Bill Text: CA AB2119 | 2023-2024 | Regular Session | Amended
Bill Title: Mental health.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Engrossed) 2024-06-10 - In committee: Referred to suspense file. [AB2119 Detail]
Download: California-2023-AB2119-Amended.html
|
Amended
IN
Assembly
March 18, 2024 |
CALIFORNIA LEGISLATURE—
2023–2024 REGULAR SESSION
Assembly Bill
No. 2119
| Introduced by Assembly Member Weber |
February 06, 2024 |
An act to amend Section 4333.5 of the Welfare and Institutions Code, Sections 4012, 4033, 4051, 4094.5, 4096, 4096.5, 4240, 4341, 5020.1, 5120, 5326.2, 5346, 5348, 5349.1, 5585.10, 5585.57, 5600.3, 5680, 5681, 5682, 5683, 5685.5, 5686, 5688.6, 5691, 5694, 5694.7, 5695, 5695.2, 5696, 5698, 5699.2, 5731, 5801, 5802, 5806, 5814, 5814.5, 5840, 5846, 5851, 5852.5, 5855, 5856, 5856.2, 5860, 5878.1, 5878.2, 5878.3, 5880, 5886, 5900, 5903, 5909,
6552, and 18986.40 of, to amend the heading of Chapter 2.5 (commencing with Section 4240) of Part 2 of Division 4 of, to amend the heading of Article 1 (commencing with Section 5150) and Article
2 (commencing with Section 5200) of Chapter 2 of Part 1 of Division 5 of, to amend the heading of Chapter 3 (commencing with Section 5350) of Part 1 of Division 5 of, and to amend the heading of Article 2 (commencing with Section 5680),
Article 5 (commencing with Section 5694.7), Article 6 (commencing with Section 5695), and Article 7 (commencing with Section 5698) of Chapter 2.5 of Part 2 of Division 5 of, the
Welfare and Institutions Code, relating to mental health.
LEGISLATIVE COUNSEL'S DIGEST
AB 2119, as amended, Weber.
State Department of State Hospitals. Mental health.
Existing law makes various references to the descriptive terms “persons with a mental health disorder,” “minors with a mental health condition,” and “children and adolescents with serious emotional disturbance” in various provisions of the Welfare and Institutions Code.
This bill would make conforming changes to these provisions for consistency with those descriptor terms to, among other things, put the person first. The bill would also make other technical changes.
Existing law establishes state hospitals for the care, treatment, and education of mentally disordered persons. These hospitals are under the jurisdiction of the State Department of State Hospitals, which is authorized by existing law to adopt regulations regarding the conduct and management of these facilities. Existing law requires the department to encourage counties to use state hospital facilities, in addition to utilizing state hospital beds pursuant to contract, for additional treatment programs through contracts, as specified.
This bill would make technical, nonsubstantive changes to that provision.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: NO Local Program: NOBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 4012 of the Welfare and Institutions Code is amended to read:4012.
The State Department of State Hospitals, the State Department of Health Care Services, and other departments as necessary, may:(a) Disseminate educational information relating to the prevention, diagnosis and treatment of mental illness.
(b) Upon request, advise all public officers, organizations and agencies a public officer,
organization, or agency
interested in the mental health of the people of the state.
(c) Conduct such educational and related work as will tend to encourage the development of proper mental health facilities throughout the state.
(d) Coordinate state activities involving other departments whose actions affect mentally ill
persons. a person with a mental health condition.
(e) Coordinate with, and provide information to, other states and national organizations, on issues involving mental health.
(f) Disseminate information and federal and private foundation funding opportunities to counties and cities that administer a county or city that administers mental health programs.
SEC. 2.
Section 4033 of the Welfare and Institutions Code is amended to read:4033.
(a) The State Department of Health Care Services shall, to the extent resources are available, comply with the Substance Abuse and Mental Health Services Administration federal planning requirements. The department shall update and issue a state plan, which may also be any federally required state service plan, so(b) (1) If the State Department of Health Care Services makes a decision not to comply with any Substance Abuse and Mental Health Services Administration federal planning requirement to which this section applies, the State Department of Health Care Services shall submit the decision, for consultation, to the County Behavioral Health Directors Association of California, the California Behavioral Health Planning Council,
and affected mental health entities.
(2) The State Department of Health Care Services shall not implement any decision not to comply with the Substance Abuse and Mental Health Services Administration federal planning requirements sooner than 30 days after notification of that decision, in writing, by the Department of Finance, to the chairperson of the committee in each house of the Legislature that considers appropriations, and the Chairperson of the Joint Legislative Budget Committee.
SEC. 3.
Section 4051 of the Welfare and Institutions Code is amended to read:4051.
The State Department of Health Care Services shall, to the extent resources are available, provide program development guidelines, evaluation models, and operational assistance on all aspects of services to(a) Self-help programs.
(b) Housing development.
(c) Disaster preparation.
(d) Vocational services.
(e) Regional programs.
(f) Multiple diagnosis programs.
SEC. 4.
Section 4094.5 of the Welfare and Institutions Code is amended to read:4094.5.
Regulations for community treatment facilities adopted pursuant to Section 4094 shall include, but not be limited to, the following:(a) Only seriously emotionally disturbed children, a child with serious emotional disturbance, as defined in Section 5699.2, either (1) for whom other less restrictive mental health interventions have been tried, as documented in the case plan, or (2) who are is currently
placed in an acute psychiatric hospital or state hospital or in a facility outside the state for mental health treatment, and who may require periods of containment to participate in, and benefit from, mental health treatment, shall be placed in a community treatment facility. For purposes of this subdivision, lesser restrictive interventions shall include, but are not limited to, outpatient therapy, family counseling, case management, family preservation efforts, special education classes, or nonpublic schooling.
(b) A facility shall have the capacity to provide secure containment. For purposes of this section, a facility or an area of a facility shall be defined as secure if residents are not permitted to leave the premises of their own volition. All or part of a facility, including its perimeter, but not a room alone, may be locked or secure. If a facility uses perimeter fencing, all beds within the perimeter shall be considered secure beds.
All beds outside of a locked or secure wing or facility shall be considered nonsecure beds.
(c) A locked or secure program in a facility shall not be used for disciplinary purposes, but shall be used for the protection of the minor. child. It may be used as a treatment modality for a child needing that level of care. The use of the secure facility program shall be for as short a period as possible, consistent with the child’s case plan and safety. The department shall develop regulations governing the oversight, review, and duration of the use of secure beds.
(d) Fire clearance approval shall be obtained pursuant to Section 1531.2 of the Health and Safety Code.
(e) (1) Prior to admission, any a child admitted to a community treatment facility shall have been certified as seriously emotionally disturbed, having serious emotional disturbance, as defined in Section 5699.2, by a licensed mental health professional.
(A) Except in the case
of placement on an emergency basis, as described in subdivision (i) of Section 4096, any child who is a dependent or ward of the juvenile court, is the subject of a petition filed pursuant to Section 300, has been detained pursuant to Section 636, or is voluntarily placed and the placement is funded by the Aid to Families with Dependent Children-Foster Care program, shall, prior to admission, have been determined by a county interagency placement committee to require placement in the community treatment facility, as prescribed by subdivision (e) of Section 4096. A copy of the interagency placement committee determination shall be provided to the facility.
(B) Any child who is a dependent or ward of the juvenile court, is the subject of a petition filed pursuant to Section 300, has been detained pursuant to Section 636, or is voluntarily placed and the placement is funded by the Aid to Families with Dependent Children-Foster Care program, shall
be assessed by a qualified individual, as defined in subdivision (l) of Section 16501, pursuant to subdivision (g) of Section 4096, as needing the level of care provided by a community treatment facility. The assessment by the qualified individual shall occur prior to the child’s admission to the facility, or, if delaying placement for the qualified individual’s assessment would be contrary to the child’s well-being, within 30 days after the child began physically residing in the facility. A copy of the completed assessment shall be provided to the facility.
(C) Federal financial participation under the Medi-Cal program shall only be available if all state and federal requirements are met and the treatment is medically necessary. Federal financial participation under the Medi-Cal program shall not be claimed for medical assistance expenditures relating to minors or nonminors detained in a juvenile justice facility, unless expressly permitted
under the federal law, or approved under the CalAIM Terms and Conditions as defined in subdivision (c) of Section 14184.101 or the approved terms and conditions of a successor waiver or demonstration project.
(2) Any county cost associated with the certification and the determination provided for in paragraph (1) may be billed as a utilization review expense.
SEC. 5.
Section 4096 of the Welfare and Institutions Code is amended to read:4096.
(a) This section governs interagency placement committees related to the placement of(1) Interagency collaboration and children’s program services shall be structured in a manner that will facilitate implementation of the goals of Part 4 (commencing with Section 5850) of Division 5 to develop protocols outlining the roles and responsibilities of placing agencies and programs regarding nonemergency placements of foster children a foster child in a certified residential therapeutic programs. program.
(2) Components shall be added to state-county performance contracts required in Section 5650 that provide for reports from counties on how this section is implemented.
(3) The State Department of Health Care Services shall develop performance contract components required by paragraph (2).
(4) Performance contracts subject to this section shall document that the procedures to be implemented in compliance with this section have been approved by the county social services department and the county probation department.
(b) Funds specified in subdivision (a) of Section 17601 for services to wards of the court and dependent children of the court shall be allocated and distributed to counties based on the number of wards of the court and dependent children of the court in the county.
(c) A county may utilize funds allocated pursuant to subdivision (b) only if the county has established an operational interagency placement committee with a membership that includes at least the county placement agency and a licensed mental health professional from the county department of mental health. If necessary, the funds may be used for costs associated with establishing the interagency placement committee.
(d) Funds allocated pursuant to subdivision (b) shall be used to provide services to wards of the court and dependent children of the court jointly identified by county mental health, social services, and probation departments as the highest priority. Every effort shall be made to match those funds with funds received pursuant to Title XIX of the federal Social Security Act, contained in Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United
States Code.
(e) (1) Each interagency placement committee shall establish procedures whereby a ward of the court or dependent child of the court, a child who is the subject of a petition filed pursuant to Section 300, a child detained pursuant to Section 636, or a voluntarily placed child whose placement is funded by the Aid to Families with Dependent Children-Foster Care program, who is to be placed or is currently placed in a program, as specified in subdivision (a), shall be determined to meet one of the following:
(A) The child or ward meets the medical necessity criteria for Medi-Cal specialty mental health services, as the criteria are described in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.
(B) The child or ward is assessed as seriously emotionally disturbed,
and diagnosed with serious emotional disturbance as described in subdivision (a) of Section 5600.3.
(C) The child’s or ward’s individual behavioral or treatment needs can only be met by the level of care provided in a program, as specified in subdivision (a).
(2) The determination required by paragraph (1) shall do all of the following:
(A) Ensure that the care and services that the child needs, including any care or service needs determined by the qualified individual assessment, are provided by a program, as specified in subdivision (a), and include documentation regarding how medically necessary Medi-Cal specialty mental health services will be provided in a provisionally licensed program.
(B) Ensure that
the requirements of subdivision (c) of Section 16514 have been met with respect to commonality of need.
(C) Consider the detailed history that shall be provided by the placing agency outlining behavior that may pose a threat to the health or safety of that child and the other children residing in the program and consider any potential interference with the effectiveness of the care and services provided to that child and the other children residing in the program, as specified in subdivision (a).
(D) Describe additional safety measures and therapeutic interventions needed to mitigate identified challenging behaviors or risks to the safety of the child and other children in the facility.
(E) Present the determination to the placing agency within five business days of the referral.
(3) This subdivision does not prohibit an interagency placement committee from considering an assessment that was provided by a licensed mental health professional, as described in subdivision (j), and that was developed consistent with procedures established by the county pursuant to paragraph (1).
