BILL NUMBER: AB 1300 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 23, 2015
AMENDED IN ASSEMBLY APRIL 13, 2015
INTRODUCED BY Assembly Member Ridley-Thomas
FEBRUARY 27, 2015
An act to amend Sections 5001, 5008, 5013, 5150, 5150.05, 5150.1,
5150.2, 5151, 5152.1, 5153, and 5270.50 of, to add Sections 5001.5,
5022, 5023, 5024, 5025, 5026, 5150.25, 5150.3, 5151.1, and
5151.2 to, to add the heading of Article 1.3 (commencing with
Section 5151) to, to add Article 1.1 (commencing with Section
5150.10) to, to add Article 1.2 (commencing with Section 5150.30) to,
Chapter 2 of Part 1 of Division 5 of, to repeal Section 5150.4 of,
and to repeal and add Section 5152.2 of, the Welfare and Institutions
Code, relating to mental health.
LEGISLATIVE COUNSEL'S DIGEST
AB 1300, as amended, Ridley-Thomas. Mental health: involuntary
commitment.
Under existing law, when a person, as a result of mental disorder,
is a danger to others, or to himself or herself, or gravely
disabled, he or she may, upon probable cause, be taken into custody
by a peace officer, member of the attending staff of an evaluation
facility, designated members of a mobile crisis team, or other
designated professional person, and placed in a facility designated
by the county and approved by the State Department of Health Care
Services as a facility for 72-hour treatment and evaluation.
This bill would authorize counties to designate one or more
persons to act as a local or regional liaison to assist a person who
is a patient in an emergency department of a defined nondesignated
hospital and who has been detained, or who may require detention, for
evaluation and treatment, as specified. The bill would reorganize
and make changes to the provisions relating to the detention for
evaluation and treatment of a person who may be subject to the above
provisions, including specifying procedures for delivery of those
individuals to various facilities; evaluation of the person for
probable cause for detention for evaluation and treatment; terms and
length of detention, where appropriate, in various types of
facilities; and criteria for release from defined designated
facilities and nondesignated hospitals. The bill would authorize a
provider of ambulance services to transfer a person who is
voluntarily transferring to a designated facility for evaluation and
treatment. The bill would also make changes to the methods by which
law enforcement is notified of the release of a person detained for
evaluation and treatment.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 5001 of the Welfare and Institutions Code is
amended to read:
5001. The provisions of this part and Part 1.5 (commencing with
Section 5585) shall be construed to promote the legislative intent as
follows:
(a) To end the inappropriate, indefinite, and involuntary
commitment of persons with mental health disorders, developmental
disabilities, and chronic alcoholism, and to eliminate legal
disabilities.
(b) To provide prompt evaluation and treatment of persons with
mental health disorders or impaired by chronic alcoholism.
(c) To guarantee and protect public safety.
(d) To safeguard individual rights through judicial review.
(e) To provide individualized treatment, supervision, and
placement services by a conservatorship program for persons who are
gravely disabled.
(f) To encourage the full use of all existing agencies,
professional personnel, and public funds to accomplish these
objectives and to prevent duplication of services and unnecessary
expenditures.
(g) To protect persons with mental health disorders and
developmental disabilities from criminal acts.
(h) To provide consistent standards for protection of the personal
rights of persons receiving services under this part and under Part
1.5 (commencing with Section 5585).
(i) To provide services in the least restrictive setting
appropriate to the needs of each person receiving services under this
part and under Part 1.5 (commencing with Section 5585).
(j) To ensure that persons receive services from facilities and
providers that are qualified and best suited to provide the services,
and that persons are not detained in settings that are not
therapeutic or not designed to meet their needs.
(k) To affirm that no person may be presumed to be incompetent
because he or she has been evaluated or treated for a mental health
disorder or chronic alcoholism, regardless of whether that evaluation
or treatment was voluntarily or involuntarily received.
SEC. 2. Section 5001.5 is added to the Welfare and Institutions
Code, to read:
5001.5. It is the intent of the Legislature that each county
shall have the responsibility to ensure that all persons with mental
health disorders who are subject to detention under this part or
under Part 1.5 (commencing with Section 5585) receive prompt
evaluation and treatment in accordance with this part and Part 1.5
(commencing with Section 5585), including prompt assessment of the
need for evaluation and treatment. It is the intent of the
Legislature that each county establish and maintain a mental health
service system that has sufficient capacity to ensure the provision
of services under this Part part and
Part 1.5 (commencing with Section 5585), including, at a minimum, the
services required under paragraph (2) of subdivision (a) of Section
5651.
SEC. 3. Section 5008 of the Welfare and Institutions Code is
amended to read:
5008. Unless the context otherwise requires, the following
definitions shall govern the construction of this part:
(a) "Antipsychotic medication" means medication customarily
prescribed for the treatment of symptoms of psychoses and other
severe mental and emotional disorders.
(b) "Application for detention for evaluation and treatment" means
the written application set forth in Section 5150.3.
(c) (1) "Assessment" means the determination, as described in
subdivision (b) of Section 5150 and Section 5151, of the following:
(A) Whether the person meets the criteria for detention for
evaluation and treatment.
(B) Whether the person is in need of evaluation and treatment and,
if so, what services are needed for the person.
(C) Whether the person can be properly served without being
detained, in which case the services shall be provided on a voluntary
basis.
(2) "Assessment" includes, but is not limited to, mental status
determination, analysis of clinical and social history, analysis of
relevant cultural issues and history, diagnosis, and the use of
testing procedures.
(d) "Authorized professional" means any of the following:
(1) A mental health professional or category of mental health
professionals, excluding peace officers, who are authorized in
writing by a county to provide services described in this
subdivision. An authorized professional shall have appropriate
training in mental health disorders and determination of probable
cause, and shall have relevant experience in providing services to
persons with mental health disorders.
(2) An authorized professional as described in paragraph (1) who
is a member of the staff of a designated facility and who is
authorized by the facility to provide services described in this
subdivision.
(3) A member of a mobile crisis team who is authorized in writing
by a county to provide services described in this subdivision.
(e) "Conservatorship investigation" means an investigation, by an
agency appointed or designated by the governing body, of cases in
which conservatorship is recommended pursuant to Chapter 3
(commencing with Section 5350).
(f) "Court," unless otherwise specified, means a court of record.
(g) "Court-ordered evaluation" means an evaluation ordered by a
superior court pursuant to Article 2 (commencing with Section 5200)
or by a superior court pursuant to Article 3 (commencing with Section
5225) of Chapter 2.
(h) "Crisis intervention" consists of an interview or series of
interviews within a brief period of time, conducted by qualified
professionals, and designed to alleviate personal or family
situations which present a serious and imminent threat to the health
or stability of the person or the family. The interview or interviews
may be conducted in the home of the person or family, or on an
inpatient or outpatient basis with such therapy, or other services,
as may be appropriate. The interview or interviews may include family
members, significant support persons, providers, or other entities
or individuals, as appropriate and as authorized by law. Crisis
intervention may, as appropriate, include suicide prevention,
psychiatric, welfare, psychological, legal, or other social services.
(i) "Crisis stabilization service or unit" means an ambulatory
service that provides probable cause determinations and assessments,
collateral services, and therapy within the scope of its designation
under this part.
(j) "Department" means the State Department of Health Care
Services.
(k) (1) "Designated facility" means a facility or a specific unit
or part of a facility that is licensed or certified as a mental
health evaluation facility, a mental health treatment facility, or a
mental health evaluation and treatment facility. A designated
facility may be an inpatient facility or an ambulatory facility.
(2) "Inpatient facility" means a health facility, or an inpatient
unit of a health facility, as defined in Chapter 2 (commencing with
Section 1250) of Division 2 of the Health and Safety Code, that is
licensed by the State of California, has the capability to admit and
treat persons on an inpatient basis subject to the requirements of
this part, and is designated by a county pursuant to Section 5023.
Inpatient facility also includes a hospital or the inpatient unit of
a hospital operated by the United States government that has the
capability to admit and treat persons on an inpatient basis, subject
to the requirements of this part, and that is designated by the
county pursuant to Section 5023. A designated inpatient facility
includes any of the following:
(A) A general acute care hospital, as defined in subdivision (a)
of Section 1250 of the Health and Safety Code.
(B) An acute psychiatric hospital, as defined in subdivision (b)
of Section 1250 of the Health and Safety Code.
