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HomeMy WebLinkAboutMINUTES - 04181989 - 1.34 TO: [BOARD Of SUPERVISOItS Mark Finucane , Health Services Director a' FROM: By : Stuart McCullough , Mental Health Director Contra DATE; April 6, 1989 CostaCounty Designation of Facilities , Agencies and Professional er SUBJECT: Welfare and Institutions Codes Sections 5000ff .. RESOLUTION NO . 89/241 SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND Alm JUSTIFICATION RECOMMENDATION TO CHANGE SECTION III . (INDIVIDUAL DESIGNATION) BY DELETING HUBERT ZAPPAS , M. D. (KAISER FOUNDATION HOSPITAL , MARTINEZ ) AND ADDING DAVID TRACHTENBERG , M. D . (KAISER FOUNDATION HOSPITAL , MARTINEZ ) , J. ROUBINIAN , M. D . (KAISER FOUNDATION HOSPITAL , RICHMOND ) , AND BRUCE BALDWIN , M. D . (JOHN MUIR HOSPITAL , WALNUT CREEK) ; TO ADOPT NEW POLICIES AND PROCEDURES FOR AUTHORIZING INVOLUNTARY PSYCHIATRIC DETENTIONS ; AND TO DESIGNATE FACILITIES AND INDIVIDUALS FOR THE IMPLEMENTATION OF THESE POLICIES AND PROCEDURES . The Contra Costa County Board of Supervisors RESOLVES that : I . Pursuant to the Lanterman-Petris-Short Act (Division 5 , Sections 5000ff of the Welfare and Institutions Code) , this Board hereby rescinds its Resolutions Number 87/343 (June 9 , 1987 ) and Number 88/23 (January 12 , 1988 ) , and adopts the attached Policies and Procedures For Authorizing Involuntary Psychiatric Detentions (Exhibit A) which is incorporated herein by reference and which re- places the previous Policy and Procedure that was last approved by the Board on January 27 , 1987 . II . FACILITY DESIGNATIONS . Pursuant to Welfare and Institutions Code Sections 5150 , 52509 52601 5304 and 53581, the following Hospitals are designated as Designated Facilities by this Board 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 . Veterans Administration Medical Center , Martinez, California CONTINUED ON ATTACHMENT; X YES SIGNATURE: �1 RECOMMENDATION OP COUNTY ADMINISTRATOR RECOMMENDATION OP BOARD COMMITTEE APPROVE OTHER SIGNATURE(S): ACTION OF BOARD ON APH APPROVED AS RECOMMENDED X OTHER RESOLUTION NO. 89/241 VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS (ABSENT AND CORRECT COPY OF AN ACTION TAKEN AYES:_- NOES:_ AND ENTERED ON T11E MINUTES OF THE BOARD ABSENT: _ ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN, cc: llealtl► Services (Contracts) ATTESTED APR 18 1989 PHIL BATCHELOR. CLERK OF TETE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR M382/7-83 Y•---- __ ,DEPUTY r Resolution 89 / 5150 Designations Page 2 D . East Bay Hospital , 820 23rd Street , Richmond , California E . CPC Walnut Creek Hospital , 175 La Casa Via , Walnut Creek, California III . 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) for the purpose of evaluation and treatment (Section 5150 ) , the following individuals are designated as Designated 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 . Jerome V. Holland , M. D . , at the U . S . Veterans Administration Hospital (Medical Center ) , 150 Muir Road , Martinez , California ; 3 . Stephen Heisler , M. D. , at East Bay Hospital , 820 23rd Street , Richmond , California ; 4 . Jon Whalen , M. D. , at CPC Walnut Creek Hospital , 175 La Casa Via , Walnut Creek, California ; and 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 for the purpose of evaluation and treat- ment (Section 5150 ) , 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 psychatric 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; and 2400 Sycamore Drive , Antioch , California C . West County Community Mental Health Center sites at 232 Broadway, Richmond; 38th and Bissell Streets , Richmond ; 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 • ,. YJ . Resolution 89/ 5150 Designations Page 3 2 . Stuart B. Shikora , M. D. , at Mount Diablo Hospital ( for the Emergency Department ) , 2540 East Street , Concord , California 3 . Charles Pollack, M. D. , at Nierika House (Phoenix Programs , Inc . ) , 1659 Solano Way, Concord , California 4 . Douglas Bond , M.F .C . C. , at Lions Gate (Health Care Delivery Systems , Inc . ) 100 Glacier Drive , Martinez , California 5 . David Trachtenberg , M. D. , at Kaiser Foundation Hospital (for the In-Patient Psychiatry Department ) , 200 Muir Road , Martinez, California 6 . Ted Bayer , M.D . , at Kaiser Foundation Hospital ( for the Emergency Department ) , 200 Muir Road, Martinez, California 7 . Daniel R. Lewis , M. D. J. at Kaiser Foundation Hospital (for the Emergency Department ) , 1425 South Main Street , Walnut Creek, California 8 . J . Roubinian , M.D. , at Kaiser Foundation Hospital (for the Emergency Department ) , 901 Nevin Avenue Richmond , California 9 . Thomas Padgett , M. D . , at Brookside Hospital (for the Emergency Department ) 2000 Vale Road , San Pablo , California 10 . Bruce Baldwin , M. D. , at John Muir Hospital (for the Emergency Department ) , 1601 Ygnacio Valley Road , Walnut Creek; and at John Muir Emergi-Center , 680 Canyon Road , San Ramon , California IV . CONSERVATORSHIP AGENCIES , PERSONS AND INVESTIGATORS . Pursuant to Sections 5008( 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 ( Sections 5009 (g) and 5351 ) . In connection therewith , the Social Service Department may contract with other public agencies (such as the Community Services Division of the State Department of Social Services ) , in order to carry out its responsibilities under Sections 5009 (g) and 5351 . 