(a) Under California Welfare & Institutions Code §§ 5150, et seq., if there is probable cause to believe that an individual is a danger to him or herself or to others, or is gravely disabled, due to a mental disorder, that individual may be taken into custody for 72 hours for an evaluation and possible treatment.
(b) At the end of that 72-hour period, the individual may be involuntarily detained under California Welfare & Institutions Code §§ 5250, et seq., for an additional 14 days of assessment and treatment, upon certification by two treating mental health professionals, and subject to review and challenge by the individual and the individual's patient advocate or attorney.
(c) There are situations when the additional 14 days are not sufficient to complete a thorough assessment, achieve patient stabilization, determine future treatment options, and investigate family and/or community resources that can support the individual in the community.
(d) Insufficient time for a thorough assessment, treatment, and investigation often results in more restrictive and costly institutional placements of these individuals who then become subject to the supervision of a court-ordered conservatorship, adding to the costs and number of cases handled by the San Francisco Public Conservator and the Superior Court.
(e) California Welfare and Institutions Code §§ 5270.10-5270.65 (Article 4.7 of Chapter 2 of the Lanterman-Petris-Short (LPS) Act) authorizes up to a 30-day extension of the 14-day hold, for additional treatment without the need for a court-ordered temporary conservatorship, for a maximum total of 47 days, which includes the initial 72-hour hold under § 5150. In California Welfare and Institutions Code § 5270.10, the Legislature stated its intent "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. This change will substantially reduce the number of conservatorship petitions filed and temporary conservatorships granted under this part which do not result in either a trial or a conservatorship."
(f) For California Welfare and Institutions Code §§ 5270.10-5270.65 to be operative in a county, the county must legislatively authorize its application in that county upon finding that any additional costs incurred by the county in implementation of those provisions are funded either by new funding sufficient to cover the resulting costs incurred by the county, or funds redirected from cost savings resulting from implementation, or a combination thereof so that no current services will be reduced as a result of implementation.
(g) The use of a hold under California Welfare and Institutions Code §§ 5270, et seq. (a "§ 5270 hold") better serves the needs and interests of the client, and allows these patients to avoid the stigma and restrictions of a conservatorship. Any person certified for an additional 30 days is entitled to an impartial certification review hearing, within four days of that determination, conducted by a court appointed commissioner or certification review hearing officer. The patient is also entitled to the assistance of an attorney or advocate. Unlike a conservatorship hearing, a § 5270 certification hearing is held at the treatment facility where the patient is located, and patient does not have to appear in court.
(h) During FY 2011-12, the San Francisco Public Conservator filed 394 petitions for Conservatorships with the San Francisco Superior Court. Of those cases filed, the court granted 255 Temporary Conservatorships. During FY 2012-13, 284 petitions were filed and the San Francisco Superior Court granted 190 applications for Temporary Conservatorships. Thus, far more petitions are filed and investigated than actually result in a Temporary Conservatorship. Authorizing the option of a § 5270 hold in the City and County of San Francisco would obviate the need for many of these petitions.
(i) For the majority of patients currently placed under a temporary conservatorship, the temporary conservatorship is dropped within 40 days. The use of the § 5270 hold allows a thorough investigation of these clients in order to regulate medications to achieve stabilization and to develop the skill set necessary for returning to the community.
(j) The San Francisco Public Conservator receives approximately 300-400 referrals for Temporary Conservatorships annually. In order for the court to grant a Temporary Conservatorship, the referral must be investigated, which can take between 6 to 10 hours, at a cost of $125.00 per hour, as of the effective date of this Sec. 4101. More than half of these Conservatorships are for less than 30 days. If these individuals were placed on a § 5270 hold, rather than a conservatorship, an investigation would be unnecessary, thereby saving the City and County of San Francisco $150,000 to $200,000 annually, and the individual would receive treatment under a less restrictive alternative.
(k) Any additional costs incurred by the City and County of San Francisco in the implementation of California Welfare and Institutions Code §§ 5270.10-5270.65 will be funded by the resulting cost savings or by new funding, so that no current service reductions will occur.