(C) A psychiatric health facility, as defined in Section 1250.2 of
the Health and Safety Code.
(D) A correctional treatment center, as defined in Section 1250 of
the Health and Safety Code, operated by a county, city, or city and
county law enforcement agency. The department may approve an
unlicensed correctional treatment center that is in existence as of
January 1, 2016, if the correctional treatment center meets all of
the licensing requirements except those that are structurally
impracticable.
(3) "Ambulatory facility" means a facility designated by a county
under Section 5023 that provides psychiatric services lasting less
than 24 hours in accordance with applicable law and within the scope
of the designation. An ambulatory facility may include an outpatient
hospital department, clinic, crisis stabilization facility or unit,
facility of a medical group, facility of a provider organization
other than a medical group, or other facility that meets the
requirements established by the department in accordance with Section
5023.
(l) "Detained for evaluation and treatment" and "detention for
evaluation and treatment" mean the taking into custody and detention
of a person in accordance with Section 5150.
(m) "Emergency" means a sudden marked change in the person's
condition such that action to impose treatment over the person's
objection is immediately necessary for the preservation of life or
the prevention of serious bodily harm to the patient or others, and
it is impracticable to first gain consent. It is not necessary for
harm to take place or become unavoidable prior to treatment.
(n) "Emergency transport provider" means a provider of ambulance
services licensed by the Department of the California Highway Patrol
or operated by a public safety agency and includes the authorized
personnel of an emergency transport provider who are certified or
licensed under Sections 1797.56, 1797.80, 1797.82, and 1797.84 of the
Health and Safety Code.
(o) "Evaluation" means a multidisciplinary professional analyses
of a person's medical, psychological, educational, social, financial,
and legal conditions as may appear to constitute a problem. Persons
providing evaluation services shall be properly qualified
professionals and may be full-time employees, part-time employees, or
independent contractors of a county, designated facility, or other
agency providing face-to-face evaluation services. Face-to-face
evaluation services includes face-to-face evaluation by means of
telehealth.
(p) (1) For purposes of Article 1 (commencing with Section 5150),
Article 2 (commencing with Section 5200), and Article 4 (commencing
with Section 5250) of Chapter 2, and for the purposes of Chapter 3
(commencing with Section 5350), "gravely disabled" means either of
the following:
(A) A condition in which a person, as a result of a mental health
disorder, is unable to provide for his or her basic personal needs
for food, clothing, or shelter.
(B) A condition in which a person, has been found mentally
incompetent under Section 1370 of the Penal Code and all of the
following facts exist:
(i) The indictment or information pending against the person at
the time of commitment charges a felony involving death, great bodily
harm, or a serious threat to the physical well-being of another
person.
(ii) The indictment or information has not been dismissed.
(iii) As a result of a mental health disorder, the person is
unable to understand the nature and purpose of the proceedings taken
against him or her and to assist counsel in the conduct of his or her
defense in a rational manner.
(2) For purposes of Article 3 (commencing with Section 5225) and
Article 4 (commencing with Section 5250), of Chapter 2, and for the
purposes of Chapter 3 (commencing with Section 5350), "gravely
disabled" means a condition in which a person, as a result of
impairment by chronic alcoholism, is unable to provide for his or her
basic personal needs for food, clothing, or shelter.
(3) The term "gravely disabled" does not include persons with
intellectual disabilities by reason of that disability alone.
(q) "Intensive treatment" consists of hospital and other services
as may be indicated. Intensive treatment shall be provided by
properly qualified professionals and carried out in facilities
qualifying for reimbursement under the California Medical Assistance
Program (Medi-Cal) set forth in Chapter 7 (commencing with Section
14000) of Part 3 of Division 9, or under Title XVIII of the federal
Social Security Act and regulations thereunder. Intensive treatment
may be provided in hospitals of the United States government by
properly qualified professionals. Nothing in this part shall be
construed to prohibit an intensive treatment facility from also
providing 72-hour evaluation and treatment.
(r) "Local or regional liaison" means a person or persons
authorized by a county, or by two or more counties acting jointly,
under Section 5024.
(s) "Mobile crisis team" means a team comprised of one or more
professionals, and which may also include peer counselors, who are
authorized by a county to provide probable cause determinations and
other services under this part.
(t) "Peace officer" means a duly sworn peace officer as that term
is defined in Chapter 4.5 (commencing with Section 830) of Title 3 of
Part 2 of the Penal Code who has completed the basic training course
established by the Commission on Peace Officer Standards and
Training, or any parole officer or probation officer specified in
Section 830.5 of the Penal Code when acting in relation to cases for
which he or she has a legally mandated responsibility.
(u) "Postcertification treatment" means an additional period of
treatment pursuant to Article 6 (commencing with Section 5300) of
Chapter 2.
(v) "Prepetition screening" is a screening of all petitions for
court-ordered evaluation as provided in Article 2 (commencing with
Section 5200) of Chapter 2, consisting of a professional review of
the petition; an interview with the petitioner and, whenever
possible, the person alleged, as a result of a mental health
disorder, to be a danger to others, or to himself or herself, or to
be gravely disabled, to assess the problem and explain the petition;
and when indicated, efforts to persuade the person to receive, on a
voluntary basis, comprehensive evaluation, crisis intervention,
referral, and other services specified in this part.
(w) "Probable cause determination" means a determination whether
there is probable cause for the detention of a person for evaluation
and treatment. A probable cause determination shall be based solely
on the criteria for detaining a person for evaluation and treatment
pursuant to Section 5150. The probable cause determination shall not
consider the availability of beds or services at designated
facilities within or outside of the county.
(x) "Professional person in charge of a facility" means the
licensed person authorized by a designated facility who is
responsible for the clinical direction of the designated facility.
(y) "Professional staff" means the medical staff or other
organized professional staff of an inpatient facility.
(z) "Referral" means referral of persons by each facility,
provider, or other organization providing assessment, evaluation,
crisis intervention, or treatment services to other facilities,
providers, or agencies in accordance with Section 5013 and Part 1.5
(commencing with Section 5585).
(aa) "Telehealth" means the telehealth services, as defined in
paragraph (6) of subdivision (a) of Section 2290.5 of the Business
and Professions Code, for the purpose of providing services under
this part, including a probable cause determination, the release of a
person from detention for evaluation and treatment under Section
5150.15, assessment or evaluation, and treatment. For purposes of
this part, telehealth services may be used by any licensed
professional, including a psychologist, clinical social worker, and
other mental health professional, acting within the scope of his or
her profession for providing evaluation, treatment, consultation, or
other mental health services under this part.
SEC. 4. Section 5013 of the Welfare and Institutions Code is
amended to read:
5013. (a) The purpose of a referral shall be to provide for
continuity of care and services. A referral may include, but need not
be limited to, informing the person of available services, making
appointments on the person's behalf, communication with the agency or
individual to which the person has been referred, appraising the
outcome of referrals, and arranging for escort, transportation, or
both, when necessary. All persons shall be advised of available
precare services that prevent initial recourse to hospital treatment
or aftercare services that support adjustment to community living
following hospital treatment. These services may be provided through
county or city mental health departments, state hospitals under the
jurisdiction of the State Department of State Hospitals, regional
centers under contract with the State Department of Developmental
Services, or other public or private entities.
(b) It is the intent of the Legislature that referrals between
facilities, providers, and other organizations shall be facilitated
by the sharing of information and records in accordance with Section
5328 and applicable federal and state laws.
(c) Each city or county behavioral health department is encouraged
to include on its Internet Web site a current list of ambulatory
behavioral health services and other resources for persons with
behavioral health disorders and substance use disorders in the city
or county that may be accessed by providers and consumers of
behavioral health services. The list of services on the Internet Web
site should be updated at least annually by the city or county
behavioral health department.
SEC. 5. Section 5022 is added to the Welfare and Institutions
Code, to read:
5022. The department shall promote the consistent statewide
application of this part in order to ensure protection of the
personal rights of all persons who are subject to this part and Part
1.5 (commencing with Section 5585). The department shall provide
oversight of the statewide application of this part and facilitate
discussion among the organizations listed in subdivision (a) of
Section 5400, law enforcement agencies, hospitals, mental health
professionals, county patients' rights advocates, the California
Office of Patients' Rights, and other stakeholders as may be
necessary or desirable to achieve the legislative intent of
consistent statewide application. These discussions shall include
situations where persons are certified for additional intensive
treatment in a county authorizing that treatment under Article 4.7
(commencing with Section 5270.10) of Chapter 2 who are then
transferred to a facility during the course of additional intensive
treatment in a county that has not authorized additional intensive
treatment.
