Amended in Assembly April 6, 2015

Amended in Assembly March 9, 2015

California Legislature—2015–16 Regular Session

Assembly Bill No. 59

Introduced by Assembly Member Waldron

(Coauthor: Assembly Member Olsen)

(Coauthors: Senators Hall and Huff)

December 9, 2014

An act to amend Sections 5346, 5347, 5348, 5349, 5349.1, and 5349.5 of, and to add Section 5349.3 to, the Welfare and Institutions Code, relating to mental health services.

LEGISLATIVE COUNSEL’S DIGEST

AB 59, as amended, Waldron. Mental health services: assisted outpatient treatment.

Existing law, the Assisted Outpatient Treatment Demonstration Project Act of 2002, known as Laura’s Law, until January 1, 2017, grants each county the authority to offer certain assisted outpatient treatment services for their begin delete residents. end delete begin insert residents by adoption of a resolution or through the county budget process and by making a finding that no mental health program, as specified, may be reduced as a result of implementation. end insert In counties in which these assisted outpatient treatment services are available, a court may order a person to receive assisted outpatient treatment for an initial treatment period not to exceed 6 months pursuant to an order if requisite criteria are met. Under that law, participating counties are required to provide prescribed assisted outpatient services, including a service planning and delivery process, that are client-directed and employ psychosocial rehabilitation and recovery principles. Existing law authorizes participating counties to pay for the services provided from moneys distributed to the counties from various continuously appropriated funds, including the Local Revenue Fund and the Mental Health Services Fund when included in a county plan, as specified.

This begin delete bill would delete the provisions that authorize a county to participate in the program, and instead require each county with available funding to implement the provisions of Laura’s Law. The end delete bill would delete the January 1, 2017, repeal date of those provisions, thereby extending the program begin delete indefinitely. By imposing additional duties upon the counties to implement these provisions, the bill would impose a state-mandated local program. end delete begin insert indefinitely, and would also delete the finding requirement described above. end insert The bill would also authorize the court to order a person to obtain assisted outpatient treatment for an initial period not to exceed 12 months if requisite criteria are met.

Existing law, the Lanterman-Petris-Short Act, authorizes the involuntary detention for a period of 72 hours for evaluation of persons who are dangerous to self or others, or gravely disabled, as defined. Existing law provides that if a person is detained for 72 hours or is under court order for evaluation and has received an evaluation, he or she may be certified for not more than 14 days of intensive treatment related to the mental disorder or impairment by chronic alcoholism if certain conditions are met, as specified. Under existing law, a person may be certified for intensive treatment for an additional period of time if he or she remains gravely disabled or unwilling or unable to accept voluntary treatment or if he or she is suicidal, as specified, or may be confined for postcertification treatment for up to 180 days if he or she has, among other things, attempted or inflicted physical harm upon another person, as specified.

This bill would, upon the release of a person from intensive treatment or postcertification treatment described above, authorize the professional staff of the agency or facility that provided the treatment to evaluate whether the person meets the criteria for assisted outpatient treatment. The bill would authorize the professional staff to request the county mental health director to file a petition in the superior court for assisted outpatient treatment if that person meets that criteria.

begin delete

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

end delete begin delete

This bill would provide that no reimbursement is required by this act for a specified reason.

end delete

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program:  begin delete yes end delete begin insert no end insert .

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

SECTION 1.  

Section 5346 of the Welfare and Institutions Code
is amended to read:

5346.  

(a)  begin delete In a county in which funding is available for assisted
outpatient treatment, end delete begin insert In any county in which services are available
as provided in Section 5348, end insert a court may order a person who is
the subject of a petition filed pursuant to this section to obtain
assisted outpatient treatment if the court finds, by clear and
convincing evidence, that the facts stated in the verified petition
filed in accordance with this section are true and establish that all
of the requisite criteria set forth in this section are met, including,
but not limited to, each of the following:

(1) The person is 18 years of age or older.

(2) The person is suffering from a mental illness as defined in
paragraphs (2) and (3) of subdivision (b) of Section 5600.3.

