Current Status:

Passed

(2024-09-29: Chaptered by Secretary of State - Chapter 948, Statutes of 2024.)

Introduced

In Committee

First Chamber

In Committee

Second Chamber

Enacted

What does this bill do?

This bill changes many Welfare and Institutions Code sections to use person‑first language (for example, “person with a mental health condition,” “minor with a mental health condition,” and “children and adolescents with serious emotional disturbance”) and updates chapter and article headings. It affects people who receive mental health services, minors and their families, and the counties and providers that run those programs. The bill also makes technical and conforming edits throughout mental‑health law, including rules about community treatment facilities, short‑term residential therapeutic programs, assisted outpatient treatment, interagency placement committees, and services for people who are homeless.

Version:

Existing law makes various references to the descriptive terms persons with a mental health disorder, minors with a mental health condition, and children and adolescents with serious emotional disturbance in various provisions of the Welfare and Institutions Code.

This bill would make conforming changes to these provisions for consistency with those descriptor terms to, among other things, put the person first. The bill would also make other technical changes.

This bill would incorporate additional changes to Sections 5348, 5600.3, 5802, 5806, 5814, 5856.2, 18986.40 of the Welfare and Institutions Code proposed by AB 2995 to be operative only if this bill and AB 2995 are enacted and this bill is enacted last.

Version:

The people of the State of California do enact as follows:SECTION 1.Section 4012 of the Welfare and Institutions Code is amended to read:4012.

The State Department of State Hospitals, the State Department of Health Care Services, and other departments as necessary, may:

(a)Disseminate educational information relating to the prevention, diagnosis, and treatment of mental illness.

(b)Upon request, advise a public officer, organization, or agency interested in the mental health of the people of the state.

(c)Conduct such educational and related work as will tend to encourage the development of proper mental health facilities throughout the state.

(d)Coordinate state activities involving other departments whose actions affect a person with a mental health condition.

(e)Coordinate with, and provide information to, other states and national organizations, on issues involving mental health.

(f)Disseminate information and federal and private foundation funding opportunities to a county or city that administers mental health programs.

SEC. 2.Section 4033 of the Welfare and Institutions Code is amended to read:4033.

(a)The State Department of Health Care Services shall, to the extent resources are available, comply with the Substance Abuse and Mental Health Services Administration federal planning requirements. The department shall update and issue a state plan, which may also be any federally required state service plan, so a citizen may be informed regarding the implementation of, and long-range goals for, programs to serve a person with a mental health condition in the state. The department shall gather information from counties necessary to comply with this section.

(b)(1)If the State Department of Health Care Services makes a decision not to comply with any Substance Abuse and Mental Health Services Administration federal planning requirement to which this section applies, the State Department of Health Care Services shall submit the decision, for consultation, to the County Behavioral Health Directors Association of California, the California Behavioral Health Planning Council, and affected mental health entities.

(2)The State Department of Health Care Services shall not implement any decision not to comply with the Substance Abuse and Mental Health Services Administration federal planning requirements sooner than 30 days after notification of that decision, in writing, by the Department of Finance, to the chairperson of the committee in each house of the Legislature that considers appropriations, and the Chairperson of the Joint Legislative Budget Committee.

SEC. 3.Section 4051 of the Welfare and Institutions Code is amended to read:4051.

The State Department of Health Care Services shall, to the extent resources are available, provide program development guidelines, evaluation models, and operational assistance on all aspects of services to a person with a mental illness of any age. These services include, but are not limited to, the following:

(a)Self-help programs.

(b)Housing development.

(c)Disaster preparation.

(d)Vocational services.

(e)Regional programs.

(f)Multiple diagnosis programs.

SEC. 4.Section 4094.5 of the Welfare and Institutions Code is amended to read:4094.5.

Regulations for community treatment facilities adopted pursuant to Section 4094 shall include, but not be limited to, the following:

(a)Only a child with serious emotional disturbance, as defined in Section 5699.2, either (1) for whom other less restrictive mental health interventions have been tried, as documented in the case plan, or (2) who is currently placed in an acute psychiatric hospital or state hospital or in a facility outside the state for mental health treatment, and who may require periods of containment to participate in, and benefit from, mental health treatment, shall be placed in a community treatment facility. For purposes of this subdivision, lesser restrictive interventions shall include, but are not limited to, outpatient therapy, family counseling, case management, family preservation efforts, special education classes, or nonpublic schooling.