SEC. 6. Section 5023 is added to the Welfare and Institutions
Code, to read:
5023. (a) Each county may designate inpatient and ambulatory
facilities within the county, with the approval of the department,
that meet the applicable requirements established by the department
by regulation. An outpatient or emergency department of a
nondesignated inpatient facility may be designated as an ambulatory
facility if it meets all the requirements for certification as an
ambulatory facility.
(b) (1) Each county may designate ambulatory facilities within the
county that meet the behavioral health needs of persons within the
requirements of applicable law and the scope of their designation.
The department shall encourage counties to use appropriate ambulatory
facilities for the evaluation and treatment of persons pursuant to
this part.
(2) Counties, mental health professionals, providers, and other
organizations, with the support of the department, are encouraged to
establish crisis stabilization services and other ambulatory
facilities that are designated by a county to provide probable cause
determinations and assessments, and, as applicable, evaluation and
treatment services and crisis stabilization services, in settings
that are appropriate to the needs of persons with severe mental
illness and less restrictive than inpatient health facilities.
(3) Nothing in this subdivision shall preclude the designation of
an ambulatory facility that is an outpatient clinic of a licensed
health facility.
(4) An ambulatory facility shall provide services within the scope
of its designation to all persons regardless of their place of
residence.
(c) Regulations adopted pursuant to this part establishing
staffing standards for designated facilities shall be consistent with
applicable licensing regulations for the type of facility. If there
are no licensing regulations for the type of designated facility, or
for certain categories of professional personnel providing services
in a type of designated facility, the regulations adopted pursuant to
this part for staffing standards may differentiate between the types
of designated facilities, including ambulatory facilities.
On January 1, 2016, the existing regulations establishing staffing
standards for designated facilities set forth in Section 663 of Title
9 of the California Code of Regulations are repealed and nullified.
(d) A county shall not charge or assess a fee for the designation
of a facility or an authorized professional.
(e) Each designated facility shall accept, within its clinical
capability and capacity, all categories of persons for whom it is
designated, without regard to insurance or financial status. If a
person presents to a designated facility with a psychiatric emergency
medical condition, as defined in subdivision (f) of Section 5150.10,
that is beyond its capability, the facility shall assist the person
in obtaining emergency services and care at an appropriate facility.
(f) In order to provide access by members of the public to
information about designated facilities, each county department
responsible for mental health services shall maintain on its Internet
Web site the locations of all designated facilities within the
county, including address, the types of services available at each
designated facility, and the hours of operation for ambulatory
facilities. The Internet Web site shall be updated if there are
changes to the information.
(g) Each county shall report to the department, on at least an
annual basis, a current list of designated facilities within the
county, including the name and address of each facility and its
facility type. The department shall maintain a list of designated
facilities, by county and facility licensure type, on its Internet
Web site, and update the list not less than annually. The department
Internet Web site shall also contain links to each county Internet
Web site required by subdivision (f).
(h) Counties are encouraged to share information with adjacent and
other counties with respect to its roster of authorized
professionals. An authorized professional shall not be required to
obtain approval from another county to be an authorized professional
in that county in order to take action under this part.
SEC. 7. Section 5024 is added to the Welfare and Institutions
Code, to read:
5024. (a) Each county may authorize one or more qualified persons
to act as a local or regional liaison to assist nondesignated
hospitals in the county in accordance with this section and Article
1.1 (commencing with Section 5150.10) of Chapter 2. Two or more
counties may enter into an intercounty arrangement under which the
participating counties agree to authorize one or more persons to act
as a local or regional liaison to assist nondesignated hospitals in
the participating counties in accordance with this section and
Article 1.1 (commencing with Section 5150.10) of Chapter 2.
(b) The role of the local or regional liaison is to assist a
person who is a patient in an emergency department of a nondesignated
hospital and who has been detained, or may require detention, for
evaluation and treatment. The assistance may include any of the
following:
(1) Arranging for an authorized professional to provide a prompt
probable cause determination under Section 5150.13.
(2) Arranging for an authorized professional to determine whether
the detention for evaluation and treatment of a person shall be
released under Section 5150.15.
(3) Arranging for the placement of a person detained for
evaluation and treatment who has been medically stabilized for
transfer or discharge to a designated facility.
(c) A local or regional liaison may be employed by, or may
contract with, a county or counties and may include personnel of one
or more designated facilities within the county or counties. The role
of the local or regional liaison may be rotated among the categories
of persons described in this subdivision.
(d) A local or regional liaison shall be available 24 hours a day,
including weekends and holidays, to provide assistance under this
section.
(e) Each county, or counties acting jointly under this section,
shall provide the nondesignated hospitals in the county or counties
with the contact information for a local or regional liaison. The
means of contact may be a designated telephone number, email,
text-messaging or other electronic means, or any combination of the
foregoing, so long as the local or regional liaison has immediate
access to the means of contact. The contact information provided to
nondesignated hospitals shall be updated as necessary.
(f) This section shall not apply to a county that has not
authorized a local or regional liaison.
SEC. 8. Section 5025 is added to the Welfare and Institutions
Code, to read:
5025. (a) A designated facility or nondesignated hospital, as
defined in subdivision (e) of Section 5150.10, or a physician,
employee, or other staff person acting within the scope of his or her
official duties or employment for the designated facility or
nondesignated hospital shall not be liable for any injury resulting
from determining any of the following:
(1) Whether to detain a person for a mental health disorder,
inebriation, chronic alcoholism, or the use of narcotics or a
restricted dangerous drug in accordance with this part.
(2) The terms, conditions, and enforcement of detention for a
person with a mental health disorder, inebriation, chronic
alcoholism, or the use of narcotics or a restricted dangerous drug in
accordance with this part.
(3) Whether to release a person detained for a mental disorder,
inebriation, chronic alcoholism, or the use of narcotics or a
restricted dangerous drug in accordance with this part.
(b) A physician, employee, or other staff person acting within the
scope of his or her official duties or employment for a designated
facility or nondesignated hospital
shall not be liable for carrying out a determination
described in subdivision (a) so long as he or she uses due care.
SEC. 9. Section 5026 is added to the Welfare and Institutions
Code, to read:
5026. (a) A designated facility or nondesignated hospital, as
defined in subdivision (e) of Section 5150.10, or a physician,
employee, or other staff person acting within the scope of his or her
official duties or employment for the designated facility or
nondesignated hospital shall not be liable for any of the following:
(1) An injury caused by an eloping or eloped person who has been
detained for a mental health disorder or addiction.
(2) An injury to, or the wrongful death of, an eloping or eloped
person who has been detained for a mental health disorder or
addiction.
(b) Nothing in this section shall exonerate a physician, employee,
or other staff person acting within the scope of his or her official
duties or employment for a designated facility or nondesignated
hospital from liability if he or she acted or failed to act because
of actual fraud, corruption, or actual malice.
SEC. 10. Section 5150 of the Welfare and Institutions Code is
amended to read:
5150. (a) When a person, as a result of a mental health disorder,
is a danger to others, or to himself or herself, or gravely
disabled, a peace officer or an authorized professional acting within
the scope of his or her authorization may, upon probable cause,
take, or cause to be taken, the person into custody for a period of
up to 72 hours for assessment, evaluation, and crisis intervention,
or placement for evaluation and treatment in a facility designated by
the county for evaluation and treatment and approved by the
department. At a minimum, assessment, as defined in subdivision (c)
of Section 5008, and evaluation, as defined in subdivision (n) of
Section 5008, shall be conducted and provided on an ongoing basis.
Crisis intervention, as defined in subdivision (g) of Section 5008,
may be provided concurrently with assessment, evaluation, or any
other service. The period of 72-hour detention for evaluation and
treatment shall begin at the time that the person is initially
detained pursuant to this section.
(b) (1) When an individual detained pursuant to subdivision (a) is
taken to a designated facility for evaluation and treatment, the
professional person in charge, a member of the attending staff of the
designated facility, or an authorized professional acting within the
scope of his or her authorization by the county, shall assess the
person to determine whether he or she can be properly served without
being detained. The assessment shall be performed based on the
clinical condition and needs of a person detained for evaluation and
treatment. This section shall not be construed to prevent an
authorized professional from providing consultation or other
professional assistance by telehealth. If in the judgment of the
authorized professional, the person can be properly served without
being detained, he or she shall be provided evaluation, crisis
intervention, or other inpatient or outpatient services on a
voluntary basis.
