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SB-1251 Conservatorships: serious mental illness and substance use disorders: counties.(2019-2020)

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Date Published: 02/21/2020 02:00 PM
SB1251:v99#DOCUMENT


CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Senate Bill
No. 1251


Introduced by Senator Moorlach

February 21, 2020


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


LEGISLATIVE COUNSEL'S DIGEST


SB 1251, as introduced, Moorlach. Conservatorships: serious mental illness and substance use disorders: counties.
Existing law establishes a procedure for the appointment of a conservator for a person who is determined to be gravely disabled as a result of a mental health disorder or an impairment by chronic alcoholism, as specified, pursuant to a petition to the superior court by an officer conducting an investigation and concurring with a recommendation of conservatorship. 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, the Assisted Outpatient Treatment Demonstration Project Act of 2002, known as Laura’s Law, until January 1, 2022, grants each county the authority to offer certain assisted outpatient treatment services for a person who meets specified criteria, including, among others, that the person is suffering from a mental illness, that the person has a history of lack of compliance with treatment for the person’s mental illness, and that the person is in need of assisted outpatient treatment, as specified. Laura’s Law authorizes designated persons to request the county behavioral health director to file a petition in the superior court for an order for assisted outpatient treatment.
Existing law, until January 1, 2024, establishes a 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 provisions if a conservatorship or guardianship exists under any of the other above-described provisions. Existing law authorizes the Judicial Council to adopt rules, forms, and standards necessary to implement these provisions.
This bill would authorize any county or city and county to adopt these conservatorship provisions within their jurisdictions.
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 only to the County of Los Angeles, the County of San Diego, and the City and County of San Francisco to any county or city and county 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 serving adults, no children’s mental health program, and no 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 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 San Diego, and the City and County of San Francisco, subject any county or city and county that has authorized the application of this chapter pursuant 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 San Diego, and the City and County of San Francisco, subject any county or city and county that has authorized the application of this chapter pursuant 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.