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MEASURE :  A.B. No. 1421

CURRENT BILL STATUS
 

MEASURE :  A.B. No. 1421
AUTHOR(S) :  Thomson (Principal coauthor: Senator Perata) (Coauthors:
 Aanestad, Canciamilla, Dutra, Jackson, Koretz,
 Longville, Richman, Salinas, and Wyland).
TOPIC :  Mental health:  involuntary treatment.
HOUSE LOCATION :  SEN
+LAST AMENDED DATE  :  04/04/2002
 

TYPE OF BILL :
                Active
                Non-Urgency
                Non-Appropriations
                Majority Vote Required
                Non-State-Mandated Local Program
                Fiscal
                Non-Tax Levy

LAST HIST. ACT. DATE:  04/04/2002
LAST HIST. ACTION   :  From committee chair, with author's amendments:  Amend,
 and re-refer to committee.  Read second time, amended,
 and re-referred to Com. on  H. & H.S.
COMM. LOCATION :  SEN HEALTH AND HUMAN SERVICES
COMM. ACTION DATE   :  04/04/2002
COMM. ACTION :  Author's amendments.

TITLE :  An act to add and repeal Article 9 (commencing with
 Section 5345) of Chapter 2 of Part 1 of Division 5 of
 the Welfare and Institutions Code, relating to mental
 health.

BILL NUMBER: AB 1421 AMENDED
 BILL TEXT

 AMENDED IN SENATE  APRIL 4, 2002
 AMENDED IN ASSEMBLY  JUNE 4, 2001
 AMENDED IN ASSEMBLY  MAY 17, 2001
 AMENDED IN ASSEMBLY  APRIL 30, 2001
 AMENDED IN ASSEMBLY  APRIL 5, 2001

INTRODUCED BY   Assembly Member Thomson
   (Principal coauthor:  Senator Perata)
   (Coauthors:  Assembly Members Aanestad, Canciamilla, Dutra,
Jackson, Koretz, Longville, Richman, Salinas, and Wyland)

                        FEBRUARY 23, 2001

   An act to add and repeal Article 9 (commencing with Section 5345)
of Chapter 2 of Part 1 of Division 5 of the Welfare and Institutions
Code, relating to mental health.
 

 LEGISLATIVE COUNSEL'S DIGEST
 

   AB 1421, as amended, Thomson.  Mental health:  involuntary
treatment.
   Existing law, the Lanterman-Petris-Short Act, makes provision for
the involuntary treatment of any person with a mental disorder who,
as a result of the mental disorder, is a danger to others or to
himself or herself, or is gravely disabled.
   This  bill would make various legislative findings
regarding involuntary outpatient treatment of persons with mental
disorders.  This  bill would  also  create
an assisted outpatient treatment program for any person who is
suffering from a mental disorder and meets certain criteria  .
The program would operate in counties that choose to provide the
services  .
   The  program could operate only in counties that receive
grants pursuant to this program.  The  program would involve
the delivery of community-based care by multidisciplinary teams of
highly trained mental health professionals with staff-to-client
ratios of not more than 1 to 10  , and additional services, as
specified, for persons with the most persistent and severe mental
illness  .  This bill would specify requirements for the
petition alleging the necessity of treatment, various rights of the
person who is the subject of the petition, and hearing procedures.
This bill would also provide for settlement agreements as an
alternative to the hearing process.  This bill would provide that if
the person who is the subject of the petition fails to comply with
outpatient treatment, despite efforts to solicit compliance, a
licensed mental health provider may request that the person be placed
under a 72-hour hold based on an involuntary commitment.
This bill would provide that a violation of a court order made
pursuant to the provisions of this bill constitutes, and be
punishable as, an infraction.
   By creating an infraction and because a violation of a court order
arising from the provisions of this bill would constitute a crime,
this bill would result in a state-mandated local program.
   This bill would require the State Department of Mental Health to
award grants to counties that provide, or demonstrate they can
provide, specified mental health services to persons with the most
severe and persistent mental illness.
   This bill would also  require   encourage
 each county  selected to receive a grant
offering assisted outpatient treatment services  to provide
certain data to the  department   State
Department of Mental Health  .
   This bill would provide that the grant program created by this
bill shall be implemented contingent upon an appropriation in the
Budget Act or other statute.
  The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.
   Vote:  majority.  Appropriation:  no.  Fiscal committee:  yes.
State-mandated local program:   yes   no  .
 

THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
 

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) On February 15, 2001, the Rand Corporation released a report,
commissioned by the California Senate Committee on Rules,
entitled   titled  "The Effectiveness of
Involuntary Outpatient Treatment:  Empirical Evidence and the
Experience of Eight States," which is an evidence-based approach to
examining and synthesizing empirical research on involuntary
outpatient treatment.
   (b) Rand's findings include the following:
   (1) Data from the State Department of Mental Health's Client Data
System, documenting about one-half of all commitments in California,
indicate that 58,439 individuals accounted for 106,314 admissions
under 72-hour holds, and, of those:
   (A) Thirty-three and two-tenths percent, or 17,062, had at least
one prior episode of involuntary commitment in the previous 12
months.
   (B) Thirty-four and three-tenths percent, or 17,627, lived with a
family member prior to the hold.
   (C) Thirty-four and three-tenths percent, or 17,627, had a
diagnosis of schizophrenia or other psychosis.
   (D) Thirty-seven and two-tenths percent, or 19,118, had no record
of outpatient service use in the previous 12 months.
   (2) Some high-risk patients do not respond well to traditional
community-based mental health services.  For various reasons, even
when treatment is made available, high-risk patients do not avail
themselves of these services.
   (3) In general, these ambulatory care data from the department's
client data system do not support the assumption that individuals
were entering the involuntary treatment system because they were not
able to access outpatient services.
   (4) The best evidence from randomized clinical trials supports the
use of assertive community treatment (ACT) programs, which involve
the delivery of community-based care by multidisciplinary teams of
highly trained mental health professionals with high staff-to-client
ratios.  The evidence also suggests that fidelity to the ACT model
ensures better client outcomes.
   (5) A study by Duke University investigators, using randomized
clinical trials, suggests that people with psychotic disorders and
those at highest risk for poor outcomes benefit from intensive mental
health services provided in concert with a sustained outpatient
commitment order.
   (6) The effect of sustained outpatient commitment, according to
the Duke study, was particularly strong for people with schizophrenia
and other psychotic disorders.  When patients with these disorders
were on outpatient commitment for an extended period of 180 days or
more, and also received intensive mental health services, they had 72
percent fewer readmissions to the hospital and 28 fewer hospital
days than the nonoutpatient commitment group.
  SEC. 2.  Article 9 (commencing with Section 5345) is added to
Chapter 2 of Part 1 of Division 5 of the Welfare and Institutions
Code, to read:

      Article 9.  The Assisted Outpatient Treatment Demonstration
Project Act of 2001

   5345.  (a) This article shall be known, and may be cited, as Laura'
s Law.
   (b) "Assisted outpatient treatment" shall be defined as categories
of outpatient services that have been ordered by a court pursuant to
Section 5346 or 5347.
   5346.  (a) In any county in which services are available as
provided in Section 5348, a court may order a person who is the
subject of a petition filed pursuant to this section to obtain
assisted outpatient treatment if the court finds, by clear and
convincing evidence, that the facts stated in the verified petition
filed in accordance with this section are true and establish that all
of the requisite criteria set forth in this section are met,
including, but not limited to, each of the following:
   (1) The person is 18 years of age or older.
   (2) The person is likely to survive safely in the community with
supervision.
   (3) The person is suffering from any of the following:
   (A) A mental disorder and, as a result, is a danger to others, or
to himself or herself, or is gravely disabled as defined in Section
5150.
   (B) A psychotic disorder and meets all of the following criteria:

