AB 1676

AB1676:v97#DOCUMENT

Bill Start

CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION

Assembly Bill

No. 1676

An act to amend Sections 5278 and 5348 of, and to add Section 5336.5 to, the Welfare and Institutions Code, relating to mental health.

LEGISLATIVE COUNSEL'S DIGEST

AB 1676, as amended, Stefani. Mental health services: assisted outpatient treatment: involuntary medication.

Existing law, known as Laura’s Law, requires a county or group of counties to provide assisted outpatient treatment as part of mental health services, unless a county or group of counties opts out by a resolution passed by the governing body, as specified. For participating counties, existing law authorizes a court to order a person who is the subject of a certain petition to obtain assisted outpatient treatment if the court finds, by clear and convincing evidence, that various conditions are met, including, among others, that the person is experiencing a mental illness and that the person has a history of lack of compliance with treatment for their mental illness, as specified. Existing law sets forth certain rights of the person relating to the hearing and imposes conditions on an extension to an initial treatment order.

This bill would authorize the county behavioral health director, or their designee, to file a petition for an order authorizing the use of involuntary psychotropic medication independent of, or concurrently with, a petition for assisted outpatient treatment. The bill would authorize a court to issue an order for the use of involuntary medication if the court finds, by clear and convincing evidence, that the facts stated in the required verified petition are true and establish that, among other things, a licensed mental health treatment provider has determined the person who is the subject of the petition has a serious mental disorder. The bill would specify rights that the person who is the subject of the petition is entitled to, including the right to demand a court or jury trial on the issue or issues of whether the person has a serious mental disorder, the person does not have the capacity to refuse treatment with psychotropic medications, or the psychotropic medications are necessary to prevent a relapse or deterioration that would be likely to result in grave disability or serious harm to the person or to others. The bill would provide the procedure for filing of the petition and setting of a trial date. The bill would prohibit any order for involuntary medication until the conclusion of the court or jury trial. The bill would authorize a licensed mental health provider who is a member of the assisted outpatient treatment services team to request that first responders take the subject of the petition into custody and transport the person, or cause the person to be transported, to a designated facility for the administration of the court-ordered medication if specified conditions are met. If the court grants the petition for involuntary psychotropic medication, the bill would require the county behavioral health director, or their designee, to file an affidavit with the court, as specified, affirming that the person who is the subject of the order continues to meet the criteria for the involuntary medication order and whether any medication changes pursuant to authorization occurred during the prior 60 days. By expanding the scope of the crime of perjury, this bill would impose a state-mandated local program.

The bill would also prohibit criminal or civil liability for an individual authorized to take custody of and transport individuals with an involuntary medication order issued pursuant to these provisions exercising this authority in accordance with the law.

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.

Digest Key

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES

Bill Text

The people of the State of California do enact as follows:

SECTION 1.

Section 5278 of the Welfare and Institutions Code is amended to read:

5278.

Individuals authorized under this part to detain a person for 72-hour treatment and evaluation pursuant to Article 1 (commencing with Section 5150) or Article 2 (commencing with Section 5200), or to certify a person for intensive treatment pursuant to Article 4 (commencing with Section 5250) or Article 4.5 (commencing with Section 5260) or Article 4.7 (commencing with Section 5270.10), or to file a petition for post-certification treatment for a person pursuant to Article 6 (commencing with Section 5300), or to take custody of and transport individuals with an involuntary medication order pursuant to Section 5336.5 shall not be held either criminally or civilly liable for exercising this authority in accordance with the law.

SEC. 2.

Section 5336.5 is added to the Welfare and Institutions Code, to read:

5336.5.

(a) A petition for an order authorizing the use of involuntary medication may be filed by the county behavioral health director, or the director’s designee, 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. An order for the use of involuntary medication pursuant to this section may be filed concurrently with a petition for assisted outpatient treatment pursuant to Section 5346 or 5346.5.

