CSAP’s Governmental Affairs Committee (GAC) will meet again on October 17 to refine and prioritize issues. You may view proposals that have been submitted for consideration below. If you have an idea that could be impactful and pursued in 2025, there is still time to contact Paul Yoder at SYASL.
1. CARE Court: For patients who fail CARE court treatment, there is currently no court-mandated transition to a higher level of care. Sponsor or support legislation to more clearly define and mandate the responsibility of the CARE court and the county to facilitate a transition to a higher level of care, such as LPS conservatorship, for patients who fail treatment through CARE court.
2. Conservatorship: There is currently no mandate for the acceptance of tele-testimony from patients during LPS conservatorship proceedings. This creates limitations and delays in conservatorship proceedings for patients who are psychiatrically unstable or unable to attend court in person. Proposal to sponsor or support legislation to correct that.
3. Board & care: Adult residential facilities, aka board and cares, are a significant housing resource for chronically mentally ill individuals who do not live with their families. Investment in board and care facilities could provide a highly cost-effective congregate living solution for chronically unhoused mentally ill individuals. Advocate for rules of sponsored legislation to include meaningful investment in Adult Residential Facilities (aka board and cares) in Prop 1 funding.
4. Defining mental disorder: Recent statutory language uses the term “behavioral health” instead of “mental health,” with the popular rationale that substance use disorders are not mental health disorders. However, substance use disorders are part of the Diagnostic and Statistical Manual of Mental Disorders. Similarly, cognitive disorders are defined as mental health disorders but are often excluded from LPS consideration, leading to recent case law decisions. By excluding cognitive disorders, individuals with major neurocognitive disorders who exhibit the most significant behavioral disturbances are left without disposition options. This bill clarifies the definition of mental health disorders. Supporting documents:
a. California Welfare and Institutions Code Section 5008
b. San Diego County Funded Long-Term Care Criteria
5. Necessary medical care capacity hearings: Senate Bill 43 extended grave disability criteria to include necessary medical care as a basis for involuntary detention. For patients who are held involuntarily, antipsychotic medication can be administered over objection after a Riese hearing demonstrates a person lacks the capacity to consent to antipsychotic medication. Like the Riese petition, this bill provides due process for individuals held involuntarily prior to receiving non-emergent necessary medical care over objection. This bill adds data requirements to track the number of petitions related to medical treatment of patients who are gravely disabled. This bill requires the creation of a petition pursuant to Probate 3201 that can be used for necessary medical care capacity hearings. Supporting documents:
a. Probate 3200
b. WIC 5338-5341
c. WIC 5402 changes
6. WIC 5270.12: the article that makes the 5270 an opt-in provision for each county, should be altered or deleted so that the 5270 is available throughout California. WIC 5270.15 allows for an individual to be held based on GD for an additional 30 days following a 5250 (14-day) hold for continued treatment. The law was intended “to reduce the number of gravely disabled persons for whom conservatorship petitions are filed and who are placed under the extensive powers and authority of a temporary conservator simply to obtain an additional period of treatment without the belief that a conservator is actually needed and without the intention of proceeding to trial on the conservatorship petition.”
7. Due process for patients with intellectual disability in acute crisis: Placement options are extremely limited for patients with intellectual disabilities who are in acute crisis. There are 15 beds in State-Operated Stabilization Training Assistance Reintegration (STAR) homes serving the entire state. This leaves community agencies and first responders with limited options to help this vulnerable population. Further, individuals with intellectual disabilities are excluded from grave disability consideration. When a patient with intellectual disabilities presents to an emergency department and is deemed unable to care for themselves, hospitals have no legal means to ensure the safety of this population. This statutory oversight leads to hospitals determining that the individual lacks the capacity to leave against medical advice. While this may ensure the safety of the patient, there is limited awareness of the process for judicial review under Welfare and Institutions Code 4800. This proposal addresses the care of patients presenting to health facilities in acute crisis and provides a mechanism for due process.
a. WIC 6500 et seq changes
b. 5008 Changes
8. Cannabis labeling: This proposal would require cannabis products to be labeled with accurate and consistent information in order to warn the public of the potential risks associated with its use. This would protect the public by requiring the inclusion of warning labels on all cannabis products that clearly communicate the potential risks associated with cannabis use, including the risk of developing psychiatric illnesses and a decrease in IQ.
All cannabis products sold or distributed within the jurisdiction shall prominently display the following warning label:
“WARNING: Cannabis use may be associated with an increased risk of developing psychiatric illnesses and a decrease in IQ. Consult with a healthcare professional before use, especially if you are pregnant, nursing, have a family history of psychiatric illnesses, or are under the legal age for cannabis consumption in your jurisdiction.”
9. Continue to seek improvements to processes and procedures at the Medical Board of California.