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Health and Human Services Agency (HHSA) recommending the Board adopt and authorize the Chair to sign Resolution 114-2023, designating dual designation of responsibilities of performing Lanterman-Petris-Short conservatorship investigations to the HHSA Behavioral Health Division and HHSA Public Guardian Office, pursuant to California Welfare and Institutions Code Section 5351, authorizing review and evaluation of a resident’s mental health and conservatorship needs, and superseding Resolution 25-83.
FUNDING: N/A
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DISCUSSION / BACKGROUND:
The LPS Act, enacted in 1967, authorizes the involuntary commitment and treatment of persons with specified mental health disorders for the protection of the persons so committed. The LPS Act of 1967 defines actions and services when an individual, as a result of a mental health disorder, is considered gravely disabled, a danger to others, or to themselves, and is taken into custody on a temporary hold or a series of progressive holds leading to a determination of conservatorship. The individual will receive an assessment and crisis intervention as necessary and may be placed in a locked Psychiatric Health Facility (PHF). LPS conservatorships are established to arrange mental health treatment and placement for people who are gravely disabled and unable to provide for their food, clothing, shelter and treatment needs as a result of a mental disorder.
Pursuant to California WIC Section 5604, the governing board in each county or counties acting jointly under the provisions of Article 1 (commencing with Section 6500) of Chapter 5 of Division 7 of Title 1 of the Government Code, shall designate the agency or agencies to provide LPS conservatorship investigation.
In accordance, on February 1, 1983, the County of El Dorado Board of Supervisors (Board), designated the HHSA Behavioral Health Division (previously titled the Mental Health Division) as the entity to conduct LPS conservatorship investigations (Resolution 25-83). Consequently, County residents who have been assessed by a psychiatrist to meet the criteria for a severe mental illness are referred to the El Dorado County HHSA Behavioral Health Division, prompting a team, including the County Mental Health Medical Director and Mental Health Clinicians, to perform LPS conservatorship investigations.
On September 30, 2022, Assembly Bill (AB) 2242 amended the LPS Act, clarifying that counties may pay for LPS services using funds from the Mental Health Services Act (MHSA) when included in county plans. On June 20, 2023, the Board approved the HHSA Fiscal Year 2023-24 through 2025-26 MHSA Three Year Program and Expenditure Plan (MHSA Plan) (File ID: 23-0933). Within this adopted MHSA Plan, the LPS Project was budgeted for an annual MHSA allocation of $500,000, to expend on support services defined within the LPS Act allowable by AB 2242. These LPS services may include the initial assessment administered by HHSA, through the final determination if an individual should be conserved or not, including any treatment services administered throughout the assessment and investigation period. MHSA may also fund care coordination, also defined by AB 2242, which supports planning for the individual’s needs after the determination of conservatorship is made.
Due to limited staffing and resources, including the limited number of Mental Health Clinicians performing LPS investigations, the HHSA Behavioral Health Division is seeking Board approval to share responsibilities of LPS conservatorship investigations with the HHSA Public Guardian Office. This will allow HHSA Behavioral Health to utilize Mental Health Clinicians more effectively through their provision of direct mental health services to County residents, versus the LPS investigation responsibilities. This designation complies with WIC Section 5351, which authorizes the governing board to designate that conservatorship services be provided by the public guardian or agency providing public guardian services.
HHSA is recommending the Board adopt and authorize the Chair to sign the attached Resolution, thereby authorizing that LPS investigations may be performed by the El Dorado County Public Guardian Office, in addition to El Dorado County Behavioral Health Division, and superseding Resolution No. 25-83.
ALTERNATIVES:
Should the Board decline to approve this recommendation, the HHSA Behavioral Health Division will continue to provide services by the Mental Health Clinicians assigned to LPS investigations.
PRIOR BOARD ACTION:
1) 02/01/1983, Archive Board of Supervisor Minutes, Adoption of Resolution 25-83 designated HHSA Mental Health Division to provide Conservatorship Investigations
2) 06/20/2023, 23-0933, HHSA Adoption of FY 2023-24 - FY 2025-26 MHSA 3-Year Program and Expenditure Plan
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no Net County Cost associated with this Agenda item.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on one (1) original Resolution.
2) Clerk of the Board to return one (1) certified Resolution via email to HHSA Contracts Unit at hhsa-contracts@edcgov.us.
STRATEGIC PLAN COMPONENT:
Healthy Families
CONTACT
Olivia Byron-Cooper, MPH, Interim Director, Health and Human Services Agency