(b)A facility shall have the capacity to provide secure containment. For purposes of this section, a facility or an area of a facility shall be defined as secure if residents are not permitted to leave the premises of their own volition. All or part of a facility, including its perimeter, but not a room alone, may be locked or secure. If a facility uses perimeter fencing, all beds within the perimeter shall be considered secure beds. All beds outside of a locked or secure wing or facility shall be considered nonsecure beds.

(c)A locked or secure program in a facility shall not be used for disciplinary purposes, but shall be used for the protection of the child. It may be used as a treatment modality for a child needing that level of care. The use of the secure facility program shall be for as short a period as possible, consistent with the childs case plan and safety. The department shall develop regulations governing the oversight, review, and duration of the use of secure beds.

(d)Fire clearance approval shall be obtained pursuant to Section 1531.2 of the Health and Safety Code.

(e)(1)Prior to admission, a child admitted to a community treatment facility shall have been certified as having serious emotional disturbance, as defined in Section 5699.2, by a licensed mental health professional.

(A)Except in the case of placement on an emergency basis, as described in subdivision (i) of Section 4096, any child who is a dependent or ward of the juvenile court, is the subject of a petition filed pursuant to Section 300, has been detained pursuant to Section 636, or is voluntarily placed and the placement is funded by the Aid to Families with Dependent Children-Foster Care program, shall, prior to admission, have been determined by a county interagency placement committee to require placement in the community treatment facility, as prescribed by subdivision (e) of Section 4096. A copy of the interagency placement committee determination shall be provided to the facility.

(B)Any child who is a dependent or ward of the juvenile court, is the subject of a petition filed pursuant to Section 300, has been detained pursuant to Section 636, or is voluntarily placed and the placement is funded by the Aid to Families with Dependent Children-Foster Care program, shall be assessed by a qualified individual, as defined in subdivision (l) of Section 16501, pursuant to subdivision (g) of Section 4096, as needing the level of care provided by a community treatment facility. The assessment by the qualified individual shall occur prior to the childs admission to the facility, or, if delaying placement for the qualified individuals assessment would be contrary to the childs well-being, within 30 days after the child began physically residing in the facility. A copy of the completed assessment shall be provided to the facility.

(C)Federal financial participation under the Medi-Cal program shall only be available if all state and federal requirements are met and the treatment is medically necessary. Federal financial participation under the Medi-Cal program shall not be claimed for medical assistance expenditures relating to minors or nonminors detained in a juvenile justice facility, unless expressly permitted under the federal law, or approved under the CalAIM Terms and Conditions as defined in subdivision (c) of Section 14184.101 or the approved terms and conditions of a successor waiver or demonstration project.

(2)Any county cost associated with the certification and the determination provided for in paragraph (1) may be billed as a utilization review expense.

SEC. 5.Section 4096 of the Welfare and Institutions Code is amended to read:4096.

(a)This section governs interagency placement committees related to the placement of a dependent child or a ward into short-term residential therapeutic programs, as specified in Section 11462.01, in a community treatment facility, as defined in paragraph (8) of subdivision (a) of Section 1502 of the Health and Safety Code, or in an out-of-state residential facility, as defined in subdivision (b) of Section 7910 of the Family Code.

(1)Interagency collaboration and childrens program services shall be structured in a manner that will facilitate implementation of the goals of Part 4 (commencing with Section 5850) of Division 5 to develop protocols outlining the roles and responsibilities of placing agencies and programs regarding nonemergency placements of a foster child in a certified residential therapeutic program.

(2)Components shall be added to state-county performance contracts required in Section 5650 that provide for reports from counties on how this section is implemented.

(3)The State Department of Health Care Services shall develop performance contract components required by paragraph (2).

(4)Performance contracts subject to this section shall document that the procedures to be implemented in compliance with this section have been approved by the county social services department and the county probation department.

(b)Funds specified in subdivision (a) of Section 17601 for services to wards of the court and dependent children of the court shall be allocated and distributed to counties based on the number of wards of the court and dependent children of the court in the county.

