Bill Text: CA AB2234 | 2009-2010 | Regular Session | Amended
Bill Title: Mental health: target populations: older adults.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2010-05-28 - In committee: Set, second hearing. Held under submission. [AB2234 Detail]
Download: California-2009-AB2234-Amended.html
BILL NUMBER: AB 2234 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MARCH 15, 2010
INTRODUCED BY Assembly Member Bonnie Lowenthal
FEBRUARY 18, 2010
An act to amend Section 5600.3 1170.9 of
the Penal Code, and to amend Sections 5346, 5600.3, 5600.6, 5600.7,
5813.5, and 5814 of the Welfare and Institutions Code, relating
to mental health.
LEGISLATIVE COUNSEL'S DIGEST
AB 2234, as amended, Bonnie Lowenthal. Mental health: target
populations: older adults.
Existing law, the Bronzan-McCorquodale Act, contains provisions
governing the operation and financing of community mental health
services for the mentally disordered in every county through locally
administered and locally controlled community mental health programs.
Existing law, the Mental Health Services Act, an initiative measure
enacted by the voters as Proposition 63 at the November 2, 2004,
statewide general election, establishes the Mental Health Services
Fund to fund various county mental health programs. The act may be
amended by the Legislature only by a 2/3 vote of both houses and only
so long as the amendment is consistent with and furthers the intent
of the act. The Legislature may clarify procedures and terms of the
act by majority vote.
Existing law, the Adult and Older Adult Mental Health System of
Care Act, sets out a system of mental health care services, provided
by participating counties pursuant to Proposition 63, for adults and
older adults with serious mental disorders. Existing law defines
serious mental disorders and includes a definition of functional
impairment for that purpose.
This bill would make the current definition of functional
impairment applicable to adults 18 to 59 years of age, inclusive, and
would, in addition, establish a definition of functional impairment
for adults 60 years of age or older. The bill would also make
eligible for services pursuant to this program adults 60
years of age or older who require brief treatment as a result of a
natural disaster or severe local emergency conforming
changes .
By expanding eligibility for community mental health services,
this bill would create a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
Vote: 2/3. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1170.9 of the Penal
Code is amended to read:
1170.9. (a) In the case of any person convicted of a criminal
offense who would otherwise be sentenced to county jail or state
prison and who alleges that he or she committed the offense as a
result of post-traumatic stress disorder, substance abuse, or
psychological problems stemming from service in a combat theater in
the United States military, the court shall, prior to sentencing,
hold a hearing to determine whether the defendant was a member of the
military forces of the United States who served in combat and shall
assess whether the defendant suffers from post-traumatic stress
disorder, substance abuse, or psychological problems as a result of
that service.
(b) If the court concludes that a defendant convicted of a
criminal offense is a person described in subdivision (a), and if the
defendant is otherwise eligible for probation and the court places
the defendant on probation, the court may order the defendant into a
local, state, federal, or private nonprofit treatment program for a
period not to exceed that which the defendant would have served in
state prison or county jail, provided the defendant agrees to
participate in the program and the court determines that an
appropriate treatment program exists.
(c) If a referral is made to the county mental health authority,
the county shall be obligated to provide mental health treatment
services only to the extent that resources are available for that
purpose, as described in paragraph (5) of
subdivision (b) (e) of Section 5600.3
of the Welfare and Institutions Code. If mental health treatment
services are ordered by the court, the county mental health agency
shall coordinate appropriate referral of the defendant to the county
veterans service officer, as described in paragraph (5) of
subdivision (b) (e) of
Section 5600.3 of the Welfare and Institutions Code. The county
mental health agency shall not be responsible for providing services
outside its traditional scope of services. An order shall be made
referring a defendant to a county mental health agency only if that
agency has agreed to accept responsibility for the treatment of the
defendant.
(d) When determining the "needs of the defendant," for purposes of
Section 1202.7, the court shall consider the fact that the defendant
is a person described in subdivision (a) in assessing whether the
defendant should be placed on probation and whether the defendant
would be best served while on probation by being ordered into a
private nonprofit treatment service program with a demonstrated
history of specializing in the treatment of military service-related
issues, such as post-traumatic stress disorder, substance abuse, or
psychological problems.
(e) A defendant granted probation under this section and committed
to a residential treatment program shall earn sentence credits for
the actual time the defendant served in residential treatment.
(f) The court, in making an order under this section to commit a
defendant to an established treatment program, shall give preference
to a treatment program that has a history of successfully treating
combat veterans who suffer from post-traumatic stress disorder,
substance abuse, or psychological problems as a result of that
service.
