HomeMy WebLinkAboutMINUTES - 12151992 - 1.111 -!rq� BOARD OF SUPERVISORS
FROM: Mark Finucane, Health Services Director Contra
By: Elizabeth A. Spooner, Contracts AdministratCosta
DATE: December 3, 1992 19 County
SUBJECT: APPROVAL OF POLICIES AND PROCEDURES AND DESIGNATION OF FACILITIES,
AGENCIES AND MENTAL HEALTH PROFESSIONALS UNDER WELFARE AND
INSTITUTIONS CODE, DIVISION 5, §§5000ff (LANTERMAN-PETRIS-SHORT ACT)
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
RESOLUTION NO. 92/815
The Contra Costa County Board of Supervisors hereby RESOLVES that:
I. RECISSION OF PRIOR RESOLUTIONS PERTAINING TO THE LANTERMAN-PETRI S-SHORT
ACT. In accordance with the recommendations of the County's Mental
Health Director,. this Board hereby rescinds its Resolutions Number
89/643 (October 3, 1989) , Number 91/374 (June 4 , 1991) and Number
91/573 (August 13 , 1991) .
II. ADOPTION OF POLICIES AND PROCEDURES FOR AUTHORIZING INVOLUNTARY
PSYCHIATRIC DETENTIONS. Pursuant to the Lanterman-Petri s-Short Act
(Division 5, §§ 5000ff of the Welfare and Institutions Code) , this
Board hereby adopts the attached "Policies and Procedures For
Authorizing Involuntary Psychiatric Detentions" (Exhibit A) which is
incorporated herein by reference.
III. FACILITY DESIGNATIONS. Pursuant to the "Policies and Procedures for
Authorizing Involuntary Psychiatric Detentions" (Exhibit A) , set forth
above, and in accordance with the recommendations of the County's
Mental Health Director, the following hospitals are designated by this
Board as facilities for involuntary 72-hour psychiatric detentions and
for evaluation and involuntary intensive treatment of persons who, as
a result of a mental disorder, are a danger to self and/or others or
are gravely disabled.
A. Merrithew Memorial Hospital, 2500 Alhambra Avenue, Martinez,
California
B. Napa State Hospital, Imola, California
C. East Bay Hospital, 820 23rd Street, Richmond, California
D. CPC Walnut Creek Hospital, 175 La Casa Via, Walnut Creek,
California
E. Center for Behavioral Medicine, Mt. Diablo Medical Center, P.O.
Box 4110, Concord, California
CONTINUED ON ATTACHMENT: - YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMM A ON OF BOARD MMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON DEL; APPROVED AS RECOMMENDED OTHER
I
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
OF SUPERVISORS ON THE DATE SHOWN.
.Contact: Patricia Roach (313-6411)
CC: See Distribution (Page 4) ATTESTED DEC 15 19b2
Phil Batchelor, Clerk of the Board of
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M382/7-93 BY J : lJ ��f�2� DEPUTY
Resolution 92/815
5150 Designations
IV. INDIVIDUAL DESIGNATIONS.
A. Designated Mental Health Professionals Authorized to Coordinate
Designated Facilities$ 5150 Programs. Pursuant to the "Policies and
Procedures for Authorizing Involuntary Psychiatric Detentions" (Exhibit
A) , set forth above, and in accordance with the recommendations of the
County's Mental Health Director, for the purpose of evaluation and
treatment, the following individuals are designated as Mental Health
Professionals who, under the auspices of the following Designated
Facilities where they are employed and/or affiliated, are authorized
to coordinate the 5150 Program at the Designated Facility:
1. William Walker, M.D. , Medical Director, Contra Costa County
Health Services Department, at Merrithew Memorial Hospital,
2500 Alhambra Avenue, Martinez, California;
2 . Stephen Heisler, M.D. , at East Bay Hospital, 820 23rd
Street, Richmond, California;
3 . Lenore McKnight, M.D. , at CPC Walnut Creek Hospital, 175 La
Casa Via, Walnut Creek, California; and
4. Peter Tamulevich, M.D. , at Center for Behavioral Medicine,
Mt. Diablo Medical Center, Concord, California.
