AMENDED IN SENATE MARCH 30, 2023
AMENDED IN SENATE FEBRUARY 28, 2023
SENATE BILL No. 43
Introduced by Senator Eggman
(Principal coauthors: Senators Niello and Wiener)
(Principal coauthor: Assembly Member Santiago)
(Coauthors: Senators Allen, Dodd, Menjivar, Roth, Rubio, and Stern)
(Coauthors: Assembly Members Chen, Friedman, Gallagher, Quirk-Silva, and Wicks)
December 5, 2022
An act to amend Section 1799.111 of the Health and Safety Code, and to amend Section 5008 Sections 5008, 5350, and 5358 of, and to add Section 5122 to, the Welfare and Institutions Code, relating to mental health.
legislative counsel’s digest
SB 43, as amended, Eggman. Behavioral health.
Existing la w, the Lanterman-Petris-Short Act, pro vides for the involuntary commitment and treatment of a person who is a danger to themselves or others or who is gra vely disabled. Existing la w, for purposes of in voluntary commitment, defines “gra vely disabled” as either a condition in which a person, as a result of a mental health disorder, is unable to pro vide for their basic personal needs for food, clothing, or shelter or has been found mentally incompetent, as specified.
This bill expands the definition of “gravely disabled” to also include a condition that will result in substantial risk of serious harm to the physical or mental health of a person due to a mental health disorder or a substance use disorder or both. The bill defines “serious harm” for
97 purposes of these pro visions to mean significant deterioration, debilitation, or illness due to a person’s inability to carry out specified tasks, failure to meet certain conditions, including, among other things, attend to needed personal or medical care and attend to self-protection or personal safety . The bill specifies circumstances under which substantial risk of serious harm may be e videnced, as specified. The bill would make conforming changes. To the e xtent that this change increases the le vel of service required of county mental health departments, the bill would impose a state-mandated local program.
Existing law also authorizes the appointment of a conservator, in the County of Los Angeles, the County of San Die go, or the City and County of San Francisco, for a person who is incapable of caring for the person’s own health and well-being due to a serious mental illness and substance use disorder. Existing law establishes the hearsay rule, under which evidence of a statement is generally inadmissible if it was made other than by a witness while testifying at a hearing and is offered to prove the truth of the matter stated. Existing law sets forth exceptions to the hearsay rule to permit the admission of specified kinds of evidence.
Under this bill, for purposes of an e xpert witness in any proceeding relating to the appointment or reappointment of a conservator pursuant to the abo ve-described provisions, the statements of specified health practitioners or a licensed clinical social worker included in the medical record would not be hearsay. The bill would authorize the court to grant a reasonable continuance if an expert witness in a proceeding relied on the medical record and the medical record has not been provided to the parties or their counsel.
The California Constitution requires the state to reimb urse local agencies and school districts for certain costs mandated by the state.
Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.
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The people of the State of California do enact as follows:
line 1 SECTION 1. Section 1799.111 of the Health and Safety Code line 2 is amended to read:
line 3 1799.111. (a) Subject to subdi vision (b), a licensed general line 4 acute care hospital, as defined in subdivision (a) of Section 1250, line 5 that is not a county-designated f acility pursuant to Section 5150 line 6 of the Welfare and Institutions Code, a licensed acute psychiatric line 7 hospital, as defined in subdivision (b) of Section 1250, that is not line 8 a county-designated f acility pursuant to Section 5150 of the line 9 Welfare and Institutions Code, licensed professional staff of those line 10 hospitals, or an y ph ysician and sur geon, pro viding emer gency line 11 medical services in any department of those hospitals to a person line 12 at the hospital is not ci villy or criminally liable for detaining a line 13 person if all of the following conditions exist during the detention:
line 14 (1) The person cannot be safely released from the hospital line 15 because, in the opinion of the treating ph ysician and surgeon, or line 16 a clinical psychologist with the medical staf f privileges, clinical line 17 privileges, or professional responsibilities pro vided in Section line 18 1316.5, the person, as a result of a mental health disorder, presents line 19 a danger to themselv es, or others, or is gra vely disabled. F or line 20 purposes of this paragraph, “gra vely disabled” has the same line 21 definition as in paragraph (1) of subdi vision (h) of Section 5008 line 22 of the Welfare and Institutions Code.