(3) There has been a clinical determination that the person is
unlikely to survive safely in the community without supervision.

(4) The person has a history of lack of compliance with
treatment for his or her mental illness, in that at least one of the
following is true:

(A) The person’s mental illness has, at least twice within the
last 36 months, been a substantial factor in necessitating
hospitalization, or receipt of services in a forensic or other mental
health unit of a state correctional facility or local correctional
facility, not including any period during which the person was
hospitalized or incarcerated immediately preceding the filing of
the petition.

(B) The person’s mental illness has resulted in one or more acts
of serious and violent behavior toward himself or herself or
another, or threats, or attempts to cause serious physical harm to
himself or herself or another within the last 48 months, not
including any period in which the person was hospitalized or
incarcerated immediately preceding the filing of the petition.

(5) The person has been offered an opportunity to participate
in a treatment plan by the director of the local mental health
department, or his or her designee, provided the treatment plan
includes all of the services described in Section 5348, and the
person continues to fail to engage in treatment.

(6) The person’s condition is substantially deteriorating.

(7) Participation in the assisted outpatient treatment program
would be the least restrictive placement necessary to ensure the
person’s recovery and stability.

(8) In view of the person’s treatment history and current
behavior, the person is in need of assisted outpatient treatment in
order to prevent a relapse or deterioration that would be likely to
result in grave disability or serious harm to himself or herself, or
to others, as defined in Section 5150.

(9) It is likely that the person will benefit from assisted
outpatient treatment.

(b) (1) A petition for an order authorizing assisted outpatient
treatment may be filed by the county mental health director, or his
or her designee, in the superior court in the county where the person
who is the subject of the petition is present or reasonably believed
to be present.

(2) A request may be made only by any of the following persons
to the county mental health department for the filing of a petition
to obtain an order authorizing assisted outpatient treatment:

(A) Any person 18 years of age or older with whom the person
who is the subject of the petition resides.

(B) Any person who is the parent, spouse, or sibling or child
18 years of age or older of the person who is the subject of the
petition.

(C) The director of any public or private agency, treatment
facility, charitable organization, or licensed residential care facility
providing mental health services to the person who is the subject
of the petition in whose institution the subject of the petition
resides.

(D) The director of a hospital in which the person who is the
subject of the petition is hospitalized.

(E) A licensed mental health treatment provider who is either
supervising the treatment of, or treating for a mental illness, the
person who is the subject of the petition.

(F) A peace officer, parole officer, or probation officer assigned
to supervise the person who is the subject of the petition.

(G) The professional staff of an agency or facility, as specified
in Section 5349.3.

(3) Upon receiving a request pursuant to paragraph (2), the
county mental health director shall conduct an investigation into
the appropriateness of filing the petition. The director shall file
the petition only if he or she determines that there is a reasonable
likelihood that all the necessary elements to sustain the petition
can be proven in a court of law by clear and convincing evidence.

(4) The petition shall state all of the following:

(A) Each of the criteria for assisted outpatient treatment as set
forth in subdivision (a).

(B) Facts that support the petitioner’s belief that the person who
is the subject of the petition meets each criterion, provided that
the hearing on the petition shall be limited to the stated facts in
the verified petition, and the petition contains all the grounds on
which the petition is based, in order to ensure adequate notice to
the person who is the subject of the petition and his or her counsel.

(C) That the person who is the subject of the petition is present,
or is reasonably believed to be present, within the county where
the petition is filed.

(D) That the person who is the subject of the petition has the
right to be represented by counsel in all stages of the proceeding
under the petition, in accordance with subdivision (c).

(5) The petition shall be accompanied by an affidavit of a
licensed mental health treatment provider designated by the local
mental health director who shall state, if applicable, either of the
following:

(A) That the licensed mental health treatment provider has
personally examined the person who is the subject of the petition
no more than 10 days prior to the submission of the petition, the
facts and reasons why the person who is the subject of the petition
meets the criteria in subdivision (a), that the licensed mental health
treatment provider recommends assisted outpatient treatment for
the person who is the subject of the petition, and that the licensed
mental health treatment provider is willing and able to testify at
the hearing on the petition.

