Lanterman-Petris-Short and Lanterman Comparisons and Contrasts Making the Systems Work

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) 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) 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)

Rights LPS 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. LPS 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. 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.

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

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

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

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

CCR Title 9 and Title 17 Good Cause The exercise of the specific right would be injurious to the patient; The exercise of the specific right would be injurious to the patient; or or There is evidence that the specific right, if exercised, would seriously infringe on the rights of others; There is evidence that the specific right, if exercised, would seriously infringe on the rights of others; or or The institution or facility would suffer serious damage if the specific right is not denied. The institution or facility would suffer serious damage if the specific right is not denied.

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

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

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: 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; 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; 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.” c) if person is adult and has no conservator, consent by someone else only if person is “mentally incapable of giving his own consent.”

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. 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. 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.

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

Action for Damages Willful Knowing Release LPS 5330 Greater of the following amounts: 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

Dual Responsibilities LPS (e) Mental health should address the special needs of children and youth, adults, and older adults with dual and multiple disabilities LPS (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 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

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

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

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

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

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

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

Federal/State Authority Individuals with Disabilities Education Act. 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.

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. 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. 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.

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.

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