line 23 (2) The hospital staf f, treating ph ysician and sur geon, or line 24 appropriate licensed mental health professional, ha ve made, and line 25 documented, repeated unsuccessful ef forts to find appropriate line 26 mental health treatment for the person.
line 27 (A) Telephone calls or other contacts required pursuant to this line 28 paragraph shall commence at the earliest possible time when the line 29 treating physician and surgeon has determined the time at which line 30 the person will be medically stable for transfer. line 31 (B) The contacts required pursuant to this paragraph shall not line 32 begin after the time when the person becomes medically stable for line 33 transfer.
line 34 (3) The person is not detained beyond 24 hours. line 35 (4) There is probable cause for the detention. line 36 (b) If the person is detained pursuant to subdivision (a) beyond line 37 eight hours, but less than 24 hours, both of the following additional line 38 conditions shall be met:
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line 1 (1) A dischar ge or transfer for appropriate e valuation or line 2 treatment for the person has been delayed because of the need for line 3 continuous and ongoing care, observ ation, or treatment that the line 4 hospital is providing.
line 5 (2) In the opinion of the treating ph ysician and sur geon, or a line 6 clinical psychologist with the medical staf f pri vileges or line 7 professional responsibilities pro vided for in Section 1316.5, the line 8 person, as a result of a mental health disorder , is still a danger to line 9 themselves, or others, or is gra vely disabled, as defined in line 10 paragraph (1) of subdivision (a).
line 11 (c) In addition to the immunities set forth in subdi vision (a), a line 12 licensed general acute care hospital, as defined in subdivision (a) line 13 of Section 1250, that is not a county-designated f acility pursuant line 14 to Section 5150 of the Welfare and Institutions Code, a licensed line 15 acute psychiatric hospital, as defined by subdivision (b) of Section line 16 1250, that is not a county-designated f acility pursuant to Section line 17 5150 of the Welfare and Institutions Code, licensed professional line 18 staff of those hospitals, or a ph ysician and sur geon, pro viding line 19 emergency medical services in any department of those hospitals line 20 to a person at the hospital shall not be civilly or criminally liable line 21 for the actions of a person detained up to 24 hours in those hospitals line 22 who is subject to detention pursuant to subdi vision (a) after that line 23 person’s release from the detention at the hospital, if all of the line 24 following conditions exist during the detention:
line 25 (1) The person has not been admitted to a licensed general acute line 26 care hospital or a licensed acute psychiatric hospital for evaluation line 27 and treatment pursuant to Section 5150 of the Welfare and line 28 Institutions Code.
line 29 (2) The release from the licensed general acute care hospital or line 30 the licensed acute psychiatric hospital is authorized by a physician line 31 and sur geon or a clinical psychologist with the medical staf f line 32 privileges or professional responsibilities provided for in Section line 33 1316.5, who determines, based on a f ace-to-face examination of line 34 the person detained, that the person does not present a danger to line 35 themselves or others and is not gra vely disabled, as defined in line 36 paragraph (1) of subdi vision (a). In order for this paragraph to line 37 apply to a clinical psychologist, the clinical psychologist shall have line 38 a collaborati ve treatment relationship with the ph ysician and line 39 surgeon. The clinical psychologist may authorize the release of line 40 the person from the detention, b ut only after the clinical 97 — 4 — SB 43
line 1 psychologist has consulted with the physician and surgeon. In the line 2 event of a clinical or professional disagreement re garding the line 3 release of a person subject to the detention, the detention shall be line 4 maintained unless the hospital’ s medical director o verrules the line 5 decision of the physician and surgeon opposing the release. Both line 6 the physician and surgeon and the clinical psychologist shall enter line 7 their findings, concerns, or objections in the person’ s medical line 8 record.