(4) The State Department of Health Care Services and the State Department of Social Services shall develop a dispute resolution process or utilize an existing dispute resolution process currently operated by each department to jointly review a disputed interagency placement committee determination made pursuant to this subdivision. The departments shall report the developed or utilized dispute resolution process to the appropriate policy and fiscal committees of the Legislature no later than January 1, 2017, and shall track the number of disputes reported and resolved, and provide that
information to the Legislature annually as part of the State Budget process. Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the departments may issue guidance on the joint review process for dispute resolution by written directive.
(f) The interagency placement committee shall document the results of the determination required by subdivision (e) and shall notify the appropriate provider in writing, of those results within 10 days of the completion of the determination.
(g) (1) For a placement in a short-term therapeutic residential program, a community treatment facility, as defined in paragraph (8) of subdivision (a) of Section 1502 of the Health and Safety Code, or in an out-of-state residential facility, as defined by
paragraph (2) of subdivision (b) of Section 7910 of the Family Code, made on or after October 1, 2021, a qualified individual, as defined pursuant to subdivision (l) of Section 16501, shall conduct an assessment pursuant to this subdivision if the child is placed by a county child welfare or probation placing agency.
(2) (A) Unless the placement is an emergency placement pursuant to paragraph (3) of subdivision (h) of Section 11462.01, the qualified individual shall conduct an independent assessment and determination regarding the needs of the child prior to placement in a short-term therapeutic residential program, in a community treatment facility, or in an out-of-state residential facility, as defined by paragraph (2) of subdivision (b) of Section 7910 of the Family Code. In the event of an emergency placement, the qualified individual shall conduct the independent assessment and determination regarding the needs of the
child within 30 days of the start of the placement.
(B) In connection with the activities required by the qualified individual, placing agencies shall adopt, and all parties to the child’s case shall utilize, the universal release of information identified by the State Department of Social Services and the State Department of Health Care Services.
(3) The assessment conducted by the qualified individual shall include, at a minimum, all of the following:
(A) Engagement with the child and family team members and, in the case of an Indian child, the Indian child’s tribe, in conducting the assessment.
(B) An assessment of the strengths and needs of the child or nonminor dependent, using an age-appropriate, evidence-based, validated, functional assessment
tool and methodology approved by the State Department of Social Services and the State Department of Health Care Services. If the authorized assessment tool has already been completed as part of the child and family team within two months of the referral to a qualified individual, the qualified individual may utilize or update those results at the discretion of the qualified individual. If the assessment tool was completed more than two months before the referral to a qualified individual, the qualified individual shall update those results.
(C) The identification of the child-specific short- and long-term mental and behavioral health goals and treatment needs of the child.
(D) In the case of an Indian child, the qualified individual’s efforts to consult with the child’s tribe. The qualified individual shall consult and confer with a representative of the child’s tribe or, at the
direction of the tribal representative, the qualified expert witness, as described in Section 224.6. Such consultation shall include, but not be limited to, determination of the social and cultural standards of the Indian child’s tribe.
(4) The qualified individual shall determine and document the following in writing:
(A) Whether the assessed needs of the child or nonminor dependent can be met with family members, in a tribally approved home in the case of an Indian child, or in another family-based setting.
(B) If the child or nonminor dependent’s needs cannot be met with family members, in a tribally approved home in the case of an Indian child, or in another family-based setting, all of the following:
(i) Why the needs of the child cannot be met
with family members of the child or in another family-based setting identified by the placing agency, or in a tribally approved home in the case of an Indian child.
(ii) Why a short-term residential therapeutic program, or, where applicable, a community treatment facility, as defined in paragraph (8) of subdivision (a) of Section 1502 of the Health and Safety Code, or an out-of-state residential facility, as defined by paragraph (2) of subdivision (b) of Section 7910 of the Family Code, is the setting that will provide the child with the most effective and appropriate level of care in the least restrictive environment.
(iii) How a short-term residential therapeutic program intervention, or, where applicable, the program intervention of a community treatment facility or an out-of-state residential facility, as defined by paragraph (2) of subdivision (b) of Section 7910 of the
Family Code, is consistent with the short- and long-term goals for the child, as specified in the permanency plan for the child, and for an Indian child, will meet the child’s needs consistent with the prevailing social and cultural conditions and way of life of the Indian child’s tribe.
(iv) The mental and behavioral health interventions and treatment that the program will implement to improve functioning and well-being and, for an Indian child, how the interventions and treatment will be conducted in a manner consistent with the prevailing social and cultural conditions and way of life of the Indian child’s tribe.
(v) Any A known multiagency care coordination needs that should be planned for
during discharge and aftercare planning, as developed pursuant to Section 4096.6, upon the child’s transition to a family-based setting.
(C) The engagement with the child and family team members and, in the case of an Indian child, the Indian child’s tribe.
(5) The assessment of the qualified individual does not replace or replicate existing case planning or case management activities, roles, and responsibilities of the county placing agency caseworker in preparation of the child’s case plan pursuant to Section 16501.1 or requirements of the interagency placement committee established pursuant to this section.
(6) The qualified individual shall provide the assessment required by paragraph (3) and the report required by paragraph (4) to the county placing agency and the short-term residential therapeutic program, or,
where applicable, the community treatment facility, as defined in paragraph (8) of subdivision (a) of Section 1502 of the Health and Safety Code, or the out-of-state residential facility, as defined by paragraph (2) of subdivision (b) of Section 7910 of the Family Code, in which the child or nonminor dependent is or will be placed.
(7) It is the intent of the Legislature that the assessments of a qualified individual provided pursuant to this subdivision are provided as specialty mental health services, whenever possible, consistent with all state and federal Medicaid requirements.
(8) For purposes of subparagraph (K) of paragraph (1) of subdivision (a) of Section 827, a qualified individual shall be considered a member of the child’s multidisciplinary team.
(h) (1) The State Department of
Social Services and the State Department of Health Care Services shall issue joint guidance that shall include, but not be limited to, all of the following:
(A) The statewide standards and approval requirements for qualified individuals, as defined in subdivision (l) of Section 16501.
(B) The requirements for referrals to, and the assessment conducted by, the qualified individual pursuant to subdivision (g).
(C) Documentation requirements necessary to meet state and federal child welfare requirements and documentation requirements for Medi-Cal specialty mental health activities conducted by the qualified individual.
(D) The applicable state and federal privacy and confidentiality laws that permit or limit the dissemination of the assessment of the
qualified individual developed pursuant to subdivision (g).
(2) The guidance issued pursuant to this subdivision shall be issued on or before July 31, 2021.
(i) Nothing in this section shall be interpreted to This section does not prevent a county placing agency from making a placement in a short-term residential therapeutic program or a community treatment facility on an emergency basis, as permitted pursuant to subdivision (h) of Section 11462.01, prior to the determination by the interagency placement committee pursuant to this section.
(j) If the child’s or youth’s placement is not funded by the Aid to Families with Dependent
Children-Foster Care program a licensed mental health professional, or an otherwise recognized provider of mental health services, shall certify that the child has been assessed as meeting the medical necessity criteria for Medi-Cal specialty mental health Early and Periodic Screening, Diagnosis, and Treatment services, as the criteria are described in Section 1830.210 of Title 9 of the California Code of Regulations, or assessed as seriously emotionally disturbed,
and diagnosed with serious emotional disturbance as described in subdivision (a) of Section 5600.3. A “licensed mental health professional” includes a physician licensed under Section 2050 of the Business and Professions Code, a licensed psychologist within the meaning of subdivision (a) of Section 2902 of the Business and Professions Code, a licensed clinical social worker within the meaning of subdivision (a) of Section 4996 of the Business and Professions Code, a licensed marriage and family therapist within the meaning of subdivision (b) of Section 4980 of the Business and Professions Code, or a licensed professional clinical counselor within the meaning of subdivision (e) of Section 4999.12.
(k) (1) Notwithstanding any other law, contracts awarded by the State Department of Social Services for purposes of this section shall be exempt from the personal services contracting
requirements of Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code.
(2) Notwithstanding any other law, contracts awarded by the State Department of Social Services for purposes of this section shall be exempt from the Public Contract Code and the State Contracting Manual, and shall not be subject to the approval of the Department of General Services.
SEC. 6.
Section 4096.5 of the Welfare and Institutions Code is amended to read:4096.5.
(a) This section governs standards for the mental health program approval for short-term residential therapeutic programs, which is required under subdivision (c) of Section 1562.01 of the Health and Safety Code.(b) All short-term residential therapeutic programs that serve children who have either been assessed as meeting the medical necessity criteria for Medi-Cal specialty mental health services, as provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations, or who have been assessed as seriously emotionally disturbed, and diagnosed with serious emotional
disturbance, as defined in subdivision (a) of Section 5600.3, shall obtain and have in good standing a mental health program approval and a Medi-Cal mental health certification, as described in Section 11462.01, issued by the State Department of Health Care Services or a county mental health plan to which the department has delegated approval authority. This approval, which is required pursuant to subdivision (c) of Section 1562.01 of the Health and Safety Code, is a condition for receiving an Aid to Families with Dependent Children-Foster Care rate pursuant to Section 11462.01.
(c) (1) A short-term residential therapeutic program shall not directly provide specialty mental health services without a current mental health program approval. A licensed short-term residential therapeutic program that has not obtained a program approval shall provide children in its care access to appropriate mental
health services.
(2) County mental health plans shall ensure that Medi-Cal specialty mental health services, including, but not limited to, services under the Early and Periodic Screening, Diagnosis and Treatment benefit, are provided to all Medi-Cal beneficiaries served by short-term residential therapeutic programs who meet medical necessity criteria, as provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.
(d) (1) The State Department of Health Care Services or a county mental health plan to which the department has delegated mental health program approval authority shall approve or deny mental health program approval requests within 45 days of receiving a request. The State Department of Health Care Services or a county mental health plan to which the department has delegated mental health program approval
authority shall issue each mental health program approval for a period of one year, except for approvals granted pursuant to paragraph (2) and provisional approvals granted pursuant to regulations promulgated under subdivision (e), and shall specify the effective date of the approval. Approved entities shall meet all program standards to be reapproved.
(2) (A) Between January 1, 2017, and December 31, 2017, the State Department of Health Care Services, or a county mental health plan to which the department has delegated mental health program approval authority, shall approve or deny a mental health program approval request within 90 days of receipt.
(B) Between January 1, 2017, and December 31, 2017, the State Department of Health Care Services, or a county mental health plan to which the department has delegated mental health program approval authority, may
issue a mental health program approval for a period of less than one year.
(e) (1) The State Department of Health Care Services and the county mental health plans to which the department has delegated mental health program approval authority may enforce the mental health program approval standards by taking any of the following actions against a noncompliant short-term residential therapeutic program:
(A) Suspend or revoke a mental health program approval.
(B) Impose monetary penalties.
(C) Place a mental health program on probation.
(D) Require a mental health program to prepare and comply with a corrective action plan.
(2) The State Department of Health Care Services and the county mental health plans to which the department has delegated mental health program approval authority shall provide short-term residential therapeutic programs with due process protections when taking any of the actions described in paragraph (1).
(f) The State Department of Health Care Services, in consultation with the State Department of Social Services, shall promulgate regulations regarding program standards, oversight, enforcement, issuance of mental health program approvals, including provisional approvals that are effective for a period of less than one year, and due process protections related to the mental health program approval process for short-term residential therapeutic programs.
(g) (1) Except for mental health program
approval of short-term residential therapeutic programs operated by a county, the State Department of Health Care Services may, upon the request of a county, delegate to that county mental health plan the mental health program approval of short-term residential therapeutic programs within its borders.
(2) Any county to which mental health program approval is delegated pursuant to paragraph (1) shall be responsible for the oversight and enforcement of program standards and the provision of due process for approved and denied entities.
