Bill Text: CA AB2134 | 2011-2012 | Regular Session | Amended
Bill Title: Community mental health services: assisted outpatient
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Engrossed - Dead) 2012-06-27 - In committee: Set second hearing. Failed passage. Reconsideration granted. [AB2134 Detail]
Download: California-2011-AB2134-Amended.html
BILL NUMBER: AB 2134 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MAY 3, 2012
AMENDED IN ASSEMBLY APRIL 30, 2012
AMENDED IN ASSEMBLY MARCH 29, 2012
INTRODUCED BY Assembly Member Chesbro
FEBRUARY 23, 2012
An act to amend Section 5348 of the Welfare and Institutions Code,
relating to mental health.
LEGISLATIVE COUNSEL'S DIGEST
AB 2134, as amended, Chesbro. Community mental health services:
assisted outpatient treatment.
Existing law, Laura's Law, until January 1, 2013, regulates
designated assisted outpatient treatment services, which counties may
elect to provide. Under existing law, in counties where assisted
outpatient treatment services are available, a court may order a
person suffering from a mental illness to obtain assisted outpatient
treatment if the court finds the requisite criteria are met.
This bill would require a county that elects to provide these
services to develop specified best practices for the purposes of
responding to a mental health crisis, and to provide for services in
connection with these best practices. The bill would exempt
counties that, as of January 1, 2012, are providing services pursuant
to Laura's Law.
Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 5348 of the Welfare and Institutions Code is
amended to read:
5348. (a) For purposes of subdivision (e) of Section 5346, a
county that elects 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 persons 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 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 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 shall also contain evaluation strategies,
which 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 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, where 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 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 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 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.
(L) (i) Provision for services related to
responding to a mental health crisis, in accordance with the best
practices developed pursuant to subdivision (e).
(ii) This subparagraph shall not apply to a county that, as of
January 1, 2012, is providing services pursuant to this article.
(3) Each 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 each
client receives those services that are agreed to in the personal
services plan. Each client shall participate in the development of
his or her 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 Mental Health 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) (1) A county that elects to provide
assisted outpatient treatment services pursuant to this article shall
develop best practices for the purposes of responding to a mental
health crisis. These best practices include, but are not limited to,
the utilization of crisis intervention teams, mobile crisis teams, or
psychiatric emergency response teams, with an emphasis on peer
support.
(2) This subdivision shall not apply to a county that, as of
January 1, 2012, is providing services pursuant to this article.