line 9 (d) Notwithstanding any other law, an examination, assessment, line 10 or evaluation that provides the basis for a determination or opinion line 11 of a ph ysician and sur geon or a clinical psychologist with the line 12 medical staff privileges or professional responsibilities pro vided line 13 for in Section 1316.5 that is specified in this section may be line 14 conducted using telehealth.
line 15 (e) This section does not af fect the responsibility of a general line 16 acute care hospital or an acute psychiatric hospital to comply with line 17 all state laws and regulations pertaining to the use of seclusion and line 18 restraint and psychiatric medications for psychiatric patients. line 19 Persons detained under this section shall retain their le gal rights line 20 regarding consent for medical treatment.
line 21 (f) A person detained under this section shall be credited for the line 22 time detained, up to 24 hours, if the person is placed on a line 23 subsequent 72-hour hold pursuant to Section 5150 of the Welfare line 24 and Institutions Code.
line 25 (g) The amendments to this section made by Chapter 308 of the line 26 Statutes of 2007 do not limit an y e xisting duties for line 27 psychotherapists contained in Section 43.92 of the Civil Code. line 28 (h) This section does not e xpand the scope of licensure of line 29 clinical psychologists.
line 30 SEC. 2. Section 5008 of the Welfare and Institutions Code is line 31 amended to read:
line 32 5008. Unless the conte xt otherwise requires, the follo wing line 33 definitions shall govern the construction of this part:
line 34 (a) “Evaluation” consists of multidisciplinary professional line 35 analyses of a person’s medical, psychological, educational, social, line 36 financial, and le gal conditions as may appear to constitute a line 37 problem. Persons providing evaluation services shall be properly line 38 qualified professionals and may be full-time emplo yees of an line 39 agency pro viding f ace-to-face, which includes telehealth, 97 SB 43 — 5 —
line 1 evaluation services or may be part-time emplo yees or may be line 2 employed on a contractual basis.
line 3 (b) “Court-ordered evaluation” means an evaluation ordered by line 4 a superior court pursuant to Article 2 (commencing with Section line 5 5200) or by a superior court pursuant to Article 3 (commencing line 6 with Section 5225) of Chapter 2.
line 7 (c) “Intensive treatment” consists of such hospital and other line 8 services as may be indicated. Intensive treatment shall be provided line 9 by properly qualified professionals and carried out in f acilities line 10 qualifying for reimb ursement under the California Medical line 11 Assistance Program (Medi-Cal) set forth in Chapter 7 (commencing line 12 with Section 14000) of Part 3 of Division 9, or under Title XVIII line 13 of the federal Social Security Act and re gulations thereunder . line 14 Intensive treatment may be pro vided in hospitals of the United line 15 States government by properly qualified professionals. This part line 16 does not prohibit an intensive treatment facility from also providing line 17 72-hour evaluation and treatment.
line 18 (d) “Referral” is referral of persons by each agenc y or facility line 19 providing assessment, evaluation, crisis intervention, or treatment line 20 services to other agencies or indi viduals. The purpose of referral line 21 shall be to pro vide for continuity of care, and may include, b ut line 22 need not be limited to, informing the person of available services, line 23 making appointments on the person’ s behalf, discussing the line 24 person’s problem with the agency or individual to which the person line 25 has been referred, appraising the outcome of referrals, and line 26 arranging for personal escort and transportation when necessary . line 27 Referral shall be considered complete when the agenc y or line 28 individual to whom the person has been referred accepts line 29 responsibility for pro viding the necessary services. All persons line 30 shall be advised of a vailable precare services that pre vent initial line 31 recourse to hospital treatment or aftercare services that support line 32 adjustment to community li ving follo wing hospital treatment. line 33 These services may be pro vided through county or city mental line 34 health departments, state hospitals under the jurisdiction of the line 35 State Department of State Hospitals, regional centers under contract line 36 with the State Department of De velopmental Services, or other line 37 public or private entities.