SEC. 2. Section 5346 of the Welfare and
Institutions Code is amended to read:
5346. (a) In any county in which services are available as
provided in Section 5348, a court may order a person who is the
subject of a petition filed pursuant to this section to obtain
assisted outpatient treatment if the court finds, by clear and
convincing evidence, that the facts stated in the verified petition
filed in accordance with this section are true and establish that all
of the requisite criteria set forth in this section are met,
including, but not limited to, each of the following:
(1) The person is 18 years of age or older.
(2) The person is suffering from a mental illness as defined in
paragraphs (2) and (3) of subdivision (b)
subdivision (b) or (c) of Section 5600.3.
(3) There has been a clinical determination that the person is
unlikely to survive safely in the community without supervision.
(4) The person has a history of lack of compliance with treatment
for his or her mental illness, in that at least one of the following
is true:
(A) The person's mental illness has, at least twice within the
last 36 months, been a substantial factor in necessitating
hospitalization, or receipt of services in a forensic or other mental
health unit of a state correctional facility or local correctional
facility, not including any period during which the person was
hospitalized or incarcerated immediately preceding the filing of the
petition.
(B) The person's mental illness has resulted in one or more acts
of serious and violent behavior toward himself or herself or another,
or threats, or attempts to cause serious physical harm to himself or
herself or another within the last 48 months, not including any
period in which the person was hospitalized or incarcerated
immediately preceding the filing of the petition.
(5) The person has been offered an opportunity to participate in a
treatment plan by the director of the local mental health
department, or his or her designee, provided the treatment plan
includes all of the services described in Section 5348, and the
person continues to fail to engage in treatment.
(6) The person's condition is substantially deteriorating.
(7) Participation in the assisted outpatient treatment program
would be the least restrictive placement necessary to ensure the
person's recovery and stability.
(8) In view of the person's treatment history and current
behavior, the person is in need of assisted outpatient treatment in
order to prevent a relapse or deterioration that would be likely to
result in grave disability or serious harm to himself or herself, or
to others, as defined in Section 5150.
(9) It is likely that the person will benefit from assisted
outpatient treatment.
(b) (1) A petition for an order authorizing assisted outpatient
treatment may be filed by the county mental health director, or his
or her designee, in the superior court in the county in which the
person who is the subject of the petition is present or reasonably
believed to be present.
(2) A request may be made only by any of the following persons to
the county mental health department for the filing of a petition to
obtain an order authorizing assisted outpatient treatment:
(A) Any person 18 years of age or older with whom the person who
is the subject of the petition resides.
(B) Any person who is the parent, spouse, or sibling or child 18
years of age or older of the person who is the subject of the
petition.
(C) The director of any public or private agency, treatment
facility, charitable organization, or licensed residential care
facility providing mental health services to the person who is the
subject of the petition in whose institution the subject of the
petition resides.
(D) The director of a hospital in which the person who is the
subject of the petition is hospitalized.
(E) A licensed mental health treatment provider who is either
supervising the treatment of, or treating for a mental illness, the
person who is the subject of the petition.
(F) A peace officer, parole officer, or probation officer assigned
to supervise the person who is the subject of the petition.
(3) Upon receiving a request pursuant to paragraph (2), the county
mental health director shall conduct an investigation into the
appropriateness of the filing of the petition. The director shall
file the petition only if he or she determines that there is a
reasonable likelihood that all the necessary elements to sustain the
petition can be proven in a court of law by clear and convincing
evidence.
(4) The petition shall state all of the following:
(A) Each of the criteria for assisted outpatient treatment as set
forth in subdivision (a).
(B) Facts that support the petitioner's belief that the person who
is the subject of the petition meets each criterion, provided that
the hearing on the petition shall be limited to the stated facts in
the verified petition, and the petition contains all the grounds on
which the petition is based, in order to ensure adequate notice to
the person who is the subject of the petition and his or her counsel.
(C) That the person who is the subject of the petition is present,
or is reasonably believed to be present, within the county where the
petition is filed.
(D) That the person who is the subject of the petition has the
right to be represented by counsel in all stages of the proceeding
under the petition, in accordance with subdivision (c).
(5) The petition shall be accompanied by an affidavit of a
licensed mental health treatment provider designated by the local
mental health director who shall state, if applicable, either of the
following:
(A) That the licensed mental health treatment provider has
personally examined the person who is the subject of the petition no
more than 10 days prior to the submission of the petition, the facts
and reasons why the person who is the subject of the petition meets
the criteria in subdivision (a), that the licensed mental health
treatment provider recommends assisted outpatient treatment for the
person who is the subject of the petition, and that the licensed
mental health treatment provider is willing and able to testify at
the hearing on the petition.