(2) If the person detained for evaluation and treatment is taken
to a designated ambulatory facility that is authorized by the county
to conduct an assessment, the assessment shall be conducted by the
professional person in charge of the designated ambulatory facility
or his or her designee acting within the scope of his or her licensed
profession. The assessment in a designated ambulatory facility may
be performed by or in consultation with an authorized member of the
professional staff of a designated inpatient facility using
telehealth if the designated inpatient facility has agreed to admit
the person in accordance with subdivision (a) upon a determination
that an involuntary admission is appropriate.
(3) This section shall not be construed to prevent a peace
officer, or an authorized professional employee of an emergency
transport provider acting at the direction of the peace officer, from
delivering individuals to a designated facility for an assessment
under this section. Furthermore, the assessment requirement of this
section shall not be construed to require peace officers or
authorized professional employees of emergency transport providers
acting at the direction of the peace officer to perform any
additional duties other than those specified in Sections 5150.1 and
5150.2.
(4) If an individual detained under subdivision (a) is first taken
to an emergency department of a nondesignated hospital, as defined
in subdivision (e) of Section 5150.10, the provisions of Article 1.1
(commencing with Section 5150.10) shall apply to the individual
during his or her stay in the emergency department of a nondesignated
hospital. This section does not require the peace officer or
authorized professional who detained the individual pursuant to
subdivision (a) to take or cause the individual to be taken to an
emergency department of a nondesignated hospital.
(5) Notwithstanding paragraph (2) of subdivision (j) of Section
5008, or any regulation, if a person detained for evaluation and
treatment presents or is transferred to a designated ambulatory
facility, and following a new determination of probable cause, the
professional person in charge of the designated ambulatory facility
or his or her designee determines that the person continues to meet
the criteria for detention under Section 5150 and should be admitted
to a designated inpatient facility for further evaluation and
treatment, the designated ambulatory facility shall make and document
good faith efforts to arrange placement for the person in a
designated inpatient facility. Subject to the requirements of
subdivision (a), if the designated ambulatory facility has been
unable to arrange placement for the person in a designated inpatient
facility within 24 hours, the designated ambulatory facility shall
continue to provide evaluation and treatment for the person beyond 24
hours in order to arrange for placement and transfer of the person
to a designated inpatient facility, provided the designated
ambulatory facility, prior to the expiration of the 24 hours,
notifies the county in which it is located and the mental health
patients' rights advocate for the county that it is continuing to
detain the person beyond 24 hours. The designated ambulatory facility
shall not transfer or send a person to an emergency department of a
nondesignated hospital unless the person requires examination or
treatment for a medical condition that is beyond the capability of
the designated ambulatory facility.
(c) Whenever a person is evaluated by an authorized professional
and is found to be in need of mental health services, but is not
admitted to the facility, all available alternative services provided
pursuant to subdivision (b) shall be offered as determined by the
county mental health director.
(d) If, in the judgment of the authorized professional, the person
cannot be properly served without being detained, the admitting
facility shall require an application in writing pursuant to Section
5150.3.
(e) At the time a person is taken into custody for evaluation, or
within a reasonable time thereafter, unless a responsible relative or
the guardian or conservator of the person is in possession of the
person's personal property, the person taking him or her into custody
shall take reasonable precautions to preserve and safeguard the
personal property in the possession of or on the premises occupied by
the person. The person taking him or her into custody shall then
furnish to the court a report generally describing the person's
property so preserved and safeguarded and its disposition, in
substantially the form set forth in Section 5211, except that if a
responsible relative or the guardian or conservator of the person is
in possession of the person's property, the report shall include only
the name of the relative or guardian or conservator and the location
of the property, whereupon responsibility of the person taking him
or her into custody for that property shall terminate. As used in
this section, "responsible relative" includes the spouse, parent,
adult child, domestic partner, grandparent, grandchild, or adult
brother or sister of the person.
(f) (1) Each person, at the time he or she is first taken into
custody under this section, shall be provided, by the person who
takes him or her into custody, the following information orally in a
language or modality accessible to the person. If the person cannot
understand an oral advisement, the information shall be provided in
writing. The information shall be in substantially the following
form:
My name is ___________________________________ .
I am a _____________________________
(peace officer/mental health
______________ .
professional)
with __________________ .
(name of agency)
You are not under criminal arrest, but I am
taking you for an examination by mental health
professionals at _____________________________ .
____________________
(name of facility)
You will be told your rights by the mental
health staff.
(2) If taken into custody at his or her own residence, the person
shall also be provided the following information:
You may bring a few personal items with you, which I will have to
approve. Please inform me if you need assistance turning off any
appliance or water. You may make a phone call and leave a note to
tell your friends or family where you have been taken.
(g) The designated facility shall keep, for each patient
evaluated, a record of the advisement given pursuant to subdivision
(f) which shall include all of the following:
(1) The name of the person detained for evaluation.
(2) The name and position of the peace officer or mental health
professional taking the person into custody.
(3) The date the advisement was completed.
(4) Whether the advisement was completed.
(5) The language or modality used to give the advisement.
(6) If the advisement was not completed, a statement of good
cause, as defined by regulations of the State Department of Health
Care Services.
(h) Each person admitted to a facility designated by the county
for evaluation and treatment shall be given the following information
by admission staff of the facility. The information shall be given
orally and in writing and in a language or modality accessible to the
person. The written information shall be available to the person in
English and in the language that is the person's primary means of
communication. Accommodations for other disabilities that may affect
communication shall also be provided. The information shall be in
substantially the following form:
My name is ____________________________________.
My position here is____________________________.
You are being placed into this psychiatric
facility because it is our professional opinion
that, as a result of a mental health disorder,
you are likely to (check applicable):
( ) Harm
yourself.
( ) Harm someone
else.
( ) Be unable to take care of your own food,
clothing, and housing
needs.
We believe this is true because
________________________________________________
(list of the facts upon which the allegation of
dangerous
or gravely disabled due to mental health
disorder is based, including pertinent
facts arising from the admission interview).
You will be held for a period up to 72 hours.
During the 72 hours you may also be transferred
to another facility. You may request to be
evaluated or treated at a facility of your
choice. You may request to be evaluated or
treated by a mental health professional of your
choice. We cannot guarantee the facility or
mental health professional you choose will be
available, but we will honor your choice if we
can.
During these 72 hours you will be evaluated by
the facility staff, and you may be given
treatment, including medications. It is
possible for you to be released before the end
of the 72 hours. But if the staff decides that
you need continued treatment you can be held
for a longer period of time. If you are held
longer than 72 hours, you have the right to a
lawyer and a qualified interpreter and a
hearing before a judge. If you are unable to
pay for the lawyer, then one will be provided
to you free of charge.
If you have questions about your legal rights,
you may contact the county Patients' Rights
Advocate at _____________________________
(phone number for the county
__________________________________.
Patients' Rights Advocacy office)
Your 72-hour period began _____________.
(date/time)
(i) For each patient admitted for evaluation and treatment, the
facility shall keep with the patient's medical record a record of the
advisement given pursuant to subdivision (h), which shall include
all of the following:
(1) The name of the person performing the advisement.
(2) The date of the advisement.
(3) Whether the advisement was completed.
(4) The language or modality used to communicate the advisement.
(5) If the advisement was not completed, a statement of good
cause.
SEC. 11. Section 5150.05 of the Welfare and Institutions Code is
amended to read:
5150.05. (a) When determining if probable cause exists to take a
person into custody, or cause a person to be taken into custody,
pursuant to Section 5150, a person who is authorized to take that
person, or cause that person to be taken, into custody pursuant to
that section shall consider available relevant information about the
historical course of the person's mental disorder if the authorized
person determines that the information has a reasonable bearing on
the determination as to whether the person is a danger to others, or
to himself or herself, or is gravely disabled as a result of the
mental disorder.
(b) For purposes of this section, "information about the
historical course of the person's mental disorder" includes evidence
presented by the person who has provided or is providing mental
health or related support services to the person subject to a
determination described in subdivision (a), evidence presented by one
or more members of the family of that person, and evidence presented
by the person subject to a determination described in subdivision
(a) or anyone designated by that person.
(c) If the probable cause in subdivision (a) is based on the
statement of a person other than one authorized to take the person
into custody pursuant to Section 5150, the person making the
statement shall be liable in a civil action for intentionally giving
a statement that he or she knows to be false.
