Bill Text

Bill Information


PDF |Add To My Favorites | print page

AB-2679 Conservatorship: serious mental illness and substance use disorders: County of Butte.(2019-2020)

SHARE THIS:share this bill in Facebookshare this bill in Twitter
Date Published: 02/20/2020 09:00 PM
AB2679:v99#DOCUMENT


CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 2679


Introduced by Assembly Member Gallagher

February 20, 2020


An act to amend Sections 5450, 5451, 5454, and 5555 of the Welfare and Institutions Code, relating to mental health.


LEGISLATIVE COUNSEL'S DIGEST


AB 2679, as introduced, Gallagher. Conservatorship: serious mental illness and substance use disorders: County of Butte.
Existing law establishes procedures for the appointment of a conservator for a person who is determined to be gravely disabled as a result of a mental disorder or an impairment by chronic alcoholism or who is unable to provide properly for the person’s personal needs for physical health, food, clothing, or shelter. Existing law also establishes a procedure for the appointment of other types of conservatorship or a guardianship as ordered by the probate court.
Existing law, until January 1, 2024, establishes an alternative procedure for the County of Los Angeles, the County of San Diego, and the City and County of San Francisco, if the board of supervisors of the respective county or city and county authorizes the application of these provisions subject to specified requirements, for the appointment of a conservator for a person who is incapable of caring for the person’s own health and well-being due to a serious mental illness and substance use disorder, as specified, for the purpose of providing the least restrictive and most clinically appropriate alternative needed for the protection of the person. Existing law prohibits a conservatorship from being established under these alternative provisions if a conservatorship or guardianship exists under any of the other above-described provisions.
This bill, until January 1, 2024, would additionally establish these alternative procedures for the County of Butte, and would make conforming changes.
This bill would make legislative findings and declarations as to the necessity of a special statute for the County of Butte.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 5450 of the Welfare and Institutions Code is amended to read:

5450.
 (a) Until January 1, 2024, this chapter shall apply applies only to the County of Los Angeles, the County of Butte, the County of San Diego, and the City and County of San Francisco if the board of supervisors of the respective county or city and county, by resolution or through the county budget process, authorizes the application of this chapter and makes a finding that no voluntary mental health program programs serving adults, no children’s mental health program, and no programs, and services or supports provided in conservatorships established pursuant to Division 4 (commencing with Section 1400) of the Probate Code or conservatorships established pursuant to Chapter 3 (commencing with Section 5350), including availability of conservators, may shall not be reduced as a result of the implementation of this chapter.
(b) (1) Before the county board of supervisors may authorize the application of this chapter, the county mental health department, the county welfare department, and, if one exists, the county department of housing and homeless services shall do both of the following:
(A) Develop a plan to implement this chapter in consultation with representatives of disability rights advocacy groups, a provider of permanent supportive housing services, the county health department, law enforcement, labor unions, and staff from hospitals located in the county or the city and county.
(B) Present before the county board of supervisors on the plan and available resources for the implementation of this chapter.
(2) In order to approve authorization of the application of this chapter, the county board of supervisors shall determine, after a public hearing, based on materials presented, that all of the following services are available in, at a minimum, sufficient quantity, resources, and funding levels to serve the identified population that the county board of supervisors intends to serve, within the county or city and county for utilization in connection with the application of this chapter:
(A) Supportive community housing that provides wraparound services, with adequate beds available.
(B) Public conservators trained on the specifics of how to assess and evaluate individuals for the new form of conservatorship described in this chapter.
(C) Outpatient mental health counseling.
(D) Coordination and access to medications.
(E) Psychiatric and psychological services.
(F) Substance use disorder services.
(G) Vocational rehabilitation.
(H) Veterans’ services.
(I) Family support and consultation services.
(J) A service planning and delivery process that includes all of the following:
(i) Plans for services that contain evaluation strategies, which shall consider cultural, linguistic, gender, sexual orientation, 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 or cultural differences.
(ii) Provision for services to meet the needs of persons who are physically disabled.
(iii) Provision for services to meet the special needs of older adults.
(iv) Provision for family support and consultation services, parenting support and consultation services, and peer support or self-help group support, if appropriate.
(v) Provision for services to be client-directed and to employ psychosocial rehabilitation and recovery principles.
(vi) Provision for psychiatric and psychological services that are integrated with other services and for psychiatric and psychological collaboration in overall service planning.
(vii) Provision for services reflecting special needs of women from diverse cultural and socioeconomic backgrounds.
(viii) Provision for housing for clients that is immediate, transitional, permanent, or all of these.
(ix) Provision for services reflecting special needs of lesbian, gay, bisexual, and transgender (LGBT) individuals.
(K) The individual personal services plan ensures that a person subject to conservatorship pursuant to this chapter receives age-appropriate, gender-appropriate, disability-appropriate, and culturally appropriate services, to the extent feasible and when appropriate, that are designed to enable those persons to do all of the following:
(i) 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.
(ii) Engage in the highest level of work or productive activity appropriate to their abilities and experience.
(iii) Create and maintain a support system consisting of friends, family, and participation in community activities.
(iv) Access an appropriate level of academic education or vocational training.
(v) Obtain an adequate income.
(vi) 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.
(vii) Access necessary physical health benefits and care and maintain the best possible physical health.
(viii) Reduce or eliminate the distress caused by the symptoms of mental illness.
(3) The county or the city and county shall not seek to conserve any individual pursuant to this chapter unless there is funding and available resources to provide all of the services set forth in paragraph (2).