B. Designated Mental Health Professionals Authorized To Refer
Patients For 72-Hour Psychiatric Detentions. Pursuant to the "Policies
and Procedures for Authorizing Involuntary Psychiatric Detentions"
(Exhibit A) for the purpose of evaluation and treatment, and in
accordance with the recommendations of the County's Mental Health
Director, the following individuals are designated as Designated Mental
Health Professionals, under the auspices of the facilities where they
are employed and/or affiliated, to refer patients to Designated
Facilities for 72-hour psychiatric detentions:
1. William Walker, M.D. , Medical Director, Contra Costa County
Health Services Department, at the following facilities:
a. Merrithew Memorial Hospital, 2500 Alhambra Avenue,
Martinez, California
b. East County Community Mental Health Clinic sites at 550
School Street, Pittsburg, California; and 2400 Sycamore
Drive, Antioch, California
C. West County Community Mental Health Center sites at 232
Broadway, Richmond, California; 38th and Bissell
Streets, Richmond, California; and 256 24th Street,
Richmond, California
d. Central County Community Mental Health Center, 2025
Port Chicago Highway, Concord, California
e. Forensic Mental Health Clinic, 10 Douglas Drive,
Martinez, California
f. Conservatorship Unit, 624 Ferry Street, Martinez,
California
g. Older Adult Clinic sites at 3052 Willow Pass Road,
Concord, California; 3505 Lone Tree Way, Antioch,
California; and 2923 MacDonald Avenue, Richmond,
California
2 . Peter Tom, M.D. , at Mount Diablo Hospital (for the Emergency
Department) , 2540 East Street, Concord, California
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Resolution 92/815
5150 Designations
3 . Charles Pollack, M.D. , at Nierika House (Phoenix Programs,
Inc. ) , 1659 Solano Way, Concord, California
4 . David Trachtenberg, M.D. , at Kaiser Foundation Hospital (for
the In-Patient Psychiatry Department, 300 Muir Road,
Martinez, California
5. Martha Butler, M.D. , at Kaiser Foundation Hospital (for the
Emergency Department) , 200 Muir Road, Martinez, California
6. Dale Poppert, M.D. , at Kaiser Foundation Hospital (for the
Emergency Department) , 1425 South Main Street, Walnut Creek,
California
7. J. Roubinian, M.D. , at Kaiser Foundation Hospital (for the
Emergency Department) , 901 Nevin Avenue, Richmond,
California
8. Elliott Nipomnick, M.D. , at Brookside Hospital (for the
Emergency Department) , 2000 Vale Road, San Pablo, California
9. Bruce Baldwin, M.D. , at John Muir Hospital (for the
Emergency Department) , 1601 Ygnacio Valley Road, Walnut
Creek, California
10. Robert Buehl, M.D. , at San Ramon Regional Center (for the
Emergency Department) 2420 Camino Ramon, San Ramon,
California
11. James Morrison, M.D. , Department of Veterans Affairs
Northern California System of Clinics (Martinez Outpatient
Clinic) 150 Muir Road, Martinez, California
V. CONSERVATORSHIP AGENCIES, PERSONS AND INVESTIGATORS_. Pursuant to §§
5009 (g) , 5201, 5202, and 5351 of the Welfare and Institutions Code,
the following are designated as agencies for the following functions:
A. The County Social Service Department is the designated agency,
and its employees are the persons, to provide conservatorship
investigation services (§§5009 (g) and 5352) . In connection
therewith, the Social Service Department may contract with other
public agencies in order to carry out its responsibilities
hereunder.
B. The County Health Services Department is the designated agency,
and its staff are the persons, to provide pre-petition screening
and to prepare and file petitions for evaluation (§§5201 and
5202) . The Health Services Director is responsible for
administering these functions, and he shall make the designations
referred to in §§5151, 5208, 5228, and 5251.
C. The County's Health Services Director, Health Services Department
and County's Social Service Director, Social Service Department,
are the agencies, officers and/or employees which may be
appointed Conservator pursuant to §5355; and
D. The County's Social Service Director and Social Service
Department and the County' s Health Services Director and Health
Services Department are the agencies, officers and/or employees
which may be appointed Temporary Conservator pursuant to § 5352.
VI. CONSERVATORS. Pursuant to §5355, Mark Finucane, Director, County
Health Services Department, is the County Public Conservator; and the
County's Health Services Department and County' s Social Service
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Resolution 92/815
5150 Designations
Department may designate officers and employees to serve as Deputy
Conservators.
VII. PROPERTY TRUST OFFICER. Mark Finucane, Director, County Health
Services Department, is authorized to appoint a Property Trust Officer
and Deputy Conservator. The designated Trust Officer is authorized to
take all necessary actions to manage and conserve the income and assets
of persons for whom the Court has designated the Health Services
Department to act as LPS Conservator of Estate or Probate Conservator
of Estate.