(c)A county may utilize funds allocated pursuant to subdivision (b) only if the county has established an operational interagency placement committee with a membership that includes at least the county placement agency and a licensed mental health professional from the county department of mental health. If necessary, the funds may be used for costs associated with establishing the interagency placement committee.

(d)Funds allocated pursuant to subdivision (b) shall be used to provide services to wards of the court and dependent children of the court jointly identified by county mental health, social services, and probation departments as the highest priority. Every effort shall be made to match those funds with funds received pursuant to Title XIX of the federal Social Security Act, contained in Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code.

(e)(1)Each interagency placement committee shall establish procedures whereby a ward of the court or dependent child of the court, a child who is the subject of a petition filed pursuant to Section 300, a child detained pursuant to Section 636, or a voluntarily placed child whose placement is funded by the Aid to Families with Dependent Children-Foster Care program, who is to be placed or is currently placed in a program, as specified in subdivision (a), shall be determined to meet one of the following:

(A)The child or ward meets the medical necessity criteria for Medi-Cal specialty mental health services, as the criteria are described in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.

(B)The child or ward is assessed and diagnosed with serious emotional disturbance as described in subdivision (a) of Section 5600.3.

(C)The childs or wards individual behavioral or treatment needs can only be met by the level of care provided in a program, as specified in subdivision (a).

(2)The determination required by paragraph (1) shall do all of the following:

(A)Ensure that the care and services that the child needs, including any care or service needs determined by the qualified individual assessment, are provided by a program, as specified in subdivision (a), and include documentation regarding how medically necessary Medi-Cal specialty mental health services will be provided in a provisionally licensed program.

(B)Ensure that the requirements of subdivision (c) of Section 16514 have been met with respect to commonality of need.

(C)Consider the detailed history that shall be provided by the placing agency outlining behavior that may pose a threat to the health or safety of that child and the other children residing in the program and consider any potential interference with the effectiveness of the care and services provided to that child and the other children residing in the program, as specified in subdivision (a).

(D)Describe additional safety measures and therapeutic interventions needed to mitigate identified challenging behaviors or risks to the safety of the child and other children in the facility.

(E)Present the determination to the placing agency within five business days of the referral.

(3)This subdivision does not prohibit an interagency placement committee from considering an assessment that was provided by a licensed mental health professional, as described in subdivision (j), and that was developed consistent with procedures established by the county pursuant to paragraph (1).

(4)The State Department of Health Care Services and the State Department of Social Services shall develop a dispute resolution process or utilize an existing dispute resolution process currently operated by each department to jointly review a disputed interagency placement committee determination made pursuant to this subdivision. The departments shall report the developed or utilized dispute resolution process to the appropriate policy and fiscal committees of the Legislature no later than January 1, 2017, and shall track the number of disputes reported and resolved, and provide that information to the Legislature annually as part of the State Budget process. Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the departments may issue guidance on the joint review process for dispute resolution by written directive.

(f)The interagency placement committee shall document the results of the determination required by subdivision (e) and shall notify the appropriate provider in writing, of those results within 10 days of the completion of the determination.

(g)(1)For a placement in a short-term therapeutic residential program, a community treatment facility, as defined in paragraph (8) of subdivision (a) of Section 1502 of the Health and Safety Code, or in an out-of-state residential facility, as defined by paragraph (2) of subdivision (b) of Section 7910 of the Family Code, made on or after October 1, 2021, a qualified individual, as defined pursuant to subdivision (l) of Section 16501, shall conduct an assessment pursuant to this subdivision if the child is placed by a county child welfare or probation placing agency.

(2)(A)Unless the placement is an emergency placement pursuant to paragraph (3) of subdivision (h) of Section 11462.01, the qualified individual shall conduct an independent assessment and determination regarding the needs of the child prior to placement in a short-term therapeutic residential program, in a community treatment facility, or in an out-of-state residential facility, as defined by paragraph (2) of subdivision (b) of Section 7910 of the Family Code. In the event of an emergency placement, the qualified individual shall conduct the independent assessment and determination regarding the needs of the child within 30 days of the start of the placement.

