SB 516: Certification for intensive treatment: review hearing.

(a)If at the conclusion of the certification review hearing the person conducting the hearing finds that there is probable cause that the person certified is, as a result of a mental disorder or impairment by chronic alcoholism, a danger to self or others, or gravely disabled, then the person may be detained for involuntary care, protection, and treatment related to the mental disorder or impairment by chronic alcoholism pursuant to Sections 5250 and 5270.15.

(b)The evidence considered in the certification review hearing may include information regarding the persons medical condition and how that condition bears on certifying the person as a danger to themselves or to others or as gravely disabled.

(c)(1)For purposes of this section, medical condition means a serious chronic or acute physical ailment for which, in the evidence submitted as part of the certification process, a psychiatrist, with documentation of consultation with an appropriate physician, certifies that all of the following apply:

(A)Without treatment, the medical condition poses a serious risk that the person, within six months, will suffer great bodily harm or death.

(B)The treatment is consistent with generally accepted standards of practice, the person will receive the treatment, as necessary, if detained pursuant to Section 5250 or 5270.15, and, upon release, the person will be provided with a treatment plan and directed to services that will facilitate appropriate treatment.

(C)During the process of detention pursuant to Section 5150, a physician advised the person on the purpose, nature, risks, and benefits of the medical condition and the treatment, consistent with the requirements for obtaining informed consent under Section 5326.2.

(D)If the medical condition is a chronic condition that existed before the person was detained pursuant to Section 5150, the person was consistently unable to comply with treatment due to their mental health condition.

(E)If released into the community, the person, due to their mental health condition at the time of certification, is likely to remain consistently unable to comply with the treatment due to either of the following:

(i)Despite the advice given, as described in subparagraph (C), the person remains unable to comply with the treatment because they cannot achieve a rudimentary understanding of the nature of the medical condition and continue to lack insight into the need for treatment.

(ii)The person understands the nature of the medical condition and wishes to comply with the treatment, but, due to the persons mental health condition, has a demonstrated history of being consistently unable to comply with the treatment, or a treatment for a similar medical condition, and this pattern is likely to recur if the person is released into the community.

(2)Medical condition does not include any of the following:

(A)A condition that predominantly involves a substance use disorder.

(B)Exposure to potential harms resulting from the persons personal circumstances, including, but not limited to, lack of health care insurance, poverty, or homelessness.

(C)Medical information that is more than four years old.

(d)This section does not authorize a patient to be detained longer than otherwise allowed for diagnosis or treatment of their mental disorder or impairment by chronic alcoholism.

(a)During the period of intensive treatment pursuant to Section 5250 or 5270.15, the persons involuntary detention shall be terminated and the person shall be released only if the psychiatrist directly responsible for the persons treatment believes, as a result of the psychiatrists personal observations, that the person certified no longer is, as a result of mental disorder or impairment by chronic alcoholism, a danger to self or others, or gravely disabled. However, in those situations in which both a psychiatrist and psychologist have personally evaluated or examined a person who is undergoing intensive treatment and there is a collaborative treatment relationship between the psychiatrist and the psychologist, either the psychiatrist or psychologist may authorize the release of the person, but only after they have consulted with one another. In the event of a clinical or professional disagreement regarding the early release of a person who is undergoing intensive treatment, the person may not be released unless the facilitys medical director overrules the decision of the psychiatrist or psychologist opposing the release. Both the psychiatrist and psychologist shall enter their findings, concerns, or objections into the persons medical record. If any other professional person who is authorized to release the person believes the person should be released during the designated period of intensive treatment, and the psychiatrist directly responsible for the persons treatment objects, the matter shall be referred to the medical director of the facility for the final decision. However, if the medical director is not a psychiatrist, the medical director shall appoint a designee who is a psychiatrist. If the matter is referred, the person shall be released during the period of intensive treatment only if the psychiatrist making the final decision believes, as a result of the psychiatrists personal observations, that the person certified no longer is, as a result of mental disorder or impairment by chronic alcoholism, a danger to self or others, or gravely disabled. This subdivision does not prohibit the person from remaining at the facility on a voluntary basis or prevent the facility from providing the person with appropriate referral information concerning mental health services. If the person needs continuing medical treatment after the termination of the involuntary detention, the facilitys medical director or designee shall inform the patient that continuing medical treatment is recommended.