(d) This section shall not be applied to limit the application of
Section 5328.
SEC. 12. Section 5150.1 of the Welfare and Institutions Code is
amended to read:
5150.1. (a) A peace officer or authorized professional employee
of an emergency transport provider acting at the direction of a peace
officer, seeking to transport, or having transported, a person to a
designated facility for assessment pursuant to subdivision (a) of
Section 5150 or Section 5151, shall not be instructed by mental
health personnel to take the person to, or keep the person at, a jail
solely because of the unavailability of an acute bed. The peace
officer or the authorized professional employee of an emergency
transport provider acting at the direction of the peace officer,
shall not be forbidden to transport the person directly to the
designated facility. No mental health employee from any county,
state, city, or any private agency providing psychiatric emergency
services shall interfere with a peace officer or an authorized
professional employee of an emergency transport provider acting at
the direction of a peace officer performing duties under Section 5150
by preventing the peace officer from detaining a person for
evaluation and treatment or preventing the peace officer or an
authorized professional employee of an emergency transport provider
acting at the direction of a peace officer from entering a designated
facility with the person for an assessment. An employee of a
facility shall not require the peace officer or an authorized
professional employee of an emergency transport provider acting at
the direction of a peace officer to remove the person without an
assessment as a condition of allowing the peace officer or an
authorized professional employee of an emergency transport provider
acting at the direction of a peace officer to depart.
(b) An emergency transport provider, or any certified or licensed
personnel of an emergency transport provider, shall not be civilly or
criminally liable for any of the following that may be applicable to
the transport of a person who has been detained for evaluation and
treatment:
(1) The continuation of the detention for evaluation and treatment
while transporting the person to a designated facility or an
emergency department of a nondesignated hospital at the direction of
a peace officer or authorized professional who detained the person
for evaluation and treatment.
(2) The continuation of the detention for evaluation and treatment
while transporting the person detained for evaluation and treatment
to a designated facility or an emergency department of a
nondesignated hospital at the direction of the treating emergency
professional in an emergency department of a nondesignated hospital
for an assessment or other service under Section 5151.
(c) For purposes of this section, "peace officer" means a peace
officer as defined in Chapter 4.5 (commencing with Section 830) of
Title 3 of Part 2 of the Penal Code and also includes a jailer
seeking to transport or transporting a person in custody to a
designated facility for an assessment consistent with Section 4011.6
or 4011.8 of the Penal Code and Section 5150.
SEC. 13. Section 5150.2 of the Welfare and Institutions Code is
amended to read:
5150.2. In each county, whenever a peace officer or the
authorized professional employee of an emergency transport provider
acting at the direction of the peace officer has transported a person
to a designated facility for an assessment, the officer or
professional employee of an emergency transporter shall be detained
no longer than the time necessary to complete documentation of the
factual basis of the detention for evaluation and treatment and
effectuate a prompt, safe, and orderly transfer of physical custody
of the person.
SEC. 14. Section 5150.3 is added to the Welfare and Institutions
Code, to read:
5150.3. (a) (1) The peace officer or an authorized professional
who takes a person into custody or otherwise initially detains a
person pursuant to Section 5150 shall complete and sign an
application for detention for evaluation and treatment, in the form
prescribed by subdivision (g), stating the circumstances under which
the person's condition was called to the attention of the peace
officer or authorized professional, and stating that the peace
officer or authorized professional has probable cause to believe that
the person is, as a result of a mental health disorder, a danger to
others, or to himself or herself, or gravely disabled.
(2) The documentation shall include detailed information regarding
the factual circumstances and observations constituting probable
cause for the peace officer or authorized professional to believe
that the person should be detained for evaluation and treatment in
accordance with Section 5150. If the probable cause is based on the
statement of a person other than the peace officer or authorized
professional, the person shall be liable in a civil action for
intentionally giving a statement that he or she knows is false.
(3) A designated facility or nondesignated hospital shall require
presentation of the application as a condition of continuation of the
detention for evaluation and treatment. If the application is not
presented to the designated facility or nondesignated hospital, as
applicable, the person shall be immediately released from detention
for evaluation and treatment.
(4) An application for detention for evaluation and treatment
shall be valid in all counties to which the person may be taken to a
designated facility.
(b) (1) If the person detained by a peace officer or authorized
professional is in a location other than a designated facility or
nondesignated hospital, the original or copy of the application for
detention for evaluation and treatment shall be presented to the
designated facility under paragraph (2) or the nondesignated hospital
under paragraph (3).
(2) If after detention under Section 5150, the person is first
taken to a designated facility, the original or a copy of the signed
application for detention for evaluation and treatment shall be
presented to the designated facility.
(3) If after detention under Section 5150, the person is first
taken to a nondesignated hospital, the original or a copy of the
signed application for detention for evaluation and treatment shall
be presented to the nondesignated hospital. If the person is
subsequently transferred to a designated facility, the nondesignated
hospital shall deliver the original or a copy of the signed
application for detention for evaluation and treatment to the
designated facility. If the person is discharged from the
nondesignated hospital under Section 5150.15 or 5150.16, without a
transfer to a designated facility, the nondesignated hospital shall
maintain the original or a copy of the original signed application
for detention for evaluation and treatment.
(c) If a person detained for evaluation and treatment is
subsequently released from detention for evaluation and treatment
pursuant to Section 5150.15 or 5151, the application for detention
for evaluation and treatment in the possession of a designated
facility or nondesignated hospital shall be retained for the period
of time required by the medical records retention policy of the
designated facility or nondesignated hospital.
(d) The determination of a peace officer or authorized
professional to detain a person under Section 5150 and complete and
sign an application for detention for evaluation and treatment, shall
be based solely on whether the person meets the criteria for
detention for evaluation and treatment as set forth in Section 5150.
The determination shall not be delayed, denied, or refused based on
the availability of beds or services at designated facilities to
which a person may be taken under this article.
(e) If a person detained for evaluation and treatment under
Section 5150 is transported by a professional employee of an
emergency transport provider to a designated facility or
nondesignated hospital at the request of a peace officer or an
authorized professional, the peace officer or authorized professional
shall give the application for detention for evaluation and
treatment to the professional employee of the emergency transport
provider if the peace officer or authorized professional does not
accompany the person to the designated facility or nondesignated
hospital.
(f) A copy of the application for detention for evaluation and
treatment shall be given to an emergency transport provider if the
person detained for evaluation and treatment is transported from a
nondesignated hospital to a designated facility or from a designated
facility to another designated facility.
(g) Not later than July 1, 2016, the department shall adopt and
make available a standardized form of the application for detention
for evaluation and treatment that shall be used by peace officers and
authorized professionals to apply for detention of a person for
evaluation and treatment under Section 5150 and by authorized
professionals to release a person from detention for evaluation and
treatment pursuant to Section 5150.15 or 5151. In developing the
form, the department shall request comments from stakeholders
including the organizations described in subdivision (b) of Section
5400. The form of the application for detention for evaluation and
treatment shall, at a minimum, provide all of the following:
(1) A description of the person's behavior and other relevant
facts that provide the basis for probable cause under Sections 5150
and 5150.05 of the person's detainment for evaluation and treatment.
(2) For persons detained for evaluation and treatment who are
first taken to an emergency department of a nondesignated hospital,
documentation of the facts and conclusions that provide the basis for
the determination of medical clearance, excluding a psychiatric
emergency medical condition, by the emergency professional treating
the person in the emergency department to transfer the person to a
designated facility.
(3) Documentation of the facts and conclusions that provide the
basis for the determination by an authorized professional authorized
to perform an assessment that the person should be admitted for
involuntary evaluation and treatment under Section 5152.
(4) Determination of the facts and conclusions that support the
determination by an authorized professional authorized to release a
person from detention in accordance with Section 5150.14 or 5151.
(5) Request by a peace officer under Section 5152.1 for
notification of the person's release or discharge by a designated
facility or nondesignated hospital.
(6) All of the information required by subdivision (f) of Section
5150.
SEC. 15. Section 5150.4 of the Welfare and Institutions Code is
repealed.