(B)In connection with the activities required by the qualified individual, placing agencies shall adopt, and all parties to the childs case shall utilize, the universal release of information identified by the State Department of Social Services and the State Department of Health Care Services.

(3)The assessment conducted by the qualified individual shall include, at a minimum, all of the following:

(A)Engagement with the child and family team members and, in the case of an Indian child, the Indian childs tribe, in conducting the assessment.

(B)An assessment of the strengths and needs of the child or nonminor dependent, using an age-appropriate, evidence-based, validated, functional assessment tool and methodology approved by the State Department of Social Services and the State Department of Health Care Services. If the authorized assessment tool has already been completed as part of the child and family team within two months of the referral to a qualified individual, the qualified individual may utilize or update those results at the discretion of the qualified individual. If the assessment tool was completed more than two months before the referral to a qualified individual, the qualified individual shall update those results.

(C)The identification of the child-specific short- and long-term mental and behavioral health goals and treatment needs of the child.

(D)In the case of an Indian child, the qualified individuals efforts to consult with the childs tribe. The qualified individual shall consult and confer with a representative of the childs tribe or, at the direction of the tribal representative, the qualified expert witness, as described in Section 224.6. Such consultation shall include, but not be limited to, determination of the social and cultural standards of the Indian childs tribe.

(4)The qualified individual shall determine and document the following in writing:

(A)Whether the assessed needs of the child or nonminor dependent can be met with family members, in a tribally approved home in the case of an Indian child, or in another family-based setting.

(B)If the child or nonminor dependents needs cannot be met with family members, in a tribally approved home in the case of an Indian child, or in another family-based setting, all of the following:

(i)Why the needs of the child cannot be met with family members of the child or in another family-based setting identified by the placing agency, or in a tribally approved home in the case of an Indian child.

(ii)Why a short-term residential therapeutic program, or, where applicable, a community treatment facility, as defined in paragraph (8) of subdivision (a) of Section 1502 of the Health and Safety Code, or an out-of-state residential facility, as defined by paragraph (2) of subdivision (b) of Section 7910 of the Family Code, is the setting that will provide the child with the most effective and appropriate level of care in the least restrictive environment.

(iii)How a short-term residential therapeutic program intervention, or, where applicable, the program intervention of a community treatment facility or an out-of-state residential facility, as defined by paragraph (2) of subdivision (b) of Section 7910 of the Family Code, is consistent with the short- and long-term goals for the child, as specified in the permanency plan for the child, and for an Indian child, will meet the childs needs consistent with the prevailing social and cultural conditions and way of life of the Indian childs tribe.

(iv)The mental and behavioral health interventions and treatment that the program will implement to improve functioning and well-being and, for an Indian child, how the interventions and treatment will be conducted in a manner consistent with the prevailing social and cultural conditions and way of life of the Indian childs tribe.

(v)A known multiagency care coordination need that should be planned for during discharge and aftercare planning, as developed pursuant to Section 4096.6, upon the childs transition to a family-based setting.

(C)The engagement with the child and family team members and, in the case of an Indian child, the Indian childs tribe.

(5)The assessment of the qualified individual does not replace or replicate existing case planning or case management activities, roles, and responsibilities of the county placing agency caseworker in preparation of the childs case plan pursuant to Section 16501.1 or requirements of the interagency placement committee established pursuant to this section.

(6)The qualified individual shall provide the assessment required by paragraph (3) and the report required by paragraph (4) to the county placing agency and the short-term residential therapeutic program, or, where applicable, the community treatment facility, as defined in paragraph (8) of subdivision (a) of Section 1502 of the Health and Safety Code, or the out-of-state residential facility, as defined by paragraph (2) of subdivision (b) of Section 7910 of the Family Code, in which the child or nonminor dependent is or will be placed.

(7)It is the intent of the Legislature that the assessments of a qualified individual provided pursuant to this subdivision are provided as specialty mental health services, whenever possible, consistent with all state and federal Medicaid requirements.

(8)For purposes of subparagraph (K) of paragraph (1) of subdivision (a) of Section 827, a qualified individual shall be considered a member of the childs multidisciplinary team.