(B) That no more than 10 days prior to the filing of the petition,
the licensed mental health treatment provider, or his or her
designee, has made appropriate attempts to elicit the cooperation of
the person who is the subject of the petition, but has not been
successful in persuading that person to submit to an examination,
that the licensed mental health treatment provider has reason to
believe that the person who is the subject of the petition meets the
criteria for assisted outpatient treatment, and that the licensed
mental health treatment provider is willing and able to examine the
person who is the subject of the petition and testify at the hearing
on the petition.
(c) The person who is the subject of the petition shall have the
right to be represented by counsel at all stages of a proceeding
commenced under this section. If the person so elects, the court
shall immediately appoint the public defender or other attorney to
assist the person in all stages of the proceedings. The person shall
pay the cost of the legal services if he or she is able.
(d) (1) Upon receipt by the court of a petition submitted pursuant
to subdivision (b), the court shall fix the date for a hearing at a
time not later than five days from the date the petition is received
by the court, excluding Saturdays, Sundays, and holidays. The
petitioner shall promptly cause service of a copy of the petition,
together with written notice of the hearing date, to be made
personally on the person who is the subject of the petition, and
shall send a copy of the petition and notice to the county office of
patient rights, and to the current health care provider appointed for
the person who is the subject of the petition, if any such provider
is known to the petitioner. Continuances shall be permitted only for
good cause shown. In granting continuances, the court shall consider
the need for further examination by a physician or the potential need
to provide expeditiously assisted outpatient treatment. Upon the
hearing date, or upon any other date or dates to which the proceeding
may be continued, the court shall hear testimony. If it is deemed
advisable by the court, and if the person who is the subject of the
petition is available and has received notice pursuant to this
section, the court may examine in or out of court the person who is
the subject of the petition who is alleged to be in need of assisted
outpatient treatment. If the person who is the subject of the
petition does not appear at the hearing, and appropriate attempts to
elicit the attendance of the person have failed, the court may
conduct the hearing in the person's absence. If the hearing is
conducted without the person present, the court shall set forth the
factual basis for conducting the hearing without the person's
presence.
(2) The court shall not order assisted outpatient treatment unless
an examining licensed mental health treatment provider, who has
personally examined, and has reviewed the available treatment history
of, the person who is the subject of the petition within the time
period commencing 10 days before the filing of the petition,
testifies in person at the hearing.
(3) If the person who is the subject of the petition has refused
to be examined by a licensed mental health treatment provider, the
court may request that the person consent to an examination by a
licensed mental health treatment provider appointed by the court. If
the person who is the subject of the petition does not consent and
the court finds reasonable cause to believe that the allegations in
the petition are true, the court may order any person designated
under Section 5150 to take into custody the person who is the subject
of the petition and transport him or her, or cause him or her to be
transported, to a hospital for examination by a licensed mental
health treatment provider as soon as is practicable. Detention of the
person who is the subject of the petition under the order may not
exceed 72 hours. If the examination is performed by another licensed
mental health treatment provider, the examining licensed mental
health treatment provider may consult with the licensed mental health
treatment provider whose affirmation or affidavit accompanied the
petition regarding the issues of whether the allegations in the
petition are true and whether the person meets the criteria for
assisted outpatient treatment.
(4) The person who is the subject of the petition shall have all
of the following rights:
(A) To adequate notice of the hearings to the person who is the
subject of the petition, as well as to parties designated by the
person who is the subject of the petition.
(B) To receive a copy of the court-ordered evaluation.
(C) To counsel. If the person has not retained counsel, the court
shall appoint a public defender.
(D) To be informed of his or her right to judicial review by
habeas corpus.
(E) To be present at the hearing unless he or she waives the right
to be present.
(F) To present evidence.
(G) To call witnesses on his or her behalf.
(H) To cross-examine witnesses.
(I) To appeal decisions, and to be informed of his or her right to
appeal.
(5) (A) If after hearing all relevant evidence, the court finds
that the person who is the subject of the petition does not meet the
criteria for assisted outpatient treatment, the court shall dismiss
the petition.
