(a)
(1)
Whenever voluntary admission into a psychiatric residential treatment facility is sought for a minor or nonminor dependent who is subject to a petition pursuant to Section 601 or 602, the court shall review the application for a voluntary admission as described in this section. A minor may not be admitted for inpatient treatment prior to court authorization unless the minor is subject to an involuntary hold pursuant to Chapter 2 (commencing with Section 5585.50) of Part 1.5 of Division 5.
(2)
For purposes of this section, “voluntary admission” for a child within the custody of a parent, guardian, or Indian custodian refers to the parent, guardian, or Indian
custodian’s voluntary decision to have the child admitted to a psychiatric residential treatment facility. “Voluntary admission” for a child not within the custody of a parent, guardian, or Indian custodian refers to the child’s decision to voluntarily admit themselves pursuant to Section 6552. “Voluntary admission” for a nonminor dependent refers to the nonminor dependent’s decision to voluntarily admit themselves.
(b)
(1)
When a parent, guardian, or Indian custodian who retains physical custody of a minor under the jurisdiction of the juvenile court pursuant to Section 601 or 602 seeks to have a minor admitted to a psychiatric residential treatment facility, or when a minor who is the subject of a petition pursuant to Section 601 or 602 seeks to make a voluntary admission to a psychiatric residential treatment facility,
the probation officer shall file an ex parte application for an order authorizing the voluntary admission pursuant to Section 6552 within 48 hours of being informed of the request or, if the courts are closed for more than 48 hours after being informed of the request, on the first judicial day after being informed of the request. The application shall satisfy the requirements of Title 3 of the California Rules of Court, and include all of the following:
(A)
A brief description of the minor mental disorder.
(B)
The name of the psychiatric residential treatment facility proposed for treatment.
(C)
A brief description of how the mental disorder may reasonably be expected to be cured or ameliorated by the course of treatment
offered by the psychiatric residential treatment facility.
(D)
A brief description of why the facility is the least restrictive setting for care and why there are no other available hospitals, programs, or facilities which might better serve the minor’s medical needs and best interest.
(E)
A copy of the plan required by subdivisions (c) and (d) of Section 16010.10.
(F)
(i)
If the parent, guardian, or Indian custodian is seeking the minor’s admission to the facility, the basis of their belief that the minor’s admission to a psychiatric residential treatment facility is necessary.
(ii)
If the minor is seeking admission, whether the parent, guardian,
or Indian custodian agrees with the minor request for admission.
(G)
A description of any mental health services, including community-based mental health services, that were offered or provided and an explanation for why those services were not sufficient, or an explanation for why no such services were offered or provided.
(H)
A statement describing how the minor was given the opportunity to confer privately with their counsel regarding the application.
(I)
A brief description of whether any member of the minor’s child and family team, if applicable, objects to the admission, and the reasons for the objection, if any.
(J)
The information required by
this paragraph shall be sufficient to satisfy the applicant’s initial burden of establishing the need for an ex parte hearing required by subdivision (c) of Rule 3.1202 of the California Rules of Court.
(2)
Upon receipt of an ex parte application pursuant to paragraph (1), the juvenile court shall schedule a hearing for the next judicial day. The court clerk shall immediately notify the probation officer and the minor’s counsel of the date, time, and place for the hearing.
(3)
The probation officer shall provide notice of the hearing in accordance with Title 3 of the California Rules of Court to the minor and their counsel of record, the minor’s parents or guardian, the minor’s tribe in the case of an Indian child, and any person designated as the minor’s educational or developmental representative
pursuant to subdivision (b) of Section 726. The provisions in subdivision (c) of Section 527 of the Code of Civil Procedure shall apply to notice of the hearing. The probation officer shall make arrangements for the minor to be transported to the hearing.
(c)
(1)
At the hearing, the court shall consider evidence in the form of oral testimony under oath, affidavit, or declaration, or other admissible evidence, including a probation department court report, as to all of the following:
(A)
Whether the minor suffers from a mental disorder which may reasonably be expected to be cured or ameliorated by a course of treatment offered by the psychiatric residential treatment facility in which the minor wishes to be placed.
(B)
Whether the psychiatric residential treatment facility is the least restrictive setting for care.
(C)
Whether there is any other available hospital, program, or facility which might better serve the minor’s medical needs and best interest, including less restrictive facilities or community-based care.