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 ( Sections 5201 and 5202 ) . The Health Services Director is responsible for administering these functions and he shall make the designations referred to in Sections 5151 , 5208 , 5228 , and 5251 . C. The County ' s Health Services Director , Health Services Department , and Social Services Director , Social Service Department , are the agencies , officers and/.or employees which may be appointed Conservator pursuant to Section 5355 ; and Resolution 89/ l 5150 Designations Page 4 D . The County ' s Social Services Director and Social Service Department and Health Services Director and Health Services Department are the agencies , officers and/or employees which may be appointed Temporary Conservator pursuant to Section 5352 . V . CONSERVATORS . Pursuant to Section 5355 , Mark Finucane , Director , County Health Services Department , is the County Public Conservator ; and the Health Services Department and Social Service Department may designate officers and employees to serve as Deputy Conservators . VI . PROPERTY TRUST OFFICER. Mark Finuance 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 . cc : Presiding Judge , Superior Court Probate Judge District Attorney County Counsel Director of Health Services , Health Services Department William Walker , M . D. , Health Services Medical Director County Welfare Director , Social Service Department County Auditor-Controller County Administrator Health Services Department Contracts and Grants Unit Executive Director , Phoenix Programs , Inc . Executive Director , Health Care Delivery Systems , Inc . Napa State Hospital Jerome V. Holland , M.D. , Veterans Administration Hospital , Martinez Stuart B. Shikora , M. D. , Mount Diablo Hospital , Concord Charles Pollack, M.D . , Nierika House , Concord Stephen Heisler , M. D . , East Bay Hospital , Richmond Jon Whalen , M.D. , CPC Walnut Creek Hospital , Walnut Creek Douglas Bond , M. F .C .C . , Lions Gate , Martinez David Trachtenberg , M.D. , Kaiser Foundation Hospital , Martinez Ted Bayer , M. D . , Kaiser Foundation Hospital , Martinez Daniel R. Lewis , M.D . Kaiser Foundation Hospital , Walnut Creek J . Roubinian , M .D. , Kaiser Foundation Hospital , Richmond Thomas Padgett , M. D . , Brookside Hospital , San Pablo Bruce Baldwin , M.D . , John Muir Hospital , Walnut Creek E X H I B I T A 1. 034 POLICIES AND PROCEDURES FOR AUTHORIZING INVOLUNTARY PSYCHIATRIC DETENTIONS POLICIES 1. The County Mental Health Director is authorized by the Board of Supervisors, pursuant to Resolution 89/2141 to be the sole authority for the designation of: A. 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", B. Mental Health Professionals who will coordinate Designated Facilities' 5150 Programs, hereafter called "Designated Facilities' Mental Health Professionals", or "Designated Mental Health Professionals", and C. 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", 2. The County Mental Health Director, is authorized by the Board of Supervisors, pursuant to Resolution 89/ 2141 ,. to have the sole authority to revoke any designation conferred under these Policies and Procedures. 3. The County Mental Health Director shall establish and maintain a current roster of all Designated Mental Health Professionals and Designated Facilities. OPERATING PRINCIPLES 1. 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: A. Designation of an individual who may initiate 72-Hour detentions shall be based on: (1) His/her clinical training, (2) State regulations, (3) 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, (4) 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, (5) Only one individuals being designated at any given facility, and (6) The individual being recommended by the County Mental Health Director to Board of Supervisors. -1- B. The scope of authority of a Designated Mental Health Professional or a Designated Facilities' Mental Health Professional shall: (1) Be limited to 72-Hour detentions initiated within or under the auspices of the facility with which s/he is affiliated, and (2) Include the option to delegate when necessary the authority to initiate 72-Hour Psychiatric Detentions , but only as such delega- tion conforms to the terms outlined under "PROCEDURES" in this document. 