(b) The court may issue an order authorizing the use of involuntary medication for a person who is the subject of a petition filed pursuant to this section 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) (A) A court has ordered the person to participate in assisted outpatient treatment pursuant to Section 5346 or 5346.5.

(B) If the court grants a petition for assisted outpatient treatment that was concurrently filed with a petition pursuant to this section, the court shall find the petitioner has satisfied the criteria in this paragraph.

(2) A licensed mental health treatment provider has determined that the person has a serious mental disorder, disorder as defined in paragraphs (2) and (3) of subdivision (b) of Section 5600.3.

(3) A physician or nurse practitioner has determined that the psychotropic medications are necessary to prevent a relapse or deterioration that would be likely to result in grave disability or serious harm to the person or to others, as described in Section 5150, and the person does not have the capacity to refuse treatment with psychotropic medication.

(4) A physician or nurse practitioner has prescribed one or more psychotropic medications for the treatment of the person’s disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.

(5) The person has been advised of the risks and benefits of, and treatment alternatives to, the psychotropic medication, and refuses, or is unable to consent to, the administration of the medication.

(6) The use of these medications is a component of the written treatment plan required by subdivision (e) of Section 5346 and is accompanied by a medication assessment prepared by the physician or nurse practitioner.

(c) A petition filed pursuant to this section shall state all of the following:

(1) Whether this petition is filed concurrently with a petition for assisted outpatient treatment pursuant to Section 5346 or 5346.5.

(2) All of the criteria for authorizing the use of involuntary medication set forth in subdivision (b).

(3) 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 of 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 that person’s counsel.

(4) That the person who is the subject of the petition has the rights specified in subdivision (f) of this section and the rights specified in paragraph (4) of subdivision (d) of Section 5346.

(d) The petition shall be accompanied by an affidavit of the provider or providers who made the determinations required in paragraphs (2) to (4), inclusive, of subdivision (b). The affidavit shall state all of the following:

(1) They personally examined the person who is the subject of the petition no more than 10 days prior to the submission of the petition.

(2) The facts and reasons why the person who is the subject of the petition meets the criteria in subdivision (b).

(3) That they made appropriate attempts to elicit the cooperation of the person who is the subject of the petition, but have not been successful in persuading that person to voluntarily take the recommended medication.

(4) That they recommend the involuntary use of medication, and that they are willing and able to testify at the hearing on the petition.

(e) (1) If a petition under this section and a petition for assisted outpatient treatment have been filed concurrently, the court shall fix and consolidate the hearing dates for both petitions and conduct the hearing consistent with the requirements specified in paragraph (1) of subdivision (d) of Section 5346. The petitioner shall promptly cause service of the petition consistent with the requirements specified in paragraph (1) of subdivision (d) of Section 5346. If the petition under this section and a petition for assisted outpatient treatment have been filed concurrently, the court shall make a determination on the petition for assisted outpatient treatment before its determination on the petition pursuant to this section.

(2) Upon receipt by the court of a petition submitted pursuant to subdivision (c) that is not filed concurrently with a petition for assisted outpatient treatment, the court shall fix the hearing date and conduct a hearing consistent with the requirements as specified in paragraph (1) of subdivision (d) of Section 5346. The petitioner shall promptly cause service of the petition consistent with the requirements specified in paragraph (1) of subdivision (d) of Section 5346.

(f) (1) In addition to all of the rights specified in paragraph (4) of subdivision (d) of Section 5346, a person who is the subject of the petition has the right to demand a court or jury trial on the issue or issues of whether the person has a serious mental disorder, the person does not have the capacity to refuse treatment with psychotropic medications, or the psychotropic medications are necessary to prevent a relapse or deterioration that would be likely to result in grave disability or serious harm to the person or to others, as described in Section 5150.