   (i) The person has received treatment for a mental disorder within
the past five years.
   (ii) The person responded to treatment and the person's condition
improved.
   (iii) The person subsequently failed to engage in treatment, was
offered an opportunity to participate in a treatment plan that
includes all of the services described in Section 5348, and continues
to fail to engage in treatment.
   (iv) The person's condition is substantially deteriorating.
   (v) Assisted outpatient treatment would be the least restrictive
placement necessary to ensure the person's recovery and stability.
   (C) Any other severe mental illness, as defined in Section 5600.3,
and the person meets all of the following criteria:
   (i) The severe mental illness puts him or her at high risk for a
poor outcome, as indicated by a history of failure to engage in a
plan of treatment for mental illness that has been a significant
factor resulting in, at least twice within the previous 36 months,
not including any period during which the person was hospitalized or
incarcerated immediately preceding the filing of the petition,
hospitalization or receipt of services in a forensic or other mental
health unit of a correctional facility or a local correctional
facility.
   (ii) The person has been offered an opportunity to participate in
a treatment plan that includes all of the services described in
Section 5348, and continues to fail to engage in treatment.
   (iii) The person's condition is substantially deteriorating.
   (iv) Assisted outpatient treatment would be the least restrictive
placement necessary to ensure the person's recovery and stability.
   (b) (1) A petition for an order authorizing assisted outpatient
treatment may be filed in the superior court in the county in which
the person who is the subject of the petition is present or
reasonably believed to be present.
   (2) A petition to obtain an order authorizing assisted outpatient
treatment may be initiated only by any of the following persons:
   (A) Any person 18 years of age or older with whom the person who
is the subject of the petition resides.
   (B) Any person who is the parent, spouse, or sibling or child 18
years of age or older of the person who is the subject of the
petition.
   (C) The director of any public or private agency, treatment
facility, charitable organization, or licensed residential care
facility providing mental health services to the person who is the
subject of the petition in whose institution the subject of the
petition resides.
   (D) The director of a hospital in which the person who is the
subject of the petition is hospitalized.
   (E) A licensed mental health provider who is either supervising
the treatment of, or treating for a mental illness, the person who is
the subject of the petition.
   (F) A peace officer, parole officer, or probation officer assigned
to supervise the person who is the subject of the petition.
   (3) The petition shall state all of the following:
   (A) Each of the criteria for assisted outpatient treatment as set
forth in subdivision (a).
   (B) Facts that support the petitioner's belief that the person who
is the subject of the petition meets each criterion, provided that
the hearing on the petition shall be limited to the stated facts in
the verified petition, and the petition contains all the grounds on
which the petition is based, in order to ensure adequate notice to
the person who is the subject of the petition and his or her counsel.