line 38 Each agenc y or f acility pro viding e valuation services shall line 39 maintain a current and comprehensi ve file of all community line 40 services, both public and private. These files shall contain current 97 — 6 — SB 43
line 1 agreements with agencies or indi viduals accepting referrals, as line 2 well as appraisals of the results of past referrals. line 3 (e) “Crisis intervention” consists of an intervie w or series of line 4 interviews within a brief period of time, conducted by qualified line 5 professionals, and designed to alle viate personal or f amily line 6 situations that present a serious and imminent threat to the health line 7 or stability of the person or the family. The interview or interviews line 8 may be conducted in the home of the person or f amily, or on an line 9 inpatient or outpatient basis with such therap y, or other services, line 10 as may be appropriate. The interview or interviews may include line 11 family members, significant support persons, pro viders, or other line 12 entities or indi viduals, as appropriate and as authorized by la w. line 13 Crisis intervention may, as appropriate, include suicide prevention, line 14 psychiatric, welfare, psychological, legal, or other social services. line 15 (f) “Prepetition screening” is a screening of all petitions for line 16 court-ordered evaluation as pro vided in Article 2 (commencing line 17 with Section 5200) of Chapter 2, consisting of a professional line 18 review of all petitions; an intervie w with the petitioner and, line 19 whenever possible, the person alleged, as a result of a mental health line 20 disorder, to be a danger to others, or to themself, themselves, or line 21 to be gra vely disabled, to assess the problem and e xplain the line 22 petition; when indicated, efforts to persuade the person to receive, line 23 on a voluntary basis, comprehensive evaluation, crisis intervention, line 24 referral, and other services specified in this part. line 25 (g) “Conservatorship investigation” means investigation by an line 26 agency appointed or designated by the governing body of cases in line 27 which conserv atorship is recommended pursuant to Chapter 3 line 28 (commencing with Section 5350).
line 29 (h) (1) For purposes of Article 1 (commencing with Section line 30 5150), Article 2 (commencing with Section 5200), and Article 4 line 31 (commencing with Section 5250) of Chapter 2, and for the purposes line 32 of Chapter 3 (commencing with Section 5350), “gravely disabled” line 33 means any of the following:
line 34 (A) A condition in which a person, as a result of a mental health line 35 disorder, is unable to pro vide for their basic personal needs for line 36 food, clothing, or shelter.
line 37 (B) A condition in which a person has been found mentally line 38 incompetent under Section 1370 of the Penal Code and all of the line 39 following facts exist:
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line 1 (i) The complaint, indictment, or information pending ag ainst line 2 the person at the time of commitment char ges a felony involving line 3 death, great bodily harm, or a serious threat to the ph ysical line 4 well-being of another person.
line 5 (ii) There has been a finding of probable cause on a complaint line 6 pursuant to paragraph (2) of subdivision (a) of Section 1368.1 of line 7 the Penal Code, a preliminary e xamination pursuant to Section line 8 859b of the Penal Code, or a grand jury indictment, and the line 9 complaint, indictment, or information has not been dismissed. line 10 (iii) As a result of a mental health disorder, the person is unable line 11 to understand the nature and purpose of the proceedings tak en line 12 against them and to assist counsel in the conduct of their defense line 13 in a rational manner.
line 14 (iv) The person represents a substantial danger of physical harm line 15 to others by reason of a mental disease, defect, or disorder. line 16 (C) (i) A condition that will result in in which a person, as a line 17 result of a mental health disorder or a substance use disorder, or line 18 both, is at substantial risk of serious harm to the their physical or line 19 mental health of a person due to one or more of the follo wing:
line 20 health.
line 21 (I) A mental health disorder.