SEC. 2.

 Section 5451 of the Welfare and Institutions Code is amended to read:

5451.
 In the County of Los Angeles, the County of Butte, the County of San Diego, and the City and County of San Francisco, subject to Section 5450, a conservator of the person may be appointed for a person who is incapable of caring for the person’s own health and well-being due to a serious mental illness and substance use disorder. The procedure for establishing, administering, and terminating a conservatorship under this chapter shall be the same as provided for in Division 4 (commencing with Section 1400) of the Probate Code, except as follows:
(a) (1) The court may appoint the public conservator in the county of residence of the person to be conserved if the person requesting the appointment establishes, and the court makes an express finding, that it is necessary for the protection of the proposed conservatee, that the proposed conservatee is 18 years of age or older, and that the granting of the conservatorship is the least restrictive alternative needed for the protection of the conservatee.
(2) (A) A conservator of the person may be appointed pursuant to this chapter only if the person is presently incapable of caring for the person’s own health and well-being due to a serious mental illness and substance use disorder.
(B) For an initial appointment of a conservator, a person meets the standard in subparagraph (A) only if the court determines by clear and convincing evidence based on comprehensive clinical evaluations conducted throughout the period in which the person has been temporarily conserved pursuant to Section 5465.5 that the person is incapable of caring for their own health and well-being due to a serious mental illness and substance use disorder, and that conservatorship is the least restrictive alternative needed for the protection of the person. The court may consider the medical history, including psychiatric history, of the person to support this determination.
(C) To reestablish a conservatorship, the person meets the standard in subparagraph (A) only if the person’s condition at the time of the petition to reestablish the conservatorship shows that the person continues to meet the standard in subparagraph (A) based on the current behavior and condition of the person. The court may consider the medical history, including psychiatric history, of the person to support this determination.
(D) In any challenge to an existing conservatorship, the person meets the standard in subparagraph (A) only if the person’s condition at the time of the challenge to the conservatorship shows that the person continues to meet the standard in subparagraph (A) based on the current behavior and condition of the person. The court may consider the medical history, including psychiatric history, of the person to support this determination.
(E) A proposed conservatee shall meet all of the following criteria:
(i) The person has both a serious mental illness and a substance use disorder, as those terms are defined in Section 5452, other than a developmental disorder or acquired traumatic brain injury, as defined in Section 4354, unless that person also has a serious mental illness and substance use disorder.
(ii) As a result of the serious mental illness and substance use disorder, the person has functional impairments, or a psychiatric history demonstrating that without treatment, it is more likely than not that the person will decompensate to functional impairment in the near future.
(iii) As a result of the functional impairment and circumstance, the person is likely to become so disabled as to require public assistance, services, or entitlements.
