The LB Report is back with a thorough review of SB 640, my effort to address our mentally ill homeless population by expanding the definition of “gravely disabled” (see MOORLACH UPDATE — Senate Bills 511, 584, 598, 496 and 640 — April 15, 2019).
The LB Report has covered this topic before and I appreciate that a news outlet is knowledgeable about what I am trying to accomplish (see MOORLACH UPDATE — Invitations and Group 9 — October 8, 2019).
If you would like to become an expert on the Lanterman-Petris-Short Act and its shortcomings, this will be a good read for you. My office will be issuing a white paper on the LPS Act soon. And, we will have a good sprint in January to get SB 640 to the Senate Floor, also explained in the piece below.
Cities 193 to 240
The fifth group finds us halfway through California’s 482 cities and we see that the zero threshold has been crossed. It includes two from Orange County, Yorba Linda (#193) and San Juan Capistrano (#239). Yorba Linda dropped 64 places. Its Other Post-Employment Benefits (OPEBs) went up $19.7 million, which explains two-thirds of the drop in its Unrestricted Net Assets of $27.9 million.
The cities of Sonoma, McFarland, Artesia and Adelanto have not completed and posted their June 30, 2018 Comprehensive Annual Financial Reports. Their Unrestricted Net Positions were estimated based on the prior year’s trends.
|Rank||City||Pop.||UNP 2018 (Thou-sands)||UNP/ Capita||2017 Rank||Rank Change|
|237||South El Monte||20,882||($3,319)||($159)||215||-22|
|239||San Juan Capistrano||36,759||($6,050)||($165)||223||-16|
25th Anniversary Look Back
The Moorlach Memo continues with Chapter 5. In this segment, I wrote something that was impossible to say after December 6, 1994, “I told you so.”
For more on the Piper Jaffray incident, see MOORLACH UPDATE — OC Register Coverage Look Back — September 16, 2019). For Cuyahoga County, Ohio, see MOORLACH UPDATE — SB 359 and Cuyahoga County — October 11, 2019.
For the first five segments, see:
Intro — Context — MOORLACH UPDATE — Constitutionally Flawed Legislation — November 5, 2019.
Chapter 1 — Introduction — MOORLACH UPDATE — Business, Electricity and Top 48 Cities — November 7, 2019
Chapter 2 — Hold to Maturity — MOORLACH UPDATE — 3P, Cities 49 to 96 and Holding to Maturity — November 12, 2019
Chapter 3 — We Do Not Mark To Market — MOORLACH UPDATE — Measuring Insincerity and Cities 97 to 144 — November 13, 2019
Chapter 4 — Prognosis — MOORLACH UPDATE — Officers, Audits, CIRM and Cities 145 to 192 — November 14, 2019
CURRENT MEDIA REVELATIONS
We’ve recently seen the articles detailing how the value of the investments managed by one regional investment firm, Piper Jaffray, plunged.
Piper Jaffray’s investment manager, Worth Bruntjen, invested over half of the portfolio in inverse floater derivatives. An investment our County is using! A strategy that, I believe, the unsophisticated Finance Directors of most of our cities and municipalities don’t understand nor have a clue as to the risks that they are taking.
Piper Jaffray’s portfolio of about $3.5 billion has lost over $700 million in value for its investors. Citron’s portfolio holds roughly $3.5 billion of inverse floaters, or one-sixth of the entire holdings, that are down in value by some $1.4 billion!
My campaign claim that Citron lost some $1.2 billion in value was a mild understatement. Those in the financial industry agreed with my claims. Those in the government bureaucracy system had conniption fits over my criticisms. But, as Piper Jaffray investors are discovering, higher returns really do equal higher risks.
Others are finding out the true risks, too, as the casualty list grows longer each passing day. The front page of the Sunday September 25, issue of “The New York Times” had this headline: “Local Governments Lose Millions In Complex and Risky Securities.” And now we have “Cuyahoga County Reels From Blow to Fund That Made Big Bet on Falling Interest Rates,” in the October 13th issue of “The Wall Street Journal,” thanks to the use of reverse repurchase agreements. To quote a fellow conservative: “I told you so.”
Annual Open House — Moved to Second Harvest Food Bank
Special Report w/ Detailed Coverage
Audio / Video / Perspective
State Senator John Moorlach Says He’d Welcome Long Beach Support For SB 640 That Would Add Language To Current CA Law Allowing Intervention To Help Severely Mentally Hill Homeless Persons Too Ill To Help Themselves
The fatal 2011 beating by Fullerton police officers of Kelly Thomas, a schizophrenic homeless man, awakened then-Orange County Supervisor John Moorlach to issues involving governmental interactions with severely mentally ill persons. Eight years later, despite major taxpayer expenditures and escalating governmental interactions, California cities including Long Beach continue to allow seriously mentally ill homeless persons to wander the streets, inhumanely depersonalized while creating serious health and safety issues for themselves and others.