VIII. EFFECTIVE DATE. The designations and statements made herein are
effective on the day following the date of action by the Board of
Supervisors.
Distribution:
Presiding Judge, Superior Court
Probate Judge
County Administrator
District Attorney
County Counsel
County Auditor-Controller
Director, Health Services Department
William Walker, M.D. , Medical Director, Health Services Department
Patricia A. Roach, M.P.H. , Mental Health Director
Joseph Hartog, M.D. , Mental Health Division Medical Director
Linda Kirkhorn, LCSW, Director Mental Health Crisis Services
Director, Social Service Department
Health Services Department Contracts and Grants Unit
Executive Director, Phoenix Programs, Inc.
Executive Director, Health Care Delivery Systems, Inc.
Napa State Hospital
James Morrison, M.D. , Department of Veterans Affairs, (Martinez Outpatient
Clinic, 150 Muir Road, Martinez, California)
Peter Tom, M.D. , Mount Diablo Hospital, Concord
Charles Pollack, M.D. , Nierika House, Concord
Stephen Heisler, M.D. , East Bay Hospital, Richmond
Lenore McKnight, M.D. , CPC Walnut Creek Hospital, Walnut Creek
David Trachtenberg, M.D. , Kaiser Foundation Hospital, Martinez
Martha Butler, M.D. , Kaiser Foundation Hospital, Martinez
Dale Poppert, M.D. , Kaiser Foundation Hospital, Walnut Creek
J. Roubinian, M.D. , Kaiser Foundation Hospital, Richmond
Elliott Nipomnick, M.D. , Brookside Hospital, San Pablo
Bruce Baldwin, M.D. , John Muir Medical Center, Walnut Creek
Robert Buehl, M.D. , San Ramon Regional Center, San Ramon
Peter Tamulevich, M.D. , Center for Behavioral Medicine,
Mt. Diablo Medical Center, Concord
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E X H I B I T A
POLICIES AND PROCEDURES FOR AUTHORIZING
INVOLUNTARY PSYCHIATRIC DETENTIONS
I. POLICIES
A. The County Mental Health Director is authorized by the Board
of Supervisors, pursuant to Resolution 92/815 (formerly:
Resolution 89/643 as amended by Resolution Numbers 91/374 and
91573) to be the sole authority for the designation of:
1. Hospitals that shall provide 72 Hour-Psychiatric
Detentions (under Welfare and Institutions Code 5150 of
patients requiring acute psychiatric inpatient care,
hereafter called "Designated Facilities" ;
2 . Mental Health Professionals who will coordinate
Designated Facilities ' 5150 Programs, hereafter called
"Designated Facilities' Mental Health Professionals", or
"Designated Mental Health Professionals" ; and
3 . Mental Health Professionals who may, under the auspices
of certain facilities with which they are associated,
refer patients for 72-Hour Psychiatric Detentions for the
purpose of evaluation and treatment of mental disorders
(under Welfare and Institutions Code 5150) , hereafter
called "Designated Mental Health Professionals" .
B. The County Mental Health Director, is authorized by the Board
of Supervisors, pursuant to Resolution 92/815, to have the
sole authority to revoke any designation conferred under these
Policies and Procedures.
C. The County Mental Health Director shall establish and maintain
a current roster of all Designated Mental Health Professionals
and Designated Facilities.
II. OPERATING PRINCIPLES
A. Designated Mental Health Professionals. The designation and
scope of authority of a Designated Facilities' Mental Health
Professional or a Designated Mental Health Professional shall
be as follows:
1. Designation of an individual who may initiate 72-Hour
detentions shall be based on:
a. His/her clinical training;
b. State regulations;
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E X H I B I T A
C. The need of the facility with which s/he is
affiliated to initiate Applications for 72-Hour
Psychiatric Detentions, as demonstrated by the
nature of the service which it provides or by its
having been designated as a Designated Facility by
the Board of Supervisors;
d. The existence at his/her Designated Facility of
County approved written procedures which describe
the process through which involuntary 72-Hour
Psychiatric detention of patients will be
authorized;
e. Only one individual being designated at any given
facility; and
f. The individual being recommended by the County
Mental Health Director to Board of Supervisors.
