Amended in Assembly April 20, 2015

Amended in Assembly April 6, 2015

Amended in Assembly March 9, 2015

California Legislature—2015–16 Regular Session

Assembly BillNo. 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 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.begin delete 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.end delete 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 bill would delete the January 1, 2017, repeal date of those provisions, thereby extending the program indefinitely, and would also delete the finding requirement described above.begin delete 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.end delete

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.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

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

P2    1

SECTION 1.  

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

P3    1

5346.  

(a) In any county in which services are available as
2provided in Section 5348, a court may order a person who is the
3subject of a petition filed pursuant to this section to obtain assisted
4outpatient treatment if the court finds, by clear and convincing
5evidence, that the facts stated in the verified petition filed in
6accordance with this section are true and establish that all of the
7requisite criteria set forth in this section are met, including, but
8not limited to, each of the following:

9(1) The person is 18 years of age or older.

10(2) The person is suffering from a mental illness as defined in
11paragraphs (2) and (3) of subdivision (b) of Section 5600.3.

12(3) There has been a clinical determination that the person is
13unlikely to survive safely in the community without supervision.

14(4) The person has a history of lack of compliance with
15treatment for his or her mental illness, in that at least one of the
16following is true:

17(A) The person’s mental illness has, at least twice within the
18last 36 months, been a substantial factor in necessitating
19hospitalization, or receipt of services in a forensic or other mental
20health unit of a state correctional facility or local correctional
21facility, not including any period during which the person was
22hospitalized or incarcerated immediately preceding the filing of
23the petition.

24(B) The person’s mental illness has resulted in one or more acts
25of serious and violent behavior toward himself or herself or
26another, or threats, or attempts to cause serious physical harm to
27himself or herself or another within the last 48 months, not
28including any period in which the person was hospitalized or
29incarcerated immediately preceding the filing of the petition.

30(5) The person has been offered an opportunity to participate
31in a treatment plan by the director of the local mental health
32department, or his or her designee, provided the treatment plan
33includes all of the services described in Section 5348, and the
34person continues to fail to engage in treatment.

35(6) The person’s condition is substantially deteriorating.

36(7) Participation in the assisted outpatient treatment program
37would be the least restrictive placement necessary to ensure the
38person’s recovery and stability.

39(8) In view of the person’s treatment history and current
40behavior, the person is in need of assisted outpatient treatment in
P4    1order to prevent a relapse or deterioration that would be likely to
2result in grave disability or serious harm to himself or herself, or
3to others, as defined in Section 5150.

4(9) It is likely that the person will benefit from assisted
5outpatient treatment.

6(b) (1) A petition for an order authorizing assisted outpatient
7treatment may be filed by the county mental health director, or his
8or her designee, in the superior court in the county where the person
9who is the subject of the petition is present or reasonably believed
10to be present.

11(2) A request may be made only by any of the following persons
12to the county mental health department for the filing of a petition
13to obtain an order authorizing assisted outpatient treatment:

14(A) Any person 18 years of age or older with whom the person
15who is the subject of the petition resides.

16(B) Any person who is the parent, spouse, or sibling or child
1718 years of age or older of the person who is the subject of the
18petition.

19(C) The director of any public or private agency, treatment
20facility, charitable organization, or licensed residential care facility
21providing mental health services to the person who is the subject
22of the petition in whose institution the subject of the petition
23resides.

24(D) The director of a hospital in which the person who is the
25subject of the petition is hospitalized.

26(E) A licensed mental health treatment provider who is either
27supervising the treatment of, or treating for a mental illness, the
28person who is the subject of the petition.

29(F) A peace officer, parole officer, or probation officer assigned
30to supervise the person who is the subject of the petition.

31(G) The professional staff of an agency or facility, as specified
32in Section 5349.3.