(B) That no more than 10 days prior to the filing of the petition,
the licensed mental health treatment provider, or his or her
designee, has made appropriate attempts to elicit the cooperation
of the person who is the subject of the petition, but has not been
successful in persuading that person to submit to an examination,
that the licensed mental health treatment provider has reason to
believe that the person who is the subject of the petition meets the
criteria for assisted outpatient treatment, and that the licensed
mental health treatment provider is willing and able to examine
the person who is the subject of the petition and testify at the
hearing on the petition.

(c) The person who is the subject of the petition shall have the
right to be represented by counsel at all stages of a proceeding
commenced under this section. If the person so elects, the court
shall immediately appoint the public defender or other attorney to
assist the person in all stages of the proceedings. The person shall
pay the cost of the legal services if he or she is able.

(d) (1) Upon receipt by the court of a petition submitted
pursuant to subdivision (b), the court shall fix the date for a hearing
at a time not later than five business days from the date the petition
is received by the court. The petitioner shall promptly cause service
of a copy of the petition, together with written notice of the hearing
date, to be made personally on the person who is the subject of the
petition, and shall send a copy of the petition and notice to the
county office of patient rights, and to the current health care
provider appointed for the person who is the subject of the petition,
if that provider is known to the petitioner. Continuances shall be
permitted only for good cause shown. In granting continuances,
the court shall consider the need for further examination by a
physician or the potential need to provide expeditiously assisted
outpatient treatment. Upon the hearing date, or upon any other
date or dates to which the proceeding may be continued, the court
shall hear testimony. If it is deemed advisable by the court, and if
the person who is the subject of the petition is available and has
received notice pursuant to this section, the court may examine in
or out of court the person who is the subject of the petition who is
alleged to be in need of assisted outpatient treatment. If the person
who is the subject of the petition does not appear at the hearing,
and appropriate attempts to elicit the attendance of the person have
failed, the court may conduct the hearing in the person’s absence.
If the hearing is conducted without the person present, the court
shall set forth the factual basis for conducting the hearing without
the person’s presence.

(2) The court shall not order assisted outpatient treatment unless
an examining licensed mental health treatment provider, who has
personally examined, and has reviewed the available treatment
history of, the person who is the subject of the petition within the
time period commencing 10 days before the filing of the petition,
testifies in person at the hearing.

(3) If the person who is the subject of the petition has refused
to be examined by a licensed mental health treatment provider,
the court may request that the person consent to an examination
by a licensed mental health treatment provider appointed by the
court. If the person who is the subject of the petition does not
consent and the court finds reasonable cause to believe that the
allegations in the petition are true, the court may order a person
designated under Section 5150 to take into custody the person who
is the subject of the petition and transport him or her, or cause him
or her to be transported, to a hospital for examination by a licensed
mental health treatment provider as soon as is practicable.
Detention of the person who is the subject of the petition under
the order may not exceed 72 hours. If the examination is performed
by another licensed mental health treatment provider, the
examining licensed mental health treatment provider may consult
with the licensed mental health treatment provider whose
affirmation or affidavit accompanied the petition regarding the
issues of whether the allegations in the petition are true and whether
the person meets the criteria for assisted outpatient treatment.

(4) The person who is the subject of the petition shall have all
of the following rights:

(A) To adequate notice of the hearings to the person who is the
subject of the petition, as well as to parties designated by the person
who is the subject of the petition.

(B) To receive a copy of the court-ordered evaluation.

(C) To counsel. If the person has not retained counsel, the court
shall appoint a public defender.

(D) To be informed of his or her right to judicial review by
habeas corpus.

(E) To be present at the hearing unless he or she waives the
right to be present.

(F) To present evidence.

(G) To call witnesses on his or her behalf.

(H) To cross-examine witnesses.

(I) To appeal decisions, and to be informed of his or her right
to appeal.

(5) (A) If after hearing all relevant evidence, the court finds
that the person who is the subject of the petition does not meet the
criteria for assisted outpatient treatment, the court shall dismiss
the petition.