(h)(1)The State Department of Social Services and the State Department of Health Care Services shall issue joint guidance that shall include, but not be limited to, all of the following:

(A)The statewide standards and approval requirements for qualified individuals, as defined in subdivision (l) of Section 16501.

(B)The requirements for referrals to, and the assessment conducted by, the qualified individual pursuant to subdivision (g).

(C)Documentation requirements necessary to meet state and federal child welfare requirements and documentation requirements for Medi-Cal specialty mental health activities conducted by the qualified individual.

(D)The applicable state and federal privacy and confidentiality laws that permit or limit the dissemination of the assessment of the qualified individual developed pursuant to subdivision (g).

(2)The guidance issued pursuant to this subdivision shall be issued on or before July 31, 2021.

(i)This section does not prevent a county placing agency from making a placement in a short-term residential therapeutic program or a community treatment facility on an emergency basis, as permitted pursuant to subdivision (h) of Section 11462.01, prior to the determination by the interagency placement committee pursuant to this section.

(j)If the childs or youths placement is not funded by the Aid to Families with Dependent Children-Foster Care program a licensed mental health professional, or an otherwise recognized provider of mental health services, shall certify that the child has been assessed as meeting the medical necessity criteria for Medi-Cal specialty mental health Early and Periodic Screening, Diagnosis, and Treatment services, as the criteria are described in Section 1830.210 of Title 9 of the California Code of Regulations, or assessed and diagnosed with serious emotional disturbance as described in subdivision (a) of Section 5600.3. A licensed mental health professional includes a physician licensed under Section 2050 of the Business and Professions Code, a licensed psychologist within the meaning of subdivision (a) of Section 2902 of the Business and Professions Code, a licensed clinical social worker within the meaning of subdivision (a) of Section 4996 of the Business and Professions Code, a licensed marriage and family therapist within the meaning of subdivision (b) of Section 4980 of the Business and Professions Code, or a licensed professional clinical counselor within the meaning of subdivision (e) of Section 4999.12.

(k)(1)Notwithstanding any other law, contracts awarded by the State Department of Social Services for purposes of this section shall be exempt from the personal services contracting requirements of Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code.

(2)Notwithstanding any other law, contracts awarded by the State Department of Social Services for purposes of this section shall be exempt from the Public Contract Code and the State Contracting Manual, and shall not be subject to the approval of the Department of General Services.

SEC. 6.Section 4096.5 of the Welfare and Institutions Code is amended to read:4096.5.

(a)This section governs standards for the mental health program approval for short-term residential therapeutic programs, which is required under subdivision (c) of Section 1562.01 of the Health and Safety Code.

(b)All short-term residential therapeutic programs that serve children who have either been assessed as meeting the medical necessity criteria for Medi-Cal specialty mental health services, as provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations, or who have been assessed and diagnosed with a serious emotional disturbance as defined in subdivision (a) of Section 5600.3, shall obtain and have in good standing a mental health program approval and a Medi-Cal mental health certification, as described in Section 11462.01, issued by the State Department of Health Care Services or a county mental health plan to which the department has delegated approval authority. This approval, which is required pursuant to subdivision (c) of Section 1562.01 of the Health and Safety Code, is a condition for receiving an Aid to Families with Dependent Children-Foster Care rate pursuant to Section 11462.01.

(c)(1)A short-term residential therapeutic program shall not directly provide specialty mental health services without a current mental health program approval. A licensed short-term residential therapeutic program that has not obtained a program approval shall provide children in its care access to appropriate mental health services.

(2)County mental health plans shall ensure that Medi-Cal specialty mental health services, including, but not limited to, services under the Early and Periodic Screening, Diagnosis and Treatment benefit, are provided to all Medi-Cal beneficiaries served by short-term residential therapeutic programs who meet medical necessity criteria, as provided for in Section 1830.205 or 1830.210 of Title 9 of the California Code of Regulations.

(d)(1)The State Department of Health Care Services or a county mental health plan to which the department has delegated mental health program approval authority shall approve or deny mental health program approval requests within 45 days of receiving a request. The State Department of Health Care Services or a county mental health plan to which the department has delegated mental health program approval authority shall issue each mental health program approval for a period of one year, except for approvals granted pursuant to paragraph (2) and provisional approvals granted pursuant to regulations promulgated under subdivision (e), and shall specify the effective date of the approval. Approved entities shall meet all program standards to be reapproved.

