Today's Law As Amended

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AB-2134 Community mental health services: assisted outpatient treatment.(2011-2012)

As Amends the Law Today


 Section 5348 of the Welfare and Institutions Code is amended to read:

 (a) For purposes of subdivision (e) of Section 5346, a county that chooses 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 those 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, if where  appropriate.
(F) Provision for services to be client-directed and to 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 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.
(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 that 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 Care Services  and, based on the data, the department shall report to the Governor and the  Legislature on or before May 1 of each year regarding the services the  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, 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.