(B) If after hearing all relevant evidence, the court finds that
the person who is the subject of the petition meets the criteria for
assisted outpatient treatment, and there is no appropriate and
feasible less restrictive alternative, the court may order the person
who is the subject of the petition to receive assisted outpatient
treatment for an initial period not to exceed 12 months. In
fashioning the order, the court shall specify that the proposed
treatment is the least restrictive treatment appropriate and feasible
for the person who is the subject of the petition. The order shall
state the categories of assisted outpatient treatment, as set forth in
Section 5348, that the person who is the subject of the petition is
to receive, and the court may not order treatment that has not been
recommended by the examining licensed mental health treatment
provider and included in the written treatment plan for assisted
outpatient treatment as required by subdivision (e). If the person
has executed an advance health care directive pursuant to Chapter
2 (commencing with Section 4650) of Part 1 of Division 4.7 of
the Probate Code, any directions included in the advance health
care directive shall be considered in formulating the written
treatment plan.

(6) If the person who is the subject of a petition for an order for
assisted outpatient treatment pursuant to subparagraph (B) of
paragraph (5) refuses to participate in the assisted outpatient
treatment program, the court may order the person to meet with
the assisted outpatient treatment team designated by the director
of the assisted outpatient treatment program. The treatment team
shall attempt to gain the person’s cooperation with treatment
ordered by the court. The person may be subject to a 72-hour hold
pursuant to subdivision (f) only after the treatment team has
attempted to gain the person’s cooperation with treatment ordered
by the court, and has been unable to do so.

(e) Assisted outpatient treatment shall not be ordered unless the
licensed mental health treatment provider recommending assisted
outpatient treatment to the court has submitted to the court a written
treatment plan that includes services as set forth in Section 5348,
and the court finds, in consultation with the county mental health
director, or his or her designee, all of the following:

(1) That the services are available from the county, or a provider
approved by the county, for the duration of the court order.

(2) That the services have been offered to the person by the
local director of mental health, or his or her designee, and the
person has been given an opportunity to participate on a voluntary
basis, and the person has failed to engage in, or has refused,
treatment.

(3) That all of the elements of the petition required by this article
have been met.

(4) That the treatment plan will be delivered to the county
director of mental health, or to his or her appropriate designee.

(f) If, in the clinical judgment of a licensed mental health
treatment provider, the person who is the subject of the petition
has failed or has refused to comply with the treatment ordered by
the court, and, in the clinical judgment of the licensed mental health
treatment provider, efforts were made to solicit compliance, and,
in the clinical judgment of the licensed mental health treatment
provider, the person may be in need of involuntary admission to
a hospital for evaluation, the provider may request that persons
designated under Section 5150 take into custody the person who
is the subject of the petition and transport him or her, or cause him
or her to be transported, to a hospital, to be held up to 72 hours for
examination by a licensed mental health treatment provider to
determine if the person is in need of treatment pursuant to Section
5150. Continued involuntary retention in a hospital beyond the
initial 72-hour period shall be pursuant to Section 5250. If at any
time during the 72-hour period the person is determined not to
meet the criteria of Section 5150, and does not agree to stay in the
hospital as a voluntary patient, he or she shall be released and any
subsequent involuntary detention in a hospital shall be pursuant
to Section 5150. Failure to comply with an order of assisted
outpatient treatment alone may not be grounds for involuntary
civil commitment or a finding that the person who is the subject
of the petition is in contempt of court.

(g) If the director of the assisted outpatient treatment program
determines that the condition of the patient requires further assisted
outpatient treatment, the director shall apply to the court, prior to
the expiration of the period of the initial assisted outpatient
treatment order, for an order authorizing continued assisted
outpatient treatment for a period not to exceed 180 days from the
date of the order. The procedures for obtaining an order pursuant
to this subdivision shall be in accordance with subdivisions (a) to
(f), inclusive. The period for further involuntary outpatient
treatment authorized by a subsequent order under this subdivision
may not exceed 180 days from the date of the order.