(D)
Whether and how the minor, parent, or legal guardian, as appropriate, has been advised of the nature of inpatient psychiatric services, patient’s rights as identified in Section 6006, and their right to contact a patients’ rights advocate.
(E)
Whether and how the probation officer addressed the possible voluntary admission with the minor’s attorney.
(F)
Whether the minor was given the opportunity to confer privately with their attorney while considering a voluntary admission.
(G)
Whether and how the possible voluntary admission was addressed with the child and family team, whether any member of the team objects to voluntary admission, and the reasons for the objection.
(H)
The probation department’s plan for the minor, as described in Section 16010.10.
(I)
A brief description of any community-based mental health services that were offered or provided, or an explanation for why no such services were offered or provided.
(2)
(A)
If the minor’s parent, guardian, or Indian
custodian seeks to give voluntary consent to the child’s admission, the court shall inquire about the child’s position on the admission.
(B)
If the minor seeks to give voluntary consent to admission, the court shall inquire of the minor whether they knowingly and intelligently consent to admission into the psychiatric residential treatment facility, and whether they are giving consent without fear or threat of detention or initiation of conservatorship proceedings.
(3)
The court shall not continue the hearing unless the minor consents to the continuance and the court determines that additional evidence is necessary to support the findings required by subdivision (c). Any continuance shall be for only such period of time as is necessary to obtain the evidence and only if it is
not detrimental to the minor’s health condition.
(d)
(1)
The court may grant a parent, guardian, or Indian custodian’s request to have a child admitted, or authorize the minor’s voluntary consent to admission, into a psychiatric residential treatment facility only if it finds, by clear and convincing evidence, all of the following:
(A)
That the minor suffers from a mental disorder which may reasonably be expected to be cured or ameliorated by a course of treatment offered by the hospital, facility, or program in which the minor wishes to be placed.
(B)
That the psychiatric residential treatment facility is the least restrictive setting to treat the child’s mental disorder.
(C)
That there is no other available hospital, program, facility, or community-based care which might better serve the minor’s medical needs and best interest.
(D)
That the minor has given knowing and intelligent consent to admission to the facility and that the consent was not made under fear or threat of detention or initiation of conservatorship proceedings.
(E)
That the minor and, where appropriate, the parent or guardian have been advised of the nature of inpatient psychiatric, patient’s rights as identified in Section 6006, and their right to contact a patients’ rights advocate.
(2)
(A)
When authorizing a parent’s or guardian’s
consent to admission or the minor’s voluntary consent, the court may make any orders necessary to ensure that the child welfare services agency promptly makes all necessary arrangements to ensure that the minor is discharged in a timely manner and with all services and supports in place as necessary for a successful transition into a less restrictive setting.
(B)
The court’s order authorizing the admission to a psychiatric residential treatment facility shall be effective until the first of the following events occurs: (1) the parent, guardian, or Indian custodian, or the child if admission was granted pursuant to Section 6552, withdraws consent for the child to be present in the psychiatric residential treatment facility, (2) the court finds that the child no longer suffers from a mental disorder that may reasonably expected to be
ameliorated by the treatment offered by the facility or that the psychiatric residential treatment facility is no longer the least restrictive setting for the treatment of the child’s mental health needs, or (3) the court makes a superseding order.
(3)
For minors who were in the custody of their parent, legal guardian or Indian custodian at the time of the authorization of admission, and based on the evidence presented during the ex parte hearing, the court shall consider whether the parent’s, legal guardian’s or Indian custodian’s conduct contributed to the deterioration of the minor’s mental disorder. If the court determines that the parent’s, legal guardian’s, or Indian custodian’s conduct may have contributed to the deterioration, it shall direct the county probation department to investigate whether the child may be safely returned to the
custody of the parent, legal guardian or Indian custodian upon their discharge from the psychiatric residential treatment facility and to take appropriate action, including, but not limited to, assessing the minor pursuant to Section 241.1, making a report to the county child welfare services agency’s suspected child abuse and neglect hotline, or proceeding to modify court orders pursuant to Article 20 (commencing with Section 775).
(e)
(1)
Whenever a nonminor dependent under the supervision of a county juvenile probation department seeks to voluntarily consent to admission to a psychiatric residential treatment facility, the probation officer shall file an ex parte application within 48 hours of the request or, if the courts are closed for more than 48 hours after being informed of the request, on the first judicial day after
being informed of the request, for a hearing to address whether the nonminor dependent has been advised of the nature of inpatient psychiatric services, patient’s rights as identified in Section 6006, and their right to contact a patients’ rights advocate, and gives informed voluntary consent to admission. The application shall satisfy the requirements of Title 3 of the California Rules of Court, and include all of the following:
(A)
A brief description of the medical necessity for admission into a psychiatric residential treatment facility.