(2) A demand for a court or jury trial shall be made within five days following the hearing on the petition. If the person demands a court or jury trial before the date of the hearing as provided for in subdivision (e), the demand shall constitute a waiver of the hearing. The court or jury trial shall commence within 10 days of the date of the demand, except that the court shall continue the trial date for a period not to exceed 15 days upon the request of counsel for person who is the subject of the petition. If the person demands a court or jury trial, any order for involuntary medication pursuant to this section shall not take effect until the conclusion of the court or jury trial. Failure to commence the trial within that period of time is grounds for dismissal of the proceedings.

(3) A person who demands a court or jury trial pursuant to this section is entitled to representation by counsel, as specified in paragraph (4) of subdivision (d) of Section 5346.

(4) The petitioner shall promptly cause service of written notice of the trial date, to be made personally on the person who is the subject of the petition and demanded the court or jury trial, and shall send a copy of the notice to the county office of patient rights, to the current health care provider appointed for the person who is the subject of the petition, if the provider is known to the petitioner, and to the petitioner’s counsel, if applicable.

(g) If, after hearing all relevant evidence, the court finds that the person who is the subject of the petition meets the criteria for involuntary medication, the court may order the person who is the subject of the petition to receive involuntary medication for the duration of the order requiring the person to obtain assisted outpatient treatment and any subsequent order issued pursuant to subdivision (g) of Section 5346. This order to receive involuntary medication shall remain in effect until one of the following occurs, whichever occurs first:

(1) An order requiring the person to obtain assisted outpatient treatment as provided in Section 5346 or 5346.5, or subdivision (g) of Section 5346, is terminated or has expired.

(2) The person is determined to have the capacity to refuse treatment with psychotropic medication. This determination shall be made by either of the following:

(A) A physician or nurse practitioner who has determined the person’s capacity has been restored or the person no longer meets the criteria for an involuntary medication order specified in subdivision (b).

(B) A court or hearing officer who has determined the person’s capacity to refuse treatment with psychotropic medication is restored.

(h) (1) A licensed mental health provider who is a member of the assisted outpatient treatment services team, as defined in paragraph (1) of subdivision (a) of Section 5348, may request that first responders, as defined in paragraphs (1) to (4), inclusive, of subdivision (a) of Section 8562, 8562 of the Government Code, take the subject of the petition into custody and transport the person, or cause the person to be transported, to a designated facility, as defined by Section 5008, for the administration of the court-ordered medication and to determine if the person is in need of involuntary care and treatment, if, in the clinical judgment of the licensed mental health provider who is a member of the assisted outpatient treatment services team, as defined in paragraph (1) of subdivision (a) of Section 5348, all of the following requirements are satisfied:

(A) The person who is the subject of the petition has failed or has refused to comply with the medication ordered by the court.

(B) Efforts were made to solicit the compliance of the person who is the subject of the petition.

(C) The person who is the subject of the petition is in need of evaluation at a designated facility, as defined by Section 5008, for the purposes of administering the court-ordered medication or determining if the person is in need of involuntary care and treatment pursuant to Section 5150. medication.

(2)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, the person shall be released.

(3)Any continued involuntary detention in a hospital beyond the initial 72-hour period shall be pursuant to Section 5250.

(4)

(2) Failure to comply with an order of involuntary medication alone may 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.

(i) If the county behavioral health director, or the director’s designee, determines that the condition of the patient requires further treatment with involuntary medication, and the county behavioral health director has also applied for an order authorizing continued assisted outpatient treatment as provided in subdivision (g) of Section 5346, the director shall apply to the court, prior to the expiration of the period of the initial involuntary medication order, for an order authorizing continued administration of involuntary medication for a period not to exceed 180 days from the date of the order. The procedures for obtaining an order pursuant to this subdivision shall be in accordance with subdivisions (b) to (g), inclusive. The period for further involuntary medication authorized by a subsequent order under this subdivision shall remain in effect until one of the following occurs, whichever occurs first:

(1) An order requiring the person to continue obtaining assisted outpatient treatment as provided in subdivision (g) of Section 5346 is terminated or has expired.

