BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 1534
                                                                  Page  1

          SENATE THIRD READING
          SB 1534 (Perata)
          As Amended August 29, 2000
          Majority vote 

           SENATE VOTE  :24-15  
           
           JUDICIARY           10-5        HEALTH              8-5         
           
           ----------------------------------------------------------------- 
          |Ayes:|Kuehl, Aroner, Bock,      |Ayes:|Gallegos, Corbett,        |
          |     |Corbett, Jackson, Knox,   |     |Firebaugh, Kuehl,         |
          |     |Longville, Shelley,       |     |Vincent, Wayne, Wesson,   |
          |     |Steinberg, Wiggins        |     |Wildman                   |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Ackerman, Bates, House,   |Nays:|Bates, Aanestad, Cox,     |
          |     |McClintock, Robert        |     |Runner, Zettel            |
          |     |Pacheco                   |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           APPROPRIATIONS      14-6                                        
           
           ----------------------------------------------------------------- 
          |Ayes:|Migden, Alquist, Aroner,  |     |                          |
          |     |Cedillo, Corbett, Davis,  |     |                          |
          |     |Kuehl, Papan, Romero,     |     |                          |
          |     |Shelley, Thomson, Wesson, |     |                          |
          |     |Wiggins, Wright           |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Campbell, Ackerman,       |     |                          |
          |     |Ashburn, Brewer,          |     |                          |
          |     |Maldonado, Zettel         |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 

           SUMMARY  :  Specifies the duties and responsibilities of patients'  
          rights advocates (PRAs) 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 the services of a  








                                                                  SB 1534
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            PRA.

          2)Adds mental health clients to the list of persons who can  
            bring an enforcement action for rights violations.

          3)Specifies that the duties of county PRAs include:

             a)   Providing representation in certification review  
               hearings, capacity hearings, and hearings pertaining to the  
               commitment of minors to public hospitals, unless such  
               representation is already provided;

             b)   Providing assistance to minors in clinical review  
               proceedings;

             c)   Assisting recipients of public mental health services  
               with grievances; and,

             d)   Providing outreach to recipients of mental health  
               services to ensure that they are aware of their rights. 

          4)Specifies that PRAs have access to mental health clients in  
            community care facilities. If a PRA conducting monitoring  
            wishes to interview a patient or resident, the advocate must  
            contact a representative of the facility and the treating  
            provider before conducting the interview.

          5)Clarifies the authority of PRAs to refer complaints to any  
            appropriate state or local government agency, and requires any  
            licensing agency that responds to a complaint referred by an  
            advocate to prepare an annual report to the Legislature, as  
            specified.

          6)Requires a county mental health director to respond to  
            complaints about any PRA.

          7)Prohibits retaliation against advocates for the performance of  
            their duties and prohibits discrimination and retaliation  
            against a resident of a community care facility who complains.  
                

          8)Imposes additional training standards upon patients' rights  
            advocates.

           EXISTING LAW  requires each local mental health director to  








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          appoint or contract for one or more county PRAs.   Requires the  
          duties of these advocates to include:

          1)Investigating complaints concerning recipients of mental  
            health services in health facilities regarding abuse or  
            withholding of their rights;

          2)Monitoring mental health facilities for compliance with  
            statutory and regulatory patients' rights provisions;

          3)Providing training and education about mental health law and  
            patients' right to mental health providers; and,

          4)Ensuring that mental health clients are notified of their  
            rights.
           
          FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee analysis, unknown major state-reimbursable costs, at  
          least $1 million, from expanding PRA scope of responsibilities  
          and requiring additional training.  Costs to Department of  
          Mental Health, about $500,000 General Fund, to collect and  
          publish specified data on complaints.

           COMMENTS  :   

          1)According to the author, the intent of this bill is to clarify  
            the rights and responsibilities of mental health advocates to  
            foster uniformity in the delivery of patient advocacy  
            services, and to facilitate responses to concerns forwarded by  
            advocates to state licensing entities. 

          2)The California Association of Mental Health Patients' Rights  
            Advocates (CAMHPRA) supports this bill to extend the basic  
            patients' rights protections currently afforded to patients in  
            mental health facilities to include persons with psychiatric  
            disabilities in community care facilities.  Protection and  
            Advocacy, Incorporated (PAI) also believes this bill will  
            greatly improve mental health services in California by  
            improving the ability of patients' rights advocates to  
            advocate on behalf of their clients.

          3)A coalition comprised of the California Alliance of Child and  
            Family Services, California Association of Health Facilities,  
            California Healthcare Association, California Mental Health  
            Directors Association, and the California Psychiatric  








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            Association (the Coalition), submitted a joint letter opposing  
            this bill unless it is amended. The Coalition argues that  
            expansion of the patients' rights advocates' duties, without  
            additional oversight, will actually lead to services being  
            delivered in an inconsistent manner.


           Analysis Prepared by  :  Ann Blackwood / HEALTH / (916) 319-2097 



                                                                            
                                                                            
                                                                            
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