line 22 (II) A substance use disorder, including alcohol use disorder. line 23 (ii) “Serious harm” means significant deterioration, debilitation, line 24 or illness due to the person’ s inability failure to do meet one or line 25 more of the following: following conditions:
line 26 (I) Satisfy the need for nourishment.
line 27 (II) Attend to necessary personal or medical care. line 28 (III) Seek Utilize adequate shelter.
line 29 (IV) Be appropriately or adequately clothed.
line 30 (V) Attend to self-protection or personal safety. line 31 (iii) A substantial risk of serious harm to the physical or mental line 32 health of the person may be e videnced by one or more of the line 33 following:
line 34 (I) The person is presently suf fering adv erse ef fects to their line 35 physical or mental health.
line 36 (II) The person pre viously suf fered adv erse ef fects to their line 37 physical or mental health in the historical course of their mental line 38 health disorder or substance use disorder and disor der, their line 39 condition is again deteriorating. deteriorating, they are unable to 97 — 8 — SB 43
line 1 understand their disorder, and their decisionmaking is impair ed line 2 due to their lack of insight into their disorder. line 3 (iv) The existence of a mental health disorder or substance use line 4 disorder diagnosis does not alone establish a substantial risk of line 5 serious harm to the physical or mental health of a person. line 6 (v) A person’s inability to appreciate the nature of their disorder line 7 and that their decisionmaking is impaired due to their lack of line 8 insight into their mental or medical disorders shall be considered line 9 by the court when evaluating a substantial risk of serious harm. line 10 (2) For purposes of Article 3 (commencing with Section 5225) line 11 and Article 4 (commencing with Section 5250), of Chapter 2, and line 12 for the purposes of Chapter 3 (commencing with Section 5350), line 13 “gravely disabled” means a person described in subparagraph (C) line 14 of paragraph (1).
line 15 (3) The term “gravely disabled” does not include persons with line 16 intellectual disabilities by reason of that disability alone. line 17 (i) “Peace officer” means a duly sw orn peace officer as that line 18 term is defined in Chapter 4.5 (commencing with Section 830) of line 19 Title 3 of Part 2 of the Penal Code who has completed the basic line 20 training course established by the Commission on Peace Officer line 21 Standards and Training, or any parole officer or probation officer line 22 specified in Section 830.5 of the Penal Code when acting in relation line 23 to cases for which the officer has a legally mandated responsibility. line 24 (j) “Postcertification treatment” means an additional period of line 25 treatment pursuant to Article 6 (commencing with Section 5300) line 26 of Chapter 2.
line 27 (k) “Court,” unless otherwise specified, means a court of record. line 28 (l) “Antipsychotic medication” means an y medication line 29 customarily prescribed for the treatment of symptoms of psychoses line 30 and other severe mental and emotional disorders. line 31 (m) “Emergency” means a situation in which action to impose line 32 treatment over the person’ s objection is immediately necessary line 33 for the preservation of life or the prevention of serious bodily harm line 34 to the patient or others, and it is impracticable to first gain consent. line 35 It is not necessary for harm to tak e place or become unavoidable line 36 prior to treatment.
line 37 (n) “Designated facility” or “facility designated by the county line 38 for evaluation and treatment” means a f acility that is licensed or line 39 certified as a mental health treatment f acility or a hospital, as line 40 defined in subdivision (a) or (b) of Section 1250 of the Health and 97 SB 43 — 9 —
line 1 Safety Code, by the State Department of Public Health, and may line 2 include, but is not limited to, a licensed psychiatric hospital, a line 3 licensed psychiatric health f acility, and a certified crisis line 4 stabilization unit.