The incompassionate and ineffective status quo has led now-state-Senator Moorlach to introduce SB 640, a bill that would add language to a current state law to enable intervention that could help severely mentally ill homeless individuals. These are persons with mental illness so severe (including schizophrenia) that the person doesn’t realize he/she is ill and needs help for their safety and sometimes for the safety of others.
SB 640 would amend the “Lanterman-Petris-Short Act” – a state law that currently permits the involuntarily treatment of individuals who are “gravely disabled” — to also include [legislative counsel’s digest] “a condition in which a person, as a result of a mental health disorder, is incapable of making informed decisions about, or providing for, the person’s own basic personal needs for food, clothing, shelter, or medical care or shelter without significant supervision and assistance from another person and, as a result of being incapable of making these informed decisions, the person is at risk of substantial bodily harm, dangerous worsening of a concomitant serious physical illness, significant psychiatric deterioration, or mismanagement of the person’s essential needs that could result in bodily harm.”
SB 640 gained early support from the CA District Attorneys Association, the CA Police Chiefs Association, the City of Santa Monica, and NAMI Sacramento but drew opposition from the American Civil Liberties Union, CA Hospital Association (unless amended), Disability Rights California, Mental Health America of Northern CA, SEIU California and the Western Center on Law and Poverty.
At an April 8, 2019 hearing in the state Senate Health Committee (video below), Sen. Moorlach explained his basis for reforming current state law. He brought witnesses who offered compelling testimony in support of SB 640 and pleaded with Committee members to move the bill forward. The Committee chair, state Senator Richard Pan (D, Sacramento) and others among the Committee’s Democrat majority politely thanked Sen. Moorlach and his witnesses but indicated they’d vote “no” on his bill, an action that would prevent SB 640 from advancing further.
Stymied for the moment, Sen. Moorlach offered to make SB 640 a “two year bill,” a way to amend the bill to address stated objections.
To see/hear what took place in the state Senate Health Committee hearing on SB 640, click the VIDEO below:
The Committee ultimately withheld a vote on SB 640. The bill remains in the state Senate Health Committee.
In June 2019, former LB Councilwoman Lena Gonzalez was elected to the state Senate. She is now a member of the state Senate Health Committee. LBREPORT.com reported on SB 640 in August 2019..
SB 640 faces legislative deadlines in late January 2020. By Jan. 24, 2020, the state Senate Health Committee must hear and report the bill to the state Senate floor and by Jan. 31, SB 640 must pass the full state Senate. If that doesn’t happen, SB 640 will die.
In a November 15, 2019 telephone conversation invited by LBREPORT.com, we asked Senator Moorlach if Long Beach Mayor Robert Garcia (who doesn’t set city policy) or any LB Councilmember(s) (who do set policy) or LB city staff (engaged in homeless/vagrancy issues) had contacted him about SB 640. Sen. Moorlach politely indicated that he didn’t recall but also indicated he’d welcome support from the City of Long Beach (L.A. County’s second largest city.) That could include a Long Beach City Council resolution supporting SB 640. Any LB Councilmember(s) could agendize this for Council action “on any Tuesday.”
To hear LBREPORT.com’s Nov. 15 telephone conversation with Sen. Moorlach, click here (MP3 file, lightly edited)
Senator Moorlach has a robust webpage devoted to SB 640. It includes links to video and statewide coverage of the issue at this link.
LBREPORT.com invites our readers to share this article on social networks and with the offices of their Councilmembers and state lawmakers. We also invite readers who receive responses from their elected officials to share them with us for possible publication.