(h) The State Department of Health Care Services or a county mental health plan to which the department has delegated mental health program approval authority shall notify the State Department of Social Services immediately upon the termination of any mental health program approval issued in accordance with subdivisions (b) and (d).
(i) The State Department of Social Services shall notify the State Department of Health Care Services and, if applicable, a county to which the department has delegated mental health program approval authority, immediately upon the revocation of any license issued pursuant to Chapter 3 (commencing with Section 1500) of Division 2 of the Health and Safety Code.
(j) Revocation of a license or a mental health program approval or failure to meet the requirements of subdivision (c) of Section 1562.01 of the Health and Safety Code shall be a basis for rate termination.
SEC. 7.
The heading of Chapter 2.5 (commencing with Section 4240) of Part 2 of Division 4 of the Welfare and Institutions Code is amended to read:
CHAPTER
2.5. Families of Persons With a Serious Mental Disorders Health Disorder
SEC. 8.
Section 4240 of the Welfare and Institutions Code is amended to read:4240.
The Legislature finds and declares all of the following:(a) The symptoms and behaviors of persons with a serious mental health disorders disorder may cause severe disruption of normal family relationships.
(b) Families are often the principal caregivers, housing providers, and case managers for family members with a serious
mental health disorders. disorder.
(c) Families of persons with a serious mental health disorders disorder more often than not have little or no legal authority over their adult family members with a mental health disorders
disorder who are sometimes difficult to manage. Consequently, they need advice, skills, emotional support, and guidance to cope with the stressful burden
stress of caregiving in order to be effective and helpful.
(d) Involved families are of inestimable value to the publicly funded and professionally operated state and county mental health system and programs emphasizing self-help can be the best way to assist families in maintaining the cohesion of family life while caring for and assisting a family member with a mental health disorder.
(e) Since the state’s mental health resources are limited and are increasingly being directed on a priority basis toward provision of services to persons with a serious mental health disorders,
disorder, informed and active families helping one another can effectively extend and amplify the value of state mental health dollars.
SEC. 9.
Section 4341 of the Welfare and Institutions Code is amended to read:4341.
(a)(b) Implementation of the program shall include negotiation with any or all of the following: the University of California, state colleges, community colleges, private universities and colleges, public and private hospitals, and public and private rehabilitation, community care, treatment providers, and professional associations, to arrange affiliations and contracts for educational and training programs to ensure appropriate numbers of graduates with experience in serving severely mentally ill persons persons with a serious
mental health condition in the most cost-effective programs.
(c) The human resources development effort shall be undertaken with active participation of the California Conference of Local Mental Health Directors, client and family representatives, and professional and academic institutions.
(d) The program shall give particular attention to areas of specific expertise where local programs and state hospitals have difficulty recruiting qualified staff, including programs for forensic persistently severely mentally ill children and youth, and severely mentally ill elderly persons. children and youth with forensic persistent and severe mental health conditions and elderly persons with serious
mental health conditions.
Specific attention shall be given to ensuring the development of a mental health work force with the necessary bilingual and bicultural skills to deliver effective service to the diverse population of the state.
SEC. 10.
Section 5020.1 of the Welfare and Institutions Code is amended to read:5020.1.
ASEC. 11.
Section 5120 of the Welfare and Institutions Code is amended to read:5120.
It is the policy of this state as declared and established in this act and in the Lanterman-Petris-Short Act that the care and treatment ofHealth facilities for inpatient and outpatient psychiatric care and treatment shall be permitted in any area zoned for hospitals or nursing homes, or in which hospitals and nursing homes are permitted by conditional use permit.
SEC. 12.
The heading of Article 1 (commencing with Section 5150) of Chapter 2 of Part 1 of Division 5 of the Welfare and Institutions Code is amended to read:
Article
1. Detention of Mentally Disordered Persons with a Mental Health Condition for Evaluation and Treatment
SEC. 13.
The heading of Article 2 (commencing with Section 5200) of Chapter 2 of Part 1 of Division 5 of the Welfare and Institutions Code is amended to read:
Article
2. Court-Ordered Evaluation for Mentally Disordered Persons with a Mental Health Condition
SEC. 14.
Section 5326.2 of the Welfare and Institutions Code is amended to read:5326.2.
To constitute voluntary informed consent, the following information shall be given to the patient in a clear and explicit manner:(a) The reason for treatment, that is, the nature and seriousness of the patient’s illness, disorder or defect. disorder, or condition.
(b) The nature of the procedures to be used in the proposed treatment, including its probable frequency and duration.
(c) The probable degree and duration
(temporary or permanent) of improvement or remission, expected with or without such treatment.
(d) The nature, degree, duration, and the probability of the side effects and significant risks, commonly known by the medical profession, of such treatment, including its adjuvants, especially noting the degree and duration of memory loss (including its irreversibility) and how and to what extent they may be controlled, if at all.
(e) That there exists a division of opinion as to the efficacy of the proposed treatment, why and how it works and its commonly known risks and side effects.
(f) The reasonable alternative treatments, and why the physician is recommending this particular treatment.
(g) That the patient has the right to accept or refuse the proposed
treatment, and that if he or she the patient consents,
the patient has the right to revoke his or her their
consent for any reason, at any time prior to or between treatments.
SEC. 15.
Section 5346 of the Welfare and Institutions Code is amended to read:5346.
(a) In any county or group of counties where 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
experiencing a mental illness as defined in paragraphs (2) and (3) of subdivision (b) of Section 5600.3.
(3) There has been a clinical determination that, in view of the person’s treatment history and current behavior, at least one of the following is true:
(A) The person is unlikely to survive safely in the community without supervision and the person’s condition is substantially deteriorating.
(B) 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 the person or to others, as defined in Section 5150.
(4) The person has a history of lack of compliance with treatment for the person’s 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 themselves or another, or threats, or attempts to cause serious physical harm to themselves 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 the director’s 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) Participation in the assisted outpatient treatment program would be the least restrictive placement necessary to ensure the person’s recovery and stability.
(7) 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 behavioral health director, or the director’s 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) A person 18 years of age or older with whom the person who is the subject of the petition resides.
(B) A 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 a 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.
(G) A judge of a superior court before whom the person who is the subject of the petition appears.
(3) Upon receiving a request pursuant to paragraph (2), the county behavioral health director shall conduct an investigation into the appropriateness of filing of the petition. The director shall
file the petition only if the director 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 that person’s 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) (A) 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:
(i) 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.
(ii) That, no more than 10 days prior to the filing of the petition, the licensed mental health treatment provider, or the provider’s 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.
(B) An examining mental health professional in their affidavit to the court shall address the issue of whether the defendant has capacity to give informed consent regarding psychotropic medication.
(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 able to do so.
(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 the 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. The person who is the subject of the petition shall maintain the right to appear before the court in person, but may appear by videoconferencing means if they choose to do so.
(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 at the hearing. An examining mental health professional may appear before the court by videoconferencing means.
(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 the person, or cause the person 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 the right to judicial review by habeas corpus.
(E) To be present at the hearing unless the person waives the right to be present.
(F) To present evidence.
(G) To call witnesses on the person’s behalf.
(H) To cross-examine witnesses.
(I) To appeal decisions, and to be informed of the 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.
(C) The court may conduct status hearings with the person and the treatment team to receive information regarding progress related to the categories of treatment listed in the treatment plan and may inquire about medication adherence.
(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) 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 behavioral health director, or the director’s 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 the director’s 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 behavioral health director, or to the director’s 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 the person, or cause the person 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, the person 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 an order pursuant to this subdivision shall be in accordance with subdivisions (a) to (f), inclusive. The period for further involuntary outpatient treatment authorized by a
subsequent order under this subdivision may not exceed 180 days from the date of the order.
(h) (1) 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 the person still meets the criteria for assisted outpatient treatment if they disagree with the director’s affidavit. The burden of proof shall be on the director.
(2) When making the affidavit pursuant to paragraph (1), the director of the outpatient treatment program shall also report to the court on adherence to
prescribed medication.
(i) During each 60-day period specified in subdivision (h), if the person who is the subject of the order believes that they are being wrongfully retained in the assisted outpatient treatment program against their wishes, the person 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) A 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.
(k) This section shall become operative on July 1, 2021.
SEC. 16.
Section 5348 of the Welfare and Institutions Code is amended to read:5348.
(a) For purposes of subdivision (e) of Section 5346, a county or group of counties that chooses to provide assisted outpatient treatment services pursuant to this article shall offer assisted outpatient treatment services, including, but not limited to, all of the following:(1) Community-based, mobile, multidisciplinary, highly trained mental health teams that use high staff-to-client ratios of no more than 10 clients per team member for those subject to court-ordered services pursuant to Section 5346.
(2) A service planning and delivery process that includes the following:
(A) Determination of the numbers
number
of persons to be served and the programs and services that will be provided to meet their needs. The local director of mental health shall consult with the sheriff, the police chief, the probation officer, the mental health board, contract agencies, and family, client, ethnic, and citizen constituency groups as determined by the director.
(B) Plans for services, including outreach to families whose severely mentally ill adult is is living with them, adult child living with them is experiencing a severe mental health condition, design of mental health services, coordination and access to medications, psychiatric and psychological services, substance abuse
services, supportive housing or other housing assistance, vocational rehabilitation, and veterans’ services. Plans shall also contain evaluation strategies that shall consider cultural, linguistic, gender, age, and special needs of minorities and those based on any characteristic listed or defined in Section 11135 of the Government Code in the target populations. Provision shall be made for staff with the cultural background and linguistic skills necessary to remove barriers to mental health services as a result of having limited-English-speaking ability and cultural differences. Recipients of outreach services may include families, the public, primary care physicians, and others who are likely to come into contact with individuals who may be suffering from
experiencing an untreated severe mental illness who would be likely to become homeless if the illness continued to be untreated for a substantial period of time. Outreach to adults may include adults voluntarily or involuntarily hospitalized as a result of a severe mental illness.
(C) Provision for services to meet the needs of persons who are physically disabled.
(D) Provision for services to meet the special needs of older adults.
(E) Provision for family support and consultation services, parenting support and consultation services, and peer support or self-help group support, if appropriate.
(F) Provision for services to be client-directed and that employ psychosocial rehabilitation and recovery
principles.
(G) Provision for psychiatric and psychological services that are integrated with other services and for psychiatric and psychological collaboration in overall service planning.
(H) Provision for services specifically directed to seriously mentally ill young adults 25 years of age or younger who have a serious mental health condition and who are homeless or at significant risk of becoming homeless. These provisions may include continuation of services that still would be received through other funds had eligibility not been terminated as a result of age.
(I) Services reflecting special needs of women from diverse
cultural backgrounds, including supportive housing that accepts children, personal services coordinator therapeutic treatment, and substance treatment programs that address gender-specific trauma and abuse in the lives of persons with a mental illness, and vocational rehabilitation programs that offer job training programs free of gender bias and sensitive to the needs of women.
(J) Provision for housing for clients that is immediate, transitional, permanent, or all of these.
(K) Provision for clients who have been suffering from experiencing an untreated severe mental illness for less
than one year, and who do not require the full range of services, but who are at risk of becoming homeless unless a comprehensive individual and family support services plan is implemented. These clients shall be served in a manner that is designed to meet their needs.
(3) Each client shall have a clearly designated mental health personal services coordinator who may be part of a multidisciplinary treatment team that is responsible for providing or ensuring needed services. Responsibilities include complete assessment of the client’s needs, development of the client’s personal services plan, linkage with all appropriate community services, monitoring of the quality and followthrough of services, and necessary advocacy to ensure each client receives those services that are agreed to in the personal services plan. Each client shall participate in the development of their personal services plan, and responsible staff shall consult with the
designated conservator, if one has been appointed, and, with the consent of the client, shall consult with the family and other significant persons as appropriate.