(B)
The name of the psychiatric residential treatment facility proposed for treatment.
(C)
A copy of the probation department’s plan developed pursuant to subdivisions (c) and (d)
of Section 16010.10.
(D)
A description of any mental health services, including community-based mental health services, that were offered or provided to the nonminor dependent and an explanation for why those services were not sufficient, or an explanation for why no such services were offered or provided.
(E)
A brief description of whether the nonminor dependent believes admission to a less restrictive facility would not adequately address their mental disorder.
(F)
A statement describing how the nonminor dependent was given the opportunity to confer privately with their counsel regarding the application.
(G)
The information required by this paragraph shall be considered
sufficient to satisfy the applicant’s initial burden of establishing the need for an ex parte hearing required by subdivision (c) of Rule 3.1202 of the California Rules of Court.
(2)
Upon receipt of an ex parte application pursuant to paragraph (1), the juvenile court shall schedule a hearing for the next judicial day. The court clerk shall immediately notify the probation officer and the nonminor dependent’s counsel of the date, time, and place for the hearing.
(3)
The probation officer shall provide notice of the hearing in accordance with Title 3 of the California Rules of Court to all parties to the proceeding and their counsel of record, the nonminor dependent’s tribe, if applicable, the nonminor dependent’s court-appointed special advocate, if applicable, and any person designated
as the nonminor dependent’s educational or developmental representative pursuant to subdivision (b) of Section 726. The provisions in subdivision (c) of Section 527 of the Code of Civil Procedure shall apply to notice of the hearing. The probation officer shall make arrangements for the nonminor dependent to be present for the hearing.
(4)
At the hearing, the court shall consider evidence in the form of oral testimony under oath, affidavit, or declaration, or other admissible evidence, as to all of the following:
(A)
Whether the nonminor dependent’s receipt of treatment in the psychiatric residential treatment facility is medically necessary.
(B)
Whether there is an available less restrictive setting sufficient to
meet the nonminor dependent’s needs, including a less restrictive facility or community-based care.
(C)
Whether and how the nonminor dependent has been advised of the nature of inpatient psychiatric services, patient’s rights as identified in Section 6006, and their right to contact a patients’ rights advocate.
(D)
Whether and how the probation officer addressed the voluntary admission with the nonminor dependent’s attorney, including whether the nonminor dependent was given the opportunity to confer privately with their attorney about a voluntary admission.
(E)
Whether and how the possible voluntary admission was addressed with the child and family team, whether any member of the team objects to voluntary admission, and
the reasons for the objection.
(F)
The probation department’s plan for the nonminor dependent, as described in Section 16010.10.
(5)
(A)
The court shall make a finding whether the nonminor dependent has given knowing and intelligent consent to admission. If the court finds that the nonminor dependent has not given knowing and intelligent consent, it shall direct the probation officer to convey its finding to the facility and direct the facility to discharge the nonminor dependent. If the court finds that the nonminor dependent has given knowing and intelligent consent, nothing in this section requires a court order to discharge the nonminor if the nonminor dependent subsequently withdraws their consent.
(B)
The court may make any orders necessary to ensure that the probation department promptly makes all necessary arrangements to ensure that the nonminor dependent is discharged in a timely manner and with all services and supports in place as necessary for a successful transition into a less restrictive setting.
(6)
The judicial proceedings described in this subdivision shall not delay a nonminor dependent’s access to medically necessary services as defined in Section 14059.5 and Section 1396d(r) of Title 42 of the United States Code, which may include voluntary admission to a psychiatric residential treatment facility for inpatient
psychiatric services, while the judicial proceedings are ongoing.
(f)
(1)
(A)
No later than 60 days following the admission of a minor to a psychiatric residential treatment facility, and every 30 days thereafter, the court shall hold a review hearing on the minor’s placement in the facility and the medical necessity of the placement.
(B)
If the hearing described in subparagraph (A) coincides with the date for a review hearing pursuant to Section 727.2, the court may hold the hearing simultaneously with the status review hearing.