Additional legislative background
An April 2019 state Senate Health Committee Legislative Analysis provided details of SB 640 here:
…According to the author, California is failing its seriously mentally ill. Current law states that a person is gravely disabled if, as a result of a mental health disorder, he or she cannot provide for their basic needs for food, clothing, and shelter. This law was intended to serve as a protection to individual liberties but has created a system that, instead of helping the most seriously mentally ill, relegates them to the streets, jails, and emergency rooms. Better metrics are needed to help seriously mentally ill individuals that are simply powerless to provide for their own personal well-being. This is especially important when the absence of significant supervision and assistance leaves the individual at risk of substantial bodily harm. Clarifying the definition of “gravely disabled” will be a step towards repairing a system that is failing to serve those who need it most.…The LPS [Lanterman-Petris-Short] Act provides for involuntary commitment for varying lengths of time for the purpose of treatment and evaluation, provided certain requirements are met. Additionally, the LPS Act provides for LPS conservatorships, resulting in involuntary commitment for the purposes of treatment if an individual is found to meet the grave disability criteria. Typically one first interacts with the LPS Act through a 5150 hold, which allows a designated facility to involuntarily commit a person for 72 hours for evaluation and treatment if they are determined to be, as a result of a mental health disorder, a threat to self or others, or gravely disabled. The peace officer or other authorized person who detains the individual must determine and document that the individual meets this standard. When making the determination or determining that a person should be placed on a 5150 hold, the peace officer or other authorized person may consider information about an individual’s historical course of a mental disorder, which includes evidence presented by a person who has provided or is providing mental health or related support services to the person on the 5150 hold; evidence presented by one or more members of the family of the person on the 5150 hold; and, evidence presented by the person on the 5150 hold, or anyone designated by that person, if the historical course of the person’s mental disorder has a reasonable bearing on making a determination that the person requires a 5150 hold.
Following an initial 5150 hold, a person may be certified for intensive treatment, which initially permits a person to be held for an additional up to 14-days, without court review, if they are found to still be a danger to self or others, or gravely disabled. When determining whether the person is eligible for a 14-day detention, the professional staff of the agency or facility providing evaluation services must find that the person has been advised of the need for, but has not been willing or able to accept, treatment on a voluntary basis. A notice of certification is required for all persons certified for intensive treatment, and a copy of the notice for certification is required to be personally delivered to the person certified, the person’s attorney, or the attorney or advocate, as specified. If after the initial 14 days a person is still found to remain gravely disabled and unwilling or unable to accept voluntary treatment, the person may be certified for an additional period of not more than 30 days of intensive treatment. A person cannot be found at this point to be gravely disabled if he or she can survive safely without involuntary detention with the help of responsible family, friends, or others who indicate they are both willing and able to help.
The LPS Act provides for a conservator of the person, of the estate, or of both the person and the estate for a person who is gravely disabled as a result of a mental health disorder or impairment by chronic alcoholism or use of controlled substances. The person for whom such a conservatorship is sought has the right to demand a court or jury trial on the issue of whether they meet the gravely disabled requirement. The purpose of an LPS conservatorship is to provide individualized treatment, supervision, and placement for the gravely disabled person. Current law also deems a person as not being gravely disabled for purposes of a conservatorship if he or she can survive safely without involuntary detention with the help of responsible family, friends, or others who indicate they are both willing and able to help.
SB 1045 (Wiener and Stern, Chapter 845, Statutes of 2018) established, under a five-year pilot project in San Francisco, Los Angeles, and San Diego Counties, a conservatorship process for individuals who are incapable of caring for their own health and well-being due to a serious mental illness and substance use disorder as evidenced by “frequent detention” for evaluation and treatment under 72-hour involuntary holds. Frequent detention is defined as having eight or more 5150 holds in the preceding 12 months.
The Committee legislative analysis summarized positions on the bill pro and con as follows:
Support. The City of Santa Monica states that although the current definition of gravely disabled was intended to protect individuals from inappropriate, indefinite, and unnecessary involuntary commitments, it has created a system that often relegates those who are gravely disabled to the streets, jails, and emergency rooms, and has failed to deliver care that is desperately needed. The City of Santa Monica argues that this bill would clarify gravely disabled to more closely align with the original intent of the LPS Act and to provide care that the current system has failed to deliver.…Support if amended. Tenet Healthcare recommends that this bill be amended to pilot modernization of conservatorship programs in counties that have also adopted specific, voluntary community mental health and sheltering programs. Tenet states that ultimately the state must have resources to expand the continuum of care for behavioral, medically fragile and homeless patients. Tenet notes, for example, that Orange County has availed itself of two very appropriate tools: Laura’s Law/Assisted Outpatient Treatment and whole person care pilot programs. Tenet argues that without county support, wrap-around services, and vested community partnerships, simply transporting the gravely disabled population to a hospital emergency department (ED) will likely only exacerbate present bottlenecks in that ED caused in part by patients that we are unable to discharge by the hospital.