(B) If after hearing all relevant evidence, the court finds that
the person who is the subject of the petition meets the criteria for
assisted outpatient treatment, and there is no appropriate and
feasible less restrictive alternative, the court may order the person
who is the subject of the petition to receive assisted outpatient
treatment for an initial period not to exceed six months. In
fashioning the order, the court shall specify that the proposed
treatment is the least restrictive treatment appropriate and feasible
for the person who is the subject of the petition. The order shall
state the categories of assisted outpatient treatment, as set forth
in Section 5348, that the person who is the subject of the petition
is to receive, and the court may not order treatment that has not
been recommended by the examining licensed mental health treatment
provider and included in the written treatment plan for assisted
outpatient treatment as required by subdivision (e). If the person
has executed an advance health care directive pursuant to Chapter 2
(commencing with Section 4650) of Part 1 of Division 4.7 of the
Probate Code, any directions included in the advance health care
directive shall be considered in formulating the written treatment
plan.
(6) If the person who is the subject of a petition for an order
for assisted outpatient treatment pursuant to subparagraph (B) of
paragraph (5) of subdivision (d) refuses to participate in the
assisted outpatient treatment program, the court may order the person
to meet with the assisted outpatient treatment team designated by
the director of the assisted outpatient treatment program. The
treatment team shall attempt to gain the person's cooperation with
treatment ordered by the court. The person may be subject to a
72-hour hold pursuant to subdivision (f) only after the treatment
team has attempted to gain the person's cooperation with treatment
ordered by the court, and has been unable to do so.
(e) Assisted outpatient treatment shall not be ordered unless the
licensed mental health treatment provider recommending assisted
outpatient treatment to the court has submitted to the court a
written treatment plan that includes services as set forth in Section
5348, and the court finds, in consultation with the county mental
health director, or his or her designee, all of the following:
(1) That the services are available from the county, or a provider
approved by the county, for the duration of the court order.
(2) That the services have been offered to the person by the local
director of mental health, or his or her designee, and the person
has been given an opportunity to participate on a voluntary basis,
and the person has failed to engage in, or has refused, treatment.
(3) That all of the elements of the petition required by this
article have been met.
(4) That the treatment plan will be delivered to the county
director of mental health, or to his or her appropriate designee.
(f) If, in the clinical judgment of a licensed mental health
treatment provider, the person who is the subject of the petition has
failed or has refused to comply with the treatment ordered by the
court, and, in the clinical judgment of the licensed mental health
treatment provider, efforts were made to solicit compliance, and, in
the clinical judgment of the licensed mental health treatment
provider, the person may be in need of involuntary admission to a
hospital for evaluation, the provider may request that persons
designated under Section 5150 take into custody the person who is the
subject of the petition and transport him or her, or cause him or
her to be transported, to a hospital, to be held up to 72 hours for
examination by a licensed mental health treatment provider to
determine if the person is in need of treatment pursuant to Section
5150. Any continued involuntary retention in a hospital beyond the
initial 72-hour period shall be pursuant to Section 5150. If at any
time during the 72-hour period the person is determined not to meet
the criteria of Section 5150, and does not agree to stay in the
hospital as a voluntary patient, he or she shall be released and any
subsequent involuntary detention in a hospital shall be pursuant to
Section 5150. Failure to comply with an order of assisted outpatient
treatment alone may not be grounds for involuntary civil commitment
or a finding that the person who is the subject of the petition is in
contempt of court.
(g) If the director of the assisted outpatient treatment program
determines that the condition of the patient requires further
assisted outpatient treatment, the director shall apply to the court,
prior to the expiration of the period of the initial assisted
outpatient treatment order, for an order authorizing continued
assisted outpatient treatment for a period not to exceed 180 days
from the date of the order. The procedures for obtaining any order
pursuant to this subdivision shall be in accordance with subdivisions
(a) to (f), inclusive. The period for further involuntary outpatient
treatment authorized by any subsequent order under this subdivision
may not exceed 180 days from the date of the order.
(h) At intervals of not less than 60 days during an assisted
outpatient treatment order, the director of the outpatient treatment
program shall file an affidavit with the court that ordered the
outpatient treatment affirming that the person who is the subject of
the order continues to meet the criteria for assisted outpatient
treatment. At these times, the person who is the subject of the order
shall have the right to a hearing on whether or not he or she still
meets the criteria for assisted outpatient treatment if he or she
disagrees with the director's affidavit. The burden of proof shall be
on the director.
(i) During each 60-day period specified in subdivision (h), if the
person who is the subject of the order believes that he or she is
being wrongfully retained in the assisted outpatient treatment
program against his or her wishes, he or she may file a petition for
a writ of habeas corpus, thus requiring the director of the assisted
outpatient treatment program to prove that the person who is the
subject of the order continues to meet the criteria for assisted
outpatient treatment.