(C)
At the hearing described in subparagraph (A), the court shall consider all of the following:
(i)
Whether the minor, or parent or guardian, continues to consent to the voluntary admission made pursuant to this section.
(ii)
Whether the minor continues to suffer from a mental disorder which may reasonably be expected to be cured or ameliorated by a course of treatment offered by the facility.
(iii)
Whether there continues to be no other available hospital, program, facility, or community-based mental health service which might better serve the minor’s medical needs and best interest.
(iv)
Whether the psychiatric residential treatment facility, which is licensed pursuant to Section 4081, continues to meet its legal obligation to provide services to the minor.
(v)
The county probation department’s plan as described in subdivisions (c) and (d) of Section 16010.10, and the department’s actions to implement that plan.
(D)
If the court finds that the minor or their parent or guardian continues to give voluntary consent to admission, that the minor continues to suffer from a mental disorder which may reasonably be expected to be cured or ameliorated by a course of treatment offered by the facility, and that there continues to be no other available hospital, program, facility, or community-based mental health service which might better serve the minor’s medical need and best interest, the court may authorize continued inpatient psychiatric services for the minor in a psychiatric residential treatment facility. If the child has been in the facility for over 30 days, there shall be a
rebuttable presumption that the facility is not the least restrictive alternative to serve the child’s medical need and best interest.
(E)
(i)
If the court finds that the minor or their parent or
guardian no longer consents to the minor’s admission, the court shall direct the probation officer to work immediately with the facility for discharge to a different setting with the appropriate and necessary services and supports in place. A statement from the minor’s attorney that the minor no longer gives voluntary consent to the admission to the facility may be sufficient to support a finding that the minor no longer gives voluntary consent. The court shall set a hearing no later than 30 days to verify that the minor has been discharged. If the minor has not been discharged by the time of the hearing, the court shall issue any and all orders to effectuate the child’s immediate discharge, including exercising its powers under subdivision (b) of Section 727. This paragraph does not preclude involuntary detention of the minor pursuant to the requirements of the Children’s Civil Commitment
and Mental Health Treatment Act of 1988 or Lanterman-Petris-Short Act if the minor withdraws voluntary consent. This paragraph does not preclude a parent, guardian, Indian custodian, or the minor’s probation officer or attorney from arranging the minor’s discharge from the facility without a court order.
(ii)
If the court’s determination under clause (i) includes a determination that the minor should receive treatment through another hospital, program, facility, or community-based mental health service, the court shall hold a hearing no later than 60 days from the child’s discharge to ensure that the other services have been provided.
(F)
If the court determines the psychiatric residential treatment facility, which is licensed pursuant to Section 4081, failed to meet its
legal obligation to provide services to the minor, it may direct the social worker to engage with the facility to ensure the minor is receiving all necessary services. If necessary, the court may exercise its powers under subdivision (b) of Section 727.
(G)
The court may make any orders necessary to ensure that the county probation department makes all necessary arrangements for the minor’s discharge promptly and that all services and supports are in place for the minor’s successful transition to a different setting. The court may direct the social worker to work with the facility on the child’s aftercare plans as appropriate based on the child’s progress.
(2)
(A)
No later than 60 days following the admission of a nonminor dependent to a psychiatric residential
treatment facility, and every 30 days thereafter, the court shall hold a review hearing on the child or nonminor dependent’s placement in the facility and the medical necessity of that placement.
(B)
If the hearing described in subparagraph (A) coincides with the date for a hearing pursuant to Sections 366.31 and 727.25, the court may hold the hearing simultaneously with the status review hearing.
(C)
At the hearing in subparagraph (A), the court shall consider all of the following:
(i)
Whether the nonminor dependent continues to consent to the voluntary admission made pursuant to this section.
(ii)
Whether there is an available less restrictive setting
sufficient to meet the nonminor dependent’s needs, including a less restrictive facility or community-based care.
(iii)
Whether the nonminor dependent continues to meet medical necessity for care and treatment in the psychiatric residential treatment facility.
(iv)
Whether the psychiatric residential treatment facility, which is licensed pursuant to Section 4081, continues to meet its legal obligation to provide services to the nonminor dependent.
(v)
The county child welfare agency’s plan as described in subdivisions (c) and (d) of Section 16010.10, and the agency’s actions to implement that plan.