(2)(A)Between January 1, 2017, and December 31, 2017, the State Department of Health Care Services, or a county mental health plan to which the department has delegated mental health program approval authority, shall approve or deny a mental health program approval request within 90 days of receipt.

(B)Between January 1, 2017, and December 31, 2017, the State Department of Health Care Services, or a county mental health plan to which the department has delegated mental health program approval authority, may issue a mental health program approval for a period of less than one year.

(e)(1)The State Department of Health Care Services and the county mental health plans to which the department has delegated mental health program approval authority may enforce the mental health program approval standards by taking any of the following actions against a noncompliant short-term residential therapeutic program:

(A)Suspend or revoke a mental health program approval.

(B)Impose monetary penalties.

(C)Place a mental health program on probation.

(D)Require a mental health program to prepare and comply with a corrective action plan.

(2)The State Department of Health Care Services and the county mental health plans to which the department has delegated mental health program approval authority shall provide short-term residential therapeutic programs with due process protections when taking any of the actions described in paragraph (1).

(f)The State Department of Health Care Services, in consultation with the State Department of Social Services, shall promulgate regulations regarding program standards, oversight, enforcement, issuance of mental health program approvals, including provisional approvals that are effective for a period of less than one year, and due process protections related to the mental health program approval process for short-term residential therapeutic programs.

(g)(1)Except for mental health program approval of short-term residential therapeutic programs operated by a county, the State Department of Health Care Services may, upon the request of a county, delegate to that county mental health plan the mental health program approval of short-term residential therapeutic programs within its borders.

(2)Any county to which mental health program approval is delegated pursuant to paragraph (1) shall be responsible for the oversight and enforcement of program standards and the provision of due process for approved and denied entities.

(h)The State Department of Health Care Services or a county mental health plan to which the department has delegated mental health program approval authority shall notify the State Department of Social Services immediately upon the termination of any mental health program approval issued in accordance with subdivisions (b) and (d).

(i)The State Department of Social Services shall notify the State Department of Health Care Services and, if applicable, a county to which the department has delegated mental health program approval authority, immediately upon the revocation of any license issued pursuant to Chapter 3 (commencing with Section 1500) of Division 2 of the Health and Safety Code.

(j)Revocation of a license or a mental health program approval or failure to meet the requirements of subdivision (c) of Section 1562.01 of the Health and Safety Code shall be a basis for rate termination.

(k)(1)Notwithstanding subdivision (f), pursuant to Section 5963.05, the State Department of Health Care Services may develop and revise documentation standards to be consistent with the standards developed pursuant to paragraph (3) of subdivision (h) of Section 14184.402.

(2)The department shall require short-term residential therapeutic programs to implement the documentation standards developed pursuant to paragraph (1) and shall monitor compliance with these standards as part of program reviews.

SEC. 7.The heading of Chapter 2.5 (commencing with Section 4240) of Part 2 of Division 4 of the Welfare and Institutions Code is amended to read:2.5.Families of Persons With a Serious Mental Health DisorderSEC. 8.Section 4240 of the Welfare and Institutions Code is amended to read:4240.

The Legislature finds and declares all of the following:

(a)The symptoms and behaviors of persons with a serious mental health disorder may cause severe disruption of normal family relationships.

(b)Families are often the principal caregivers, housing providers, and case managers for family members with a serious mental health disorder.

(c)Families of persons with a serious mental health disorder more often than not have little or no legal authority over their adult family members with a mental health disorder who are sometimes difficult to manage. Consequently, they need advice, skills, emotional support, and guidance to cope with the stress of caregiving in order to be effective and helpful.

(d)Involved families are of inestimable value to the publicly funded and professionally operated state and county mental health system and programs emphasizing self-help can be the best way to assist families in maintaining the cohesion of family life while caring for and assisting a family member with a mental health disorder.

(e)Since the states mental health resources are limited and are increasingly being directed on a priority basis toward provision of services to persons with a serious mental health disorder, informed and active families helping one another can effectively extend and amplify the value of state mental health dollars.