(j) Any person ordered to undergo assisted outpatient treatment
pursuant to this article, who was not present at the hearing at which
the order was issued, may immediately petition the court for a writ
of habeas corpus. Treatment under the order for assisted outpatient
treatment may not commence until the resolution of that petition.
SECTION 1. SEC. 3. Section 5600.3 of
the Welfare and Institutions Code is amended to read:
5600.3. To the extent resources are available, the primary goal
of the use of funds deposited in the mental health account of the
local health and welfare trust fund should be to serve the target
populations identified in the following categories, which shall not
be construed as establishing an order of priority:
(a) (1) Seriously emotionally disturbed children or adolescents.
(2) For the purposes of this part, "seriously emotionally
disturbed children or adolescents" means minors under the age of 18
years who have a mental disorder as identified in the most recent
edition of the Diagnostic and Statistical Manual of Mental Disorders,
other than a primary substance use disorder or developmental
disorder, which results in behavior inappropriate to the child's age
according to expected developmental norms. Members of this target
population shall meet one or more of the following criteria:
(A) As a result of the mental disorder, the child has substantial
impairment in at least two of the following areas: self-care, school
functioning, family relationships, or ability to function in the
community; and either of the following occur:
(i) The child is at risk of removal from home or has already been
removed from the home.
(ii) The mental disorder and impairments have been present for
more than six months or are likely to continue for more than one year
without treatment.
(B) The child displays one of the following: psychotic features,
risk of suicide or risk of violence due to a mental disorder.
(C) The child meets special education eligibility requirements
under Chapter 26.5 (commencing with Section 7570) of Division 7 of
Title 1 of the Government Code.
(b) (1) Adults and older adults 18 to 59
years of age, inclusive, who have a serious mental disorder.
(2) For the purposes of this part, "serious mental disorder" means
a mental disorder that is severe in degree and persistent in
duration, that may cause behavioral functioning which interferes
substantially with the primary activities of daily living, and that
may result in an inability to maintain stable adjustment and
independent functioning without treatment, support, and
rehabilitation for a long or indefinite period of time. Serious
mental disorders include, but are not limited to, schizophrenia,
bipolar disorder, post-traumatic stress disorder, as well as major
affective disorders or other severely disabling mental disorders.
This section shall not be construed to exclude persons with a serious
mental disorder and a diagnosis of substance abuse, developmental
disability, or other physical or mental disorder.
(3) Members of this target population shall meet all of the
following criteria:
(A) The person has a mental disorder as identified in the most
recent edition of the Diagnostic and Statistical Manual of Mental
Disorders, other than a substance use disorder or developmental
disorder or acquired traumatic brain injury pursuant to subdivision
(a) of Section 4354 unless that person also has a serious mental
disorder as defined in paragraph (2).
(B) (i) As a result of the mental disorder, the person has
substantial functional impairments or symptoms, or a psychiatric
history demonstrating that without treatment there is an imminent
risk of decompensation to having substantial impairments or symptoms.
(ii) For the purposes of this part, "functional impairment" means
either of the following:
(I) For an adult
who is 18 to 59 years of age, inclusive, being being
substantially impaired as the result of a mental disorder in
independent living, social relationships, vocational skills, or
physical condition.
(II) For an adult who is 60 years of age or older, being
substantially impaired in major life activities because of a mental
disorder in at least two of the following areas on a continuing or
intermittent basis: (ia) independent living, (ib) social and family
relationships, (ic) vocational skills, employment, or leisure
activities, (id) basic living skills, including instrumental
activities of daily living, (ie) money management, (if) self-care,
including activities of daily living, or (ig) physical condition.
(C) As a result of a mental functional impairment and
circumstances, the person is likely to become so disabled as to
require public assistance, services, or entitlements.
(c) (1) Adults who are 60 years of age or older who have a serious
mental disorder.
(2) For purposes of this subdivision, "serious mental disorder"
means a mental disorder that is severe in degree and persistent in
duration, which may cause behavioral functioning which interferes
substantially with the primary activities of daily living, and which
may result in an inability to maintain stable adjustment and
independent functioning without treatment, support, and
rehabilitation for a long or indefinite period
of time. Serious mental disorders include, but
are not limited to, schizophrenia, bipolar disorder, post-traumatic
stress disorder, as well as major affective disorders or other
severely disabling mental disorders. This section shall not be
construed to exclude persons with a serious mental disorder and a
diagnosis of substance abuse, developmental disability, or other
physical or mental disorder.