(4) The individual personal services plan shall ensure that persons subject to assisted outpatient treatment programs receive age-appropriate, gender-appropriate, and culturally appropriate services, to the extent feasible, that are designed to enable recipients to:
(A) Live in the most independent, least restrictive housing feasible in the local community, and, for clients with children, to live in a supportive housing environment that strives for reunification with their children or assists clients in maintaining custody of their children, as is appropriate.
(B) Engage in the highest level of work or productive activity appropriate to their abilities and
experience.
(C) Create and maintain a support system consisting of friends, family, and participation in community activities.
(D) Access an appropriate level of academic education or vocational training.
(E) Obtain an adequate income.
(F) Self-manage their illnesses and exert as much control as possible over both the day-to-day and long-term decisions that affect their lives.
(G) Access necessary physical health care and maintain the best possible physical health.
(H) Reduce or eliminate serious antisocial or criminal behavior, and thereby reduce or eliminate their contact with the criminal justice system.
(I) Reduce or eliminate the distress caused by the symptoms of mental illness.
(J) Have freedom from dangerous addictive substances.
(5) The individual personal services plan shall describe the service array that meets the requirements of paragraph (4) and, to the extent applicable to the individual, the requirements of paragraph (2).
(b) A county that provides assisted outpatient treatment services pursuant to this article also shall offer the same services on a voluntary basis.
(c) Involuntary medication shall not be allowed absent a separate order by the court pursuant to Sections 5332 to 5336, inclusive.
(d) A county that
operates an assisted outpatient treatment program pursuant to this article shall provide data to the State Department of Health Care Services and, based on the data, the department shall report to the Legislature on or before May 1 of each year in which the county provides services pursuant to this article. The report shall include, at a minimum, an evaluation of the effectiveness of the strategies employed by each program operated pursuant to this article in reducing homelessness and hospitalization of persons in the program and in reducing involvement with local law enforcement by persons in the program. The evaluation and report shall also include any other measures identified by the department regarding persons in the program and all of the following, based on information that is available:
(1) The number of persons served by the program and, of those, the number who are able to maintain housing and the number who maintain contact with the
treatment system.
(2) The number of persons in the program with contacts with local law enforcement, and the extent to which local and state incarceration of persons in the program has been reduced or avoided.
(3) The number of persons in the program participating in employment services programs, including competitive employment.
(4) The days of hospitalization of persons in the program that have been reduced or avoided.
(5) Adherence to prescribed treatment by persons in the program.
(6) Other indicators of successful engagement, if any, by persons in the program.
(7) Victimization of persons in the program.
(8) Violent behavior of persons in the program.
(9) Substance abuse by persons in the program.
(10) Type, intensity, and frequency of treatment of persons in the program.
(11) Extent to which enforcement mechanisms are used by the program, when applicable.
(12) Social functioning of persons in the program.
(13) Skills in independent living of persons in the program.
(14) Satisfaction with program services both by those receiving them, and by their families, when relevant.
(e) This section shall become
operative on July 1, 2021.
SEC. 17.
Section 5349.1 of the Welfare and Institutions Code is amended to read:5349.1.
(a) A county or group of counties that implements this article, shall, in consultation with the State Department of Health Care Services, client and family advocacy organizations, and other stakeholders, develop a training and education program for purposes of improving the delivery of services to(b) The training shall include both of the following:
(1) Information relative to legal requirements for detaining a person for involuntary inpatient and outpatient treatment, including criteria to be considered with respect to determining if a person is considered to be gravely disabled. have a grave disability.
(2) Methods for ensuring that decisions regarding involuntary treatment, as provided for in this part, direct patients toward the most effective treatment. Training shall include an emphasis on each patient’s right to provide informed consent to assistance.
(c) This section shall become operative on July 1, 2021.
SEC. 18.
The heading of Chapter 3 (commencing with Section 5350) of Part 1 of Division 5 of the Welfare and Institutions Code is amended to read:
CHAPTER
3. Conservatorship for Gravely Disabled Persons with a Grave Disability
SEC. 19.
Section 5585.10 of the Welfare and Institutions Code is amended to read:5585.10.
This part shall be construed to promote the legislative intent and purposes of this part as follows:(a) To provide prompt evaluation and treatment of minors with a mental health disorders, disorder, with particular priority given to seriously emotionally disturbed children and adolescents. a child or adolescent with serious
emotional disturbance.
(b) To safeguard the rights to due process for minors and their families through judicial review.
(c) To provide individualized treatment, supervision, and placement services for gravely disabled minors. minors with a grave disability.
(d) To prevent severe and long-term mental disabilities among minors through early identification, effective family service interventions, and public education.
SEC. 20.
Section 5585.57 of the Welfare and Institutions Code is amended to read:5585.57.
SEC. 21.
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. A child or adolescent with serious emotional disturbance.
(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 a “child or adolescent with serious emotional disturbance” means a minor under 18 years of age who has 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 disorder that 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 suicide, or risk of violence due to a mental disorder.
(C) The child has been assessed pursuant to Article 2 (commencing with Section 56320) of Chapter 4 of Part 30 of Division 4 of Title 2 of the Education Code and determined to have an emotional disturbance, as defined in paragraph (4) of
subdivision (c) of Section 300.8 of Title 34 of the Code of Federal Regulations.
(b) (1) Adults and older adults 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, 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 the purposes of this part, “functional impairment” means being substantially impaired as the result of a mental disorder in independent living, social relationships, vocational skills, 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) For the purpose of organizing outreach and treatment options, to the extent resources are available, this target population includes, but is not limited to, persons who are any of the following:
(A) Homeless persons who are mentally ill.
have a mental illness.
(B) 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) Persons arrested or convicted of crimes.
(D) Persons who require acute treatment as a result of a first episode of mental illness with psychotic features.
(5) 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 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, but the eligible veteran shall not be denied county mental or behavioral health services while waiting for a determination of eligibility for, and availability of, mental or behavioral health services provided by the United States Department of Veterans Affairs.
(A) An eligible veteran shall not be denied county mental health services based solely on his or her the person’s status as a veteran, including whether or not the person is eligible for services provided by the United States Department of Veterans Affairs.
(B) 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) Counties should consider contracting with community-based veterans’ services agencies, where possible, to provide high-quality, veteran specific mental health services.
(c) 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) Persons who need brief treatment as a result of a natural disaster or severe local emergency.
SEC. 22.
The heading of Article 2 (commencing with Section 5680) of Chapter 2.5 of Part 2 of Division 5 of the Welfare and Institutions Code is amended to read:
Article
2. Community Support System for Homeless Mentally Disabled Persons Who are Homeless with a Mental Health Disability
SEC. 23.
Section 5680 of the Welfare and Institutions Code is amended to read:5680.
SEC. 24.
Section 5681 of the Welfare and Institutions Code is amended to read:5681.
(a) It is the intent of the Legislature(b) It is further the intent of the Legislature
that specific outreach and service priority be given under this chapter to homeless mentally disabled persons
who are homeless with a mental health disability not served by any a local or state programs program as of September 30, 1985.
SEC. 25.
Section 5682 of the Welfare and Institutions Code is amended to read:5682.
The goal of the community support system is to assure that needed community services are provided toSEC. 26.
Section 5683 of the Welfare and Institutions Code is amended to read:5683.
The function of the community support system is to conduct active outreach to(a) Personal assistance to secure and maintain housing, food, clothing, income, and health benefits.
(b) Accessing social and vocational skill development activities when they are available, case management, and crisis intervention, with a focus on finding alternatives to acute inpatient hospital care, services when they are needed.
SEC. 27.
Section 5685.5 of the Welfare and Institutions Code is amended to read:5685.5.
(a) A county may contract with the local office of the public guardian to receive and manage income and benefits for(1) Outreach and casefinding to locate mentally ill persons with a mental health condition in need of services.
(2) Establishing liaison with charitable organizations which
serve mentally ill persons. persons with a mental health condition.
(3) Assistance in applying for and obtaining public assistance benefits for which they are eligible.
(b) Any office of the public guardian contracting with the county to provide these management services shall maintain a record of those individuals being assisted, including information about whether the
individual is under conservatorship, the type of service assistance provided by the office of the public guardian, and any agencies any agency with which the office of the public guardian is coordinating efforts.
SEC. 28.
Section 5686 of the Welfare and Institutions Code is amended to read:5686.
SEC. 29.
Section 5688.6 of the Welfare and Institutions Code is amended to read:5688.6.
SEC. 30.
Section 5691 of the Welfare and Institutions Code is amended to read:5691.
(a)(b) It is the intent of the Legislature that on an annual basis five hundred thousand dollars ($500,000), or 17 percent, whichever is less, of the total federal funds available to the State of California pursuant to Section 611 of the Stewart B. McKinney Homeless Assistance Act, Public Law 100-77 (42
U.S.C. Sec. 290aa) shall be used to fund services pursuant to this chapter for homeless mentally disabled persons
who are homeless with a mental disability and those at risk of becoming homeless who have been identified pursuant to Chapter 2.6 (commencing with Section 5680).
Counties may not use these funds to provide services, including, but not limited to, vocational services, which could be funded by the Department of Rehabilitation.
SEC. 31.
Section 5694 of the Welfare and Institutions Code is amended to read:5694.
SEC. 32.
The heading of Article 5 (commencing with Section 5694.7) of Chapter 2.5 of Part 2 of Division 5 of the Welfare and Institutions Code is amended to read:
Article
5. Policy Initiatives for Seriously Emotionally Disturbed Children with Serious Emotional Disturbance
SEC. 33.
Section 5694.7 of the Welfare and Institutions Code is amended to read:5694.7.
When the director of behavioral health in a county is notified pursuant to Section 319.1 or 635.1, or Section 7572.5 of the Government Code about a specific case, the county behavioral health director shall assign the responsibility either directly or through contract with a private provider, to review the information and assess whether or not the childSEC. 34.
The heading of Article 6 (commencing with Section 5695) of Chapter 2.5 of Part 2 of Division 5 of the Welfare and Institutions Code is amended to read:
Article
6. Regional Facilities for Seriously Emotionally Disturbed Wards with Serious Emotional Disturbance
SEC. 35.
Section 5695 of the Welfare and Institutions Code is amended to read:5695.
The Legislature finds and declares the following:(a) The Legislature has declared its intent to provide, at the local level, a range of appropriate mental health services for seriously emotionally disturbed minors. minors with serious emotional disturbance. These programs include both outpatient and nonsecure residential care and treatment.
(b) The Legislature recognizes that, while some minors will benefit from this care and treatment, there exists a population within that group who have been adjudged wards of the juvenile court pursuant to Section 602 who are seriously emotionally disturbed, have serious emotional disturbance and by lack of behavior control and offense history, are not benefiting from existing programs, including the 24-hour facilities currently being operated under juvenile court law (Chapter 2 (commencing with Section 200) of Part 1 of Division 2).
(c) The Legislature finds that there are no treatment facilities specifically designed and operated to provide both intensive mental health treatment and behavior control to this population of wards in a secure setting. These wards are frequent failures
have not been successful in open residential care and when confined to traditional juvenile justice system facilities, disrupt programming, endanger themselves and others, and require intensive supervision including occasional isolation and provision of a one-to-one supervision ratio. The behavior and needs of this population affect the ability of the existing facilities to meet the program needs of the remainder of the population which is more appropriately detained or committed there.
(d) Psychiatric hospitals frequently refuse to accept these wards because of their offense history or their extremely disruptive behavior, because they do not always meet medical necessity for acute admission, or because the lengths of stay in inpatient programs are too limited in duration. Because of these problems, seriously emotionally disturbed
minors with serious emotional disturbance who have been adjudged to be wards pursuant to Section 602 do not receive the level of mental health care necessary to interrupt the cycle of emotional disturbance leading to assaultive or self-destructive behavior.