(b) (1) The person for whom conservatorship is sought shall have the right to demand a court or jury trial on the issue of whether the person is shown to be, beyond a reasonable doubt, incapable of caring for the person’s own health and well-being due to a serious mental illness and substance use disorder. For an initial conservatorship, demand for a court or jury trial shall be made no later than seven days following the establishment of a temporary conservatorship pursuant to Section 5465.5, provided the proposed conservatee has had the opportunity to confer with the attorney of the proposed conservatee during that time. If the proposed conservatee demands a court or jury trial before the date of the hearing as provided for in Section 5465, the demand shall constitute a waiver of that hearing.
(2) Court or jury trial shall commence within 10 days of the date of the demand, except that the court shall continue the trial date for a period not to exceed 10 days upon the request of the attorney for the proposed conservatee.
(3) This right shall also apply in subsequent proceedings to reestablish a conservatorship, except that the demand for a court or jury trial shall be made within seven days following the hearing on the petition to reestablish the conservatorship.
(c) Conservatorship investigation shall be conducted pursuant to Chapter 3 (commencing with Section 5350) and shall not be subject to Section 1826 of, or Chapter 2 (commencing with Section 1850) of Part 3 of Division 4 of, the Probate Code.
(d) Notice of proceedings under this chapter shall be given to a guardian or conservator of the person or estate of the proposed conservatee appointed under the Probate Code and as otherwise provided in Section 5350.2.
(e) As otherwise provided for in this chapter.
(f) A conservatorship pursuant to this chapter shall not be established if a conservatorship or guardianship exists under Division 4 (commencing with Section 1400) of the Probate Code or under Chapter 3 (commencing with Section 5350).
(g) A petition seeking to establish a conservatorship pursuant to this chapter shall be filed with the court no later than 28 days following the eighth detention for evaluation and treatment pursuant to Section 5150 in a 12-month period.
(h) (1) For the 28 days following the eighth detention, the court may establish a temporary conservatorship pursuant to Section 5465.5 in order to assess the need for a conservatorship pursuant to this chapter. A petition to establish an initial conservatorship pursuant to this chapter may be filed only in conjunction with a petition to establish a temporary conservatorship pursuant to Section 5465.5.
(2) A supplement to the petition for an initial conservatorship shall be filed within 14 days of the initial petition pursuant to paragraph (1). The supplemental petition shall include, at a minimum, all of the following information:
(A) A detailed description of the comprehensive clinical evaluation of the person that has been performed since initiating the temporary conservatorship.
(B) The results and determinations based on the evaluation described in subparagraph (A).
(C) A detailed description of any treatment attempted or provided for the person since initiating the temporary conservatorship.
(D) A description of the person’s response to treatment, if any.
(E) Any additional information pertaining to the person’s condition and behavior during the temporary conservatorship that may aid in determining whether a conservatorship pursuant to this chapter is appropriate.
(F) A determination as to whether, based on the evidence provided in subparagraphs (A) to (E), inclusive, the petition for an initial conservatorship pursuant to this chapter should be heard or withdrawn.

SEC. 3.

 Section 5454 of the Welfare and Institutions Code is amended to read:

5454.
 In the County of Los Angeles, the County of Butte, the County of San Diego, and the City and County of San Francisco, subject to Section 5450, the board of supervisors of the respective county or city and county shall designate the agency or agencies to provide conservatorship investigation as set forth in this chapter, and those investigations shall comply with the requirements of Section 5354. The governing board may designate that conservatorship services be provided by the public guardian or agency providing public guardian services.

SEC. 4.