   (C) That the person who is the subject of the petition is present,
or is reasonably believed to be present, within the county where the
petition is filed.
   (D) That the person who is the subject of the petition has the
right to be represented by counsel in all stages of the proceeding
under the petition, in accordance with subdivision (c).
   (4) The petition shall be accompanied by an affirmation or
affidavit of a licensed mental health provider who shall not be the
petitioner, and who shall state, if applicable, either of the
following:
   (A) That the licensed mental health provider has personally
examined the person who is the subject of the petition no more than
10 days prior to the submission of the petition, that the licensed
mental health provider recommends assisted outpatient treatment for
the person who is the subject of the petition, and that the licensed
mental health provider is willing and able to testify at the hearing
on the petition.
   (B) That no more than 10 days prior to the filing of the petition,
the licensed mental health provider, or his or her designee, has
made appropriate attempts to elicit the cooperation of the person who
is the subject of the petition, but has not been successful in
persuading that person to submit to an examination, that the licensed
mental health provider has reason to believe that the person who is
the subject of the petition meets the criteria for assisted
outpatient treatment, and that the licensed mental health provider is
willing and able to examine the person who is the subject of the
petition and testify at the hearing on the petition.
   (5) The petitioner shall cause written notice of the petition to
be given to the person who is the subject of the petition, and a copy
thereof shall be given personally or by mail to the county office of
patient rights, the current health care provider appointed by the
person who is the subject of the petition if any such provider is
known to him or her, the appropriate outpatient program coordinator,
and the director of the county mental health department if the
director is not the petitioner.
   (c) The person who is the subject of the petition shall have the
right to be represented by counsel at all stages of a proceeding
commenced under this section.  If the person so elects, the court
shall immediately appoint the public defender or other attorney to
assist the person in all stages of the proceedings.  The person shall
pay the cost of the legal services if he or she is able.
   (d) (1) Upon receipt by the court of a petition submitted pursuant
to subdivision (b), the court shall fix the date for a hearing at a
time not later than three days from the date the petition is received
by the court, excluding Saturdays, Sundays, and holidays.
Continuances shall be permitted only for good cause shown.  In
granting continuances, the court shall consider the need for further
examination by a physician or the potential need to provide
expeditiously assisted outpatient treatment.  The court shall cause
the person who is the subject of the petition, any other person
receiving notice pursuant to paragraph (5) of subdivision (b), the
petitioner, the licensed mental health provider whose affirmation or
affidavit accompanied the petition, the appropriate director, and any
other person the court may determine is required to be advised of
the date.  Upon the hearing date, or upon any other date or dates to
which the proceeding may be continued, the court shall hear
testimony.  If it is deemed advisable by the court, and if the person
who is the subject of the petition is available and has received
notice pursuant to this section, the court may examine in or out of
court the person who is the subject of the petition who is alleged to
be in need of assisted outpatient treatment.  If the person who is
the subject of the petition does not appear at the hearing, and
appropriate attempts to elicit the attendance of the person have
failed, the court may conduct the hearing in the person's absence.
If the hearing is conducted without the person present, the court
shall set forth the factual basis for conducting the hearing without
the person's presence.
   (2) The court shall not order assisted outpatient treatment unless
an examining licensed mental health provider, who has personally
examined, and has reviewed the available treatment history of, the
person who is the subject of the petition within the time period
commencing 10 days before the filing of the petition, testifies in
person at the hearing.
   (3) If the person who is the subject of the petition has refused
to be examined by a licensed mental health provider, the court may
request that the person consent to an examination by a licensed
mental health provider appointed by the court.  If the person who is
the subject of the petition does not consent and the court finds
reasonable cause to believe that the allegations in the petition are
true, the court may order those persons designated under Section 5150
to take into custody the person who is the subject of the petition
and transport him or her, or cause him or her to be transported, to a
hospital for examination by a licensed mental health provider.
Detention of the person who is the subject of the petition under the
order shall not exceed 72 hours.  If the examination is performed by
another licensed mental health provider, the examining licensed
mental health provider shall be authorized to consult with the
licensed mental health provider whose affirmation or affidavit
accompanied the petition regarding the issues of whether the
allegations in the petition are true and whether the person meets the
criteria for assisted outpatient treatment.
   (4) The person who is the subject of the petition shall have all
of the following rights:
   (A) To adequate notice of the hearings to the person who is the
subject of the petition, as well as to parties designated by the
person who is the subject of the petition.
   (B) To receive a copy of the court ordered evaluation.
   (C) To counsel.
   (D) To be informed of his or her right to judicial review by
habeas corpus.
   (E) To be present at the hearing unless he or she waives the right
to be present.
   (F) To present evidence.
   (G) To call witnesses on his or her behalf.
   (H) To cross-examine witnesses.
   (I) To appeal decisions, and to be informed of his or her right to
appeal.
   (5) (A) If after hearing all relevant evidence, the court finds
that the person who is the subject of the petition does not meet the
criteria for assisted outpatient treatment, the court shall dismiss
the petition.
   (B) If after hearing all relevant evidence, the court finds that
the person who is the subject of the petition meets the criteria for
assisted outpatient treatment, and there is no appropriate and
feasible less restrictive alternative, the hearing officer may order
the person who is the subject of the petition to receive assisted
outpatient treatment for an initial period not to exceed six months.
In fashioning the order, the court shall specify that the proposed
treatment is the least restrictive treatment appropriate and feasible
for the person who is the subject of the petition.  The order shall
state the categories of assisted outpatient treatment, as set forth
in Section 5348,  which   that  the person
who is the subject of the petition is to receive, and the hearing
officer may not order treatment that has not been recommended by the
examining licensed mental health provider and included in the written
treatment plan for assisted outpatient treatment as required by
subdivision (e).
   (6) The examining mental health treatment provider shall set out
in an affirmation or affidavit the facts and reasons why the person
who is the subject of the petition meets the criteria in paragraphs
(1) and (2) and subparagraph (A), (B), or (C) of paragraph (3) of
subdivision (a).
   (e) Assisted outpatient treatment shall not be ordered unless the
licensed mental health treatment provider recommending assisted
outpatient treatment to the court has submitted to the court a
written treatment plan that includes services as set forth in Section
5348, and the court finds that the services are available from the
county, or a provider approved by the county, for the duration of the
court order.  The treatment plan shall be delivered to the county
director of mental health or his or her appropriate designee.
   (f) If, in the clinical judgment of a licensed mental health
provider, the person who is the subject of the petition has failed or
has refused to comply with the treatment ordered by the court, and
 ,  in the clinical judgment of the licensed mental health
provider  , efforts were made to solicit compliance, and, in
the clinical judgment of the licensed mental health provider, the
person may be in need of involuntary admission to a hospital pursuant
to  Section 5346   this section  , the
provider may request that persons designated under Section 5150 take
into custody the person who is the subject of the petition and
transport him or her, or cause him or her to be transported, to a
hospital, to be held up to 72 hours for examination by a licensed
mental health provider to determine if the person is in need of
treatment pursuant to Section 5150.  Any continued involuntary
retention in a hospital beyond the initial 72-hour period shall be
pursuant to Section 5150. If at any time during the 72-hour period
the person is determined not to meet the criteria of Section 5150,
and does not agree to stay in the hospital as a voluntary patient, he
or she shall be released.  Failure to comply with an order of
assisted outpatient treatment alone shall not be grounds for
involuntary civil commitment or a finding that the person who is the
subject of the petition is in contempt of court.
   (g) If the director of the assisted outpatient treatment program
determines that the condition of the patient requires further
assisted outpatient treatment, the director shall apply to the court,
prior to the expiration of the period of the initial assisted
outpatient treatment order, for an order authorizing continued
assisted outpatient treatment for a period not to exceed 180 days
from the date of the order.  The procedures for obtaining any order
pursuant to this subdivision shall be in accordance with subdivisions
(a) to (f), inclusive, of this section.  The period for further
involuntary outpatient treatment authorized by any subsequent order
under this subdivision shall not exceed 180 days from the date of the
order.
   5347.  (a) In any county in which services are available pursuant
to  a grant awarded as provided in Section 5349,
Section 5348,  any person who is determined by the court to
be subject to subdivision (a) of Section 5346, or subject to
detention pursuant to Section 5150, 5250, 5260, or 5270.15, may
voluntarily enter into an agreement for services under this section.