33(3) Upon receiving a request pursuant to paragraph (2), the
34county mental health director shall conduct an investigation into
35the appropriateness of filing the petition. The director shall file
36the petition only if he or she determines that there is a reasonable
37likelihood that all the necessary elements to sustain the petition
38can be proven in a court of law by clear and convincing evidence.

39(4) The petition shall state all of the following:

P5    1(A) Each of the criteria for assisted outpatient treatment as set
2forth in subdivision (a).

3(B) Facts that support the petitioner’s belief that the person who
4is the subject of the petition meets each criterion, provided that
5the hearing on the petition shall be limited to the stated facts in
6the verified petition, and the petition contains all the grounds on
7which the petition is based, in order to ensure adequate notice to
8the person who is the subject of the petition and his or her counsel.

9(C) That the person who is the subject of the petition is present,
10or is reasonably believed to be present, within the county where
11the petition is filed.

12(D) That the person who is the subject of the petition has the
13right to be represented by counsel in all stages of the proceeding
14under the petition, in accordance with subdivision (c).

15(5) The petition shall be accompanied by an affidavit of a
16licensed mental health treatment provider designated by the local
17mental health director who shall state, if applicable, either of the
18 following:

19(A) That the licensed mental health treatment provider has
20personally examined the person who is the subject of the petition
21no more than 10 days prior to the submission of the petition, the
22facts and reasons why the person who is the subject of the petition
23meets the criteria in subdivision (a), that the licensed mental health
24treatment provider recommends assisted outpatient treatment for
25the person who is the subject of the petition, and that the licensed
26mental health treatment provider is willing and able to testify at
27the hearing on the petition.

28(B) That no more than 10 days prior to the filing of the petition,
29the licensed mental health treatment provider, or his or her
30designee, has made appropriate attempts to elicit the cooperation
31of the person who is the subject of the petition, but has not been
32successful in persuading that person to submit to an examination,
33that the licensed mental health treatment provider has reason to
34believe that the person who is the subject of the petition meets the
35criteria for assisted outpatient treatment, and that the licensed
36mental health treatment provider is willing and able to examine
37the person who is the subject of the petition and testify at the
38hearing on the petition.

39(c) The person who is the subject of the petition shall have the
40right to be represented by counsel at all stages of a proceeding
P6    1commenced under this section. If the person so elects, the court
2shall immediately appoint the public defender or other attorney to
3assist the person in all stages of the proceedings. The person shall
4pay the cost of the legal services if he or she is able.

5(d) (1) Upon receipt by the court of a petition submitted
6pursuant to subdivision (b), the court shall fix the date for a hearing
7at a time not later than five business days from the date the petition
8is received by the court. The petitioner shall promptly cause service
9of a copy of the petition, together with written notice of the hearing
10date, to be made personally on the person who is the subject of the
11petition, and shall send a copy of the petition and notice to the
12county office of patient rights, and to the current health care
13provider appointed for the person who is the subject of the petition,
14if that provider is known to the petitioner. Continuances shall be
15permitted only for good cause shown. In granting continuances,
16the court shall consider the need for further examination by a
17physician or the potential need to provide expeditiously assisted
18outpatient treatment. Upon the hearing date, or upon any other
19date or dates to which the proceeding may be continued, the court
20shall hear testimony. If it is deemed advisable by the court, and if
21the person who is the subject of the petition is available and has
22received notice pursuant to this section, the court may examine in
23or out of court the person who is the subject of the petition who is
24alleged to be in need of assisted outpatient treatment. If the person
25who is the subject of the petition does not appear at the hearing,
26and appropriate attempts to elicit the attendance of the person have
27failed, the court may conduct the hearing in the person’s absence.
28If the hearing is conducted without the person present, the court
29shall set forth the factual basis for conducting the hearing without
30the person’s presence.

31(2) The court shall not order assisted outpatient treatment unless
32an examining licensed mental health treatment provider, who has
33personally examined, and has reviewed the available treatment
34history of, the person who is the subject of the petition within the
35time period commencing 10 days before the filing of the petition,
36testifies in person at the hearing.