line 5 SEC. 3. Section 5122 is added to the Welfare and Institutions line 6 Code, to read:
line 7 5122. (a) For purposes of an e xpert witness in a proceeding line 8 relating to the appointment or reappointment of a conserv ator line 9 pursuant to Chapter 3 (commencing with Section 5350) or Chapter line 10 5 (commencing with Section 5450), the statements of a health line 11 practitioner described in paragraphs (21) to (25), inclusi ve, of line 12 subdivision (a) of Section 11165.7 of the Penal Code, or a social line 13 worker licensed pursuant to Chapter 14 (commencing with Section line 14 4991) of Division 2 of the Business and Professions Code, included line 15 in the medical record are not hearsay.
line 16 (b) This section does not pre vent a party from calling as a line 17 witness the author of any statement contained in the medical record, line 18 whether or not the author was relied on by the expert witness. line 19 (c) The court may grant a reasonable continuance if an e xpert line 20 witness in a proceeding relied on the medical record and the line 21 medical record has not been provided to the parties or their counsel. line 22 SEC. 4. Section 5350 of the Welfare and Institutions Code is line 23 amended to read:
line 24 5350. A conservator of the person, of the estate, or of the person line 25 and the estate may be appointed for a person who is gra vely line 26 disabled as a result of a mental health disorder or impairment by line 27 chronic alcoholism.
line 28 The procedure for establishing, administering, and terminating line 29 a conserv atorship under this chapter shall be the same as that line 30 provided in Di vision 4 (commencing with Section 1400) of the line 31 Probate Code, except as follows:
line 32 (a) A conserv ator may be appointed for a gra vely disabled line 33 minor.
line 34 (b) (1) Appointment of a conservator under this part, including line 35 the appointment of a conserv ator for a person who is gra vely line 36 disabled, as defined in subparagraph (A) or (C) of paragraph (1) line 37 of subdivision (h) of Section 5008, shall be subject to the list of line 38 priorities in Section 1812 of the Probate Code unless the officer line 39 providing conserv atorship in vestigation recommends otherwise line 40 to the superior court.
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line 1 (2) In appointing a conservator, as defined in subparagraph (B) line 2 of paragraph (1) of subdivision (h) of Section 5008, the court shall line 3 consider the purposes of protection of the public and the treatment line 4 of the conserv atee. Notwithstanding an y other pro vision of this line 5 section, the court shall not appoint the proposed conservator if the line 6 court determines that appointment of the proposed conserv ator line 7 will not result in adequate protection of the public. line 8 (c) No conservatorship of the estate pursuant to this chapter line 9 shall be established if a conserv atorship or guardianship of the line 10 estate exists under the Probate Code. When a gra vely disabled line 11 person already has a guardian or conserv ator of the person line 12 appointed under the Probate Code, the proceedings under this line 13 chapter shall not terminate the prior proceedings b ut shall be line 14 concurrent with and superior thereto. The superior court may line 15 appoint the e xisting guardian or conserv ator of the person or line 16 another person as conservator of the person under this chapter. line 17 (d) (1) The person for whom conserv atorship is sought shall line 18 have the right to demand a court or jury trial on the issue of whether line 19 the person is gravely disabled. Demand for court or jury trial shall line 20 be made within fiv e days follo wing the hearing on the line 21 conservatorship petition. If the proposed conserv atee demands a line 22 court or jury trial before the date of the hearing as provided for in line 23 Section 5365, the demand shall constitute a waiver of the hearing. line 24 (2) Court or jury trial shall commence within 10 days of the line 25 date of the demand, e xcept that the court shall continue the trial line 26 date for a period not to exceed 15 days upon the request of counsel line 27 for the proposed conservatee. Failure to commence the trial within line 28 that period of time is grounds for dismissal of the conservatorship line 29 proceedings.
line 30 (3) This right shall also apply in subsequent proceedings to line 31 reestablish conservatorship.