   (b) (1) The person who is the subject of the petition, or the
person's legal counsel with the person's consent, may waive the right
to an assisted outpatient treatment hearing or probable cause
hearing pursuant to Section 5150, 5250, 5260, or 5270.15 for the
purpose of obtaining treatment under a voluntary settlement
agreement, provided that an examining licensed mental health
treatment provider states that the person can survive safely in the
community.  The voluntary settlement agreement shall not exceed 180
days in duration and shall be agreed to by all parties.
   (2) The voluntary settlement agreement shall be in writing, shall
be approved by the court, and shall include a treatment plan
developed by the community-based program that will provide services
that provide treatment in the least restrictive manner consistent
with the needs of the person who is the subject of the petition.
   (3) Either party may request that the court modify the treatment
plan at any time during the 180-day period.
   (4) The court shall designate the appropriate county department to
monitor the person's treatment under, and compliance with, the
settlement agreement.  If the person fails to comply with the
treatment according to the agreement, the designated county
department shall notify the counsel designated by the county and the
person's counsel of the individual's noncompliance.
   (5) If, within 180 days from the date of the waiver of the right
to a hearing, the person who is the subject of the petition fails to
comply with the settlement agreement approved by the court, the
county-designated counsel may file with the court a statement of
facts.  The statement of facts shall support the stated belief that
the person who is the subject of the petition is not in compliance.
The statement shall be sworn to be true and may be based on the
information and belief of the person filing the statement.  Upon
receipt of the statement of noncompliance, the court may issue an
order to detain the person who is the subject of the petition for a
probable cause hearing.  The hearing shall take place within 72 hours
from the time of detention, excluding Saturdays, Sundays, and legal
holidays.
   (6) If a probable cause hearing was held prior to the approval of
the settlement agreement, the court shall hold a final hearing within
14 days from the time of detention.
   (7) The facts alleged as the basis for commitment prior to the
waiver of the time periods for hearings shall be the basis for a
finding of probable cause or a final disposition at a hearing under
this subdivision.
   (8) Upon the motion of the person who is the subject of the
petition, the court shall hold a hearing on the issue of
noncompliance with the settlement agreement within 72 hours from the
time the motion for a hearing under this subdivision is filed with
the court, excluding Saturdays, Sundays, and legal holidays.
   (9) The hearing under this subdivision may be held as part of the
probable cause hearing if the probable cause hearing is held within
72 hours from the time the motion is filed with the court, excluding
Saturdays, Sundays, and legal holidays.
   (10) At a hearing on the issue of noncompliance with the
agreement, the written statement of noncompliance submitted shall be
prima facie evidence that a violation of the conditions of the
agreement has occurred.  If the person who is the subject of the
petition denies any of the facts as stated in the statement, he or
she has the burden of proving by a preponderance of the evidence that
the alleged facts are false.
   (11) Upon a finding of noncompliance, the court may initiate a
probable cause hearing.
   5347.5.  Notwithstanding Section 166 of the Penal Code, a
violation of a court order pursuant to Section 5346 or Section 5347
shall constitute and be punishable as an infraction.
   5348.  (a)  The department shall provide oversight of
grants issued pursuant to this article to ensure that the services
prescribed by this subdivision are offered.  The services include,
but are not limited to:   For purposes of subdivision
(e) of Section 5346, any county that chooses to provide assisted
outpatient treatment services pursuant to this article shall offer
assisted outpatient treatment services including, but not limited to,
all of the following:
   (1) Multidisciplinary  provider  teams.
   (2) Medication.
   (3) Individual or group therapy.
   (4) Day or partial-day programming activities.
   (5) Education and vocational training or activities.
   (6) Alcohol or substance abuse treatment and counseling.
   (7) Supervision of living arrangements.
   (8) Any other services available through the local mental health
delivery system to assist the person to gain optimal living and
functioning in the community, or to attempt to prevent a relapse or
deterioration that may reasonably be predicted to result in the need
for hospitalization or in arrest or incarceration.
   (9) Services including, but not limited to, all of the following,
that are individually tailored to the client's needs and in the
location in which the client needs them for any client with a
persistent and severe mental illness:
   (A) Community-based, mobile, multidisciplinary, highly trained
mental health teams that use high staff-to-client ratios of no more
than 10 clients per team member.
   (B) Clinical intervention that includes active participation of
the consumer, the appropriate family member or members, and peer
counselors.
   (C) A multidisciplinary team approach in which each team member is
an active member of the team.
   (D) Multidisciplinary team services that are available to the
client at all times.
   (b) Involuntary medication shall not be allowed absent a separate
order by the court pursuant to Sections 5332 to 5336, inclusive.
   (c) Each county  shall ensure that funds provided by these
grants are used to provide new services in accordance with the
purpose for which they were appropriated, and that these funds shall
be used to augment and not supplant existing services to adults with
severe mental illness.
   (d) Each county selected to receive a grant pursuant to this
section shall provide data to the department on, but not limited to,
  offering services pursuant to this article is
encouraged to provide data to the department on, but not limited to,
all of  the following outcomes and any changes over time for
enrolled participants in order to assess the extent of improvement to
their quality of life:
   (1) Stable housing.
   (2) Gainful activity.
   (3) Contacts maintained with treatment system.
   (4) Adherence to prescribed treatment.
   (5) Other indicators of successful engagement, if any.
   (6) The number of hospitalizations and duration of hospital stays.