(e) The Legislature therefore declares its intent to establish regional facilities which will provide an additional dispositional resource to the juvenile justice system, and which will demonstrate the feasibility and effectiveness of providing the services described in this chapter to seriously emotionally disturbed
minors with serious emotional disturbance who have been adjudged wards of the juvenile court pursuant to Section 602 and whose physical and mental treatment needs require a secure facility and program. It is also the intent of the Legislature to secure for the minors committed to such a facility, the protection, custody, care, treatment, and guidance that is consistent with the purpose of the juvenile court law (Chapter 2 (commencing with Section 200) of Part 1 of Division 2).
SEC. 36.
Section 5695.2 of the Welfare and Institutions Code is amended to read:5695.2.
There may be established, on a regional basis, secure facilities which are physically and programmatically designed for the commitment and ongoing treatment ofSEC. 37.
Section 5696 of the Welfare and Institutions Code is amended to read:5696.
Prior to the opening of a regional facility, the board of directors shall develop written admission criteria, approved by the Department of Corrections and Rehabilitation, Division of Juvenile Facilities, for those minors who are most at risk of entering the adult criminal justice system as offenders who have mental health disorders and are at high risk of committing predatory and violent crimes, including, but not limited to, the following requirements:(a) The minor is at the time of commitment between 12 and 18 years of age, he or she the minor has been adjudged to be a ward of the juvenile
court pursuant to Section 602, and his or her
the minor’s custody has been placed under the supervision of a probation officer pursuant to Section 727.
(b) The ward is seriously emotionally disturbed has serious emotional disturbance as is evidenced by a diagnosis from the current edition of the Diagnostic and Statistical Manual of Mental Disorders and evidences behavior inappropriate to the ward’s age according to expected developmental norms. Additionally, all of the following must be present:
(1) The behavior presents a danger to the community or self and requires intensive supervision
and treatment, but the ward is not amenable to other private or public residential treatment programs because his or her the ward’s behavior requires a secure setting.
(2) The symptomology is both severe and frequent.
(3) The inappropriate behavior is persistent.
SEC. 38.
The heading of Article 7 (commencing with Section 5698) of Chapter 2.5 of Part 2 of Division 5 of the Welfare and Institutions Code is amended to read:
Article
7. System of Care for Seriously Emotionally Disturbed Children and Youth with Serious Emotional Disturbance
SEC. 39.
Section 5698 of the Welfare and Institutions Code is amended to read:5698.
It is the intent of the Legislature to encourage in each county a system of care for(a) A defined range of interagency services, blended programs and program standards that facilitate appropriate service delivery in the least restrictive environment as close to home as possible. The system should use available and accessible intensive home and school-based alternatives.
(b) A defined mechanism to ensure that services are child centered and family focused with parental participation in all aspects of the planning and delivery of service.
(c) A formalized multiagency policy making council and an interagency case management services council. The roles and responsibilities of these councils should be specified in existing interagency agreements or memoranda of understanding, or both.
(d) A defined interagency case management system designed to
facilitate services to the defined target population.
(e) A defined mechanism to ensure that services are culturally competent.
SEC. 40.
Section 5699.2 of the Welfare and Institutions Code is amended to read:5699.2.
Children identified for case management services under this section shall be minors under 18 years of age described in Section 5600.3(a) A child who is a ward or dependent of the juvenile court pursuant to Section
300, 601, or 602 and is placed out-of-home.
(b) A child who is a special education student
pupil
defined in paragraph 8 of subdivision (b) of Section 300.5 of Title 34 of the Code of Federal Regulations and is receiving residential care pursuant to an individual educational program. This section also includes special education students pupils through age 21 identified in paragraph (4) of subdivision (c) of Section 56026 of the Education Code.
(c) An inpatient in a psychiatric hospital, psychiatric health facility, or residential treatment facility receiving services either on a voluntary or involuntary basis.
(d) An outpatient receiving intensive non-24-hour mental health treatment, such as day treatment or crisis services who is “at risk” of psychiatric hospitalization
or out-of-home placement for residential treatment.
SEC. 41.
Section 5731 of the Welfare and Institutions Code is amended to read:5731.
The Legislature finds and declares that the mental health system is a large and important segment of California’s system of health care. The Legislature further finds and declares all of the following:(a) Public Law 99-660 requires that the State Department of Mental Health develop a state plan for the Short-Doyle mental health system which includes all of the following:
(1) Plans developed in response to federal planning requirements shall be submitted to the Legislature.
(2) Evidence of broad participation from concerned citizens and mental health consumers.
(3) An analysis of the needs of seriously and persistently mentally ill adults, severely emotionally disturbed children and homeless mentally ill
adults with a serious and persistent mental illness, children and youth with serious emotional disturbance, and persons who are homeless with a mental illness in California.
(4) Improvements in the mental health delivery system are needed for seriously mentally ill adults, severely emotionally disabled children, and homeless mentally ill.
adults with a serious and persistent mental illness, children and youth with serious emotional disturbance, and persons who are homeless with a mental illness.
(5) Given the existing mental health funding base, priorities need to be established for the Short-Doyle community mental health system.
(6) There is no minimum range of treatment services which should be available in every county in California.
(7) Most funding formulas for state mental health programs are not client based.
(8) The state has a special responsibility for the care and treatment of seriously and persistently mentally ill adults, seriously emotionally disturbed minors, and homeless mentally ill adults with a serious and persistent mental illness, minors with serious
emotional disturbance, and persons who are homeless with a mental illness who are the most vulnerable and who require consistent supportive services to meet their health and safety needs in the community.
(9) Legislative action is required to ensure that a comprehensive policy is developed which addresses the critical problems and key issues currently facing the mental health system in California.
SEC. 42.
Section 5801 of the Welfare and Institutions Code is amended to read:5801.
(a) A system of care for adults and older adults with severe mental illness results in the highest benefit to the client, family, and community while ensuring that the public sector meets its legal responsibility and fiscal liability at the lowest possible cost.(b) The underlying philosophy for these systems of care includes the following:
(1) Mental health care is a basic human service.
(2) Seriously mentally disordered adults and older adults Adults and older adults with
a serious mental health condition are citizens of a community with all the rights, privileges, opportunities, and responsibilities accorded other citizens.
(3) Seriously mentally disordered adults and older adults Adults and older adults with a serious mental health condition usually have multiple disorders and disabling conditions and should have the highest priority among adults for mental health services.
(4) Seriously mentally disordered adults and older adults Adults
and older adults with a serious mental health condition should have an interagency network of services with multiple points of access and be assigned a single person or team to be responsible for all treatment, case management, and community support services.
(5) The client should be fully informed and volunteer for all treatment provided, unless danger to self or others or grave disability requires temporary involuntary treatment, or the client is under a court order for assisted outpatient treatment pursuant to Section 5346 and, prior to the filing of the petition for assisted outpatient treatment pursuant to Section 5346, the client has been offered an opportunity to participate in treatment on a voluntary basis and has failed to engage in that treatment, or the client is under a court order for CARE pursuant to Part 8 (commencing with Section 5970) and, prior to the court-ordered CARE plan, the client has been
offered an opportunity to enter into a CARE agreement on a voluntary basis and has declined to do so.
(6) Clients and families should directly participate in making decisions about services and resource allocations that affect their lives.
(7) People in local communities are the most knowledgeable regarding their particular environments, issues, service gaps and strengths, and opportunities.
(8) Mental health services should be responsive to the unique characteristics of people with a mental disorders health condition,
including age, gender, minority and ethnic status, and the effect of multiple disorders.
conditions.
(9) For the majority of seriously mentally disordered adults and older adults,
adults and older adults with a serious mental health condition, treatment is best provided in the client’s natural setting in the community. Treatment, case management, and community support services should be designed to prevent inappropriate removal from the natural environment to more restrictive and costly placements.
(10) Mental health systems of care shall have measurable goals and be fully accountable by providing measures of client outcomes and cost of services.
(11) State and county government agencies each have
responsibilities and fiscal liabilities for seriously mentally disordered adults and seniors. adults and older adults with a serious mental health condition.
SEC. 43.
Section 5802 of the Welfare and Institutions Code is amended to read:5802.
(a) The Legislature finds that a mental health system of care for adults and older adults with severe and persistent mental illness is vital for successful management of mental health care in California. Specifically:(1) A comprehensive and coordinated system of care includes community-based treatment, outreach services and other early intervention strategies, case management, and interagency system components required by adults and older adults with severe and persistent mental illness.
(2) Mentally ill adults Adults and
older adults
with a mental health condition receive service from many different state and county agencies, particularly criminal justice, employment, housing, public welfare, health, and mental health. In a system of care these agencies collaborate in order to deliver integrated and cost-effective programs.
(3) The recovery of persons with severe mental illness and their financial means are important for all levels of government, business, and the community.
(4) System of care services that ensure culturally competent care for persons with severe mental illness in the most appropriate, least restrictive level of care are necessary to
achieve the desired performance outcomes.
(5) Mental health service providers need to increase accountability and further develop methods to measure progress towards client outcome goals and cost-effectiveness as required by a system of care.
(b) The Legislature further finds that the adult system of care model, beginning in the 1989–90 fiscal year through the implementation of Chapter 982 of the Statutes of 1988, provides models for adults and older adults with severe mental illness that can meet the performance outcomes required by the Legislature.
(c) The Legislature also finds that the system components established in adult systems of care are of value in providing greater benefit to adults and older adults with severe and persistent mental illness at a lower cost in California.
(d) Therefore, using the guidelines and principles developed under the demonstration projects implemented under the adult system of care legislation in 1989, it is the intent of the Legislature to accomplish the following:
(1) Encourage each county to implement a system of care as described in this legislation for the delivery of mental health services to adults and older adults with a serious mental illness.
(2) To promote a system of care accountability for performance outcomes that enable adults with severe mental illness to reduce symptoms that impair their ability to live independently, work, maintain
community supports, care for their children, stay in good health, not abuse drugs or alcohol, and not commit crimes.
(3) Maintain funding for the existing pilot adult system of care programs that meet contractual goals as models and technical assistance resources for future expansion of system of care programs to other counties as funding becomes available.
(4) Provide funds for counties to establish outreach programs and to provide mental health services and related medications, substance abuse services, supportive housing or other housing assistance, vocational rehabilitation, and other nonmedical programs necessary to stabilize homeless persons who are mentally ill or persons who are mentally ill and
persons who are homeless with a mental health condition or persons with a mental health condition who are at risk of being homeless, get them off the street, and into treatment and recovery, or to provide access to veterans’ services that will also provide for treatment and recovery.
SEC. 44.
Section 5806 of the Welfare and Institutions Code is amended to read:5806.
The State Department of Health Care Services shall establish service standards that ensure that members of the target population are identified, and services provided to assist them to live independently, work, and reach their potential as productive citizens. The department shall provide annual oversight of grants issued pursuant to this part for compliance with these standards. These standards shall include, but are not limited to, all of the following:(a) A service planning and delivery process that is target population based and includes the following:
(1) Determination of the numbers of clients to be served and the programs and services that will be provided to meet their needs. The local director of mental health
shall consult with the sheriff, the police chief, the probation officer, the mental health board, contract agencies, and family, client, ethnic, and citizen constituency groups as determined by the director.
(2) Plans for services, including outreach to families whose severely mentally ill adult is who have an adult child experiencing a serious mental health condition living with them, design of mental health services, coordination and access to medications, psychiatric and psychological services, substance abuse services, supportive housing or other housing assistance, vocational rehabilitation, and veterans’ services. Plans also shall contain evaluation strategies, that shall consider cultural, linguistic, gender, age, and special needs of minorities in
the target populations. Provision shall be made for staff with the cultural background and linguistic skills necessary to remove barriers to mental health services due to limited-English-speaking ability and cultural differences. Recipients of outreach services may include families, the public, primary care physicians, and others who are likely to come into contact with individuals who may be suffering from experiencing an untreated severe mental illness who would be likely to become homeless if the illness continued to be untreated for a substantial period of time. Outreach to adults may include adults voluntarily or involuntarily hospitalized as a result of a severe mental illness.