Opposition. Disability Rights California, the American Civil Liberties Union, and the Western Center on Law and Poverty write as a coalition to argue that this bill needlessly expands LPS to permit an undefined standard by which to impose involuntary care for individuals in a restrictive and confined environment; proposes a solution that does not meet the stated goals of addressing homelessness; and, does nothing to ensure that those proposed to be conserved under the expansion will be provided with adequate food, clothing, shelter, or medical and behavioral health care. The coalition states that many terms in the expanded definition are undefined and expansively broad and that the bill does nothing to promote uniformity between the counties and, to the contrary, substitutes a vastly more confusing standard for every stakeholder in the LPS system to attempt to learn and attempt to consistently apply. The coalition further states that involuntary treatment means the county has the duty to treat and house conservatees, which includes making physical and mental health services actually available, and this bill puts the cart before the horse since the counties are already unable to provide services and supportive housing for this population. The coalition states that they do not believe this bill has specified a clear or factual underpinning to support moving away from the current gravely disabled standard that has served for decades to balance the needs of individuals with behavioral illnesses and the protection of their own and others safety. Mental Health America of Northern California (MHA NorCal) shares similar concerns as the coalition. MHA NorCal also argues that efforts to institutionalize people with mental health conditions is not only counterproductive to the recovery model embraced by California but may also be a violation of civil rights. MHA NorCal also notes that Laura’s Law has been implemented in various counties, which consists of court-ordered coercive treatment with appropriate conditional elements that promote opportunities to remain in community services. SEIU California shares similar concerns as the coalition and argues that this bill would not assist the state with a more uniform application of conservatorships. Instead, it would create a more confusing set of criteria which will be newly reinterpreted and tested throughout California’s various jurisdictions in myriad ways. SEIU California states that by opening the definition up to include individuals who need help with providing for their basic needs, it fears it would be even harder to provide help on a voluntary basis to our most in-need populations.
Oppose unless amended. CHA states that this bill will only make it more challenging for hospitals to meet the needs of an increasing volume of patients with behavioral health needs. Over a six-year period, data shows that ED utilization increased by a staggering 47% for people with behavioral health conditions, while overall ED use increased only 14%. CHA argues that this bill expands criteria for 5150s and causes an unintended ripple effect that will negatively impact patient care such that under the expanded definition many patients with mental health disorders could be involuntarily detained simply because they do not follow a doctor’s recommended treatment; patients on 5150s would linger in EDs; and hospitals could not forcibly treat patients but would need to keep them. CHA argues that broader policy changes and investment need to be made, such as: standardization of involuntary commitment laws; mandated assisted outpatient treatment in all counties; and adequately funding California’s overburdened court and public conservatorship system.
Additional Long Beach background
In L.A. County’s second largest city, Long Beach Mayor Garcia (who doesn’t set city policy) has acknowledged homelessness is complex with multiple aspects but has tried to steer discussion mainly toward building more housing units (including below market/subsidized “affordable” housing.) In 2018, Mayor Garcia chose an “Everyone Home Task Force” that included a number of affordable (subsidized) housing developers and homeless service providers. It produced a Dec. 2018 report contending LB (parts of which are already densely populated) needs thousands of new housing units. On a separate track, Councilman Rex Richardson has been soliciting contributions (as of June 30 over $200,000) from affordable housing developers and homeless service providers for a future revenue-raising (read: tax imposing) LB ballot measure (LBREPORT.com coverage here.)
The Garcia-chosen Task Force acknowledged that a 2017 Long Beach homeless count found roughly a third (31%) reported a mental illness and 21% report a substance use disorder but its recommendations focused on housing, offering mainly conventional bureaucratic responses regarding mental illness issues. Under the heading “Increase access to Behavioral Health and Physical Health Services” the Garcia Task Force wrote:
Improving access to services is an important step to accessing housing and helping people maintain their housing once housed. In addition, our hospitals are impacted by those experiencing homelessness who have physical and behavioral health conditions. With state legislation in place that precludes discharging a person into homelessness, there is a tremendous need to increase collaboration among hospitals and community partners to access shelter and housing, as well as to increase the number of, and access to, recuperative care beds and sobering center opportunities in the City.
The Garcia Task Force recommended an agreement with LA County’s Housing for Health program for “a coordinated referral program to serve the City’s most vulnerable and most frequent users of City resources”; “partnering” with LA County and the State “to implement a substance use detox center, sobering center, and increased recuperative care beds and work to implement a safe needle exchange program; substance use treatment opportunities.”
It also advised a “significantly increase [in] long-term mental healthcare capacity” and “to reform the conservatorship rules and processes to make it easier to get people the care they need and maintain it as long as the level is appropriate.” However that measure is already in place. SB 1045, enacted in 2018 and co-authored by state Senator Scott Wiener, established a five-year pilot project in San Francisco, Los Angeles, and San Diego Counties for “a conservatorship process for individuals incapable of caring for their own health and well-being due to a serious mental illness and substance use disorder as evidenced by ‘frequent detention’ for evaluation and treatment under 72-hour involuntary holds.”
SB 640 would go where some in Long Beach and Sacramento haven’t yet gone.
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