Department of Children and Family Services
_____________________________________________________________________________
POLICY AND PROCEDURE GUIDE
DIVISION 32 – FAMILY & COURT SERVICES
CHAPTER 4 – YOUTH LINK CONSUMERS
ITEM 4.32:
DATE: 12-01-00
REVISION: 04-25-03
PREPARED BY: MENTAL HEALTH
ROGER S
POLICY:
Human Services System shall provide due process procedures. Minors
being considered for voluntary admission to Psychiatric Health Facility or
any inpatient facility under contract to the Human Services System for
provision of services.
PURPOSE:
To comply with California Supreme Court opinions (In re Roger S. 19 Cal.
3d921 [141 Cal.Rptr. 298, 569P. 2d 1286], In re Michael E. [1975] Cal.
3d183) and the opinion of the legal staff of the State Department of Mental
Health. This procedure applies to only those admissions described in
Section II of this document.
REFERENCES:
Admissions or detentions which are not referenced in these procedures
shall not be affected by these procedures, including but not limited to, the
Welfare and Institutions Code Sections:
5150 et seq., Detention of Mentally Disordered Persons for Evaluation and Treatment
5170 et seq., Detention of Inebriate for Evaluation and Treatment
5200 et seq., Court ordered Evaluation for Mentally Disorder Persons
5225 et seq., Court Ordered Evaluations for Persons Impaired by Chronic Alcoholism Abuse
5250 et seq., Certification for Intensive Treatment
5260 et seq., Additional Intensive Treatment of Suicidal Persons
5300 et seq., Post Certification Procedures for Dangerous Persons
5350 et seq., Placement for Conservator for Gravely Disabled
PROCEDURE:
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POLICY AND PROCEDURE GUIDE
DIVISION 32 – CHAPTER 4 – ITEM 4.32
1.
2.
Applicability:
A.
This procedure shall not affect laws pertaining to what agency or individuals has
the right to consent to mental health or psychiatric treatment on behalf of a minor.
B.
When the responsible person (other than a public official) seeks to admit a
minor 14 through 17 years of age to a public facility (e.g., Fresno County
Human Services System , Psychiatric Health Facility (HSS), for evaluation or
treatment of a mental disorder; or
C.
When the responsible person, acting in his/her official capacity, is a state or
county official who is entitled to, or has legal custody of a minor 10 through 17
years of age and seeks to admit the minor to a public or private facility which
primarily contracts with Fresno County HSS.
Initiating Hospitalization
A.
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In Admissions as described in Section I above, if a mental health professional
determines that a minor is in need of psychiatric inpatient services and that
the standards referenced in Section IV (L) (1-4) are met, the responsible
person, or staff representing the proposed treatment facility, shall, prior to any
admission to a facility based on these procedures:
(1).
Obtain a psychiatrist’s affidavit. The "Psychiatrist's Affidavit"
(Attachment A) shall include the following:
a.
Whether the minor suffered from a mental disorder and if so, its
nature;
b.
That the proposed treatment program, which requires 24-hour
hospital care, is reasonably expected to ameliorate the mental
disorder;
c.
That the proposed facility in which the minor is to be placed is
the least restrictive and most appropriate available facility
which can fulfill objectives of treatment; and
d.
That the treatment facility is in the minor’s home community or
that the benefit of placement outside the home community
outweighs the detriment of separating the minor from his/her
community.
(2).
Contact the Patient Advocate who shall meet with the minor
client prior to inpatient admission. Such clients should be seen
without parents, doctor, or social worker present unless client
clearly and freely wants them there. The Advocate shall use
"Guidelines for Patient Advocate in Roger S. Hearings"
(Attachment B). The procedure should include the following:
POLICY AND PROCEDURE GUIDE
DIVISION 32 – CHAPTER 4 – ITEM 4.32
a.
The Advocate shall inform the minor of his/her right to a
hearing and determine whether the minor will freely,
voluntarily and intelligently waive his/her rights to a
hearing and may inform the minor of the other patient
rights.
b.
When a minor will reach his/her l4th birthday while
hospitalized as a voluntary patient based on the parent
or guardian’s signature (other than a public official) or
when the minor is a Dependent Child or Ward of the
Court and will reach his/her l4th birthday while
hospitalized, the responsible person, or the facility on
behalf of the responsible person, shall initiate the
procedure described in Section II (1) and (2) above, one
week or more prior to the minor’s birthday.
c.
When a minor has been involuntarily detained at a
facility under the provisions of law, and the responsible
person desires to voluntarily admit the minor, either:

the facility staff shall inform the responsible person
of the procedure of seeking admission (Attachment
E); or

the responsible person shall initiate the procedure
described in Section 2 (1) and (2).
For the purpose of this procedure, the voluntary admission shall be treated as a new
admission to the facility regardless of prior involvement of the minor with the facility.
NOTE: The Psychiatrist’s Affidavit (Attachment A) must be available to the facility
when the Patient Advocate determines whether the minor is protesting the admission,
and must be available to the Hearing Officer at the hearing. The professional person
testifying at the hearing may be a person other than the person signing the
Psychiatrist’s Affidavit who is familiar with the treatment needs of the minor and
available and/or potential resources.
When the minor protests the admission at the time of the evaluation for admission, or
prior to the time of the Patient Advocate seeing the minor, to ascertain whether the
minor is protesting the admission, the procedures described in Section IV shall apply.
3.
Non-protesting minor (minor who wishes to waive his/her right to a hearing):
A.
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Before the minor waives the right to a hearing, the Patient Advocate shall
contact the minor by telephone or in person to ascertain whether the minor is
protesting the admission, and to notify him/her of the rights to a hearing.
(1).
The Patient Advocate shall certify that the minor freely, voluntarily and
intelligently waives the right to a hearing.