(3) Provision for services to meet the needs of target population clients
who are physically disabled.
(4) Provision for services to meet the special needs of older adults.
(5) Provision for family support and consultation services, parenting support and consultation services, and peer support or self-help group support, where appropriate for the individual.
(6) Provision for services to be client-directed and that employ psychosocial rehabilitation and recovery principles.
(7) Provision for psychiatric and psychological services that are integrated with other services and for psychiatric and psychological collaboration in overall service planning.
(8) Provision for services specifically directed to seriously mentally ill
young adults 25 years of age or younger who have a serious mental illness and are homeless or at significant risk of becoming homeless. These provisions may include continuation of services that still would be received through other funds had eligibility not been terminated due to age.
(9) Services reflecting special needs of women from diverse cultural backgrounds, including supportive housing that accepts children, personal services coordinator therapeutic treatment, and substance treatment programs that address gender-specific trauma and abuse in the lives of persons with mental illness, and vocational rehabilitation programs that offer job training programs free of gender bias and sensitive to the needs of women.
(10) Provision for housing for clients
that is immediate, transitional, permanent, or all of these.
(11) Provision for clients who have been suffering from experiencing an untreated severe mental illness for less than one year, and who do not require the full range of services but are at risk of becoming homeless unless a comprehensive individual and family support services plan is implemented. These clients shall be served in a manner that is designed to meet their needs.
(12) Provision for services for veterans.
(b) A client shall have a clearly designated mental health personal services coordinator who may be part of a multidisciplinary treatment team who is
responsible for providing or assuring needed services. Responsibilities include complete assessment of the client’s needs, development of the client’s personal services plan, linkage with all appropriate community services, monitoring of the quality and followthrough of services, and necessary advocacy to ensure that the client receives those services that are agreed to in the personal services plan. A client shall participate in the development of his or her
the client’s personal services plan, and responsible staff shall consult with the designated conservator, if one has been appointed, and, with the consent of the client, consult with the family and other significant persons as appropriate.
(c) The individual personal services plan shall ensure that members of the target population involved in the system of care receive age-appropriate, gender-appropriate, and culturally appropriate services or appropriate services based on any characteristic listed or defined in Section 11135 of the Government Code, to the extent feasible, that are designed to enable recipients to:
(1) Live in the most independent, least restrictive housing feasible in the local community, and for clients with children, to live in a supportive housing environment that strives for reunification with their children or
assists clients in maintaining custody of their children as is appropriate.
(2) Engage in the highest level of work or productive activity appropriate to their abilities and experience.
(3) Create and maintain a support system consisting of friends, family, and participation in community activities.
(4) Access an appropriate level of academic education or vocational training.
(5) Obtain an adequate income.
(6) Self-manage their illness and exert as much control as possible over both the day-to-day and long-term decisions that affect their lives.
(7) Access necessary physical health care and maintain the best possible physical
health.
(8) Reduce or eliminate serious antisocial or criminal behavior and thereby reduce or eliminate their contact with the criminal justice system.
(9) Reduce or eliminate the distress caused by the symptoms of mental illness.
(10) Have freedom from dangerous addictive substances.
(d) The individual personal services plan shall describe the service array that meets the requirements of subdivision (c), and to the extent applicable to the individual, the requirements of subdivision (a).
SEC. 45.
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(2) The Director of Health Care Services 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 of Health Care Services 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 Department of Corrections and Rehabilitation, 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 California Behavioral Health Planning Council, the Mental Health Services Oversight and Accountability Commission, 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 Act, the State Department of Health Care Services shall establish programs that offer individual counties sufficient funds to comprehensively serve severely mentally ill adults with a serious mental health condition 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) of Section 5600.3. them. 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, have a serious mental health condition, 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 persons with a mental health condition
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 have a serious mental health condition 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. 46.
Section 5814.5 of the Welfare and Institutions Code is amended to read:5814.5.
(a) (1) In any year in which funds are appropriated for this purpose through the annual Budget Act, counties funded under this part in the 1999–2000 fiscal year are eligible for funding to continue their programs if they have successfully demonstrated the effectiveness of their grants received in that year and to expand their programs if they also demonstrate significant continued unmet need and capacity for expansion without compromising quality or effectiveness of care.(2) In any year in which funds are appropriated for this purpose through the annual Budget Act, other counties or portions of counties, or cities that operate independent public mental health programs pursuant to Section 5615 of the Welfare and Institutions Code, are
eligible for funding to establish programs if a county or eligible city demonstrates that it can provide comprehensive services, as set forth in this part, to a substantial number of adults who are severely mentally ill, have a severe mental illness, as defined in Section 5600.3, and are homeless or recently released from the county jail or who are untreated, unstable, and at significant risk of incarceration or homelessness unless treatment is provided.
(b) (1) Counties eligible for funding pursuant to subdivision (a) shall be those that have or can develop integrated adult service programs that meet the criteria for an adult system of care, as set forth in Section 5806, and that have, or can develop, integrated forensic programs
with similar characteristics for parolees and those recently released from county jail who meet the target population requirements of Section 5600.3 and are at risk of incarceration unless the services are provided. Before a city or county submits a proposal to the state to establish or expand a program, the proposal shall be reviewed by a local advisory committee or mental health board, which may be an existing body, that includes clients, family members, private providers of services, and other relevant stakeholders. Local enrollment for integrated adult service programs and for integrated forensic programs funded pursuant to subdivision (a) shall adhere to all conditions set forth by the department, including the total number of clients to be enrolled, the providers to which clients are enrolled and the maximum cost for each provider, the maximum number of clients to be served at any one time, the outreach and screening process used to identify enrollees, and the total cost of the program. Local
enrollment of each individual for integrated forensic programs shall be subject to the approval of the county behavioral health director or his or her their
designee.
(2) Each county shall ensure that funds provided by these grants are used to expand existing integrated service programs that meet the criteria of the adult system of care to provide new services in accordance with the purpose for which they were appropriated and allocated, and that none of these funds shall be used to supplant existing services to severely mentally ill adults. In order to adults with a serious mental health condition. To ensure that this requirement is met, the department shall develop methods and contractual requirements, as it determines necessary. At a minimum, these assurances shall include that state and federal requirements
regarding tracking of funds are met and that patient records are maintained in a manner that protects privacy and confidentiality, as required under federal and state law.
(c) Each county selected to receive a grant pursuant to this section shall provide data as the department may require, that demonstrates the outcomes of the adult system of care programs, shall specify the additional numbers of severely mentally ill adults with a severe mental health condition to whom they will provide comprehensive services for each million dollars of
additional funding that may be awarded through either an integrated adult service grant or an integrated forensic grant, and shall agree to provide services in accordance with Section 5806. Each county’s plan shall identify and include sufficient funding to provide housing for the individuals to be served, and shall ensure that any hospitalization of individuals an individual participating in the program are is coordinated with the provision of other mental health services provided under the program.
SEC. 47.
Section 5840 of the Welfare and Institutions Code is amended to read:5840.
(a) The State Department of Health Care Services, in coordination with counties, shall establish a program designed to prevent mental(b) The program shall include the following components:
(1) Outreach to families, employers, primary care health care providers, and others to recognize the early signs of potentially severe and disabling mental illnesses.
(2) Access and linkage to medically necessary care provided by county mental health programs for children with severe mental illness, as defined in Section 5600.3, and for adults and seniors with severe mental illness, as defined in Section 5600.3, as early in the onset of these conditions as practicable.
(3) Reduction in stigma associated with either being diagnosed with a mental illness or seeking mental health services.
(4) Reduction in discrimination against people with mental illness.
(c) The program shall include mental health services similar to those provided under other programs that are effective in preventing mental illnesses from becoming severe, and shall also include components similar to programs that have been successful in reducing the
duration of untreated severe mental illnesses and assisting people in quickly regaining productive lives.
(d) The program shall emphasize strategies to reduce the following negative outcomes that may result from untreated mental illness:
(1) Suicide.
(2) Incarcerations.
(3) School failure or dropout.
(4) Unemployment.
(5) Prolonged suffering. Worsening of symptoms and the condition over time.
(6) Homelessness.
(7) Removal of children from their homes.
(e) Prevention and early intervention funds may be used to broaden the provision of community-based mental health services by adding prevention and early intervention services or activities to these services, including prevention and early intervention strategies that address mental health needs, substance misuse or substance use disorders, or needs relating to cooccurring mental health and substance use services.
(f) In consultation with mental health stakeholders, and consistent with regulations from the Mental Health Services Oversight and Accountability Commission, pursuant to Section 5846, the department shall revise the program elements in Section 5840 applicable to all county mental health
programs in future years to reflect what is learned about the most effective prevention and intervention programs for children, adults, and seniors. older adults.
SEC. 48.
Section 5846 of the Welfare and Institutions Code is amended to read:5846.
(a) The commission shall adopt regulations for programs and expenditures pursuant to Part 3.2 (commencing with Section 5830), for innovative programs, and Part 3.6 (commencing with Section 5840), for prevention and early intervention.(b) Any regulations regulation adopted by the department pursuant to Section 5898 shall be consistent with the commission’s regulations.
(c) The commission may provide technical assistance to any county mental health plan as needed to address concerns or recommendations of the
commission or when local programs could benefit from technical assistance for improvement of their plans.
(d) The commission shall ensure that the perspective and participation of diverse community members reflective of California populations and others suffering from severe mental illness California’s diverse populations, persons experiencing a severe mental health condition, and their
family members of persons experiencing a severe mental health condition is a significant factor in all of its the commission’s decisions and recommendations.
SEC. 49.
Section 5851 of the Welfare and Institutions Code is amended to read:5851.
(a) The Legislature finds and declares that there is no comprehensive county interagency system throughout California for the delivery of mental health services to(1) The population of children which should receive highest priority for services has not been defined.
(2) Clear and objective client outcome goals for children receiving services have not been specified.
(3) Although seriously emotionally and behaviorally disturbed children with serious emotional and behavioral disturbance usually have multiple disabilities, the many different state and county agencies, particularly education, social services, juvenile justice, health, and mental health agencies, with shared responsibility
for these individuals, do not always collaborate to develop and deliver integrated and cost-effective programs.
(4) A range of community-based treatment, case management, and interagency system components required by children with serious emotional disturbances disturbance has not been identified and implemented.
(5) Service delivery standards that ensure culturally competent care in the most appropriate, least restrictive environment have not been specified and required.
(6) The mental health system lacks accountability and methods to measure progress towards client outcome goals and cost-effectiveness. There are also no
requirements for other state and county agencies to collect or share relevant data necessary for the mental health system to conduct this evaluation.
(b) The Legislature further finds and declares that the model developed in Ventura County beginning in the 1984–85 fiscal year through the implementation of Chapter 1474 of the Statutes of 1984 and expanded to the Counties of Santa Cruz, San Mateo, and Riverside in the 1989–90 fiscal year pursuant to Chapter 1361 of the Statutes of 1987, provides a comprehensive, interagency system of care for seriously emotionally and behaviorally disturbed children
with serious emotional and behavioral disturbance and their families and has successfully met the performance outcomes required by the Legislature. The Legislature finds that this accountability for outcome is a defining characteristic of a system of care as developed under this part. It finds that the system established in these four counties can be expanded statewide to provide greater benefit to children with serious emotional and behavioral disturbances disturbance
at a lower cost to the taxpayers. It finds further that substantial savings to the state and these four counties accrue annually, as documented by the independent evaluator provided under this part. Of the amount continuing to be saved by the state in its share of out-of-home placement costs and special education costs for those counties and others currently funded by this part, a portion is hereby reinvested to expand and maintain statewide the system of care for children with serious emotional and behavioral disturbances. disturbance.