(2) The person is determined to have the capacity to refuse treatment with psychotropic medication. This determination shall be made by either of the following:

(A) A physician or nurse practitioner who has determined the person’s capacity has been restored or the person no longer meets the criteria for an involuntary medication order specified in subdivision (b).

(B) A court or hearing officer who has determined the person’s capacity to refuse treatment with psychotropic medication is restored.

(j) At intervals of not less than 60 days during an involuntary medication order and as a component of the submittal required by subdivision (h) of Section 5346, the county behavioral health director, or the director’s designee, shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for the involuntary medication order. The affidavit shall also specify whether any medication changes pursuant to authorization occurred during the prior 60 days. At these times, the person who is the subject of the order shall have the right to a hearing on whether or not the person still meets the criteria for involuntary medication if they disagree with the director’s affidavit. The burden of proof shall be on the director.

(k) During each 60-day period specified in subdivision (k), if the person who is the subject of the order believes that they are being wrongfully medicated against their wishes, the person may file a petition for a writ of habeas corpus, requiring the director to prove that the person who is the subject of the order continues to meet the criteria for involuntary medication.

(l) A person ordered to receive medication pursuant to this section who was not present at the hearing at which the order was issued may immediately petition the court for a writ of habeas corpus. Administration of involuntary medication under the order may not commence until the resolution of that petition.

(m) 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 involuntary medication, the court shall dismiss the petition.

SEC. 3.

Section 5348 of the Welfare and Institutions Code is amended to read:

5348.

(a) For purposes of subdivision (e) of Section 5346, a county or group of counties 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) 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 for those subject to court-ordered services pursuant to Section 5346.

(2) A service planning and delivery process that includes the following:

(A) Determination of the number of persons to be served and the programs and services that will be provided to meet their needs. The local director of mental health shall consult with the sheriff, the police chief, the probation officer, the mental health board, contract agencies, and family, client, ethnic, and citizen constituency groups as determined by the director.

(B) Plans for services, including outreach to families whose adult child living with them is experiencing a severe mental health condition, design of mental health services, coordination and access to medications, psychiatric and psychological services, substance use disorder services, supportive housing or other housing assistance, vocational rehabilitation, and veterans’ services. Plans shall also contain evaluation strategies that shall consider cultural, linguistic, gender, age, and special needs of minorities and those based on any characteristic listed or defined in Section 11135 of the Government Code in the target populations. Provision Provisions shall be made for staff with the cultural background and linguistic skills necessary to remove barriers to mental health services as a result of having limited-English-speaking ability and cultural differences. Recipients of outreach services may include families, the public, primary care physicians, and others who are likely to come into contact with individuals who may be experiencing an untreated severe mental illness who would be likely to become homeless if the illness continued to be untreated for a substantial period of time. Outreach to adults may include adults voluntarily or involuntarily hospitalized as a result of a severe mental illness.

(C) Provision Provisions for services to meet the needs of persons who are physically disabled.

(D) Provision Provisions for services to meet the special needs of older adults.

(E) Provision Provisions for family support and consultation services, parenting support and consultation services, and peer support or self-help group support, if appropriate.

(F) Provision Provisions for services to be client-directed and that employ psychosocial rehabilitation and recovery principles.

(G) Provision Provisions for psychiatric and psychological services that are integrated with other services and for psychiatric and psychological collaboration in overall service planning.

(H) Provision Provisions for services specifically directed to young adults 25 years of age or younger who have a serious mental health condition and who are homeless or at significant risk of becoming homeless. These provisions may include continuation of services that still would be received through other funds had eligibility not been terminated as a result of age.

(I) Services reflecting special needs of women from diverse cultural backgrounds, including supportive housing that accepts children, personal services coordinator therapeutic treatment, and substance treatment programs that address gender-specific trauma and abuse in the lives of persons with a mental illness, and vocational rehabilitation programs that offer job training programs free of gender bias and sensitive to the needs of women.