37(3) If the person who is the subject of the petition has refused
38to be examined by a licensed mental health treatment provider,
39the court may request that the person consent to an examination
40by a licensed mental health treatment provider appointed by the
P7    1court. If the person who is the subject of the petition does not
2consent and the court finds reasonable cause to believe that the
3allegations in the petition are true, the court may order a person
4designated under Section 5150 to take into custody the person who
5is the subject of the petition and transport him or her, or cause him
6or her to be transported, to a hospital for examination by a licensed
7mental health treatment provider as soon as is practicable.
8Detention of the person who is the subject of the petition under
9the order may not exceed 72 hours. If the examination is performed
10by another licensed mental health treatment provider, the
11examining licensed mental health treatment provider may consult
12with the licensed mental health treatment provider whose
13affirmation or affidavit accompanied the petition regarding the
14issues of whether the allegations in the petition are true and whether
15the person meets the criteria for assisted outpatient treatment.

16(4) The person who is the subject of the petition shall have all
17of the following rights:

18(A) To adequate notice of the hearings to the person who is the
19subject of the petition, as well as to parties designated by the person
20who is the subject of the petition.

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

22(C) To counsel. If the person has not retained counsel, the court
23shall appoint a public defender.

24(D) To be informed of his or her right to judicial review by
25habeas corpus.

26(E) To be present at the hearing unless he or she waives the
27right to be present.

28(F) To present evidence.

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

30(H) To cross-examine witnesses.

31(I) To appeal decisions, and to be informed of his or her right
32to appeal.

33(5) (A) If after hearing all relevant evidence, the court finds
34that the person who is the subject of the petition does not meet the
35criteria for assisted outpatient treatment, the court shall dismiss
36the petition.

37(B) If after hearing all relevant evidence, the court finds that
38the person who is the subject of the petition meets the criteria for
39assisted outpatient treatment, and there is no appropriate and
40feasible less restrictive alternative, the court may order the person
P8    1who is the subject of the petition to receive assisted outpatient
2treatment for an initial period not to exceedbegin delete 12end deletebegin insert sixend insert months. In
3fashioning the order, the court shall specify that the proposed
4treatment is the least restrictive treatment appropriate and feasible
5for the person who is the subject of the petition. The order shall
6state the categories of assisted outpatient treatment, as set forth in
7Section 5348, that the person who is the subject of the petition is
8to receive, and the court may not order treatment that has not been
9recommended by the examining licensed mental health treatment
10provider and included in the written treatment plan for assisted
11outpatient treatment as required by subdivision (e). If the person
12has executed an advance health care directive pursuant to Chapter
132 (commencing with Section 4650) of Part 1 of Division 4.7 of
14the Probate Code, any directions included in the advance health
15care directive shall be considered in formulating the written
16treatment plan.

17(6) If the person who is the subject of a petition for an order for
18assisted outpatient treatment pursuant to subparagraph (B) of
19paragraph (5) refuses to participate in the assisted outpatient
20treatment program, the court may order the person to meet with
21the assisted outpatient treatment team designated by the director
22of the assisted outpatient treatment program. The treatment team
23shall attempt to gain the person’s cooperation with treatment
24ordered by the court. The person may be subject to a 72-hour hold
25pursuant to subdivision (f) only after the treatment team has
26attempted to gain the person’s cooperation with treatment ordered
27by the court, and has been unable to do so.

28(e) Assisted outpatient treatment shall not be ordered unless the
29licensed mental health treatment provider recommending assisted
30outpatient treatment to the court has submitted to the court a written
31treatment plan that includes services as set forth in Section 5348,
32and the court finds, in consultation with the county mental health
33director, or his or her designee, all of the following:

34(1) That the services are available from the county, or a provider
35approved by the county, for the duration of the court order.

