Temporary conservatorship filing
Yes. If, during the 5270 time it appears the person will require appointment of a temporary conservator, the conservatorship referral can be made. The referral must be made with sufficient time to allow for investigation and legal procedures. Because the conservatee must receive 5 days’ notice of the intent to file a temporary conservatorship before the petition is filed, the conservatorship hearing has to take place on day 30 of the 5270 hold, and the conservatee must receive 15 days’ notice of the hearing date, in order to allow for investigation of the petition, the referral for conservatorship must be made by day 5 of the 5270 hold.
The 5270 is absolutely not required in Santa Clara County in order to progress to a TCon. In fact, the law requires that if the doctor believes a T-Con is necessary during the 14 days of the 5250, it must be filed during the 5250. Further, the doctor is required to evaluate for the patient for necessity of a T-Con during the 5250 time. It should be rare to file a T-Con after a 5270. If the clinicians believe a T-Con is necessary, the 5270 is not appropriate.
That is not accurate. In every County where WIC 5270 has been enacted, there are many more 5270s filed than temporary conservatorships. The statute requires doctors to make a determination as to whether a patient will need a temporary conservatorship BEFORE placing the 5270. The 5270 should be used in appropriate circumstances where the doctor believes that the patient will reconstitute within 30 days. The Board of Supervisors expressed their intent to monitor the implementation of the 5270 hold and assess whether it appears to be reducing TCons
Medication
Refusal is required in order to file a Riese petition. However, if a patient has been continuing to refuse medication during the 5250 time period, even though there is an order for involuntary medication, and a 5270 has been placed, those facts can be used to show refusal.
Correct, a Riese order on a 5270 still does not allow for the use of LAI Medications.
There is no grace period. At the end of the 5250, the patient must be told they have a right to refuse until another medication order is obtained.
Voluntary treatment
Yes, if the patient meets criteria and it is still within the 47 day time-frame, the patient can be placed on a 5270, accounting for all voluntary time. Voluntary time counts in the 47 days and the doctor must subtract voluntary time from the expiration date of the hold.
Yes, if the patient is placed on voluntary status after the 5270 is placed and/or upheld, and then within the 47 days they ask to leave again, they can be placed back on the 5270 if they still meet criteria. Voluntary patients placed on a hold go back on the hearing calendar and have a right to a hearing to determine if they presently meet the criteria for the hold. You must notify MHAP of a hold placed on a voluntary patient.
Yes, the 5270 can be written after the initial 17 days if there is an intervening period of voluntariness. Days spent voluntary between holds are subtracted from the end date of the hold.
Signature requirements
Physicians are not subject to the 5 years experiences requirement. The statute says the second signature must be "either a physician who shall, if possible, be a board-qualified psychiatrist, or a licensed psychologist who has a doctoral degree in psychology and at least five years of postgraduate experience in the diagnosis and treatment of emotional and mental disorders."
Yes. The first must be the professional person in charge of the facility and the second can be a physician who, if possible, is a board-qualified psychiatrist or a licensed psychologist with 5- years post graduate training in mental health disorders. If the professional person in charge of the facility participated in the evaluation of the patient, the second signature can be an LMFT, RN, or MSW.
The professional person in charge of the facility means a person as defined in Title 9, California Code of Regulations, Section 623, 624, 625, 626, or 627 who is designated by the governing board of the facility or a person having control of the facility for the purposes of LPS. The designation must be in writing. Please consult your counsel as to what staff might fit this definition.
Please consult your counsel for application of the above-referenced statute to your facility’s circumstances.
Out-of-county patients
The 5270 can be used for out-of-county patient meeting its criteria. The temporary conservatorship processes of the county of residence would apply.
Writ hearings
Yes.
Anyone who is familiar with the patient can testify if they are also familiar with the criteria for grave disability.
Yes, the patient can access the writ once during the 5250 and again during the 5270.
Third party assistance
“Third-party support” is when a third-party is willing and able to provide the patient with the basic necessities of life. If the family member is not willing or able to provide that support, the patient could still meet the criteria for grave disability. This is a factual analysis that is often brought up at certification review hearings.
Certification review hearings
Yes, the 5270 hearings will occur during the same days and times as the 5250 hearings.