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AB-1566 Mental health: Psychiatric Emergency Response program: Sacramento County.(2001-2002)

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CALIFORNIA LEGISLATURE— 2001–2002 REGULAR SESSION

Assembly Bill
No. 1566


Introduced  by  Assembly Member Cox

February 23, 2001


An act to add Chapter 7 (commencing with Section 5551) to Part 1 of Division 5 of the Welfare and Institutions Code, relating to mental health.


LEGISLATIVE COUNSEL'S DIGEST


AB 1566, as introduced, Cox. Mental health: Psychiatric Emergency Response program: Sacramento County.
Existing law requires that each county have a plan for the provision of community mental health services.
This bill would make various legislative findings and declarations regarding the number of people with mental illness who come into contact with members of law enforcement; the inadequacy of law enforcement personnel to appropriately deal with these persons and make adequate mental health referrals; the financial burden placed on the court, probation and law enforcement systems as a result of this problem; and the need for the teaming of law enforcement officers with licensed mental health clinicians to deal with persons with mental illness who come into contact with members of law enforcement.
This bill would create the Psychiatric Emergency Response pilot program, which would require the State Department of Mental Health, in conjunction with the Sacramento County Sheriff’s Department, the City of Sacramento Police Department, and local mental health agencies in Sacramento County, with the consent of the county, to design and implement a 3-year pilot project in which the County of Sacramento would contract with a corporation that specializes in enabling local agencies to establish psychiatric emergency response teams as described.
This bill would require that the State Department of Mental Health, in collaboration with the other agencies involved, report to the Legislature on or before January 1, 2003, and January 1, 2004, as prescribed.
This bill would express the intent of the Legislature that state funding for purposes of this bill be appropriated in the Budget Act.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 The Legislature finds and declares all of the following:
(a) The population of people with mental illness and homeless people with mental illness in Sacramento County has increased every year, while treatment and services available to these people have decreased as a result of budget cutbacks. As a result of the increased population of people with mental illness and the concomitant reduction in services, the jails in the county have become the de facto treatment site of people with mental illness.
(b) Patrol officers of the Sacramento County Sheriff’s Department and the Sacramento City Police Department are often the first responding treatment providers when people with mental illness are in crisis. Responding to these calls is time-consuming for officers, who are often ill-equipped to deal with the crises presented. Patrol officers’ time is often diverted from their primary duty of performing criminal investigations. Further, patrol officers, most of whom are unfamiliar with the mental illnesses presented and the various treatment options available for persons with mental illness, will often choose incarceration or unnecessary hospitalization at the Sacramento County Mental Health Treatment Center.
(c) The Sacramento County Sheriff’s Department responds to approximately 525 calls per month involving persons with mental illness. While some of these calls are dispatched to officers as ones involving the necessity of a 72-hour hold and evaluation pursuant to the Lanterman-Petris-Short Act, often the calls actually involve people with mental illness, but are dispatched as matters involving incorrigible children, the need for providing assistance to the fire department, being drunk in public, defrauding an innkeeper, disturbances involving a customer, welfare checks, and suicide attempts.
(d) The Sacramento County Sheriff’s Department and the City of Sacramento Police Department are required to deal with an increasing population of persons, and homeless persons, with mental illness. These people are often charged with minor crimes such as failure to pay the fare for public transportation, failure to appear in court, or camping illegally by the river. These people have often failed to take their medication, and are in crisis when arrested. This population is cycling through the criminal justice system at twice the rate of offenders who do not have a mental illness.
(e) Persons with mental illness often come to the attention of law enforcement as a result of the reporting of nuisance crimes. The responding officer will often arrest and book the person as the disposition of the matter, when a mental health referral would be the appropriate disposition.
(f) In March 1999, the Mentally Ill Offender Crime Reduction Grant Program reported an average of 150 people per day were booked into the Sacramento County jail system. Arrest data revealed that 13.5 percent of those arrested in a year had previously received treatment from county mental health inpatient and outpatient programs. The program concluded that approximately 9,720 persons arrested every year have mental health issues. This figure is likely an underestimate because the program identified as having mental health issues only those people who had utilized the public mental health system.
(g) In a 10-day study conducted in April 1995, the Department of Psychiatry for the University of California at Davis reported that 19.5 percent of arrestees booked into the main jail in Sacramento had prior admissions to Sacramento County mental health facilities. The majority of the arrests were for misdemeanors (66 percent), and a large number were as a result of the commission of violations involving alcohol or drugs (45 percent).
(h) The results of the 1995 study of the University of California, Davis, show that arrestees with mental health histories were more likely to be homeless (7 percent) than arrestees without a mental health history. It is estimated that 40 percent of homeless individuals encountered by patrol officers have a history of mental health treatment. An eight-day study of admissions to the Sacramento County Mental Health Treatment Center in October 1999 revealed that 13 percent of all admissions of persons precipitated by law enforcement officers were of people who were homeless. Based on this finding, in one year, law enforcement officers will admit as many as 676 homeless patients into the treatment center.
(i) In dispatch calls involving a mentally ill person who has not committed a crime and does not meet the criteria required to place the person on a 72-hour hold for evaluation, an officer may do nothing more than attempt to mediate the problem as a result of the officer’s lack of expertise in mental health issues and referral options. The officer’s inability to provide adequate mental health service often results in repeated calls for service dealing with the same person with mental illness.
(j) Conversely, many persons with mental illness may be placed under 72-hour holds unnecessarily and when another disposition would be more appropriate for the person, such as a referral to one of the various programs in the county. The Sacramento County Mental Health Treatment Center Crisis Unit receives an average of 700 admissions per month. Sixty to 70 percent of these admissions are people brought in by law enforcement, at an average cost of $1,700 per admission. Thus, inappropriate response by law enforcement officers to persons with mental illness has a significant impact on the Sacramento County Mental Health System.
(k) A typical call involving a person with mental illness can take two officers out of service for up to one hour each, and for an additional hour if the person needs to be transported to the Sacramento County Mental Health Treatment Center. Additional time may be required when medical clearance is necessary as a result of, for example, inebriation, a preexisting medical condition, or a suicide attempt. A police or sheriff’s unit may be taken out of service for up to five hours as a result of a call involving a person with a mental illness.
(l) A policy paper published by the Pacific Research Foundation estimates the cost of using the criminal justice system as a treatment option, and often the first or only treatment option, for persons with mental illness, costs the county up to $53,000,000 per year, as follows:
(1) Ten million six hundred thousand dollars ($10,600,000) for the county jail.
(2) Two million two hundred eighty thousand dollars ($2,280,000) for the probation department.
(3) Seven million six hundred thousand dollars ($7,600,000) for patrol services for the Sacramento County Sheriff’s Department.
(4) Twenty-one million dollars ($21,000,000) for patrol services for the City of Sacramento Police Department.
(5) Eleven million nine hundred thousand dollars ($11,900,000) for the courts.
(m) Persons with mental illness are ultimately the responsibility of the mental health system. Without specialized training or assistance from the mental health system, law enforcement officers are ill-equipped and ill-prepared to effectively and appropriately handle persons suffering from mental illness.
(n) When a person in our society has a medical emergency and authorities are contacted, highly trained paramedics respond to provide emergency medical treatment and transportation to a hospital where appropriate treatment may be administered by people trained to administer the treatment. When a person in our society has a psychiatric emergency and authorities are contacted, an officer who is minimally trained in psychiatric assessment and treatment options will respond and will typically choose to arrest and book the person, transport the person to the county mental health hospital, or do nothing, which often results in further calls to authorities.
(o) The Legislature recognizes the importance of developing a cooperative program, involving both members of law enforcement and the mental health system, to properly manage, treat, and provide appropriate referrals to persons with mental illness who come into contact with members of law enforcement.