36(2) That the services have been offered to the person by the
37local director of mental health, or his or her designee, and the
38person has been given an opportunity to participate on a voluntary
39basis, and the person has failed to engage in, or has refused,
40treatment.

P9    1(3) That all of the elements of the petition required by this article
2have been met.

3(4) That the treatment plan will be delivered to the county
4director of mental health, or to his or her appropriate designee.

5(f) If, in the clinical judgment of a licensed mental health
6treatment provider, the person who is the subject of the petition
7has failed or has refused to comply with the treatment ordered by
8the court, and, in the clinical judgment of the licensed mental health
9treatment provider, efforts were made to solicit compliance, and,
10in the clinical judgment of the licensed mental health treatment
11provider, the person may be in need of involuntary admission to
12a hospital for evaluation, the provider may request that persons
13designated under Section 5150 take into custody the person who
14is the subject of the petition and transport him or her, or cause him
15or her to be transported, to a hospital, to be held up to 72 hours for
16examination by a licensed mental health treatment provider to
17determine if the person is in need of treatment pursuant to Section
185150. Continued involuntary retention in a hospital beyond the
19initial 72-hour period shall be pursuant to Section 5250. If at any
20time during the 72-hour period the person is determined not to
21meet the criteria of Section 5150, and does not agree to stay in the
22hospital as a voluntary patient, he or she shall be released and any
23subsequent involuntary detention in a hospital shall be pursuant
24to Section 5150. Failure to comply with an order of assisted
25outpatient treatment alone may not be grounds for involuntary
26civil commitment or a finding that the person who is the subject
27of the petition is in contempt of court.

28(g) If the director of the assisted outpatient treatment program
29determines that the condition of the patient requires further assisted
30outpatient treatment, the director shall apply to the court, prior to
31the expiration of the period of the initial assisted outpatient
32treatment order, for an order authorizing continued assisted
33outpatient treatment for a period not to exceed 180 days from the
34date of the order. The procedures for obtaining an order pursuant
35to this subdivision shall be in accordance with subdivisions (a) to
36(f), inclusive. The period for further involuntary outpatient
37treatment authorized by a subsequent order under this subdivision
38may not exceed 180 days from the date of the order.

39(h) At intervals of not less than 60 days during an assisted
40outpatient treatment order, the director of the outpatient treatment
P10   1program shall file an affidavit with the court that ordered the
2outpatient treatment affirming that the person who is the subject
3of the order continues to meet the criteria for assisted outpatient
4treatment. At these times, the person who is the subject of the order
5shall have the right to a hearing on whether or not he or she still
6meets the criteria for assisted outpatient treatment if he or she
7disagrees with the director’s affidavit. The burden of proof shall
8be on the director.

9(i) During each 60-day period specified in subdivision (h), if
10the person who is the subject of the order believes that he or she
11is being wrongfully retained in the assisted outpatient treatment
12program against his or her wishes, he or she may file a petition for
13a writ of habeas corpus, thus requiring the director of the assisted
14outpatient treatment program to prove that the person who is the
15subject of the order continues to meet the criteria for assisted
16outpatient treatment.

17(j) Any person ordered to undergo assisted outpatient treatment
18pursuant to this article, who was not present at the hearing at which
19the order was issued, may immediately petition the court for a writ
20of habeas corpus. Treatment under the order for assisted outpatient
21treatment may not commence until the resolution of that petition.

22

SEC. 2.  

Section 5347 of the Welfare and Institutions Code is
23amended to read:

24

5347.  

(a) In any county in which services are available
25pursuant to Section 5348, a person who is determined by the court
26to be subject to subdivision (a) of Section 5346 may voluntarily
27enter into an agreement for services under this section.