(3) Members of this target population shall meet all of the
following criteria:
(A) The person has a mental disorder as identified in the most
recent edition of the Diagnostic and Statistical Manual of Mental
Disorders, other than a substance use disorder or developmental
disorder or acquired traumatic brain injury pursuant to subdivision
(a) of Section 4354 unless that person also has a serious mental
disorder as defined in paragraph (2).
(B) (i) As a result of the mental disorder, the person has
substantial functional impairments or symptoms, or a psychiatric
history demonstrating that without treatment there is an imminent
risk of decompensation to having substantial impairments or symptoms.
(ii) For purposes of this subdivision, functional impairment means
being substantially impaired as a result of a mental disorder in two
of the following areas on a continuing or intermittent basis:
independent living; social and family relationships; vocational
skills, employment, or leisure activities; basic living skills,
including instrument activities of daily living; money management;
self-care capacities, including activities of daily living; or
physical condition.
(C) As a result of a mental functional impairment and
circumstances, the person is likely to become so disabled as to
require public assistance, services, or entitlements.
(4)
(d) For the purpose of organizing outreach and
treatment options, to the extent resources are available,
this target population includes the adult and older
adult target populations, as defined in subdivisions (b) and (c),
include , but is are not limited
to, persons who are any of the following:
(A)
(1) Homeless persons who are mentally ill.
(B)
(2) Persons evaluated by appropriately licensed persons
as requiring care in acute treatment facilities including state
hospitals, acute inpatient facilities, institutes for mental disease,
and crisis residential programs.
(C)
(3) Persons arrested or convicted of crimes.
(D)
(4) Persons who require acute treatment as a result of
a first episode of mental illness with psychotic features.
(5)
(e) California veterans in need of mental health
services and who meet the existing eligibility requirements of this
section, shall be provided services to the extent services are
available to other adults and older adults pursuant to
this section. Veterans who may be eligible for mental health services
through the United States Department of Veterans Affairs should be
advised of these services by the county and assisted in linking to
those services.
(A)
(1) No eligible veteran shall be denied county mental
health services based solely on his or her status as a veteran.
(B)
(2) Counties shall refer a veteran to the county
veterans service officer, if any, to determine the veteran's
eligibility for, and the availability of, mental health services
provided by the United States Department of Veterans Affairs or other
federal health care provider.
(C)
(3) Counties should consider contracting with
community-based veterans' services agencies, where possible, to
provide high-quality, veteran specific mental health services.
(6) Adults 60 years of age or older shall be eligible if they
require brief treatment as a result of a natural disaster or severe
local emergency.
(c)
(f) Adults or older adults who require or are at risk
of requiring acute psychiatric inpatient care, residential treatment,
or outpatient crisis intervention because of a mental disorder with
symptoms of psychosis, suicidality, or violence.
(d)
(g) Persons who need brief treatment as a result of a
natural disaster or severe local emergency.
SEC. 4. Section 5600.6 of the Welfare
and Institutions Code is amended to read:
5600.6. The minimum array of services for adults meeting the
target population criteria established in subdivision
subdivisions (b) and (c) of Section
5600.3 should include the following modes of service in every
geographical area, to the extent resources are available:
(a) Precrisis and crisis services.
(b) Assessment.
(c) Medication education and management.
(d) Case management.
(e) Twenty-four-hour treatment services.
(f) Rehabilitation and support services.
(g) Vocational services.
(h) Residential services.
SEC. 5. Section 5600.7 of the Welfare
and Institutions Code is amended to read:
5600.7. The minimum array of services for older adults meeting
the target population criteria established in subdivision
subdivisions (b) and (c) of Section
5600.3 should include the following modes of service in every
geographical area, to the extent resources are available:
(a) Precrisis and crisis services, including mobile services.
(b) Assessment, including mobile services.
(c) Medication education and management.
(d) Case management, including mobile services.
(e) Twenty-four-hour treatment services.
(f) Residential services.
(g) Rehabilitation and support services, including mobile
services.
SEC. 6. Section 5813.5 of the Welfare
and Institutions Code is amended to read:
5813.5. Subject to the availability of funds from the Mental
Health Services Fund, the State Department of Mental Health shall
distribute funds for the provision of services under Sections 5801,
5802 and 5806 to county mental health programs. Services shall be
available to adults and seniors with severe illnesses who meet the
eligibility criteria in subdivisions (b) and (c)
to (f), inclusive, of Section 5600.3 of the Welfare and
Institutions Code. For purposes of this act, seniors means older
adult persons identified in Part 3 (commencing with Section 5800) of
this division.
