement, or conservatorship
proceedings.
6)Provides that a person may be postcertified for up to 180 days
following 14 days of intensive treatment if the person is
dangerous to others, as specified.
FISCAL EFFECT : Implementation subject to Budget Act
appropriation, unknown one-time time costs to the Department of
Mental Health, likely $150,000 to $200,000 General Fund, to
compile data from counties.
COMMENTS : The author wishes to revise involuntary treatment law
to provide intervention for those with a history of mental
illness, to give those persons access to timely treatment. The
author asserts it is past time to provide more effective and
humane treatment and commitment laws. Supporters of this bill
include the California Psychiatric Association (the Psychiatric
Association), and the National Alliance for the Mentally Ill
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(NAMI). The Psychiatric Association argues this bill will save
suffering and expense by consolidating into one hearing the
issues of whether a person meets criteria for involuntary
commitment, and whether the person has the capacity to consent
to medication. The Psychiatric Association notes there have
been cases where a person did not appear to have deteriorated,
was not detained, and then committed murder or suicide. NAMI
hopes this bill will improve prognoses and lower costs.
Organizations opposing this bill include the California Mental
Health Planning Council, the California Network of Mental Health
Clients (Network), the California Psychological Association (the
Psychological Association) and the California Association of
Mental Health Patients' Rights Advocates (CAMHPRA). The
Coalition Advocate for Rights, Empowerment and Services (CARES),
consisting of CAMHPRA, the California Association of Social
Rehabilitation Agencies, the Network and Protection and
Advocacy, issued a joint statement in opposition to this bill.
CARES argues this bill institutes a vague and broad definition
of grave disability that provides for the confinement of
mentally ill persons simply to raise their standards of living,
a purpose courts have rejected as constitutionally inadequate.
The Network argues that more voluntary services, not forced
treatment, is the answer. The Network and the California Mental
Health Directors Association are concerned that subjective
criteria in this bill, coupled with the reduction of due process
rights, will return California to abuse of civil commitment and
violations of civil rights as occurred prior to the LPS Act.
Analysis Prepared by : Ann Blackwood / HEALTH / (916) 319-2097
FN:
0005185