(h) At intervals of not less than 60 days during an assisted
outpatient treatment order, the director of the outpatient treatment
program shall file an affidavit with the court that ordered the
outpatient treatment affirming that the person who is the subject
of the order continues to meet the criteria for assisted outpatient
treatment. At these times, the person who is the subject of the order
shall have the right to a hearing on whether or not he or she still
meets the criteria for assisted outpatient treatment if he or she
disagrees with the director’s affidavit. The burden of proof shall
be on the director.

(i) During each 60-day period specified in subdivision (h), if
the person who is the subject of the order believes that he or she
is being wrongfully retained in the assisted outpatient treatment
program against his or her wishes, he or she may file a petition for
a writ of habeas corpus, thus requiring the director of the assisted
outpatient treatment program to prove that the person who is the
subject of the order continues to meet the criteria for assisted
outpatient treatment.

(j) Any person ordered to undergo assisted outpatient treatment
pursuant to this article, who was not present at the hearing at which
the order was issued, may immediately petition the court for a writ
of habeas corpus. Treatment under the order for assisted outpatient
treatment may not commence until the resolution of that petition.

SEC. 2.  

Section 5347 of the Welfare and Institutions Code is
amended to read:

5347.  

(a)  begin delete In a county in which funding is available for assisted
outpatient treatment, end delete begin insert In any county in which services are available
pursuant to Section 5348, end insert a person who is determined by the court
to be subject to subdivision (a) of Section 5346 may voluntarily
enter into an agreement for services under this section.

(b) (1) After a petition for an order for assisted outpatient
treatment is filed, but before the conclusion of the hearing on the
petition, the person who is the subject of the petition, or the
person’s legal counsel with the person’s consent, may waive the
right to an assisted outpatient treatment hearing for the purpose of
obtaining treatment under a settlement agreement, if an examining
licensed mental health treatment provider states that the person
can survive safely in the community. The settlement agreement
may not exceed 180 days in duration and shall be agreed to by all
parties.

(2) The settlement agreement shall be in writing, shall be
approved by the court, and shall include a treatment plan developed
by the community-based program that will provide services that
provide treatment in the least restrictive manner consistent with
the needs of the person who is the subject of the petition.

(3) Either party may request that the court modify the treatment
plan at any time during the 180-day period.

(4) The court shall designate the appropriate county department
to monitor the person’s treatment under, and compliance with, the
settlement agreement. If the person fails to comply with the
treatment according to the agreement, the designated county
department shall notify the counsel designated by the county and
the person’s counsel of the person’s noncompliance.

(5) A settlement agreement approved by the court pursuant to
this section shall have the same force and effect as an order for
assisted outpatient treatment pursuant to Section 5346.

(6) At a hearing on the issue of noncompliance with the
agreement, the written statement of noncompliance submitted shall
be prima facie evidence that a violation of the conditions of the
agreement has occurred. If the person who is the subject of the
petition denies any of the facts as stated in the statement, he or she
has the burden of proving by a preponderance of the evidence that
the alleged facts are false.

SEC. 3.  

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

5348.  

(a)  begin delete Each county with available funding end delete begin insert For purposes
of subdivision (e) of Section 5346, a county that chooses to provide
assisted outpatient treatment services pursuant to this article end insert 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 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 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 abuse 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.

(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 begin delete with available funding end delete begin insert that operates an assisted
outpatient treatment program pursuant to this article end insert shall provide
data to the State Department of Health Care Services and, based
on the data, the department shall report to the Legislature on or
before May 1 of each year regarding the services the county
provides 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.

begin delete

SEC. 4.  

Section 5349 of the Welfare and Institutions Code is
amended to read:

5349.  

To the extent otherwise permitted under state and federal
law, counties may pay for the provision of services under Sections
5347 and 5348 using funds distributed to the counties from the
Mental Health Subaccount, the Mental Health Equity Subaccount,
and the Vehicle License Collection Account of the Local Revenue
Fund, funds from the Mental Health Account and the Behavioral
Health Subaccount within the Support Services Account of the
Local Revenue Fund 2011, funds from the Mental Health Services
Fund when included in county plans pursuant to Section 5847, and
any other funds from which the Controller makes distributions to
the counties for those purposes. Compliance with this section shall
be monitored by the State Department of Health Care Services as
part of its review and approval of county performance contracts.

end delete

begin insert

begin insert SEC. 4. end insert   

end insert

begin insert Section 5349 of the end insert begin insert Welfare and Institutions Code end insert begin insert is
amended to read: end insert

5349.  