(a) Funding shall be provided at sufficient levels to ensure that
counties can provide each adult and senior served pursuant to this
part with the medically necessary mental health services, medications
and supportive services set forth in the applicable treatment plan.
(b) The funding shall only cover the portions of those costs of
services that cannot be paid for with other funds including other
mental health funds, public and private insurance, and other local,
state and federal funds.
(c) Each county mental health programs plan shall provide for
services in accordance with the system of care for adults and seniors
who meet the eligibility criteria in subdivisions (b) and
(c) to (f), inclusive, of Section 5600.3.
(d) Planning for services shall be consistent with the philosophy,
principles, and practices of the Recovery Vision for mental health
consumers:
(1) To promote concepts key to the recovery for individuals who
have mental illness: hope, personal empowerment, respect, social
connections, self-responsibility, and self-determination.
(2) To promote consumer-operated services as a way to support
recovery.
(3) To reflect the cultural, ethnic and racial diversity of mental
health consumers.
(4) To plan for each consumer's individual needs.
(e) The plan for each county mental health program shall indicate,
subject to the availability of funds as determined by Part 4.5
(commencing with Section 5890) of this division, and other funds
available for mental health services, adults and seniors with a
severe mental illness being served by this program are either
receiving services from this program or have a mental illness that is
not sufficiently severe to require the level of services required of
this program.
(f) Each county plan and annual update pursuant to Section 5847
shall consider ways to provide services similar to those established
pursuant to the Mentally Ill Offender Crime Reduction Grant Program.
Funds shall not be used to pay for persons incarcerated in state
prison or parolees from state prisons.
(g) The department shall contract for services with county mental
health programs pursuant to Section 5897. After the effective date of
this section the term grants referred to in Sections 5814 and 5814.5
shall refer to such contracts.
SEC. 7. Section 5814 of the Welfare and
Institutions Code is amended to read:
5814. (a) (1) This part shall be implemented only to the extent
that funds are appropriated for purposes of this part. To the extent
that funds are made available, the first priority shall go to
maintain funding for the existing programs that meet adult system of
care contract goals. The next priority for funding shall be given to
counties with a high incidence of persons who are severely mentally
ill and homeless or at risk of homelessness, and meet the criteria
developed pursuant to paragraphs (3) and (4).
(2) The director shall establish a methodology for awarding grants
under this part consistent with the legislative intent expressed in
Section 5802, and in consultation with the advisory committee
established in this subdivision.
(3) (A) The director shall establish an advisory committee for the
purpose of providing advice regarding the development of criteria
for the award of grants, and the identification of specific
performance measures for evaluating the effectiveness of grants. The
committee shall review evaluation reports and make findings on
evidence-based best practices and recommendations for grant
conditions. At not less than one meeting annually, the advisory
committee shall provide to the director written comments on the
performance of each of the county programs. Upon request by the
department, each participating county that is the subject of a
comment shall provide a written response to the comment. The
department shall comment on each of these responses at a subsequent
meeting.
(B) The committee shall include, but not be limited to,
representatives from state, county, and community veterans' services
and disabled veterans outreach programs, supportive housing and other
housing assistance programs, law enforcement, county mental health
and private providers of local mental health services and mental
health outreach services, the Board of Corrections, the State
Department of Alcohol and Drug Programs, local substance abuse
services providers, the Department of Rehabilitation, providers of
local employment services, the State Department of Social Services,
the Department of Housing and Community Development, a service
provider to transition youth, the United Advocates for Children of
California, the California Mental Health Advocates for Children and
Youth, the Mental Health Association of California, the California
Alliance for the Mentally Ill, the California Network of Mental
Health Clients, the Mental Health Planning Council, and other
appropriate entities.
(4) The criteria for the award of grants shall include, but not be
limited to, all of the following:
(A) A description of a comprehensive strategic plan for providing
outreach, prevention, intervention, and evaluation in a cost
appropriate manner corresponding to the criteria specified in
subdivision (c).
(B) A description of the local population to be served, ability to
administer an effective service program, and the degree to which
local agencies and advocates will support and collaborate with
program efforts.
(C) A description of efforts to maximize the use of other state,
federal, and local funds or services that can support and enhance the
effectiveness of these programs.
(5) In order to reduce the cost of providing supportive housing
for clients, counties that receive a grant pursuant to this part
after January 1, 2004, shall enter into contracts with sponsors of
supportive housing projects to the greatest extent possible.
Participating counties are encouraged to commit a portion of their
grants to rental assistance for a specified number of housing units
in exchange for the counties' clients having the right of first
refusal to rent the assisted units.