(b)A person who has been certified for a period of intensive treatment pursuant to Section 5250 shall be released at the end of 14 days unless the patient either:

(1)Agrees to receive further treatment on a voluntary basis.

(2)Is certified for an additional 14 days of intensive treatment pursuant to Article 4.5 (commencing with Section 5260).

(3)Is certified for an additional 30 days of intensive treatment pursuant to Article 4.7 (commencing with Section 5270.10).

(4)Is the subject of a conservatorship petition filed pursuant to Chapter 3 (commencing with Section 5350).

(5)Is the subject of a petition for postcertification treatment of a dangerous person filed pursuant to Article 6 (commencing with Section 5300).

(c)The amendments to this section made by Chapter 94 of the Statutes of 2003 shall not be construed to revise or expand the scope of practice of psychologists, as defined in Chapter 6.6 (commencing with Section 2900) of Division 2 of the Business and Professions Code.

(a)If at the conclusion of the certification review hearing the person conducting the hearing finds that there is probable cause that the person certified is, as a result of a mental disorder or impairment by chronic alcoholism, a danger to self or others, or gravely disabled, then the person may be detained for involuntary care, protection, and treatment related to the mental disorder or impairment by chronic alcoholism pursuant to Sections 5250 and 5270.15. This

(d)This section does not authorize a patient to be detained longer than otherwise allowed for diagnosis or treatment of their mental disorder or impairment by chronic alcoholism.

(a)During the period of intensive treatment pursuant to Section 5250 or 5270.15, the persons involuntary detention shall be terminated and the person shall be released only if the psychiatrist directly responsible for the persons treatment believes, as a result of the psychiatrists personal observations, that the person certified no longer is, as a result of mental disorder or impairment by chronic alcoholism, a danger to self or others, or gravely disabled. However, in those situations in which both a psychiatrist and psychologist have personally evaluated or examined a person who is undergoing intensive treatment and there is a collaborative treatment relationship between the psychiatrist and the psychologist, either the psychiatrist or psychologist may authorize the release of the person, but only after they have consulted with one another. In the event of a clinical or professional disagreement regarding the early release of a person who is undergoing intensive treatment, the person may not be released unless the facilitys medical director overrules the decision of the psychiatrist or psychologist opposing the release. Both the psychiatrist and psychologist shall enter their findings, concerns, or objections into the persons medical record. If any other professional person who is authorized to release the person believes the person should be released during the designated period of intensive treatment, and the psychiatrist directly responsible for the persons treatment objects, the matter shall be referred to the medical director of the facility for the final decision. However, if the medical director is not a psychiatrist, the medical director shall appoint a designee who is a psychiatrist. If the matter is referred, the person shall be released during the period of intensive treatment only if the psychiatrist making the final decision believes, as a result of the psychiatrists personal observations, that the person certified no longer is, as a result of mental disorder or impairment by chronic alcoholism, a danger to self or others, or gravely disabled. This subdivision does not prohibit the person from remaining at the facility on a voluntary basis or prevent the facility from providing the person with appropriate referral information concerning mental health services. If the person needs continuing medical treatment after the termination of the involuntary detention, the facilitys medical director or designee shall inform the patient that continuing medical treatment is recommended.

(b)A person who has been certified for a period of intensive treatment pursuant to Section 5250 shall be released at the end of 14 days unless the patient either:

(1)Agrees to receive further treatment on a voluntary basis.

(2)Is certified for an additional 14 days of intensive treatment pursuant to Article 4.5 (commencing with Section 5260).

(3)Is certified for an additional 30 days of intensive treatment pursuant to Article 4.7 (commencing with Section 5270.10).

(4)Is the subject of a conservatorship petition filed pursuant to Chapter 3 (commencing with Section 5350).

(5)Is the subject of a petition for postcertification treatment of a dangerous person filed pursuant to Article 6 (commencing with Section 5300).