28(b) (1) After a petition for an order for assisted outpatient
29treatment is filed, but before the conclusion of the hearing on the
30petition, the person who is the subject of the petition, or the
31person’s legal counsel with the person’s consent, may waive the
32right to an assisted outpatient treatment hearing for the purpose of
33obtaining treatment under a settlement agreement, if an examining
34licensed mental health treatment provider states that the person
35can survive safely in the community. The settlement agreement
36may not exceed 180 days in duration and shall be agreed to by all
37parties.

38(2) The settlement agreement shall be in writing, shall be
39approved by the court, and shall include a treatment plan developed
40by the community-based program that will provide services that
P11   1provide treatment in the least restrictive manner consistent with
2the needs of the person who is the subject of the petition.

3(3) Either party may request that the court modify the treatment
4plan at any time during the 180-day period.

5(4) The court shall designate the appropriate county department
6to monitor the person’s treatment under, and compliance with, the
7settlement agreement. If the person fails to comply with the
8treatment according to the agreement, the designated county
9department shall notify the counsel designated by the county and
10the person’s counsel of the person’s noncompliance.

11(5) A settlement agreement approved by the court pursuant to
12this section shall have the same force and effect as an order for
13assisted outpatient treatment pursuant to Section 5346.

14(6) At a hearing on the issue of noncompliance with the
15agreement, the written statement of noncompliance submitted shall
16be prima facie evidence that a violation of the conditions of the
17agreement has occurred. If the person who is the subject of the
18petition denies any of the facts as stated in the statement, he or she
19has the burden of proving by a preponderance of the evidence that
20the alleged facts are false.

21

SEC. 3.  

Section 5348 of the Welfare and Institutions Code is
22amended to read:

23

5348.  

(a) For purposes of subdivision (e) of Section 5346, a
24county that chooses to provide assisted outpatient treatment
25services pursuant to this article shall offer assisted outpatient
26treatment services, including, but not limited to, all of the
27following:

28(1) Community-based, mobile, multidisciplinary, highly trained
29mental health teams that use high staff-to-client ratios of no more
30than 10 clients per team member for those subject to court-ordered
31services pursuant to Section 5346.

32(2) A service planning and delivery process that includes the
33following:

34(A) Determination of the numbers of persons to be served and
35the programs and services that will be provided to meet their needs.
36The local director of mental health shall consult with the sheriff,
37the police chief, the probation officer, the mental health board,
38contract agencies, and family, client, ethnic, and citizen
39constituency groups as determined by the director.

P12   1(B) Plans for services, including outreach to families whose
2severely mentally ill adult is living with them, design of mental
3health services, coordination and access to medications, psychiatric
4and psychological services, substance abuse services, supportive
5housing or other housing assistance, vocational rehabilitation, and
6veterans’ services. Plans shall also contain evaluation strategies,
7which shall consider cultural, linguistic, gender, age, and special
8needs of minorities and those based on any characteristic listed or
9defined in Section 11135 of the Government Code in the target
10populations. Provision shall be made for staff with the cultural
11background and linguistic skills necessary to remove barriers to
12mental health services as a result of having
13limited-English-speaking ability and cultural differences.
14Recipients of outreach services may include families, the public,
15primary care physicians, and others who are likely to come into
16contact with individuals who may be suffering from an untreated
17severe mental illness who would be likely to become homeless if
18the illness continued to be untreated for a substantial period of
19time. Outreach to adults may include adults voluntarily or
20involuntarily hospitalized as a result of a severe mental illness.

21(C) Provision for services to meet the needs of persons who are
22 physically disabled.

23(D) Provision for services to meet the special needs of older
24adults.

25(E) Provision for family support and consultation services,
26parenting support and consultation services, and peer support or
27self-help group support, if appropriate.

28(F) Provision for services to be client-directed and that employ
29psychosocial rehabilitation and recovery principles.

30(G) Provision for psychiatric and psychological services that
31are integrated with other services and for psychiatric and
32psychological collaboration in overall service planning.