SEC. 16. Article 1.1 (commencing with Section 5150.10) is added to
Chapter 2 of Part 1 of Division 5 of the Welfare and Institutions
Code, to read:
Article 1.1. Persons Detained in Nondesignated Hospitals
5150.10. Unless the context otherwise requires, the following
definitions shall govern the construction of this article:
(a) "Emergency department of a nondesignated hospital" means a
basic, comprehensive, or standby emergency medical service that is
approved by the State Department of Public Health as a special or
supplemental service of a nondesignated hospital. For purposes of
this part, an emergency department of a nondesignated hospital shall
include an observation or similar unit of the hospital that meets
both of the following criteria:
(1) The unit is operated under the direction and policies of the
emergency department.
(2) The unit provides continuing emergency services and care to
patients prior to an inpatient admission, transfer, or discharge.
(b) "Emergency professional" means either of the
following:
(1) A physician and surgeon who is board certified or pursuing
board certification in emergency medicine, or a qualified licensed
person, as defined in subdivision (g), during any scheduled period
that he or she is on duty to provide medical screening and treatment
of patients in an emergency department of a nondesignated hospital.
(2) A physician and surgeon, or a qualified licensed person, as
defined in subdivision (g), during any scheduled period that he or
she is on duty to provide medical screening and treatment of patients
in the emergency department of a nondesignated hospital that is a
critical access hospital within the meaning of Section 1250.7 of the
Health and Safety Code. A physician and surgeon on duty under this
paragraph shall include a physician and surgeon on call for a standby
emergency medical service who is responsible to provide professional
coverage for the emergency department. A physician and surgeon on
duty under this paragraph does not include a physician and surgeon
who is providing on-call specialty coverage services to the emergency
department of a nondesignated hospital, unless the physician and
surgeon is an emergency professional under paragraph (1).
(c) "Emergency services and care" has the same meaning as in
subdivision (a) of Section 1317.1 of the Health and Safety Code.
(d) "EMTALA" means the Emergency Medical Treatment and Labor Act,
and regulations adopted pursuant thereto, as defined in Section
1395dd of Title 42 of the United States Code.
(e) "Nondesignated hospital" means a general acute care hospital,
as defined in subdivision (a) of Section 1250 of the Health and
Safety Code or an acute psychiatric hospital, as defined in
subdivision (b) of Section 1250 of the Health and Safety Code, that
is not a designated facility.
(f) "Psychiatric emergency medical condition" has the same meaning
as in subdivision (k) of Section 1317.1 of the Health and Safety
Code.
(g) "Psychiatric professional" means a physician and surgeon who
is board certified or pursuing board certification in psychiatry and
who is providing specialty services to the emergency department of a
nondesignated hospital.
(h) "Qualified licensed person" means a licensed person designated
by the medical staff and governing body of a nondesignated hospital
to provide emergency services and care, to the extent permitted by
applicable law, in an emergency department of the nondesignated
hospital under the supervision of a physician and surgeon.
(i) "Stabilized" has the same meaning as in subdivision (j) of
Section 1317.1 of the Health and Safety Code.
5150.11. (a) The Legislature finds and declares all of the
following:
(1) A person who has been detained for evaluation and treatment
pursuant to Section 5150 should be taken to a designated facility
rather than an emergency department of a nondesignated hospital.
(2) A person who has been detained for evaluation and treatment
pursuant to Section 5150 should be detained in an emergency
department of a nondesignated hospital only for the time necessary to
provide required emergency services and care and obtain medical
clearance, unless the person requires an admission for inpatient
services.
(3) A person who has been detained for evaluation and treatment
pursuant to Section 5150 has the right to receive a prompt assessment
to determine the appropriateness of the detention and the need for
evaluation and treatment at a designated facility.
(b) It is also the intent of the Legislature that nothing in this
chapter shall be construed to require a peace officer or any other
authorized professional to take a person detained for evaluation and
treatment to an emergency department of a nondesignated hospital
instead of taking the person to a designated facility, unless the
peace officer or authorized professional reasonably determines that
the person is in need of emergency care and services that should be
provided at an emergency department of a nondesignated hospital
before the person is transported to a designated facility.
5150.12. (a) This section shall apply to a person who has been
detained for evaluation and treatment by a peace officer or an
authorized professional and is taken to an emergency department of a
nondesignated hospital for emergency services and care.
(b) While the person is in the emergency department of the
nondesignated hospital, the detention of the person for evaluation
and treatment shall continue, unless the person is released from
detention pursuant to Section 5150.15 or 5150.16.
5150.13. (a) This section shall apply if, during a person's
examination or treatment in an emergency department, there is a need
for a determination of probable cause for the detention of the person
for evaluation and treatment.
(b) If a person who has not been detained for evaluation and
treatment has signs or symptoms, in the judgment of the treating
emergency professional, that indicate probable cause for detention
for evaluation and treatment, the person shall have the right to a
prompt probable cause determination in accordance with any of the
following:
(1) The hospital may contact the county to arrange for a probable
cause determination by an authorized professional, including, but not
limited to, a member of a mobile crisis team.
(2) (A) If the county in which the nondesignated hospital is
located has a local or regional liaison, the hospital may contact the
local or regional liaison to arrange for an authorized professional
to provide a prompt probable cause determination of the person.
(B) The local or regional liaison shall advise the nondesignated
hospital within 30 minutes of the time of the initial contact whether
an authorized professional can perform the probable cause
determination within two hours from the time of the initial contact
with the local or regional liaison.
(C) The probable cause determination shall be based solely on the
criteria for detaining a person for evaluation and treatment. The
probable cause determination shall not consider the availability of
beds or services at designated facilities within or outside of the
county.
(D) The probable cause determination may be conducted by an
authorized professional utilizing telehealth.
(3) The treating emergency professional may conduct a probable
cause determination and, upon a finding of probable cause, detain the
person for evaluation and treatment in accordance with Sections 5150
and 5150.3.
(c) If the person is detained for evaluation and treatment
pursuant to this section, the detention shall continue during his or
her stay in the emergency department of a nondesignated hospital,
unless the person is released from detention pursuant to Section
5150.15 or 5150.16 or the detention ends by reason of the expiration
of 72 hours pursuant to subdivision (a) of Section 5150.
5150.14. (a) This section shall apply to a person who is first
detained pursuant to Section 5150 for evaluation and treatment in a
nondesignated hospital emergency department or has been detained
pursuant to Section 5150 for evaluation and treatment and first taken
to an emergency department of a nondesignated hospital.
(b) (1) Except as provided in subdivision (e), the nondesignated
hospital shall notify the county in which the nondesignated hospital
is located of the person's detention.
(2) If the person was detained for evaluation and treatment and
taken to the emergency department of the nondesignated hospital
pursuant to Section 5150.12, the notification shall occur after the
hospital has performed an initial medical screening of the person in
accordance with paragraphs (1) and (2) of subdivision (a) of Section
1317.1 of the Health and Safety Code.
(3) If the person is first detained for evaluation and treatment
in the emergency department of the nondesignated hospital pursuant to
Section 5150.13, the notification shall occur when the probable
cause determination has been completed.
(c) The notification to the county shall be made using the 24-hour
toll-free telephone number established by the county's mental health
program for psychiatric emergency services and crisis stabilization
if the county's mental health program has a 24-hour toll-free
telephone number in operation on January 1, 2016, for this purpose.
The notification shall be documented in the patient's medical record.
(d) The nondesignated hospital shall advise the county of all of
the following:
(1) The time when the 72-hour detention period for evaluation and
treatment expires.
(2) An estimate of the time when the person will be medically
stable for transfer to a designated facility.
(3) The county in which the person resides, if known.
(e) The notification to the county under this section shall not be
required if the treating emergency professional determines that the
person will be admitted, pursuant to Section 5150.16, to an acute
care bed of a nondesignated hospital for the primary purpose of
receiving acute inpatient services for a medical condition that is in
addition to the person's psychiatric condition.
5150.15. (a) This section shall establish a process for releasing
from detention a person who has been detained for evaluation and
treatment during the time that the person is detained in the
emergency department of a nondesignated hospital.
(b) If the treating emergency professional determines that there
is no longer probable cause to continue the detention for evaluation
and treatment, the treating emergency professional may initiate a
followup probable cause determination to determine whether the person
may be released from detention for evaluation and treatment. The
followup probable cause determination shall be made in accordance
with either of the following:
(1) The hospital may contact the county, or a local or regional
liaison if authorized by the county, to arrange for an authorized
professional to perform a followup probable cause determination to
determine whether the person may be released from detention for
evaluation and treatment. If a county or a local or regional liaison
cannot arrange for an authorized professional to make the
determination within two hours of the initial call to the county or
the local or regional liaison and there is no probable cause for
detention, the treating emergency professional may perform a followup
probable cause determination to determine whether the person may be
released from detention for evaluation and treatment.