line 32 (e) (1) Notwithstanding subparagraph subparagraphs (A) and line 33 (C) of paragraph (1) of subdivision (h) of Section 5008, a person line 34 is not “gravely disabled” if that person can survive safely without line 35 involuntary detention with the help of responsible family, friends, line 36 or others who are both willing and able to help pro vide for the line 37 person’s basic personal needs for food, clothing, or shelter. needs. line 38 (2) However, unless they specifically indicate in writing their line 39 willingness and ability to help, family, friends, or others shall not line 40 be considered willing or able to provide this help. 97 SB 43 — 11 —
line 1 (3) The purpose of this subdivision is to avoid the necessity for, line 2 and the harmful effects of, requiring family, friends, and others to line 3 publicly state, and requiring the court to publicly find, that no one line 4 is willing or able to assist a person with a mental health disorder line 5 in providing for the person’ s basic needs for food, clothing, or line 6 shelter.
line 7 (4) This subdivision does not apply to a person who is gravely line 8 disabled, as defined in subparagraph (B) of paragraph (1) of line 9 subdivision (h) of Section 5008.
line 10 (f) Conservatorship investigation shall be conducted pursuant line 11 to this part and shall not be subject to Section 1826 or Chapter 2 line 12 (commencing with Section 1850) of P art 3 of Di vision 4 of the line 13 Probate Code.
line 14 (g) Notice of proceedings under this chapter shall be gi ven to line 15 a guardian or conservator of the person or estate of the proposed line 16 conservatee appointed under the Probate Code.
line 17 (h) As otherwise provided in this chapter.
line 18 SEC. 5. Section 5358 of the Welfare and Institutions Code is line 19 amended to read:
line 20 5358. (a) (1) When ordered by the court after the hearing line 21 required by this section, a conservator appointed pursuant to this line 22 chapter shall place his or her conservatee as follows:
line 23 (A) For a conserv atee who is gra vely disabled, as defined in line 24 subparagraph (A) or (C) of paragraph (1) of subdi vision (h) of line 25 Section 5008, in the least restricti ve alternati ve placement, as line 26 designated by the court.
line 27 (B) For a conserv atee who is gra vely disabled, as defined in line 28 subparagraph (B) of paragraph (1) of subdi vision (h) of Section line 29 5008, in a placement that achie ves the purposes of treatment of line 30 the conservatee and protection of the public.
line 31 (2) The placement may include a medical, psychiatric, nursing, line 32 or other state-licensed facility, or a state hospital, county hospital, line 33 hospital operated by the Re gents of the University of California, line 34 a United States government hospital, or other nonmedical facility line 35 approved by the State Department of Health Care Services or an line 36 agency accredited by the State Department of Health Care Services, line 37 or in addition to an y of the fore going, in cases of chronic line 38 alcoholism, to a county alcoholic treatment center. line 39 (b) A conservator shall also ha ve the right, if specified in the line 40 court order, to require his or her conservatee to receive treatment 97 — 12 — SB 43
line 1 related specifically to remedying or pre venting the recurrence of line 2 the conservatee’s being gravely disabled, or to require his or her line 3 conservatee to recei ve routine medical treatment unrelated to line 4 remedying or preventing the recurrence of the conservatee’s being line 5 gravely disabled. Except in emer gency cases in which the line 6 conservatee faces loss of life or serious bodily injury, no surgery line 7 shall be performed upon the conservatee without the conservatee’s line 8 prior consent or a court order obtained pursuant to Section 5358.2 line 9 specifically authorizing that surgery.
line 10 (c) (1) For a conserv atee who is gra vely disabled, as defined line 11 in subparagraph (A) or (C) of paragraph (1) of subdivision (h) of line 12 Section 5008, if the conserv atee is not to be placed in his or her line 13 own home or the home of a relati ve, first priority shall be to line 14 placement in a suitable f acility as close as possible to his or her line 15 home or the home of a relati ve. For the purposes of this section, line 16 suitable facility means the least restricti ve residential placement line 17 available and necessary to achie ve the purpose of treatment. At line 18 the time that the court considers the report of the officer providing line 19 conservatorship investigation specified in Section 5356, the court line 20 shall consider available placement alternatives. After considering line 21 all the e vidence e vidence, the court shall determine the least line 22 restrictive and most appropriate alternati ve placement for the line 23 conservatee. The court shall also determine those persons to be line 24 notified of a change of placement. The fact that a person for whom line 25 conservatorship is recommended is not an inpatient shall not be line 26 construed by the court as an indication that the person does not line 27 meet the criteria of grave disability.
