BILL ANALYSIS
SB 1534
Page 1
Date of Hearing: August 23, 2000
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Carole Migden, Chairwoman
SB 1534 (Perata) - As Amended: August 18, 2000
Policy Committee: JudiciaryVote:10-5
Health 8-5
Urgency: No State Mandated Local Program:
Yes Reimbursable: Yes
SUMMARY
This bill expands the responsibilities and authority of
patients' rights advocates and clarifies the rights of mental
health clients. Specifically, this bill:
1)Specifies that people with psychiatric disabilities residing
in specified community care facilities have the same legal and
civil rights guaranteed patients hospitalized in mental health
treatment facilities, including access to a patients' rights
advocate (PRA). Gives PRAs access to mental health clients in
community care facilities.
2)Specifies the duties of county PRAs include:
a) Representing clients in certification review hearings,
capacity hearings, and hearings on committing minors to
public hospitals, unless representation is already
provided.
b) Assisting minors in clinical review proceedings.
c) Assisting recipients of public mental health services
with grievances.
d) Providing outreach to mental health service recipients
to make them aware of their rights.
3)Permits a PRA to inspect and copy confidential client
information and records, without authorization from the client
or guardian ad litem, in the course of investigating a
complaint made by or about a client. Permits copying
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confidential medical information only if individually
identifying information is redacted or the patient consents to
the copying. Denies access to confidential records if a
client objects.
4)Requires the Department of Mental Health (DMH) annually
collect and publish data on patients' rights complaints.
FISCAL EFFECT
1)Unknown major state-reimbursable costs, at least $1 million,
from expanding PRA scope of responsibilities and requiring
additional training.
2)Costs to DMH, about $500,000 GF, to collect and publish
specified data on complaints.
COMMENTS
1)Purpose . This bill is sponsored by the California Association
of Mental Health Patients' Rights Advocates to clarify the
rights and responsibilities of mental health advocates. It
consolidates into one provision, the numerous duties of PRAs.
It specifies that persons with psychiatric disabilities living
in specified community care facilities are also within the
scope of responsibility of PRAs. More importantly, it allows
a PRA to inspect and copy confidential patient records without
the consent of the patient, unless the patient objects.
Confidential medical information must be redacted to eliminate
individually identifying information, unless the patient
specifically consents to their copying.
2)Opposition . The California Mental Health Directors
Association and several organizations of private mental health
providers oppose this bill unless amended to include the
additional resources necessary to expand the PRA duties. They
object to the lack of oversight of PRA activities and
recommends that the county mental health director exercise
additional oversight when an advocate seeks access to medical
records.
Finally, opponents note the current training provided PRAs is
limited and varies from county to county. They recommend a
standardized training program to provide basic knowledge of
services to be provided and instruction on consistent
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application of laws and regulations.
Analysis Prepared by : Joyce Iseri / APPR. / (916) 319-2081