(2) The treating emergency professional, without first contacting
the county or a local or regional liaison, may perform a followup
probable cause determination to determine whether the person may be
released from detention for evaluation and treatment.
(c) The determination under this section to release a person from
detention for evaluation and treatment shall be based solely on
whether there is probable cause to continue the detention for
evaluation and treatment. The determination to continue the detention
or to release the person from detention shall not be based on the
availability of beds or services at designated facilities within or
outside of the county, or on anything other than whether there is
probable cause for detention.
(d) The followup probable cause determination under this section
may be conducted by an authorized professional utilizing telehealth.
(e) The followup probable cause determination under this section
may be conducted by a psychiatric professional.
5150.16. (a) This section shall apply to a person detained for
evaluation and treatment who is admitted to a nonpsychiatric unit of
a general acute care hospital for acute medical services. This
section shall apply to all general acute care hospitals, including
general acute care hospitals that are designated facilities.
(b) If the person detained for evaluation and treatment is
admitted to a nonpsychiatric unit of a general acute care hospital
for the primary purpose of receiving acute inpatient services for a
medical condition that is in addition to the person's psychiatric
condition, the effect on the detention for evaluation and treatment
while receiving acute medical services shall be as follows:
(1) If the hospital offers to provide assessment, evaluation, and
crisis intervention services and the person consents to the services
on a voluntary basis in addition to acute medical services, the
person shall be released from detention.
(2) If the hospital offers to provide assessment, evaluation, and
crisis intervention services and the person refuses or is unable to
consent to the services on a voluntary basis in addition to acute
medical services, the detention for evaluation and treatment shall
continue in effect during the acute hospital stay, for so long as
there continues to be probable cause for the detention.
(3) If the hospital does not have the capability to provide
assessment, evaluation, and crisis intervention services, the person
shall be released from detention for evaluation and treatment.
(c) The release of the person from detention for evaluation and
treatment shall be communicated to the person and documented in the
person's medical record.
(d) This section shall not apply to a person detained for
evaluation and treatment who meets both of the following:
(1) The person does not require acute inpatient services for a
medical condition.
(2) The person is awaiting a transfer to a designated facility and
is placed in an acute bed of the nondesignated hospital for the
purpose of securing the protection of the person or other persons, or
both, in the nondesignated hospital pending the transfer of the
person to a designated facility.
(e) In all cases described in subdivision (b), if the discharge
plan for the patient provides for followup evaluation and treatment
at a psychiatric facility, the patient shall be advised of the
recommended need for the followup evaluation and treatment.
(f) If the person is not able or willing to accept treatment on a
voluntary basis, or to accept the referral or transfer to a
psychiatric facility, the hospital shall obtain a new probable cause
determination for detention for evaluation and treatment pursuant to
Section 5150 in order to take or cause the person to be taken to a
designated facility. Upon request by the hospital, a county shall
arrange for an authorized professional to conduct a probable cause
determination in a timely manner, which may be performed by the
authorized professional utilizing telehealth.
5150.17. (a) This section, together with Sections 5150.18 and
5150.19, shall apply to the placement in a designated facility of a
person in a nondesignated hospital emergency department who has been
detained for evaluation and treatment.
(b) The person may be placed in any designated facility that has
the capability to meet the needs of the person, including a
designated ambulatory facility.
(c) Prior to placement in a designated ambulatory facility,
personnel at the designated ambulatory facility shall confirm whether
the facility can meet the needs of the person within the scope of
its designation and capability.
5150.18. (a) This section shall apply to the placement in a
designated facility for a person described in Section 5150.17 if the
person has a psychiatric emergency medical condition.
(b) If a person, in the judgment of the treating emergency
professional, has a psychiatric emergency medical condition, the
placement in a designated facility shall be made as follows:
(1) The placement may be in any designated facility that has the
capability and capacity to provide evaluation and treatment for the
person, whether that designated facility is located within or outside
of the county of the hospital.
(2) The treating emergency professional shall determine the mode
of transportation, including personnel and equipment, that are
appropriate for the transport of the person to the designated
facility.
(3) In the event of a disagreement as to whether the person under
this section has a psychiatric emergency medical condition, the
judgment of the treating emergency professional shall prevail.
(4) The placement of a person described in this subdivision shall
take precedence over provider networks.
(c) If the person, in the judgment of the treating emergency
professional, does not have a psychiatric emergency medical
condition, the placement of the person in a designated facility for
evaluation and treatment shall be deemed to be made for a medical
reason within the meaning of Section 1317.2 of the Health and Safety
Code.
(d) This section shall also apply to a person who has been
medically stabilized, but is being held in an inpatient unit of the
nondesignated hospital for the purposes of ensuring the safety and
security of the person or other persons, pending placement of the
person in a designated facility for evaluation and treatment.
(e) If a person detained for evaluation and treatment is in the
emergency department of a nondesignated hospital, or in a bed not
licensed for psychiatric care, the nondesignated hospital shall make
good faith efforts to arrange placement for the person in a
designated facility and, pending placement, shall provide further
screening, treatment, and monitoring consistent with the needs of the
patient and within the capacity of the hospital.
5150.19. (a) This section describes assistance that may be
available to an emergency department of a nondesignated hospital for
the placement in a designated facility of a person described in
Section 5150.17.
(b) If a person has been taken to or detained by a
county-authorized professional in the emergency department of the
nondesignated hospital, the authorized professional shall assist the
nondesignated hospital in arranging for the placement of the person
with an appropriate designated facility.
(c) If a person is detained for evaluation and treatment by a
peace officer or a treating emergency professional in the emergency
department of the nondesignated hospital, the hospital may contact
the local or regional liaison, if authorized for the county in which
the nondesignated hospital is located, to assist the hospital in
arranging for the placement of the person in a designated facility,
as follows:
(1) Contact with the local or regional liaison may be initiated
when the treating emergency professional has medically stabilized the
person for placement in a designated facility.
(2) The hospital shall inform the county or the local or regional
liaison whether the person has a psychiatric emergency medical
condition that requires a transport of the person in accordance with
the EMTALA obligations for making an appropriate transfer.
(d) A nondesignated hospital shall make efforts to obtain
placement of the person in a designated facility without first
contacting the county or the local or regional liaison under this
section or in addition to requesting assistance that may be provided
by the county or the local or regional liaison.
5150.20. (a) The determination of probable cause to detain a
person for evaluation and treatment shall be independent of a
determination as to whether the person has a psychiatric emergency
medical condition for the provision of emergency services and care.
(b) A determination of probable cause to detain a person for
evaluation and treatment, whether by a peace officer or an authorized
professional, shall not be deemed to constitute a psychiatric
emergency medical condition unless a treating emergency professional
or psychiatric professional has determined that the person has a
psychiatric emergency medical condition.
(c) A determination by a treating emergency professional or a
psychiatric professional that a person has a psychiatric emergency
medical condition shall not be deemed to constitute probable cause
under Section 5150 that the person may be detained for evaluation and
treatment.
(d) A determination by a treating emergency professional or a
psychiatric professional that a person detained for evaluation and
treatment does not have a psychiatric emergency medical condition, or
that the person's psychiatric emergency medical condition is
stabilized, shall not be deemed to constitute a release of the person
from detention for evaluation and treatment.
5150.21. (a) A nondesignated hospital and the professional staff
of the nondesignated hospital shall not be civilly or criminally
liable for the transfer of a person detained for evaluation and
treatment to a designated facility in accordance with this article.
(b) The peace officer or authorized professional responsible for
the detention of the person for evaluation and treatment who
transfers the custody of the person to an emergency professional of a
nondesignated hospital, shall not be civilly or criminally liable
for any of the following:
(1) The continuation and enforcement of the detention for
evaluation and treatment during the person's stay in the emergency
department of the nondesignated hospital prior to the discharge of
the person from the hospital in accordance with this article.
(2) The release of the person from detention for evaluation and
treatment in accordance with this article.
(3) The transfer of the person detained for evaluation and
treatment to a designated facility in accordance with this article.
SEC. 17. Section 5150.25 is added to the
Welfare and Institutions Code , to read:
5150.25. Nothing in this chapter supersedes or abrogates the
provisions governing medical control set forth in Chapter 5
(commencing with Section 1798) of Division 2.5 of the Health and
Safety Code.