(c) Therefore, using the Ventura County model guidelines, it is the intent of the Legislature to accomplish the following:
(1) To phase in the
system of care for children with a serious emotional and behavioral problems problem developed under this part to all counties within the state.
(2) To require that 100 percent of the new funds appropriated under this part be dedicated to the targeted population as defined in Sections 5856 and 5856.2. To this end, it is the intent of the Legislature that families of eligible children be involved in county program planning and design and, in all cases, be involved in the development of individual child treatment plans.
(3) To expand interagency collaboration and shared responsibility for seriously emotionally and behaviorally disturbed
children
with serious emotional and behavioral disturbance in order to do the following:
(A) Enable children a child to remain at home with their families the child’s family whenever possible.
(B) Enable children
a child placed in foster care for their
the child’s protection to remain with a foster family in their the child’s community as long as separation from their the child’s natural family is determined necessary by the juvenile court.
(C) Enable a special education pupils pupil
to attend public school and make academic progress.
(D) Enable a juvenile offenders offender to decrease delinquent behavior.
(E) Enable children a child requiring out-of-home placement in a licensed residential group homes
home
or psychiatric hospitals
hospital to receive that care in as close proximity as possible to the child’s usual residence.
(F) Separately identify and categorize funding for these services.
(4) To increase accountability by expanding the number of counties with a performance contract that requires measures of client outcome and cost avoidance.
(d) It is the intent of the Legislature that the outcomes prescribed by this section shall be achieved regardless of the cultural or ethnic origin of the seriously emotionally and behaviorally disturbed children and their families. child with
serious and behavioral disturbance or the child’s family.
SEC. 50.
Section 5852.5 of the Welfare and Institutions Code is amended to read:5852.5.
The State Department of Health Care Services, in consultation with the Mental Health Services Oversight and Accountability(a) The total estimated cost avoidance in all of the following categories shall equal or exceed the applications for funding award moneys:
(1) Group home costs paid by Aid to Families with Dependent Children-Foster Care (AFDC-FC) program.
(2) Children and adolescent state hospital and acute inpatient programs.
(3) Nonpublic school residential placement costs.
(4) Juvenile justice reincarcerations.
(5) Other short- and long-term savings in public funds resulting from the applications for funding award moneys.
(b) If the department determines that the total cost avoidance listed in subdivision (a) does not equal or exceed applications for funding award amounts, the department shall determine that the county that has been awarded funding shall achieve substantial
compliance with all of the following goals:
(1) Total cost avoidance in the categories listed in subdivision (a) to exceed 50 percent of the applications for funding award moneys.
(2) A 20-percent reduction in out-of-county ordered placements of juvenile justice wards and social service dependents.
(3) A statistically significant reduction in the rate of recidivism by juvenile offenders.
(4) A 25-percent reduction in the rate of state hospitalization of minors from placements of special education pupils.
(5) A 10-percent reduction in out-of-county nonpublic school residential placements of special education pupils.
(6) Allow
at least 50 percent of children at risk of imminent placement served by the intensive in-home crisis treatment programs, which are wholly or partially funded by applications for funding award moneys, to remain at home at least six months.
(7) Statistically significant improvement in school attendance and academic performance of seriously emotionally disturbed special education pupils with serious emotional disturbance treated in day treatment programs which are wholly or partially funded by applications for funding award moneys.
(8) Statistically significant increases in services provided in nonclinic settings among agencies.
(9) Increase in ethnic minority and gender access to services proportionate to the percentage of these groups in the county’s school-age population.
SEC. 51.
Section 5855 of the Welfare and Institutions Code is amended to read:5855.
The State Department of Health Care Services shall adopt as part of its overall mission the development of community-based, comprehensive, interagency systems of care that target(a) Family preservation. Children
A child shall be maintained in their homes with their families the child’s family whenever possible.
(b) Least restrictive setting. Children A child shall be placed in the least restrictive and least costly setting appropriate to their the child’s needs when out-of-home placement is necessary.
(c) Natural setting. Children benefit
A child benefits most from mental health services in their natural environments, where they live and learn, the child’s natural environment, where the child lives and learns, such as home, school, foster home, or a juvenile detention center.
(d) Interagency collaboration and a coordinated service delivery system. The primary child-serving agencies, such as social services, probation, education, health, and mental health agencies, shall collaborate at the policy, management, and service levels to provide a coordinated, goal-directed system of care for seriously emotionally disturbed
children with serious emotional disturbance and their families.
(e) Family involvement. Family participation is an integral part of assessment, intervention, and evaluation.
(f) Cultural competence. Service effectiveness is dependent upon both culturally relevant and competent service delivery.
SEC. 52.
Section 5856 of the Welfare and Institutions Code is amended to read:5856.
For the purposes of this part,SEC. 53.
Section 5856.2 of the Welfare and Institutions Code is amended to read:5856.2.
(a)(b) Counties A county shall ensure, within available resources, that programs are designed to serve young children from zero to five years of age, inclusive, their families, and adolescents in transition from 15 to 21 years of age, inclusive.
SEC. 54.
Section 5860 of the Welfare and Institutions Code is amended to read:5860.
(a) Final selection of county proposals shall be subject to the amount of funding approved for expansion of services under this part.(b) Counties A county shall use funds distributed under this part only in support of a mental health system serving seriously emotionally disturbed children
with serious emotional disturbance in accordance with the principles and program requirements associated with the system of care model described in this part. The State Department of Mental Health shall audit and monitor the use of these funds to ensure that the funds are used solely in support of the children’s system of care program and in accordance with the performance contract described in subdivision (c). If county programs receiving children’s system of care funding do not comply with program and audit requirements determined by the department, funds shall be redistributed to other counties to implement, expand, or model children’s system of care programs.
(c) The department shall
enter into annual performance contracts with the selected counties and enter into training and consultation contracts as necessary to fulfill its obligations under this part. These annual performance contracts shall be in addition to the county mental health services performance contracts submitted to the department under Section 5650. Any changes in the staffing patterns or protocols, or both, approved in the original program proposal shall be identified and justified in these annual performance contracts. Annual performance contracts filed by counties operating the program as of January 1, 2001, shall, if approved by the department, serve as the baseline contract for purposes of this subdivision. The contracts shall be exempt from the requirements of the Public Contract Code and the State Administrative Manual and shall be exempt from approval by the Department of General Services.
SEC. 55.
Section 5878.1 of the Welfare and Institutions Code is amended to read:5878.1.
(a) It is the intent of this article to establish programs that ensure services will be provided to(b) Nothing in this act shall be construed to This
act does not authorize any services to be provided to a minor without the consent of the child’s minor’s parent or legal guardian beyond those already authorized by existing statute.
SEC. 56.
Section 5878.2 of the Welfare and Institutions Code is amended to read:5878.2.
For purposes of this article,SEC. 57.
Section 5878.3 of the Welfare and Institutions Code is amended to read:5878.3.
(a) Subject to the availability of funds as determined pursuant to Part 4.5 (commencing with Section 5890) of this division, county mental health programs shall offer services to(b) Funding shall be at sufficient levels to ensure that counties can provide each child served all of the necessary services set forth in the applicable treatment plan developed in accordance with this part, including services where appropriate and necessary to prevent an out of home placement, such as services pursuant to Chapter 4 (commencing with Section 18250) of Part 6 of Division 9.
(c) The State Department of Health Care Services shall contract with county mental health programs for the provision of services under this article in the manner set forth in Section 5897.
SEC. 58.
Section 5880 of the Welfare and Institutions Code is amended to read:5880.
For each selected county the State Department of Health Care Services shall define and establish client and cost outcome and other system performance goals, and negotiate the expected levels of attainment for each year of participation. Expected levels of attainment shall include a breakdown by ethnic origin and shall be identified by a county in its proposal. These goals shall include, but not be limited to, both of the following:(a) Client improvement and cost avoidance outcome measures, as follows:
(1) To reduce the number of child months in group homes, residential placements pursuant to Chapter 26.5 (commencing with Section 7570) of Division 7 of Title 1 of the Government Code, and state hospital placements.
(2) To reduce the cost of AFDC-FC group home care, residential placements as described in paragraph (1), and state hospital utilization, by an amount which equals at least 50 percent of the third year project cost. Cost avoidance shall be based on data comparisons of statewide average expenditure and population.
(3) To increase school attendance for pupils in targeted programs.
(4) To increase the grade level equivalent of pupils in targeted programs from admission to discharge.
(5) To reduce the rate of recidivism incurred for wards in targeted juvenile justice programs.
(6) To show measurable improvement in individual and family functional status for a representative sample of children
enrolled in the system of care.
(7) To achieve statistically significant increases in services provided in nonclinic settings among agencies.
(8) To increase ethnic minority and gender access to services proportionate to the percentage of these groups in the county’s school-age population.
(b) System development and operation measures, as follows:
(1) To provide an integrated system of care that includes multiagency programs and joint case planning, to children who
are seriously emotionally and behaviorally disturbed with serious emotional disturbance as defined in Section 5856.
(2) To identify and assess children who comprise the target population in the county evidenced by a roster which contains all children receiving mental health case management and treatment services. This roster shall include necessary standardized and uniform identifying information and demographics about the children served.
(3) To
develop and maintain individualized service plans that will facilitate interagency service delivery in the least restrictive environment.
(4) To develop or provide access to a range of intensive services that will meet individualized service plan needs. These services shall include, but not be limited to, case management, expanded treatment services at schoolsites, local juvenile corrections facilities, and local foster homes, and flexible services.
(5) To ensure the development and operation of the interagency policy council and the interagency case management council.
(6) To provide culturally competent programs that recognize and address the unique needs of ethnic populations in relation to equal access, program design and operation, and program evaluation.
(7) To develop parent education and support groups, and linkages with parents to ensure their involvement in the planning process and the delivery of services.
(8) To provide a system of evaluation that develops outcome criteria and which will measure performance, including client outcome and cost avoidance.
(9) To gather, manage, and report data in accordance with the requirements of the state funded outcome evaluation.
SEC. 59.
Section 5886 of the Welfare and Institutions Code is amended to read:5886.
(a) The Mental Health Student Services Act is hereby established as a mental health partnership grant program for the purpose of establishing mental health partnerships between a county’s mental health or behavioral health departments and school districts, charter schools, and the county office of education within the county.(b) The Mental Health Services Oversight and Accountability Commission shall award grants to county mental health or behavioral health departments to fund partnerships between educational and county mental health entities. Subject to an appropriation for this purpose, commencing with the 2021–22 fiscal year, the commission shall award a grant under this section to a county mental health or behavioral health department or another lead agency,
as identified by the partnership within each county that meets the requirements of this section.
(1) County, city, or multicounty mental health or behavioral health departments, or a consortium of those entities, including multicounty partnerships, may, in partnership with one or more school districts and at least one of the following educational entities located within the county, apply for a grant to fund activities of the partnership:
(A) The county office of education.
(B) A charter school.
(2) An educational entity may be designated as the lead agency at the request of the county, city, or multicounty department, or consortium, and authorized to submit the application. The county, city, or multicounty department, or consortium, shall be the grantee
and receive any grant funds awarded pursuant to this section even if an educational entity is designated as the lead agency and submits the application pursuant to this paragraph.
(c) The commission shall establish criteria for awarding funds under the grant program, including the allocation of grant funds pursuant to this section, and shall require that applicants comply with, at a minimum, all of the following requirements:
(1) That all school districts, charter schools, and the county office of education have been invited to participate in the partnership, to the extent possible.