SEC. 9.Section 4341 of the Welfare and Institutions Code is amended to read:4341.

(a)To ensure the availability of an adequate number of persons from all disciplines necessary to implement appropriate and effective services to a person with a serious mental health condition, of any age and from any ethnic group, the department shall, to the extent resources are available, implement a Human Resources Development Program.

(b)Implementation of the program shall include negotiation with any or all of the following: the University of California, state colleges, community colleges, private universities and colleges, public and private hospitals, and public and private rehabilitation, community care, treatment providers, and professional associations, to arrange affiliations and contracts for educational and training programs to ensure appropriate numbers of graduates with experience in serving persons with a serious mental health condition in the most cost-effective programs.

(c)The human resources development effort shall be undertaken with active participation of the California Conference of Local Mental Health Directors, client and family representatives, and professional and academic institutions.

(d)The program shall give particular attention to areas of specific expertise where local programs and state hospitals have difficulty recruiting qualified staff, including programs for children and youth with forensic persistent and severe mental health conditions and elderly persons with serious mental health conditions. Specific attention shall be given to ensuring the development of a mental health work force with the necessary bilingual and bicultural skills to deliver effective service to the diverse population of the state.

SEC. 10.Section 5020.1 of the Welfare and Institutions Code is amended to read:5020.1.

A minor with a mental health condition, between the ages of 3 and 18, upon being considered for release from a state hospital shall have an aftercare plan developed. Such plan shall include educational or training needs, provided these are necessary for the patients well-being.

SEC. 11.Section 5120 of the Welfare and Institutions Code is amended to read:5120.

It is the policy of this state as declared and established in this act and in the Lanterman-Petris-Short Act that the care and treatment of individuals with a mental health condition be provided in the local community. In order to achieve uniform statewide implementation of the policies of this act, it is necessary to establish the statewide policy that, notwithstanding any other provision of law, no city or county shall discriminate in the enactment, enforcement, or administration of any zoning laws, ordinances, or rules and regulations between the use of property for the treatment of general hospital or nursing home patients and the use of property for the psychiatric care and treatment of patients, both inpatient and outpatient.

Health facilities for inpatient and outpatient psychiatric care and treatment shall be permitted in any area zoned for hospitals or nursing homes, or in which hospitals and nursing homes are permitted by conditional use permit.

SEC. 12.The heading of Article 1 (commencing with Section 5150) of Chapter 2 of Part 1 of Division 5 of the Welfare and Institutions Code is amended to read:1.Detention of Persons with a Mental Health Condition for Evaluation and TreatmentSEC. 13.The heading of Article 2 (commencing with Section 5200) of Chapter 2 of Part 1 of Division 5 of the Welfare and Institutions Code is amended to read:2.Court-Ordered Evaluation for Persons with a Mental Health ConditionSEC. 14.Section 5326.2 of the Welfare and Institutions Code is amended to read:5326.2.

To constitute voluntary informed consent, the following information shall be given to the patient in a clear and explicit manner:

(a)The reason for treatment, that is, the nature and seriousness of the patients illness, disorder, or condition.

(b)The nature of the procedures to be used in the proposed treatment, including its probable frequency and duration.

(c)The probable degree and duration (temporary or permanent) of improvement or remission, expected with or without such treatment.

(d)The nature, degree, duration, and the probability of the side effects and significant risks, commonly known by the medical profession, of such treatment, including its adjuvants, especially noting the degree and duration of memory loss (including its irreversibility) and how and to what extent they may be controlled, if at all.

(e)That there exists a division of opinion as to the efficacy of the proposed treatment, why and how it works and its commonly known risks and side effects.

(f)The reasonable alternative treatments, and why the physician is recommending this particular treatment.

(g)That the patient has the right to accept or refuse the proposed treatment, and that if the patient consents, the patient has the right to revoke their consent for any reason, at any time prior to or between treatments.

SEC. 15.Section 5346 of the Welfare and Institutions Code is amended to read:5346.

(a)In any county or group of counties where services are available as provided in Section 5348, 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 experiencing 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, in view of the persons treatment history and current behavior, at least one of the following is true:

(A)The person is unlikely to survive safely in the community without supervision and the persons condition is substantially deteriorating.