SEC. 17. SEC. 18. Article 1.2
(commencing with Section 5150.30) is added to Chapter 2 of Part 1 of
Division 5 of the Welfare and Institutions Code, to read:
Article 1.2. Voluntary Patients
5150.30. (a) A provider of ambulance services licensed by the
Department of the California Highway Patrol or operated by a public
safety agency, and the employees of those providers who are certified
or licensed under Section 1797.56 of the Health and Safety Code,
shall be authorized to transport a person who is in a hospital or
facility on a voluntary basis to a designated facility for
psychiatric treatment. This section shall apply to transfers from any
type of facility, including nondesignated hospitals and other
facilities.
(b) A person shall not be detained for evaluation and treatment
solely for the purpose of transporting the person, or transferring
the person by a provider of ambulance services, to a designated
facility or an emergency department of a nondesignated hospital.
(c) Not later than July 1, 2016, the department shall adopt and
make available a standardized form that will enable voluntary
patients to consent to transfer between facilities by a provider of
ambulance services. The form shall be provided to voluntary patients
to sign before the transfer of the patient. The form shall be kept in
the patient's chart. medical record.
Copies of the form shall be given to the patient and the provider of
ambulance services.
(d) This section shall apply to all patients who are on voluntary
status, regardless of whether the person was previously detained for
evaluation and treatment at any point during the course of treatment
at a nondesignated hospital or designated facility prior to the
transfer.
(e) No person shall require a person to be subject to detention
for evaluation and treatment for the purpose of authorizing or
providing evaluation, treatment, or admission to a facility, or as a
condition for providing or paying for medical services, care, or
treatment, including emergency services and care, unless there is
probable cause under Section 5150 to detain the person for evaluation
and treatment and the person cannot be properly served on a
voluntary basis. Nothing in this part shall be construed as
preventing a person subject to detention for evaluation and treatment
from receiving evaluation or treatment on a voluntary basis unless
there has been an adjudication under this part that the person lacks
the capacity to do so.
SEC. 18. SEC. 19. The heading of
Article 1.3 (commencing with Section 5151) is added to Chapter 2 of
Part 1 of Division 5 of the Welfare and Institutions Code, to read:
Article 1.3. Admission to a Designated Facility
SEC. 19. SEC. 20. Section 5151 of
the Welfare and Institutions Code is amended to read:
5151. (a) If a designated facility for evaluation and treatment
admits the person, it may detain him or her for evaluation and
treatment for a period not to exceed 72 hours from the time that the
person was initially detained pursuant to subdivision (a) of Section
5150.
(b) Prior to admitting a person to the facility for evaluation and
treatment, the professional person in charge of the facility or his
or her designee shall conduct an assessment of the individual in
person to determine the appropriateness of the involuntary detention.
SEC. 20. SEC. 21. Section 5151.1 is
added to the Welfare and Institutions Code, to read:
5151.1. If the assessment results in a determination that the
person is in need of mental health services, but he or she is not
admitted to the facility, the designated facility shall provide the
person with appropriate referrals and a list of alternative services
and other resources that are appropriate to the needs of the person.
The alternative services and other resources shall include both of
the following, as applicable:
(a) The services described in subdivision (b) of Section 5150.
(b) The services for persons with severe mental illness and
substance use disorders posted by a county on its Internet Web site
pursuant to Section 5013.
SEC. 21. SEC. 22. Section 5151.2 is
added to the Welfare and Institutions Code, to read:
5151.2. (a) Each county shall establish disposition procedures
and guidelines with local law enforcement agencies for the safe and
orderly transfer of persons detained for evaluation and treatment by
a peace officer, who has requested notification under Section 5152.1
of the person's release from detention for evaluation and treatment
in accordance with Section 5150.15, 5150.16, or 5151. The disposition
procedures and guidelines shall include persons who are not admitted
for evaluation and treatment and who decline alternative mental
health services and persons who have a criminal detention pending.
(b) The disposition procedures and guidelines should include
interagency communication between law enforcement agencies located
within the county, as well as law enforcement
agencies located in other counties, that take or
arrange to take persons detained for evaluation and treatment under
Section 5150 to health facilities within the county. The disposition
procedures and guidelines, including updates, shall be disseminated
to designated facilities and nondesignated hospitals.
SEC. 22. SEC. 23. Section 5152.1 of
the Welfare and Institutions Code is amended to read:
5152.1. (a) A designated facility or nondesignated hospital shall
notify the county mental health director, or the director's
designee, and the law enforcement agency that employs the peace
officer who makes the application for detention for 72-hour
evaluation and treatment pursuant to Section 5150, if the person
admitted pursuant to Section 5152 will be discharged after a 72-hour
inpatient admission, when the person is not admitted by the
designated facility, when the person discharged before the expiration
of the 72-hour inpatient admission, when the person discharged from
detention for evaluation and treatment is released under Section
5150.15, 5150.16, or 5151, or if the person elopes from a designated
facility or nondesignated hospital, if both of the following
conditions apply:
(1) The peace officer who made the application for detention for
evaluation and treatment requests notification of the person's
release or discharge at the time he or she makes the application for
detention for evaluation and treatment and the peace officer
certified at that time in writing that the person has been detained
for evaluation and treatment under circumstances which, based upon an
allegation of facts regarding actions witnessed by the officer or
another person, would support the filing of a criminal complaint. The
application for detention for evaluation and treatment shall include
one or more methods of contacting a person at the law enforcement
agency who may receive the notification.
(2) The notice is limited to the person's name, address, date of
admission or initial service, and date of release.
(b) If a police officer, law enforcement agency, or designee of
the law enforcement agency, possesses any record of information
obtained pursuant to the notification requirements of this section,
the officer, agency, or designee shall destroy that record two years
after receipt of notification.
(c) The notice required by this section shall be made prior to the
release or discharge of the person, if possible. The designated
facility or nondesignated hospital shall consider the distance from
the law enforcement agency to the location of the designated facility
or nondesignated hospital in giving the notice. The peace officer or
other representative of the law enforcement agency receiving the
notice shall promptly advise the designated facility or nondesignated
hospital whether the peace officer or other law enforcement agency
representative shall take custody of the person upon his or her
release or discharge from the designated facility or nondesignated
hospital and, if so, the time at which the peace officer or other law
enforcement agency representative will be present at the designated
facility or nondesignated hospital.
(d) Nothing in this section shall be construed to require the
designated facility or nondesignated hospital to delay the discharge
of a person for purposes of awaiting the arrival of the peace officer
or another representative of the law enforcement agency.
SEC. 23. SEC. 24. Section 5152.2 of
the Welfare and Institutions Code is repealed.
SEC. 24. SEC. 25. Section 5152.2 is
added to the Welfare and Institutions Code, to read:
5152.2. In addition to the request for notification set forth in
the application for detention for evaluation and treatment, each law
enforcement agency shall arrange with the county mental health
director for a method for designated facilities and nondesignated
hospitals to give prompt notification to peace officers under Section
5152.1. The methods for notification for each county shall be
disseminated by the county to the designated facilities and
nondesignated hospitals located within the county.
SEC. 25. SEC. 26. Section 5153 of
the Welfare and Institutions Code is amended to read:
5153. Whenever possible, officers charged with apprehension of
persons pursuant to this chapter shall dress in plain clothes and
travel in unmarked vehicles.
SEC. 26. SEC. 27. Section 5270.50 of
the Welfare and Institutions Code is amended to read:
5270.50. (a) Notwithstanding Section 5113, if the provisions of
Section 5270.35 have been met, the professional person in charge of
the facility providing intensive treatment, his or her designee, the
medical director of the facility or his or her designee described in
Section 5270.53, the psychiatrist directly responsible for the person'
s treatment, or the psychologist shall not be held civilly or
criminally liable for any action by a person released before the end
of 30 days pursuant to this article.
(b) The professional person in charge of the facility providing
intensive treatment or his or her designee, the medical director of
the facility or his or her designee described in Section 5270.35, the
psychiatrist directly responsible for the person's treatment, or the
psychologist shall not be held civilly or criminally liable for any
action by a person released at the end of the 30 days pursuant to
this article.
(c) The attorney or advocate representing the person, the
court-appointed commissioner or referee, the certification review
hearing officer conducting the certification review hearing, and the
peace officer responsible for detaining the person shall not be
civilly or criminally liable for any action by a person released at
or before the end of 30 days pursuant to this article.