(D)
If the court finds at any review hearing that the
nonminor dependent continues to voluntarily consent to admission and that the evidence supports the nonminor dependent’s need for care and treatment in the psychiatric residential treatment facility, the court shall enter these findings in the record and direct the probation officer to transmit them to the facility or interdisciplinary team. If the nonminor dependent continues to voluntarily consent to admission, the court may direct the probation officer to work with the facility on the nonminor dependent’s aftercare plans as appropriate based on the nonminor dependent’s needs to achieve independence.
(E)
(i)
If the court finds that the nonminor dependent no longer voluntarily consents, the court shall direct the probation officer to notify the facility and immediately work with the nonminor dependent and the
facility for discharge to a less restrictive setting with the appropriate and necessary services and supports in place. A statement from the nonminor dependent’s attorney that the nonminor dependent no longer gives voluntary consent to the admission to the facility may be sufficient to support a finding that the nonminor dependent no longer gives voluntary consent. The court shall set a hearing no later than 30 days to verify that the nonminor dependent has been discharged. If the nonminor dependent has not been discharged by the time of the hearing, the court shall issue any and all orders to effectuate the nonminor dependents’s immediate discharge, including exercising its powers under subdivision (b) of Section 727. This paragraph does not preclude involuntary detention of the nonminor dependent pursuant to the requirements of the Lanterman-Petris-Short Act if the nonminor dependent withdraws
voluntary consent. This paragraph does not preclude the nonminor dependent from arranging their own discharge from the facility without a court order.
(ii)
If the court’s determination under clause (i) includes a determination that the nonminor dependent should receive treatment through another hospital, program, facility, or community-based mental health service, the court shall hold a hearing no later than 60 days from the nonminor dependent’s discharge to ensure that the other services have been provided.
(F)
This paragraph does not prevent the court from holding review hearings more frequently at its discretion.
(g)
(1)
The court’s order authorizing a request for admission to a psychiatric
residential treatment facility shall be effective until the first of the following events occurs: (1) the parent, guardian, or Indian custodian, or minor if admission was granted pursuant to Section 6552, or nonminor dependent withdraws consent for the minor or nonminor dependent to be present in the psychiatric residential treatment facility, (2) the court finds that the minor or nonminor dependent no longer suffers from a mental disorder that may reasonably expected to be ameliorated by the treatment offered by the facility or that the psychiatric residential treatment facility is no longer the least restrictive setting for the treatment of the minor’s mental health needs, or (3) the court makes a superseding order. This section does not require a court order to discharge a patient if the parent, guardian, Indian custodian, minor, or nonminor dependent withdraw their consent for admission.
(2)
Whenever a minor or nonminor dependent is discharged due to revocation of consent to admission, the county probation department shall, within two court days of being notified of the revocation of consent, file a petition pursuant to Section 778 requesting an order vacating the court’s authorization of the minor’s or nonminor dependent’s admission to the facility. This subdivision does not require a court order for the discharge of a minor arranged for by the child’s probation officer or attorney or nonminor dependent when consent to admission has been withdrawn.
(h)
At any review hearing pursuant to Section 366.31, 727.2, or 727.25, if a minor or nonminor dependent has been admitted to a psychiatric residential treatment facility, as defined in Section 1250.10, pursuant
to the consent of a conservator, the court shall
review the probation department’s plan developed pursuant to subdivisions (c) and (d) of Section 16010.10. The court may make any orders necessary to ensure that the probation department promptly makes all necessary arrangements to ensure that the minor or nonminor dependent is discharged in a timely manner and with all services and supports in place as necessary for a successful transition to a less restrictive setting. The court may direct the probation officer to work with the facility or, where appropriate, the minor’s or nonminor dependent’s court-appointed conservator to ensure the minor or nonminor dependent is receiving all necessary child welfare services and to develop the minor’s or nonminor dependent’s aftercare plan as appropriate based on the evidence of the minor’s or nonminor dependent’s progress.
(i)
The
documentation required by this section shall not contain information that is privileged or confidential under existing state
or federal law or regulation without the appropriate wavier or consent.
(j)
For purposes of this section, a “psychiatric residential treatment facility” refers to a psychiatric residential treatment facility defined in Section 1250.10 of the Health and Safety Code.
(k)
All provisions in this section that apply to nonminor dependents shall apply equally to foster children who remain under juvenile court jurisdiction pursuant to subdivision (a) of Section 303 after reaching the age of majority even if they do not meet the definition of “nonminor dependent” contained in subdivision (v) of Section 11400.