2. Designated Facilities. The requirements for designation and the obligations of Designated Facilities (defined as 72-Hour involuntary treatment and eva- luation facilities pursuant to Welfare and Institutions Code Sections 5150 and 5250 et seq.) shall be as follows: A. In order to be designated, a facility shall: (1) Have been selected pursuant to the Lanterman-Petris-Short Act (Division Sections 5000ff) of the Welfare and Institutions Code, (2) Have submitted a written request for designation to the County Mental Health Director, (3) 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 (4) Have been recommended by the County Mental Health Director to the Board of Supervisors and have been approved by the Board for designation. B. A Designated Facility shall meet these requirements: (1) Maintain policies and procedures that are in compliance with all State Mental Health Laws regulating the involuntary detention of persons for purposes of evaluation and treatment of mental disor- ders, (2) 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, (3) Maintain such written County-approved policies as the County Mental Health Director may require regarding the involuntary detention, treatment and/or evaluation of individuals, (4) Ensure that all policies and procedures that are required herein are auditable for compliance by appropriate County and/or State representatives, and (5) 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. PROCEDURES 1. Designated Mental Health Professionals A. To be named as a Designated Mental Health Professional who may initiate involuntary 72-Hour Psychiatric Detentions, an individual shall have: -2- (1) Submitted a request in writing to the County Mental Health Director. The request shall include the following: (a) The name of the individual applying for designation, (b) Evidence of employment or professional staff affiliation at a Designated Facility or other facility, which may be con- sidered because of the nature of the service it provides, (c) A resume of relevant past clinical experience, (d) Evidence of current California licensure, (e) 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 (f) A completed application packet as provided by the County Mental Health Director. (2) Been recommended by the County Mental Health Director to the Board of Supervisors for such designation and been approved by the Board. B. 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. C. The County Mental Health Director shall consider an individual's fami- liarity 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. D. Those requests and credentials submitted for designation will be main- tained and available for review in the office of the County Mental Health Director. E. 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 deten- tions to others (who will hereafter be called "Delegated Mental Health Professionals"), s/he may do so pursuant to the following conditions and requirements : (1) 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 affiliated with the same facility as the Designated Facilities' Mental Health Professional, or the Designated Mental Health Professional, (2) The Designated Mental Health Professionals shall provide the County Mental Health Director with a current roster of individuals to which s/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 s/he holds at the Service Site or Designated Facility. Each deletion or addi- tion 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, -3- (3) 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, (4) The Designated Professionals shall maintain on file at their respective facilities the following records regarding each Delegated Mental Health Professional that s/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 poli- cies, procedures and regulations: (a) Evidence of the Delegated Mental Health Professional's employment or professional staff affiliation at that faci- lity, including notation of position held, (b) A statement of his/her relevant clinical experience or exper- tise, and (c) Evidence of current California licensure. (5) The authority of a Delegated Mental Health Professional shall be limited to detentions initiated within or under the auspices of the facility with which s/he is associated. F. 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. G. 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. H. Should a Designated Mental Health Professional wish to terminate his/her authority to initiate 72-Hour Psychiatric Detentions or should s/he expect to sever his/her employment or affiliation with his/her Service 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 ceases. 3. Designated Facilities A. 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: -4- (1) Name and Location of the Facility; (2) Evidence of California Licensure for Psychiatry; (3) Evidence of Approval by the California State Department of Mental Health for this supplemental/special permit service; (4) Maximum number of beds which will be used for the treatment of involuntary patients; (5) Evidence of Provision for Patients' Rights Advocacy, including arrangement for certification review hearings; (6) Name of the Designated Mental Health Professional who is, or has applied to be, designated to authorize 72-Hour Psychiatric Detentions at the facility; (7) 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 (8) Completed application packet as provided by the County Mental Health Director. B. 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. C. The requests and credentials submitted by a facility for designation as a Designated Facility shall be maintained and available for review in the Office of the County Mental Health Director. D. Should a Designated Facility wish to terminate its privileges and obli- gations 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 obliga- tions 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. -5-