(b) In each year in which additional funding is provided by the
annual Budget Act the department shall establish programs that offer
individual counties sufficient funds to comprehensively serve
severely mentally ill adults who are homeless, recently released from
a county jail or the state prison, or others who are untreated,
unstable, and at significant risk of incarceration or homelessness
unless treatment is provided to them and who are severely mentally
ill adults. For purposes of this subdivision, "severely mentally ill
adults" are those individuals described in subdivision (b)
subdivisions (b) and (c) of Section 5600.3. In
consultation with the advisory committee established pursuant to
paragraph (3) of subdivision (a), the department shall report to the
Legislature on or before May 1 of each year in which additional
funding is provided, and shall evaluate, at a minimum, the
effectiveness of the strategies in providing successful outreach and
reducing homelessness, involvement with local law enforcement, and
other measures identified by the department. The evaluation shall
include for each program funded in the current fiscal year as much of
the following as available information permits:
(1) The number of persons served, and of those, the number who
receive extensive community mental health services.
(2) The number of persons who are able to maintain housing,
including the type of housing and whether it is emergency,
transitional, or permanent housing, as defined by the department.
(3) (A) The amount of grant funding spent on each type of housing.
(B) Other local, state, or federal funds or programs used to house
clients.
(4) The number of persons with contacts with local law
enforcement and the extent to which local and state incarceration has
been reduced or avoided.
(5) The number of persons participating in employment service
programs including competitive employment.
(6) The number of persons contacted in outreach efforts who appear
to be severely mentally ill, as described in Section 5600.3, who
have refused treatment after completion of all applicable outreach
measures.
(7) The amount of hospitalization that has been reduced or
avoided.
(8) The extent to which veterans identified through these programs'
outreach are receiving federally funded veterans' services for which
they are eligible.
(9) The extent to which programs funded for three or more years
are making a measurable and significant difference on the street, in
hospitals, and in jails, as compared to other counties or as compared
to those counties in previous years.
(10) For those who have been enrolled in this program for at least
two years and who were enrolled in Medi-Cal prior to, and at the
time they were enrolled in, this program, a comparison of their
Medi-Cal hospitalizations and other Medi-Cal costs for the two years
prior to enrollment and the two years after enrollment in this
program.
(11) The number of persons served who were and were not receiving
Medi-Cal benefits in the 12-month period prior to enrollment and, to
the extent possible, the number of emergency room visits and other
medical costs for those not enrolled in Medi-Cal in the prior
12-month period.
(c) To the extent that state savings associated with providing
integrated services for the mentally ill are quantified, it is the
intent of the Legislature to capture those savings in order to
provide integrated services to additional adults.
(d) Each project shall include outreach and service grants in
accordance with a contract between the state and approved counties
that reflects the number of anticipated contacts with people who are
homeless or at risk of homelessness, and the number of those who are
severely mentally ill and who are likely to be successfully referred
for treatment and will remain in treatment as necessary.
(e) All counties that receive funding shall be subject to specific
terms and conditions of oversight and training which shall be
developed by the department, in consultation with the advisory
committee.
(f) (1) As used in this part, "receiving extensive mental health
services" means having a personal services coordinator, as described
in subdivision (b) of Section 5806, and having an individual personal
service plan, as described in subdivision (c) of Section 5806.
(2) The funding provided pursuant to this part shall be sufficient
to provide mental health services, medically necessary medications
to treat severe mental illnesses, alcohol and drug services,
transportation, supportive housing and other housing assistance,
vocational rehabilitation and supported employment services, money
management assistance for accessing other health care and obtaining
federal income and housing support, accessing veterans' services,
stipends, and other incentives to attract and retain sufficient
numbers of qualified professionals as necessary to provide the
necessary levels of these services. These grants shall, however, pay
for only that portion of the costs of those services not otherwise
provided by federal funds or other state funds.
(3) Methods used by counties to contract for services pursuant to
paragraph (2) shall promote prompt and flexible use of funds,
consistent with the scope of services for which the county has
contracted with each provider.
(g) Contracts awarded pursuant to this part shall be exempt from
the Public Contract Code and the state administrative manual and
shall not be subject to the approval of the Department of General
Services.
(h) Notwithstanding any other provision of law, funds awarded to
counties pursuant to this part and Part 4 (commencing with Section
5850) shall not require a local match in funds.
SEC. 2. SEC. 8. If the Commission on
State Mandates determines that this act contains costs mandated by
the state, reimbursement to local agencies and school districts for
those costs shall be made pursuant to Part 7 (commencing with Section
17500) of Division 4 of Title 2 of the Government Code.