 Section 5555 of the Welfare and Institutions Code is amended to read:

5555.
 (a) The County of Los Angeles, the County of Butte, the County of San Diego, and the City and County of San Francisco, subject to Section 5450, shall establish a working group to conduct an evaluation of the effectiveness of the implementation of Chapter 5 (commencing with Section 5450) in addressing the needs of persons with serious mental illness and substance use disorders in the county or the city and county. The evaluation shall include all of the following:
(1) An assessment of the number and status of persons who have been conserved under Chapter 5 (commencing with Section 5450), the effectiveness of these conservatorships in addressing the short- and long-term needs of those persons, and the impact of conservatorships established pursuant to that chapter on existing conservatorships established pursuant to Division 4 (commencing with Section 1400) of the Probate Code or Chapter 3 (commencing with Section 5350) and on mental health programs provided by the county or the city and county.
(2) The service planning and delivery process for persons conserved pursuant to Chapter 5 (commencing with Section 5450).
(3) The number of persons conserved pursuant to Chapter 5 (commencing with Section 5450) who are placed in locked, acute psychiatric, hospital, rehabilitation, transitional, board and care, or any other facilities or housing types, and the duration of the confinement or placement in each of the facilities or housing types, including descriptions and analyses of the various types of confinement or placements and the types of onsite wraparound or other services, such as physical and behavioral health services.
(4) The number of persons conserved pursuant to Chapter 5 (commencing with Section 5450) placed in another county and the types of facilities and the duration of the placements, including the types of onsite wraparound or other services, such as physical and behavioral health services.
(5) The number of persons conserved pursuant to Chapter 5 (commencing with Section 5450) by the conserving county who receive permanent supportive housing in any county during their conservatorship, whether permanent supportive housing was provided during the conservatorship, and the wraparound services or other services, such as physical and behavioral health services, provided.
(6) The number of persons conserved pursuant to Chapter 5 (commencing with Section 5450) who are able to maintain housing and the number who maintain contact with the treatment system after the termination of the conservatorship, including the type and level of support they were receiving at the time they were conserved pursuant to Chapter 5 (commencing with Section 5450).
(7) The number of persons conserved pursuant to Chapter 5 (commencing with Section 5450) who successfully complete substance use disorder treatment programs.
(8) The incidence and rate of persons conserved pursuant to Chapter 5 (commencing with Section 5450) who have been detained pursuant to Section 5150 subsequent to termination of the conservatorship at 6, 12, and 24 months following conservatorship.
(9) An analysis of demographic data of persons conserved pursuant to Chapter 5 (commencing with Section 5450), including gender, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, marital status, and sexual orientation.
(10) A survey of the individuals conserved pursuant to Chapter 5 (commencing with Section 5450) and an analysis of the effectiveness of the placements and services they were provided while conserved.
(11) The substance use relapse rate of persons conserved pursuant to Chapter 5 (commencing with Section 5450) at 6, 12, and 24 months following conservatorship, to the extent this information can be obtained.
(12) The number of deaths of persons conserved pursuant to Chapter 5 (commencing with Section 5450) within 6, 12, and 24 months following conservatorship, and the causes of death, to the extent this information can be obtained.
(13) A detailed explanation for the absence of any information required in paragraph (11) or paragraph (12) that was omitted from the evaluation.
(b) The working group shall be comprised of representatives of disability rights advocacy groups, the county mental health department, the county health department, the county social services department, law enforcement, labor unions, staff from hospitals located in the county or the city and county, and, if one exists, the county department of housing and homeless services.
(c) Each working group shall prepare and submit a preliminary report and a final report to the Legislature on its findings and recommendations regarding the implementation of Chapter 5 (commencing with Section 5450). The preliminary report shall be submitted to the Legislature no later than January 1, 2021, and the final report shall be submitted to the Legislature no later than January 1, 2023, in compliance with Section 9795 of the Government Code.

SEC. 5.

 The Legislature finds and declares that a special statute is necessary and that a general statute cannot be made applicable within the meaning of Section 16 of Article IV of the California Constitution because of the unique circumstances of the County of Butte.