SEC. 2.

 It is the intent of the Legislature in enacting this act to require the State Department of Mental Health, in conjunction with the City and County of Sacramento to design and implement a three-year pilot program involving both members of law enforcement and the mental health system, to properly manage, treat, and provide appropriate referrals to persons with mental illness who come into contact with members of law enforcement.

SEC. 3.

 Chapter 7 (commencing with Section 5551) is added to Part 1 of Division 5 of the Welfare and Institutions Code, to read:
CHAPTER  7. Psychiatric Emergency Response Pilot Program

5551.
 The State Department of Mental Health shall, in conjunction with the Sacramento County Sheriff’s Department, the City of Sacramento Police Department, and local mental health agencies in Sacramento County, with the consent of the city and county, design and oversee the implementation of a three-year pilot program to provide, through a team approach between law enforcement and a corporation providing psychiatric emergency response consultation services, for a psychiatric emergency response team pilot program.

5551.1.
 (a) In order to implement this program, the county shall contract with a corporation with expertise in training law enforcement to work with mentally ill individuals and in enabling local agencies to establish psychiatric emergency response teams. The program provided for under this chapter shall require adequate training of law enforcement officers, and adequate teaming with licensed mental health clinicians, in order to establish psychiatric emergency response teams that will refer individuals to needed services.
(b) The purpose of the program provided for under this chapter, shall be to provide mobile crisis intervention to individuals who are experiencing mental health crises involving contact law enforcement. The program shall be designed and implemented to achieve the goal of increasing safe and effective responses and services to persons with mental illness who come into contact with law enforcement, while reducing unnecessary incarceration or hospitalization, increasing public safety, decreasing unnecessary arrests and prosecutions of persons with mental illness, and returning patrol officers to service more quickly.
(c) Each psychiatric emergency response team shall consist of a law enforcement officer and a licensed mental health clinician.

5551.2.
 The Sacramento County Sheriff’s Department and the Sacramento City Police Department shall each provide all of the following:
(a) Officers to be trained and function as team members pursuant to the program. These officers shall complete a training academy in psychiatric emergency response. These officers shall also work closely with the corporation providing the services, the department, and law enforcement agencies that may be involved in the program.
(b) Patrol vehicles and a work area at each station to house the teams.
(c) Initial employee background investigations for clinical staff. These investigations shall be the equivalent of a civilian background investigation.

5551.3.
 The department shall, to the extent that funds are appropriated for this purpose, provide funding to the City and County of Sacramento to implement this pilot program.

5551.4.
 (a) The department shall, in conjunction with the Sacramento County Sheriff’s Department and the Sacramento City Police Department, report to the Legislature no later than January 1, 2003, as to the effectiveness of the program and any cost savings to law enforcement.
(b) The department shall, in conjunction with the Sacramento County Sheriff’s Department and the Sacramento City Police Department, report to the Legislature no later than January 1, 2004, as to the effectiveness of the program, any cost savings to law enforcement, a recommendation as to whether the program should be continued, and a recommendation as to how the program may be implemented in other counties if it is recommended that it be continued in Sacramento County.

SEC. 4.

 It is the intent of the Legislature that the sum of five million three hundred seventy thousand dollars ($5,370,000) be appropriated in the Budget Act, as follows, for purposes of Chapter 7 (commencing with Section 5551) of Part 1 of Division 5 of the Welfare and Institutions Code:
(a) Two million dollars ($2,000,000) for the first year of the program.
(b) One million six hundred fifty thousand dollars ($1,650,000) for the second year of the program.
(c) One million seven hundred twenty thousand dollars ($1,720,000) for the third year of the program.