2. The scope of authority of a Designated Mental Health
Professional or a Designated Facilities' Mental Health
Professional shall:
a. Be limited to 72-Hour detentions initiated within
or under the auspices of the facility with which
she/he is affiliated; and
b. Include the option to delegate when necessary the
authority to initiate 72-Hour Psychiatric
Detentions, but only as such delegation conforms to
the terms outlined under "PROCEDURES" in this
document.
B. Designated Facilities. The requirements for designation and
the obligations of Designated Facilities (defined as 72-Hour
involuntary treatment and evaluation facilities pursuant to
Welfare and Institutions Code Sections 5150 and 5250 et seq. )
shall be as follows:
1. In order to be designated, a facility shall:
a,. Have been selected pursuant to the Lanterman-
Petris-Short Act (Division Sections 5000ff) of the
Welfare and Institutions Code;
b. Have submitted a written request for designation to
the County Mental Health Director;
C. Either employ or maintain a professional staff
affiliation with a Designated Facilities' Mental
Health Professional who is designated according to
these Policies and Procedures; and
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E X H I B I T A
d. Have been recommended by the County Mental Health
Director to the Board of Supervisors and have been
approved by the Board for designation.
2. A Designated Facility shall meet these requirements:
a. Maintain policies and procedures that are in
compliance with State Mental Health Laws regulating
the involuntary detention of persons for purposes
of evaluation and treatment of mental disorders;
b. Maintain policies and procedures that are in
compliance with all State laws that apply to the
rights of patients detained for the purpose of
evaluation and treatment of mental disorders;
C. Maintain such written County-approved policies as
the County Mental Health Director may require
regarding the involuntary detention, treatment
and/or evaluation of individuals;
d. Ensure that all policies and procedures that are
required herein are auditable for compliance by
appropriate County and/or State representatives;
and
e. Notify the County Mental Health Director within two
weeks of any change in the relationship between the
Designated Facility and the Designated Facilities'
Mental Health Professional employed by or
affiliated with the facility.
III. PROCEDURES
A. Designated Mental Health Professionals
1. To be named as a Designated Mental Health Professional
who may initiate involuntary 72-Hour Psychiatric
Detentions, an individual shall have:
a. Submitted a request in writing to the County Mental
Health Director. The request shall include the
following:
(1) The name of the individual applying for
designation;
(2) Evidence of employment or professional staff
affiliation at a Designated Facility of other
facility, which may be considered because of
the nature of the service it provides;
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E X H I B I T A
(3) A resume of relevant past clinical experience;
(4) Evidence of current California licensure;
(5) A letter documenting the Designated Facility's
or Service Site's support and commitment to
adhere to its obligations under these Policies
and Procedures; and
(6) A completed application packet as provided by
the County Mental Health Director.
b. Been recommended by the County Mental Health
Director to the Board of Supervisors for such
designation and been approved by the Board.
2 . Pursuant to California mental health laws, only those
Psychiatrists, Clinical Social Workers, Clinical
Psychologists, Psychiatric Nurses, Psychiatric
Technicians, and Marriage, Family and Child Counselors
licensed to practice in California shall be designated.
Physicians in specialties other than psychiatry may be
designated in the absence of appropriate mental health
staff.
3 . The County Mental Health Director shall consider an
.individual 's familiarity with Lanterman-Petris-Short
criteria and his/her clinical expertise in mental health
.diagnosis and evaluation when determining whether to
recommend an individual for designation.
4 . Those requests and credentials submitted for designation
will be maintained and available for review in the office
of the County Mental Health Director, or his/her
designee.
5. Should the Designated Facilities ' Mental . Health
Professional or the Designated Mental Health Professional
deem it appropriate and necessary to delegate his/her
authority to initiate 72-Hour psychiatric detentions to
others (who will hereafter be called "Delegated Mental
Health Professionals") , she/he may do so pursuant to the
following conditions and requirements:
a. The Designated Mental Health Professionals shall
limit delegation to specifically named individuals
with appropriate licensure as specified by
California mental health laws who are employed by
or work within the same facility as Designated
Facilities' Mental Health Professional, or the
Designated Mental Health Professional;
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E X H I B I T A
b. The Designated Mental Health Professionals shall
provide the County Mental Health Director with a
current roster of individuals to which she/he has
delegated the authority to initiate 72-Hour
psychiatric detentions. This roster shall contain
the delegate's name, signature, professional title
and the position she/he holds at the Service Site
or Designated Facility. Each deletion or addition
of a Delegated Mental Health Professional to this
roster shall be submitted to the County Mental
Health Director within two weeks of the action, and
said Director shall have the ultimate authority to
approve or disapprove of said delegation;
C. The Designated Mental Health Professionals shall be
responsible for the adherence to all pertinent
County and State regulations, policies and
procedures by those Delegated Mental Health
Professionals authorized by him/her to initiate 72-
Hour psychiatric detentions on his/her behalf;
d. The Designated Professionals shall maintain on file
at their respective facilities the following
records regarding each Delegated Mental Health
Professional that she/he has named, and these
records shall be available to the County Mental
.Health Director or his/her designee in a form
convenient to review for purposes of auditing
compliance with all County and State policies,
procedures and regulations:
(1) Evidence of the Delegated Mental Health
Professional 's employment or professional
staff affiliation at that facility, including
notation of position held;
(2) A statement of his/her relevant clinical
experience or expertise; and
(3) Evidence of current California licensure.