This article shall be operative in those counties in which
the county board of supervisors, by resolution or through the county
budget process, authorizes its begin delete application and makes a finding that
no voluntary mental health program serving adults, and no
children’s mental health program, may be reduced as a result of
the implementation of this article. end delete begin insert application. end insert To the extent
otherwise permitted under state and federal law, counties that elect
to implement this article may pay for the provision of services
under Sections 5347 and 5348 using funds distributed to the
counties from the Mental Health Subaccount, the Mental Health
Equity Subaccount, and the Vehicle License Collection Account
of the Local Revenue Fund, funds from the Mental Health Account
and the Behavioral Health Subaccount within the Support Services
Account of the Local Revenue Fund 2011, funds from the Mental
Health Services Fund when included in county plans pursuant to
Section 5847, and any other funds from which the Controller makes
distributions to the counties for those purposes. Compliance with
this section shall be monitored by the State Department of Health
Care Services as part of its review and approval of county
performance contracts.

SEC. 5.  

Section 5349.1 of the Welfare and Institutions Code
is amended to read:

5349.1.  

(a) Counties begin delete with available funding end delete begin insert that elect to
implement this article end insert shall, in consultation with the State
Department of Health Care Services, client and family advocacy
organizations, and other stakeholders, develop a training and
education program for purposes of improving the delivery of
services to mentally ill individuals who are, or who are at risk of
being, involuntarily committed under this part. This training shall
be provided to mental health treatment providers contracting with
participating counties and to other individuals, including, but not
limited to, mental health professionals, law enforcement officials,
and certification hearing officers involved in making treatment
and involuntary commitment decisions.

(b) The training shall include both of the following:

(1) Information relative to legal requirements for detaining a
person for involuntary inpatient and outpatient treatment, including
criteria to be considered with respect to determining if a person is
considered to be gravely disabled.

(2) Methods for ensuring that decisions regarding involuntary
treatment as provided for in this part direct patients toward the
most effective treatment. Training shall include an emphasis on
each patient’s right to provide informed consent to assistance.

SEC. 6.  

Section 5349.3 is added to the Welfare and Institutions
Code, to read:

5349.3.  

(a) Upon the release of a person from involuntary
treatment pursuant to Section 5257, 5264, 5270.35, or 5304, the
professional staff of the agency or facility that provided that
treatment may evaluate whether that person meets the criteria
established in subdivision (a) of Section 5346 for assisted
outpatient treatment.

(b) If that person meets the criteria in subdivision (a) of Section
5346, the professional staff of the agency or facility may request
the county mental health director, or his or her designee, to file a
petition in the superior court pursuant to subdivision (b) of Section
5346 for assisted outpatient treatment.

SEC. 7.  

Section 5349.5 of the Welfare and Institutions Code
is amended to read:

5349.5.  

The State Department of Health Care Services shall
submit a report and evaluation of all counties begin delete providing assisted
outpatient treatment pursuant to end delete begin insert implementing any component of end insert
this article to the Governor and to the Legislature by July 1, 2015.
The evaluation shall include data described in subdivision (d) of
Section 5348.

begin delete

SEC. 8.  

To the extent that this act has an overall effect of
increasing the costs already borne by a local agency for programs
or levels of service mandated by the 2011 Realignment Legislation
within the meaning of Section 36 of Article XIII of the California
Constitution, it shall apply to local agencies only to the extent that
the state provides annual funding for the cost increase. Any new
program or higher level of service provided by a local agency
pursuant to this act above the level for which funding has been
provided shall not require a subvention of funds by the state nor
otherwise be subject to Section 6 of Article XIII B of the California
Constitution.

end delete