   (7) The number of incarcerations and duration of incarcerations.
   (8) Other relapse indicators, if any.
   (9) Victimization.
   (10) Violent behavior.
   (11) Substance abuse.
   (12) Type, intensity, and frequency of treatment.
   (13) Extent to which enforcement mechanisms are used when
applicable.
   (14) Social functioning.
   (15) Skills in independent living.
   (16) Satisfaction with services both by those receiving them and
by families when relevant.
   5349.  The department shall award grants to those counties that
provide, or demonstrate that they can provide, all of the following
services for persons with the most persistent and severe mental
illness:
   (a) Community-based, mobile, multidisciplinary, highly trained
mental health provider teams that uses high staff-to-client ratios.
   (b) A clinical intervention that actively includes participation
of the consumer, the appropriate family members, and peer counselors.

                                               (c) Services in the
location in which the person needs them.
   (d) A multidisciplinary team approach in which all team members
are active members of the team.
   (e) Team services that are available to the client at all times.
   (f) Teams that operate on a ratio of no more than 10 clients per
team member.
   (g) Individually tailored services.
   (h) Performance measurement to document an improvement in
obtaining employment or other gainful activity, and obtaining skills
of independent living, reducing hospitalization and incarceration or
arrest rates, and other improvements, as applicable.
   5349.5.  This article shall remain in effect only until January 1,
2006, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2006, deletes or extends
that date.
   5349.6.  Implementation of Sections 5348 and 5349 shall be
contingent on an appropriation in the Budget Act or another statute.

  SEC. 3.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.