(J) Provision Provisions for housing for clients that is immediate, transitional, permanent, or all of these.

(K) Provision Provisions for clients who have been experiencing an untreated severe mental illness for less than one year, and who do not require the full range of services, but who are at risk of becoming homeless unless a comprehensive individual and family support services plan is implemented. These clients shall be served in a manner that is designed to meet their needs.

(3) Each client shall have a clearly designated mental health personal services coordinator who may be part of a multidisciplinary treatment team that is responsible for providing or ensuring needed services. Responsibilities include complete assessment of the client’s needs, development of the client’s personal services plan, linkage with all appropriate community services, monitoring of the quality and followthrough of services, and necessary advocacy to ensure each client receives those services that are agreed to in the personal services plan. Each client shall participate in the development of their personal services plan, and responsible staff shall consult with the designated conservator, if one has been appointed, and, with the consent of the client, shall consult with the family and other significant persons as appropriate.

(4) The individual personal services plan shall ensure that persons subject to assisted outpatient treatment programs receive age-appropriate, gender-appropriate, and culturally appropriate services, to the extent feasible, that are designed to enable recipients to:

(A) Live in the most independent, least restrictive housing feasible in the local community, community and, for clients with children, to live in a supportive housing environment that strives for reunification with their children or assists clients in maintaining custody of their children, as is appropriate.

(B) Engage in the highest level of work or productive activity appropriate to their abilities and experience.

(C) Create and maintain a support system consisting of friends, family, and participation in community activities.

(D) Access an appropriate level of academic education or vocational training.

(E) Obtain an adequate income.

(F) Self-manage their illnesses and exert as much control as possible over both the day-to-day and long-term decisions that affect their lives.

(G) Access necessary physical health care and maintain the best possible physical health.

(H) Reduce or eliminate serious antisocial or criminal behavior, and thereby reduce or eliminate their contact with the criminal justice system.

(I) Reduce or eliminate the distress caused by the symptoms of mental illness.

(J) Have freedom from dangerous addictive substances.

(5) The individual personal services plan shall describe the service array that meets the requirements of paragraph (4) and, to the extent applicable to the individual, the requirements of paragraph (2).

(b) A county that provides assisted outpatient treatment services pursuant to this article also shall offer the same services on a voluntary basis.

(c) Involuntary medication shall not be allowed absent a separate order by the court pursuant to Sections 5332 to 5336.5, inclusive.

(d) A county that operates an assisted outpatient treatment program pursuant to this article shall provide data to the State Department of Health Care Services and, based on the data, the department shall report to the Legislature on or before May 1 of each year in which the county provides services pursuant to this article. The report shall include, at a minimum, an evaluation of the effectiveness of the strategies employed by each program operated pursuant to this article in reducing homelessness and hospitalization of persons in the program and in reducing involvement with local law enforcement by persons in the program. The evaluation and report shall also include any other measures identified by the department regarding persons in the program and all of the following, based on information that is available:

(1) The number of persons served by the program and, of those, the number who are able to maintain housing and the number who maintain contact with the treatment system.

(2) The number of persons in the program with contacts with local law enforcement, and the extent to which local and state incarceration of persons in the program has been reduced or avoided.

(3) The number of persons in the program participating in employment services programs, including competitive employment.

(4) The days of hospitalization of persons in the program that have been reduced or avoided.

(5) Adherence to prescribed treatment by persons in the program.

(6) Other indicators of successful engagement, if any, by persons in the program.

(7) Victimization of persons in the program.

(8) Violent behavior of persons in the program.

(9) Inappropriate use of substances by persons in the program.

(10) Type, intensity, and frequency of treatment of persons in the program.

(11) Extent to which enforcement mechanisms are used by the program, when applicable.

(12) Social functioning of persons in the program.

(13) Skills in independent living of persons in the program.

(14) Satisfaction with program services both by those receiving them, and by their families, when relevant.

(e) This section shall become operative on July 1, 2021.

SEC. 4.

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.