(B)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 the person or to others, as defined in Section 5150.

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

(A)The persons 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 persons mental illness has resulted in one or more acts of serious and violent behavior toward themselves or another, or threats, or attempts to cause serious physical harm to themselves 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 the directors 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)Participation in the assisted outpatient treatment program would be the least restrictive placement necessary to ensure the persons recovery and stability.

(7)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 behavioral health director, or the directors designee, in the superior court in the county in which 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)A person 18 years of age or older with whom the person who is the subject of the petition resides.

(B)A 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 a 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)A judge of a superior court before whom the person who is the subject of the petition appears.

(3)Upon receiving a request pursuant to paragraph (2), the county behavioral health director shall conduct an investigation into the appropriateness of filing of the petition. The director shall file the petition only if the director 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 petitioners 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 that persons 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)(A)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:

(i)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.

(ii)That, no more than 10 days prior to the filing of the petition, the licensed mental health treatment provider, or the providers 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.

(B)An examining mental health professional in their affidavit to the court shall address the issue of whether the defendant has capacity to give informed consent regarding psychotropic medication.

(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 able to do so.

(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 days from the date the petition is received by the court, excluding Saturdays, Sundays, and holidays. 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 the 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 persons absence. If the hearing is conducted without the person present, the court shall set forth the factual basis for conducting the hearing without the persons presence. The person who is the subject of the petition shall maintain the right to appear before the court in person, but may appear by videoconferencing means if they choose to do so.

(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 at the hearing. An examining mental health professional may appear before the court by videoconferencing means.

(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 any person designated under Section 5150 to take into custody the person who is the subject of the petition and transport the person, or cause the person 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 the right to judicial review by habeas corpus.

(E)To be present at the hearing unless the person waives the right to be present.

(F)To present evidence.

(G)To call witnesses on the persons behalf.

(H)To cross-examine witnesses.

(I)To appeal decisions, and to be informed of the 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 six 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.

(C)The court may conduct status hearings with the person and the treatment team to receive information regarding progress related to the categories of treatment listed in the treatment plan and may inquire about medication adherence.

(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 persons 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 persons 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 behavioral health director, or the directors 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 the directors 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 behavioral health director, or to the directors 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 the person, or cause the person 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. Any continued involuntary retention in a hospital beyond the initial 72-hour period shall be pursuant to Section 5150. 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, the person 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)(1)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 the person still meets the criteria for assisted outpatient treatment if they disagree with the directors affidavit. The burden of proof shall be on the director.

(2)When making the affidavit pursuant to paragraph (1), the director of the outpatient treatment program shall also report to the court on adherence to prescribed medication.

(i)During each 60-day period specified in subdivision (h), if the person who is the subject of the order believes that they are being wrongfully retained in the assisted outpatient treatment program against their wishes, the person 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)A 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.

(k)This section shall become operative on July 1, 2021.

SEC. 16.Section 5348 of the Welfare and Institutions Code is amended to read:5348.

(a)For purposes of subdivision (e) of Section 5346, a county or group of counties that chooses to provide assisted outpatient treatment services pursuant to this article 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 number 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 adult child living with them is experiencing a severe mental health condition, 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 that 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 experiencing 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 young adults 25 years of age or younger who have a serious mental health condition and 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 treatment programs that address gender-specific trauma and abuse in the lives of persons with a 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 experiencing an untreated severe mental illness for less than one year, and who do not require the full range of services, but who 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 that is responsible for providing or ensuring needed services. Responsibilities include complete assessment of the clients needs, development of the clients 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 their 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 that operates an assisted outpatient treatment program pursuant to this article 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 in which the county provides services 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.

(e)This section shall become operative on July 1, 2021.

SEC. 16.5.Section 5348 of the Welfare and Institutions Code is amended to read:5348.

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

(B)Plans for services, including outreach to families whose adult child living with them is experiencing a severe mental health condition, design of mental health services, coordination and access to medications, psychiatric and psychological services, substance use disorder services, supportive housing or other housing assistance, vocational rehabilitation, and veterans services. Plans shall also contain evaluation strategies that 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 experiencing 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.