33(H) Provision for services specifically directed to seriously
34mentally ill young adults 25 years of age or younger who are
35homeless or at significant risk of becoming homeless. These
36provisions may include continuation of services that still would
37be received through other funds had eligibility not been terminated
38as a result of age.

39(I) Services reflecting special needs of women from diverse
40cultural backgrounds, including supportive housing that accepts
P13   1children, personal services coordinator therapeutic treatment, and
2substance abuse treatment programs that address gender-specific
3trauma and abuse in the lives of persons with mental illness, and
4vocational rehabilitation programs that offer job training programs
5free of gender bias and sensitive to the needs of women.

6(J) Provision for housing for clients that is immediate,
7transitional, permanent, or all of these.

8(K) Provision for clients who have been suffering from an
9untreated severe mental illness for less than one year, and who do
10not require the full range of services, but are at risk of becoming
11homeless unless a comprehensive individual and family support
12services plan is implemented. These clients shall be served in a
13manner that is designed to meet their needs.

14(3) Each client shall have a clearly designated mental health
15personal services coordinator who may be part of a
16multidisciplinary treatment team who is responsible for providing
17or assuring needed services. Responsibilities include complete
18assessment of the client’s needs, development of the client’s
19personal services plan, linkage with all appropriate community
20services, monitoring of the quality and followthrough of services,
21and necessary advocacy to ensure each client receives those
22services that are agreed to in the personal services plan. Each client
23shall participate in the development of his or her personal services
24plan, and responsible staff shall consult with the designated
25conservator, if one has been appointed, and, with the consent of
26the client, shall consult with the family and other significant
27persons as appropriate.

28(4) The individual personal services plan shall ensure that
29persons subject to assisted outpatient treatment programs receive
30age-appropriate, gender-appropriate, and culturally appropriate
31services, to the extent feasible, that are designed to enable
32recipients to:

33(A) Live in the most independent, least restrictive housing
34feasible in the local community, and, for clients with children, to
35live in a supportive housing environment that strives for
36reunification with their children or assists clients in maintaining
37custody of their children as is appropriate.

38(B) Engage in the highest level of work or productive activity
39appropriate to their abilities and experience.

P14   1(C) Create and maintain a support system consisting of friends,
2family, and participation in community activities.

3(D) Access an appropriate level of academic education or
4vocational training.

5(E) Obtain an adequate income.

6(F) Self-manage their illnesses and exert as much control as
7possible over both the day-to-day and long-term decisions that
8affect their lives.

9(G) Access necessary physical health care and maintain the best
10possible physical health.

11(H) Reduce or eliminate serious antisocial or criminal behavior,
12and thereby reduce or eliminate their contact with the criminal
13justice system.

14(I) Reduce or eliminate the distress caused by the symptoms of
15mental illness.

16(J) Have freedom from dangerous addictive substances.

17(5) The individual personal services plan shall describe the
18service array that meets the requirements of paragraph (4), and to
19the extent applicable to the individual, the requirements of
20paragraph (2).

21(b) A county that provides assisted outpatient treatment services
22pursuant to this article also shall offer the same services on a
23voluntary basis.

24(c) Involuntary medication shall not be allowed absent a separate
25order by the court pursuant to Sections 5332 to 5336, inclusive.

26(d) A county that operates an assisted outpatient treatment
27program pursuant to this article shall provide data to the State
28Department of Health Care Services and, based on the data, the
29department shall report to the Legislature on or before May 1 of
30each year regarding the services the county provides pursuant to
31this article. The report shall include, at a minimum, an evaluation
32of the effectiveness of the strategies employed by each program
33operated pursuant to this article in reducing homelessness and
34hospitalization of persons in the program and in reducing
35involvement with local law enforcement by persons in the program.
36The evaluation and report shall also include any other measures
37identified by the department regarding persons in the program and
38all of the following, based on information that is available:

P15   1(1) The number of persons served by the program and, of those,
2the number who are able to maintain housing and the number who
3maintain contact with the treatment system.

