Lanterman-Petris-Short and Lanterman

1. Lanterman-Petris-ShortandLanterman Comparisons and Contrasts Making the Systems Work

2. Legislative Intent • LPS: End inappropriate, indefinite, and involuntary commitment of mentally disordered persons, developmentally disabled persons, and eliminate legal disabilities (Added by Stats.1967, operative July 1, 1969) • Lanterman: Clarify role of consumers and families in determining service needs and describe service options pursuant to IPP (Division 4.5 added by Stats.1977, operative July 1, 1978)

3. Rights • LPS 5600.2 Persons with mental disabilities retain all the rights, privileges, opportunities, and responsibilities of other citizens unless specifically limited by federal or state law or regulations. • Lanterman 4502 Persons with developmental disabilities have the same legal rights and responsibilities guaranteed all other individuals by the United States Constitution and laws and the Constitution and laws of the State of California.

4. LPS 5325.1Lanterman 4502(a) • Treatment services which promote the potential to function independently/Treatment and habilitation in the least restrictive environment • Shall protect the personal liberty of the individual • Right to dignity, privacy, humane care • Religious freedom and practice • Social interaction/community activities • Physical exercise/recreational opportunities • Freedom from harm, unnecessary physical restraint, isolation, excessive medication, abuse, neglect • Freedom from hazardous procedures.

5. LPS 5325 & 5327 Lanterman 4503 • Clothes, personal possessions, toilet articles, money • Storage space for private use • Visitors each day • Access to telephones • Letterwriting material • *Plus 5170.5 immediate right (no more than 3 hours) to 2 phone calls at his own expense or free local toll free or collect calls

6. Minors with Dual Diagnosis • Under 18/not conserved • Developmental disability/mental health • Residing at Fred Finch • Ran away from the house/into the freeway • Threw rocks and bottles • Tennis shoes taken away • Need to engage in safe behaviors for extended period of time and work toward Level I

7. Denial of Rights • LPS 5326 Rights may be denied for good cause—defined by regulation • Lanterman 4504 Rights may be denied for good cause—defined by regulation

8. CCR Title 9 and Title 17Good Cause • The exercise of the specific right would be injurious to the patient; • or • There is evidence that the specific right, if exercised, would seriously infringe on the rights of others; • or • The institution or facility would suffer serious damage if the specific right is notdenied.

9. Right to Refuse • LPS 5325 --convulsive treatment including ECT and insulin coma --psychosurgery • Lanterman 4503 (f-h) --electroconvulsive therapy --behavior modification techniques/pain or trauma --psychosurgery

10. Consent to Treatment • LPS • 5152(c) written and oral information on effects of medication • 5326.5 written informed consent • 5332 antipsychotics unless finding of incapacity or emergency

11. Consent, cont. • Lanterman 4655 Director of regional center or designee may give consent to medical, dental, or surgical treatment and provide for such treatment if: • a) the person’s parent, guardian, or conservator does not respond within a reasonable time to the request; • b) if the person has no parent, guardian, or conservator/director may initiate guardianship or conservatorship proceedings; • c) if person is adult and has no conservator, consent by someone else only if person is “mentally incapable of giving his own consent.”

12. Confidential Information • LPS 5328 Confidential Information and Records: All information and records obtained in the course of providing services to either voluntary or involuntary recipients of services shall be confidential. • Lanterman 4514 Confidential Information and Records: All information and records obtained in the course of providing intake, assessment, and services to persons with developmental disabilities shall be confidential.

13. Adult Client/Dual Diagnosis • Picked up by police at group home after breaking window • Placement funded by regional center • Admitted to LPS facility on 5150 • Facility staff disclosed prior history to police • What are client’s potential remedies??

14. Action for DamagesWillful Knowing Release LPS 5330 Greater of the following amounts: --Ten thousand dollars or --Three times the amount of actual damages Lanterman 4518 Greater of the following amounts: --Five hundred dollars --Three times the amount of actual damages

15. Dual Responsibilities • LPS 5600.2(e) Mental health should address the special needs of children and youth, adults, and older adults with dual and multiple disabilities • Lanterman 4510 DDS and DMH shall jointly develop and implement a statewide program for encouraging the establishment of sufficient numbers and types of living arrangements, both in communities and state hospitals, as necessary to meet the needs of persons served by those departments

16. Legislative Mandate • 4696.1 Legislature finds and declares that improved cooperative efforts between regional centers and county mental health are necessary • Each regional center and county mental health agency shall develop a memorandum of understanding

17. Disputed Cases (Michael A v. SARC) • Premature birth with subsequent heart surgeries • ADHD-learning disabilities-organic deficits • 5th grade/Santa Clara County Mental Health • 6th grade-SED-1:1 aide • FS IQ 90 with deficits in adaptive functioning • Organic brain syndrome secondary to cardiac surgery and brain injury • 5th category eligibility for regional center

18. Disputed Cases (JB v. NBRC) • Born 1946—age 54 • 1954 admission LPNI • 1960 Napa State Hospital • Schizophrenia • 1970 D/C NSH/homeless • 35 acute admissions; LPS conservatorship at time of hearing

19. Disputed Cases (AR v. SARC) • Head Start age 5 and special education first grade • Dysthymic disorder, schizophreniform disorder, amphetamine dependence, schizoaffective disorder • 21 years old • NSH 1026 commitment

20. Special Education • W & I 5600.3(a)(2)(C) Minors who meet special education eligibility requirements • Lanterman 4501.5 DDS shall insure that appropriate special education and related services are provided eligible individuals with exceptional needs

21. Special Education/Related Services • AG v. San Francisco Unified School District • Epilepsy, chromosome 5 inversion, microcephaly, global delay in cognitive, language, and fine and gross motor development • VNS/Diastat • District refused to administer medication ordered by client’s physicians

22. Federal/State Authority • Individuals with Disabilities Education Act. --Students have the right to a free appropriate public education --Special education is specially designed education, at no cost to parents, to meet the unique needs of the student --Related services means transportation and other developmental, corrective, and supportive services that may be required to assist the child to benefit from special education California Education Code.

23. U.S. Supreme Court • Irving v. Tatro, 468 U.S. 883 (1984). Court determined that any service that could properly be termed a “related service” and could not be termed “medical service” was the responsibility of a school district. “Bright line” test. • Cedar Rapids Community School District v. Garret F., 526 U.S. 66 (1999). Reaffirmed the “bright line” test of Tatro. Only medical services must be performed by physician; all others by school district.

24. Commitment Lanterman 4507 Developmental disability alone shall not constitute sufficient justification for judicial commitment. Persons who constitute a danger to themselves or others may be judicially committed if evidence of such danger is proven in court.

25. Questions Evaluations CLE Certificates