Stanislaus County Supervisors Vote To Delay Implementing Controversial Mental Health Bill

Stanislaus County leaders are delaying implementation of a state law expanding the criteria for involuntary mental health.

People with serious mental illness can be detained for 72 hours and taken to a psychiatric facility for emergency treatment if their mental illness poses a danger to themselves or others, or if they have a serious disability.

Senate Bill 43, sponsored by Sen. Susan Eggman, D-Stockton, would add people with serious substance use disorders to the 5,150 criteria for detention starting Jan. 1. This can help spread treatment to people on the streets. become disabled due to drug addiction.

Most of California's 58 counties are expected to opt for the two-year delay allowed by law while the details of implementing the changes are worked out.

Stanislaus County leaders voted unanimously to postpone Tuesday, but Stanislaus can't wait like other counties. Tony Warta, the county's director of behavioral health and rehabilitation services, is expected to speak with officials at affected hospitals and other facilities and return Jan. 30 with a recommended implementation date for the bill.

Comptroller Terry Withrow proposed an implementation date of Dec. 1, 2024, citing the incentive value of time. "I think it's going to save lives," Wittrow said. "We need to try to launch it as soon as possible. »

The state bill aims to treat people who ended up on the streets because of drug addiction but did not previously meet the criteria for mandatory treatment.

The new law expands the definition of "severe disability" in the Lanterman-Petris Act to include a person who cannot meet basic needs for food, clothing, shelter, personal safety, or necessary medical care because of severe substance use. disorder. . . .

Senate Bill 43 adds "personal safety" and "necessary medical care" to the broader criteria. A person may meet the definition of severe disability for involuntary treatment or care if they have a serious substance use disorder, a co-occurring mental disorder, or a serious mental health disorder.

Under the new definition, a health care professional can determine that guardianship is necessary to prevent a medical problem such as diabetes from worsening and causing serious injury.

County officials explained the new law at Tuesday's Board of Supervisors meeting. A definition of serious disability would allow for involuntary institutionalization or placement on the basis of a serious substance use disorder or a co-occurring mental health disorder and serious SUD.

States may consider less restrictive alternatives, such as the Community Assistance, Recovery and Empowerment (CARE) court, to enroll individuals in a treatment plan.

The staff report says counties, police departments, courts, hospitals and mental health facilities should plan for changes in SB43. The Senate bill does not include state funding to implement it, and the district needs more time to organize its staff and resources.

The hospital association is concerned

The California Hospital Association, citing concerns, asked states to delay implementation and use the time to work with hospitals and law enforcement on policies and procedures to handle the changes. The CHA said the new law means police or authorized professionals can "inadvertently arrest large groups of people and take them to a facility for assessment and treatment."

Wharton said that if the county passes the law soon, empty beds in emergency rooms will be filled with severely disabled addicts waiting to be placed in treatment centers. "There are very few treatment facilities capable of caring for people with co-occurring complex medical needs, substance use disorders and mental health treatment," the services report said.

County officials said there are no criteria for evaluating whether a person with a serious substance use disorder is seriously disabled and that a criterion needs to be developed.

It remains to be seen when guardianship of someone being treated for a serious substance use disorder will end because there are no clinical standards for that designation, the staff report said.

As of Oct. 30, the county's BHRS served as a public guardian for 252 people in residential care, managing their housing and serving their personal needs.

The group opposes Senate Bill 43.

Disability Rights California opposes the new law, saying it will exacerbate bottlenecks in the state's weak mental health system. The group's website says: “Many of the 5,150 people admitted to hospital languish in hospital emergency rooms for days, waiting to be referred to community services or admitted to a mental health unit. »

Stanislaus was one of the first seven states to open a CARE court Oct. 1 for adults with untreated mental illness referred by families or other applicants.

County Supervisor Vito Chiesa didn't want to set an arbitrary deadline for implementing SB 43, but Wittrow suggested it was a way to bring in community partners.

Wittrow acknowledged concerns about funding for increased addiction treatment, but Proposition 1 on the March ballot, if approved, would change the way the state spends mental health revenue and allocate $6.3 billion to build inpatient and mental health facilities in California, including bonds .

Modesto, CA Commission Meeting 9/10/19 Part 3 of 3