line 28 (2) For a conserv atee who is gra vely disabled, as defined in line 29 subparagraph (B) of paragraph (1) of subdi vision (h) of Section line 30 5008, first priority shall be placement in a f acility that achieves line 31 the purposes of treatment of the conservatee and protection of the line 32 public. The court shall determine the most appropriate placement line 33 for the conservatee. The court shall also determine those persons line 34 to be notified of a change of placement, and additionally require line 35 the conserv ator to notify the district attorne y or attorne y line 36 representing the originating county prior to an y change of line 37 placement.
line 38 (3) For any conservatee, if requested, the local mental health line 39 director shall assist the conserv ator or the court in selecting a line 40 placement facility for the conserv atee. When a conservatee who 97 SB 43 — 13 —
line 1 is recei ving services from the local mental health program is line 2 placed, the conservator shall inform the local mental health director line 3 of the facility’s location and any movement of the conservatee to line 4 another facility.
line 5 (d) (1) Except for a conserv atee who is gra vely disabled, as line 6 defined in subparagraph (B) of paragraph (1) of subdi vision (h) line 7 of Section 5008, the conservator may transfer his or her conservatee line 8 to a less restrictive alternative placement without a further hearing line 9 and court appro val. In an y case in which a conserv ator has line 10 reasonable cause to believe that his or her conservatee is in need line 11 of immediate more restrictive placement because the condition of line 12 the conserv atee has so changed that the conserv atee poses an line 13 immediate and substantial danger to himself or herself or others, line 14 the conservator shall have the right to place his or her conservatee line 15 in a more restrictive facility or hospital. Notwithstanding Section line 16 5328, if the change of placement is to a placement more restrictive line 17 than the court-determined placement, the conservator shall provide line 18 written notice of the change of placement and the reason therefor line 19 to the court, the conservatee’s attorney, the county patient’s rights line 20 advocate and any other persons designated by the court pursuant line 21 to subdivision (c).
line 22 (2) For a conserv atee who is gra vely disabled, as defined in line 23 subparagraph (B) of paragraph (1) of subdi vision (h) of Section line 24 5008, the conserv ator may not transfer his or her conserv atee line 25 without pro viding written notice of the proposed change of line 26 placement and the reason therefor to the court, the conserv atee’s line 27 attorney, the county patient’s rights advocate, the district attorney line 28 of the county that made the commitment, and an y other persons line 29 designated by the court to receive notice. If any person designated line 30 to receive notice objects to the proposed transfer within 10 days line 31 after receiving notice, the matter shall be set for a further hearing line 32 and court appro val. The notification and hearing is not required line 33 for the transfer of persons between state hospitals. line 34 (3) At a hearing where the conservator is seeking placement to line 35 a less restrictive alternative placement pursuant to paragraph (2), line 36 the placement shall not be appro ved where it is determined by a line 37 preponderance of the e vidence that the placement poses a threat line 38 to the safety of the public, the conservatee, or any other individual. line 39 (4) A hearing as to placement to a less restricti ve alternative line 40 placement, whether requested pursuant to paragraph (2) or pursuant 97 — 14 — SB 43
line 1 to Section 5358.3, shall be granted no more frequently than is line 2 provided for in Section 5358.3.
line 3 SEC. 4.
line 4 SEC. 6. If the Commission on State Mandates determines that line 5 this act contains costs mandated by the state, reimb ursement to line 6 local agencies and school districts for those costs shall be made line 7 pursuant to Part 7 (commencing with Section 17500) of Division line 8 4 of Title 2 of the Government Code.
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