(c)The amendments to this section made by Chapter 94 of the Statutes of 2003 shall not be construed to revise or expand the scope of practice of psychologists, as defined in Chapter 6.6 (commencing with Section 2900) of Division 2 of the Business and Professions Code.

At the certification review hearing, the evidence in support of the certification decision shall be presented by a person designated by the director of the facility. In addition, either the district attorney or the county counsel may, at his or her discretion, counsel, in the district attorneys or county counsels discretion, may elect to present evidence at the certification review hearing. The evidence presented in support of the certification decision may include information regarding the persons medical condition and how that condition bears on certifying the person as a danger to themselves or to others or as gravely disabled. The information shall be considered by the hearing officer in the determination of probable cause, as set forth in Section 5256.6.

If at the conclusion of the certification review hearing the person conducting the hearing finds that there is probable cause that the person certified is, as a result of a mental disorder or impairment by chronic alcoholism, a danger to self or others, or to himself or herself, or gravely disabled, then the person may be detained for involuntary care, protection, and treatment related to the mental disorder or impairment by chronic alcoholism pursuant to Sections 5250 and 5270.15. This section does not authorize a patient to be detained longer than otherwise allowed for diagnosis or treatment of their mental disorder or impairment by chronic alcoholism.

(a)During the period of intensive treatment pursuant to Section 5250 or 5270.15, the persons involuntary detention shall be terminated and the person shall be released only if the psychiatrist directly responsible for the persons treatment believes, as a result of the psychiatrists personal observations, that the person certified no longer is, as a result of mental disorder or impairment by chronic alcoholism, a danger to self or others, or to himself or herself, or gravely disabled. However, in those situations in which both a psychiatrist and psychologist have personally evaluated or examined a person who is undergoing intensive treatment and there is a collaborative treatment relationship between the psychiatrist and the psychologist, either the psychiatrist or psychologist may authorize the release of the person, but only after they have consulted with one another. In the event of a clinical or professional disagreement regarding the early release of a person who is undergoing intensive treatment, the person may not be released unless the facilitys medical director overrules the decision of the psychiatrist or psychologist opposing the release. Both the psychiatrist and psychologist shall enter their findings, concerns, or objections into the persons medical record. If any other professional person who is authorized to release the person believes the person should be released during the designated period of intensive treatment, and the psychiatrist directly responsible for the persons treatment objects, the matter shall be referred to the medical director of the facility for the final decision. However, if the medical director is not a psychiatrist, he or she the medical director shall appoint a designee who is a psychiatrist. If the matter is referred, the person shall be released during the period of intensive treatment only if the psychiatrist making the final decision believes, as a result of the psychiatrists personal observations, that the person certified no longer is, as a result of mental disorder or impairment by chronic alcoholism, a danger to others, or to himself or herself, or gravely disabled. Nothing herein shall self or others, or gravely disabled. This subdivision does not prohibit the person from remaining at the facility on a voluntary basis or prevent the facility from providing the person with appropriate referral information concerning mental health services. If the person needs continuing medical treatment after the termination of the involuntary detention, the facilitys medical director or designee shall inform the patient that continuing medical treatment is recommended.

(b)A person who has been certified for a period of intensive treatment pursuant to Section 5250 shall be released at the end of 14 days unless the patient either:

(1)Agrees to receive further treatment on a voluntary basis.

(2)Is certified for an additional 14 days of intensive treatment pursuant to Article 4.5 (commencing with Section 5260).

(3)Is certified for an additional 30 days of intensive treatment pursuant to Article 4.7 (commencing with Section 5270.10).

(4)Is the subject of a conservatorship petition filed pursuant to Chapter 3 (commencing with Section 5350).

(5)Is the subject of a petition for postcertification treatment of a dangerous person filed pursuant to Article 6 (commencing with Section 5300).

(c)The amendments to this section made by Assembly Bill 348 of the 200304 Regular Session Chapter 94 of the Statutes of 2003 shall not be construed to revise or expand the scope of practice of psychologists, as defined in Chapter 6.6 (commencing with Section 2900) of Division 2 of the Business and Professions Code.