(2) That applicants an applicant include with
their application a plan developed and approved in collaboration with participating educational entity partners and that include a letter of intent, a memorandum of understanding, or other evidence of support or approval by the governing boards of all partners.
(3) That plans address all of the following goals:
(A) Preventing mental illnesses from becoming severe and disabling.
(B) Improving timely access to services for underserved populations.
(C) Providing outreach to families, employers, primary care health care providers, and others to recognize the early signs of potentially severe and disabling mental illnesses.
(D) Reducing the stigma associated with the diagnosis of a mental
illness or seeking mental health services.
(E) Reducing discrimination against people with mental illness.
(F) Preventing negative outcomes in the targeted population, including, but not limited to:
(i) Suicide and attempted suicide.
(ii) Incarceration.
(iii) School failure or dropout.
(iv) Unemployment.
(v) Prolonged suffering. Worsening of symptoms and the condition over time.
(vi) Homelessness.
(vii) Removal of children from their homes. a child from their home.
(viii) Involuntary mental health detentions.
(4) That the plan includes a description of the
following:
(A) The need for mental health services for children and youth, including campus-based mental health services, as well as potential gaps in local service connections.
(B) The proposed use of funds, which shall include, at a minimum, that funds will be used to provide personnel or peer support.
(C) How the funds will be used to facilitate linkage and access to ongoing and sustained services, including, but not limited to, objectives and anticipated outcomes.
(D) How the partnership will collaborate with preschool and childcare providers, or other early childhood service organizations, to ensure the mental health needs of children are met before and after they transition to a school setting.
(E) The partnership’s ability to do all of the following:
(i) Obtain federal Medicaid or other reimbursement, including Early and Periodic Screening, Diagnostic, and Treatment funds, when applicable, or to leverage other funds, when feasible.
(ii) Collect information on the health insurance carrier for each child or youth, with the permission of the child or youth’s parent, to allow the partnership to seek reimbursement for mental health services provided to children and youth, where applicable.
(iii) Engage a health care service plan or a health insurer in the mental health partnership, when applicable, and to the extent mutually agreed to by the partnership and the plan or insurer.
(iv) Administer an effective service program and the
degree to which mental health providers and educational entities will support and collaborate to accomplish the goals of the effort.
(v) Connect children and youth to a source of ongoing mental health services, including, but not limited to, through Medi-Cal, specialty mental health plans, county mental health programs, or private health coverage.
(vi) Continue to provide services and activities under this program after grant funding has been expended.
(d) Grants awarded pursuant to this section shall be used to provide support services that include, at a minimum, all of the following:
(1) Services provided on school campuses, to the extent practicable.
(2) Suicide prevention services.
(3) Drop-out prevention services.
(4) Outreach to high-risk youth and young adults, including, but not limited to, foster youth, youth who identify as lesbian, gay, bisexual, transgender, or queer, and youth who have been expelled or suspended from school.
(5) Placement assistance and development of a service plan that can be sustained over time for students in need of ongoing services.
(e) Funding may also be used to provide other prevention, early intervention, and direct services, including, but not limited to, hiring qualified mental health personnel, professional development for school staff on trauma-informed and evidence-based mental health practices, and other strategies that respond to the mental health needs of children and youth, as determined
by the commission.
(f) The commission shall determine the amount of grants and shall take into consideration the level of need and the number of schoolage youth in participating educational entities when determining grant amounts. In determining the distribution of funds appropriated in the 2021–22 fiscal year, the commission shall take into consideration any previous funding the grantee received under this section.
(g) The commission may establish incentives to provide matching funds by awarding additional grant funds to partnerships that do so.
(h) If the commission is unable to provide a grant to a partnership in a county because of a lack of applicants or because no applicants met the minimum requirements within the timeframes established by the commission, the commission may redistribute those funds to other
eligible grantees.
(i) Partnerships currently receiving grants from the Investment in Mental Health Wellness Act of 2013 (Part 3.8 (commencing with Section 5848.5)) are eligible to receive a grant under this section for the expansion of services funded by that grant or for the inclusion of additional educational entity partners within the mental health partnership.
(j) Grants awarded pursuant to this section may be used to supplement, but not supplant, existing financial and resource commitments of the county, city, or multi-county multicounty mental health or behavioral health departments, or a consortium of those entities, or educational entities that receive a grant.
(k) (1) The commission shall develop metrics and a system to measure and publicly report on the performance outcomes of services provided using the grants.
(2) (A) The commission shall provide a status report to the fiscal and policy committees of the Legislature on the progress of implementation of this section no later than March 1, 2022, and provide an updated report no later than March 1, 2024. The reports shall address, at a minimum, all of the following:
(i) Successful strategies.
(ii) Identified needs for additional services.
(iii) Lessons learned.
(iv) Numbers of, and
demographic information for, the schoolage children and youth served.
(v) Available data on outcomes, including, but not limited to, linkages to ongoing services and success in meeting the goals identified in paragraph (3) of subdivision (c).
(B) The reports to be submitted pursuant to this paragraph shall be submitted in compliance with Section 9795 of the Government Code.
(l) This section does not require the use of funds allocated for the purpose of satisfying the minimum funding obligation under Section 8 of Article XVI of the California Constitution for the partnerships established by this section.
(m) The commission may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis in order to implement
this section. Contracts entered into or amended pursuant to this subdivision are exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, and Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and shall be exempt from the review or approval of any division of the Department of General Services.
(n) This section shall be implemented only to the extent moneys are appropriated in the annual Budget Act or another statute for purposes of this section.
SEC. 60.
Section 5900 of the Welfare and Institutions Code is amended to read:5900.
This part is intended to organize and finance mental health services in skilled nursing facilities designated as institutions for mental disease, in a way that will promote the well-being of the residents. It is furthermore intended to effectively utilize existing resources in the delivery of mental health services toSEC. 61.
Section 5903 of the Welfare and Institutions Code is amended to read:5903.
(a) For the purposes of this section, the following definitions shall apply:(1) “Client” means an individual who is all of the following:
(A) Mentally disabled. A person with a mental health disability.
(B) Medi-Cal eligible.
(C) Under the age of 65 years.
65 years of age.
(D) Certified for placement in an institution for mental disease by a county.
(E) Eligible for Supplemental Security Income/State Supplementary Program for the Aged, Blind, and Disabled (SSI/SSP) benefits.
(2) “Client’s payee” means an authorized representative who may receive revenue resources, including SSI/SSP benefits, on behalf of a client.
(3) “SSI/SSP benefits” means revenue resources paid to an eligible client, or the client’s payee, by the federal Social Security Administration pursuant to Subchapter 16 (commencing with Section 1381) of Chapter 7 of Title 42 of the United States Code, and Chapter 3 (commencing with Section 12000) of Part 3 of Division 9.
(b) (1) Between August 1, 1991, and June 30, 1992, institution for mental disease providers shall make reasonable efforts to collect SSI/SSP benefits from a client or a client’s payee. The provider shall invoice the client or the client’s payee for the SSI/SSP benefits, minus the personal and incidental allowance amount as established by the Social Security Administration, and remit all SSI/SSP funds collected to the department pursuant to procedures established by the department.
(2) Commencing July 1, 1992, and to the extent permitted by federal law, institution for mental disease providers may collect SSI/SSP benefits from a client or a client’s payee. The amount to be invoiced shall be the amount of the client’s SSI/SSP benefits, minus the personal and incidental allowance amount as established by the Social Security Administration. The administrative
mechanism for collection of SSI/SSP benefits, including designation of the party responsible for collection, shall be determined by negotiation between the counties and the providers.
(c) In collecting SSI/SSP benefits from the client or the client’s payee, the provider shall not be deemed to be the authorized representative, as defined in Section 72015 of Title 22 of the California Code of Regulations, for purposes of handling the client’s moneys or valuables.
(d) Providers shall make all reasonable efforts, as specified in procedures developed by the department in consultation with providers, to collect SSI/SSP benefits from the client or the client’s payee. Providers shall establish an accounting procedure, approved by the department, for the actual collection and remittance of these funds.
(e) Providers shall
prorate the client’s SSI/SSP benefits by the number of days spent in the facility.
(f) After June 30, 1992, and not later than January 1, 1993, the department shall make data available to the Legislature, upon request, regarding the SSI/SSP collections made by institution for mental disease providers pursuant to this section.
SEC. 62.
Section 5909 of the Welfare and Institutions Code is amended to read:5909.
(a) The Director of Health Care Services shall retain the authority and responsibility to monitor and approve special treatment programs in skilled nursing facilities in accordance with Sections 72443 to 72475, inclusive, of Title 22 of the California Code of Regulations.(b) The State Department of Health Care Services shall conduct annual certification inspections of special treatment programs for the mentally disordered persons with a mental
health disability for the purpose of approving the special treatment programs that are located in skilled nursing facilities licensed pursuant to Section 1265 of the Health and Safety Code.
SEC. 63.
Section 6552 of the Welfare and Institutions Code is amended to read:6552.
A minor who has been declared to be within the jurisdiction of the juvenile court may, with the advice of counsel, make voluntary application for inpatient or outpatient mental health services in accordance with Section 5003. NotwithstandingIf the minor is accepted as a voluntary patient, the juvenile court may issue an order to the minor and to the person in charge of the hospital, facility, or program in which the minor is to be placed that should the minor leave or demand to leave the care or custody thereof prior to the time they are discharged by the superintendent or person in charge, they shall be returned forthwith to the juvenile court for a further dispositional hearing pursuant to the juvenile court law.
The provisions of this section shall continue to apply to the minor until the
termination or expiration of the jurisdiction of the juvenile court.
SEC. 64.
Section 18986.40 of the Welfare and Institutions Code is amended to read:18986.40.
(a) For the purposes of this chapter, “program” or “integrated children’s services programs” means a coordinated children’s service system, operating as a program that is part of a department or State Department of Health Care Services initiative, that offers a full range of integrated behavioral social, health, and mental health services, including applicable educational services, to(1) Educational services for children at risk of dropping out, or who need additional educational services to be successful academically.
(2) Health care.
(3) All mental health diagnostic and treatment services, including medication.
(4) Substance abuse use and misuse prevention and treatment.
(5) Child abuse prevention, identification,
and treatment.
(6) Nutrition services.
(7) Child care and development services.
(8) Juvenile justice services.
(9) Child welfare services.
(10) Early intervention and prevention services.
(11) Crisis intervention services, as defined in subdivision (c).
(12) Any other service which will enhance the health, development, and well-being of children and their families.
(b) For the purposes of this chapter, “children’s multidisciplinary services team” means a team of two or more persons trained and
qualified to provide one or more of the services listed in subdivision (a), who are responsible in the program for identifying the educational, health, or social service needs of a child and his or her the child’s family, and for developing a plan to address those needs. A family member, or the designee of a family member, shall be invited to participate in team meetings and decisions, unless the team determines that, in its professional judgment, this participation would present a reasonable risk of a significant adverse or detrimental effect on the minor’s psychological or physical safety. Members of the team shall be trained in the confidentiality and information sharing provisions of this chapter.
(c) “Crisis intervention services” means early support
and psychological assistance, to be continued as necessary, to children who have been victims of, or whose lives have
to a child who was the victim of, or whose life has been affected by, a violent crime or a cataclysmic incident, such as a natural disaster, or who have been involved in a school, neighborhood, or family based family-based critical incidents incident likely to cause profound psychological effects if not addressed immediately and thoroughly.
(a)The State Department of State Hospitals shall encourage counties to use state hospital facilities, in addition to utilizing state hospital beds pursuant to contract, for additional treatment programs through contracts, on either an individual county or regional basis.
(b)For purposes of contracts entered into through the department’s encouragement pursuant to subdivision (a), costs shall be based on the actual costs to the state, and shall be prorated on an annual lease basis.