4(2) The number of persons in the program with contacts with
5local law enforcement, and the extent to which local and state
6incarceration of persons in the program has been reduced or
7avoided.

8(3) The number of persons in the program participating in
9employment services programs, including competitive employment.

10(4) The days of hospitalization of persons in the program that
11have been reduced or avoided.

12(5) Adherence to prescribed treatment by persons in the program.

13(6) Other indicators of successful engagement, if any, by persons
14in the program.

15(7) Victimization of persons in the program.

16(8) Violent behavior of persons in the program.

17(9) Substance abuse by persons in the program.

18(10) Type, intensity, and frequency of treatment of persons in
19the program.

20(11) Extent to which enforcement mechanisms are used by the
21program, when applicable.

22(12) Social functioning of persons in the program.

23(13) Skills in independent living of persons in the program.

24(14) Satisfaction with program services both by those receiving
25them and by their families, when relevant.

26

SEC. 4.  

Section 5349 of the Welfare and Institutions Code is
27amended to read:

28

5349.  

This article shall be operative in those counties in which
29the county board of supervisors, by resolution or through the county
30budget process, authorizes its application. To the extent otherwise
31permitted under state and federal law, counties that elect to
32implement this article may pay for the provision of services under
33Sections 5347 and 5348 using funds distributed to the counties
34from the Mental Health Subaccount, the Mental Health Equity
35Subaccount, and the Vehicle License Collection Account of the
36Local Revenue Fund, funds from the Mental Health Account and
37the Behavioral Health Subaccount within the Support Services
38Account of the Local Revenue Fund 2011, funds from the Mental
39Health Services Fund when included in county plans pursuant to
40Section 5847, and any other funds from which the Controller makes
P16   1distributions to the counties for those purposes. Compliance with
2this section shall be monitored by the State Department of Health
3Care Services as part of its review and approval of county
4performance contracts.

5

SEC. 5.  

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

7

5349.1.  

(a) Counties that elect to implement this article shall,
8in consultation with the State Department of Health Care Services,
9client and family advocacy organizations, and other stakeholders,
10develop a training and education program for purposes of
11improving the delivery of services to mentally ill individuals who
12are, or who are at risk of being, involuntarily committed under this
13part. This training shall be provided to mental health treatment
14providers contracting with participating counties and to other
15individuals, including, but not limited to, mental health
16professionals, law enforcement officials, and certification hearing
17officers involved in making treatment and involuntary commitment
18decisions.

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

20(1) Information relative to legal requirements for detaining a
21person for involuntary inpatient and outpatient treatment, including
22criteria to be considered with respect to determining if a person is
23considered to be gravely disabled.

24(2) Methods for ensuring that decisions regarding involuntary
25treatment as provided for in this part direct patients toward the
26most effective treatment. Training shall include an emphasis on
27each patient’s right to provide informed consent to assistance.

28

SEC. 6.  

Section 5349.3 is added to the Welfare and Institutions
29Code
, to read:

30

5349.3.  

(a) Upon the release of a person from involuntary
31treatment pursuant to Section 5257, 5264, 5270.35, or 5304, the
32professional staff of the agency or facility that provided that
33treatment may evaluate whether that person meets the criteria
34established in subdivision (a) of Section 5346 for assisted
35outpatient treatment.

36(b) If that person meets the criteria in subdivision (a) of Section
375346, the professional staff of the agency or facility may request
38the county mental health director, or his or her designee, to file a
39petition in the superior court pursuant to subdivision (b) of Section
405346 for assisted outpatient treatment.

P17   1

SEC. 7.  

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

3

5349.5.  

The State Department of Health Care Services shall
4submit a report and evaluation of all counties implementing any
5component of this article to the Governor and to the Legislature
6by July 1, 2015. The evaluation shall include data described in
7subdivision (d) of Section 5348.



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