e. The authority of a Delegated Mental Health
Professional shall be limited to detentions
initiated within or under the auspices of the
facility with which she/he is associated.
6. Both Designated Mental Health Professionals and Delegated
Mental Health Professionals will be required to
participate in Information Sessions regarding 72-Hour
Psychiatric Detentions as deemed necessary by the County
Mental Health Director.
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E X H I B I T A
7. Designated Mental Health Professionals and Delegated
Mental Health Professionals are responsible for ensuring
that a copy of each application for 72-Hour Detention for
Evaluation and Treatment which they have initiated (under
Welfare and Institutions Code, Section 5150) shall be
sent to the Office of the County Mental Health Director
for review within 72 hours of such application.
8. Should a Designated Mental Health Professional wish to
terminate his/her authority to initiate 72-Hour
Psychiatric detentions or should she/he expect to sever
his/her employment or affiliation with his/her Service
Site/Designated Facility, the Designated Mental Health
Site/Designated Facility, the Designated Mental Health
Professional shall provide written notice of this
intention to the County Mental Health Director 30 days in
advance of the termination date. The authority bestowed
under these Policies and Procedures to those Delegated
Mental Health Professionals named by the Designated
Mental Health Professional shall end on the same day on
which the authority of the Designated Mental Health
Professional shall be on the same day on which the
authority of the Designated Mental Health Professional
ceases.
B. Designated Facilities
1. To apply .for designation as a Designated Facility for the
evaluation and treatment of individuals under involuntary
psychiatric detention (as authorized by Welfare and
Institutions Code Sections 5150 and 5250 et seq. ) , a
facility shall submit an application in writing to the
Local Mental Health Director. This request must be in
compliance with the aforementioned policies and operating
principles and include the following information.
a. Name and Location of the Facility;
b. Evidence of California Licensure for Psychiatry;
C. Evidence of Approval by the California State
Department of Mental Health for this
supplemental/special permit service;
d. Maximum number of beds' which will be used for the
treatment of involuntary patients;
e. Evidence of Provision for Patients ' Rights
Advocacy, including arrangement for certification
review and competency ("Riese") hearings;
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E X H I B I T A
f. Name of the Designated Mental Health Professional
who is, or has applied to be, designated to
authorize 72-Hour Psychiatric Detentions at the
facility;
g. Names of those physicians who are members of the
facility staff and who will provide evaluation and
treatment to those patients admitted under 72-Hour
Psychiatric Detention; and
h. Completed application packet as provided by the
County Mental Health Director.
2. To receive designation as a Designated Facility, a
facility must have submitted an application as outlined
in these Policies and Procedures, been recommended by the
County Mental Health Director to the Board of
Supervisors, and received the approval of the Board.
3 . The requests and credentials submitted by a facility for
designation as a Designated Facility shall be maintained
and available for a review in the Office of the county
Mental Health Director.
4 . Should a Designated Facility wish to terminate its
privileges and obligations bestowed under these Policies
and Procedures and to no longer function as a facility
where a Designated Mental Health Professional is
authorized to initiate 72-Hour Psychiatric Detentions or
to no longer provide evaluation and treatment for the
involuntary patient requiring acute psychiatric inpatient
care, it shall provide written notice of this intention
to the County Mental Health Director 30 days in advance
of the termination date. All of the facility's
privileges and obligations conferred under these Policies
and Procedures shall terminate . simultaneously on that
termination date. The authority to initiate 72-Hour
Psychiatric detentions of all Delegated and Designated
Mental Health Professionals employed or affiliated with
the Designated Facility shall also end on the same day on
which the designation of the Designated Facility
terminates.
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