POLICY AND PROCEDURE GUIDE
DIVISION 32 – CHAPTER 4 – ITEM 4.32
B.
(2).
The Patient Advocate and the minor shall sign the approved "Waiver of
Hearing” form, hereinafter referred to as "waiver" (Attachment C).
When the waiver is signed, this shall allow admission to the facility,
providing other necessary authorization(s) (e.g., permission of the
responsible person or his/her legally authorized designee) is/are also
available.
(3).
One copy of the signed waiver sha11 be forwarded to the Court or
agency having custody and control, when the minor is a Ward or
Dependent of the Court.
(4).
If the minor is not a Ward or Dependent of the Court, the waiver shall
remain in the minor's record at the treating facility.
(5).
A copy of the signed waiver and the Psychiatrist’s Affidavit shall be
given to the facility to which the minor is to be admitted.
When the waiver has been signed by a person other than the Patient
Advocate due to telephone authorization, on the next work day following
admission of the minor, the Patient Advocate shall personally interview the
minor and review the waiver. The Patient Advocate shall also sign the waiver.
(1).
If, in the opinion of the Patient Advocate, the minor is not freely,
voluntarily and intelligently waiving his/her right to the hearing, or if the
minor is now protesting the admission and requesting a hearing, the
Patient Advocate shall again advise the minor of his/her right to a
hearing.
(2).
Facility staff shall be notified and a hearing shall be held within four (4)
work days from the date of the minor's request unless an agreement has
been reached pursuant to Section 4 (H).
(3).
4.
In situations where a minor was admitted as an inpatient to a facility in
accordance with the provisions of this procedure and waived the right
to a hearing and subsequently indicates to the Patient Advocate,
his/her counsel, any member of the treatment staff, or the responsible
person, a desire to have a hearing and/or be released from the facility,
then a hearing shall be conducted by a Hearing Officer within four (4)
work days from the time of the request for hearing being filed, unless
agreement has been reached pursuant to Section IV (H).
Protesting Minor
A.
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When the minor protests the admission and requests a hearing, the Patient
Advocate shall promptly telephone the Hearing Officer and request a hearing.
POLICY AND PROCEDURE GUIDE
DIVISION 32 – CHAPTER 4 – ITEM 4.32
B.
No admission shall be made for a protesting minor under the procedures until
a hearing is held or the minor waives his/her right to a hearing.
NOTE: IT IS THE INTENT OF THESE PROCEDURES THAT HEARINGS
SHALL BE HELD ON A PRE-ADMISSION BASIS, UNLESS THE MINOR
HAS BEEN PREVIOUSLY ADMITTED UNDER OTHER PROVISIONS OF
LAW.
C.
The Patient Advocate shall represent the minor at all hearings for admission to
a hospital for acute psychiatric treatment.
D.
Upon receipt of the request for a hearing, the Patient Advocate shall:
(1).
Set a date for a hearing which shall be scheduled no later than four
work days after the request for hearing has been received unless
agreement has been reached pursuant to Section V (H); and
(2).
Shall give notice of the hearing date to the following by telephone:
a.
Hearing Officer
b.
The proposed facility.
E.
The Patient Advocate shall notify the minor of the hearing.
F.
The proposed facility shall make reasonable effort to notify the responsible
person of the hearing.
G.
The facility shall provide appropriate interpreters for non-English speaking and
hearing impaired patients.
H.
Nothing herein shall preclude the hearing from being held more than four work
days from the date of the request, for good cause, and upon agreement of the
Hearing Officer and Patient Advocate.
The Hearing Officer and Patient Advocate may review all clinical and medical
records in accordance with the W & I Code Sections 5328 (j), 5328 (m) and
5540-5546.
I.
J.
K.
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At the hearing the minor and Patient Advocate shall have the right to:
(1).
Review the Psychiatrist's Affidavit;
(2).
Be present at the hearing;
(3).
Present evidence and call witnesses;
(4).
Confront and cross-examine witnesses; and
(5).
Waive the minor's right to be present at the hearing.
The hearing shall be held in a place convenient to the parties and in an
informal setting. The public shall be excluded from the hearing, subject to
exceptions made at the discretion of the Hearing Officer, inclusive of family
members. Hearings and all shall be held as confidential as provided in Section
5328 of the Welfare and Institutions Code.
POLICY AND PROCEDURE GUIDE
DIVISION 32 – CHAPTER 4 – ITEM 4.32
L.
M.
Hearings shall be conducted in an informal manner and the Hearing Officer
may consider all evidence of probative value irrespective of whether it
complies with formal rules of evidence. The Hearing Officer shall base his/her
decisions on the preponderance of evidence. Wherever possible, a mental
health professional, who will participate in treatment in the proposed facility or
a professional person who has participated in the minor’s treatment, shall be
available to present testimony at the hearing. All of the following shall be
established at the hearing:
(1).
The minor suffers from a mental disorder;
(2).
The proposed treatment program requires 24-hour hospital care and is
reasonably expected to ameliorate the mental disorder;
(3).
The proposed facility in which the minor is to be placed is the least
restrictive and most appropriate facility which can fulfill the objectives
of treatment; and
(4).
If the treatment program is not in the minor’s home community, the
benefit of placement outside the home community outweighs the
detriment of separating the minor from his or her home community.
The Hearing Officer shall make findings in writing (Attachment D) to support
the decision. Following the hearing, the Hearing Officer shall issue an order
authorizing admission to the recommended or alternate facility, or an order
denying admission. Copies of the findings and order shall be provided to all
the following:
(1).
The minor;
(2).
The Patient Advocate;
(3).
The responsible person, upon request;
(4).
The proposed facility;
(5).
The Juvenile Court (where the minor is a Dependent Child or Ward of
the Juvenile Court).
N.
Nothing in these procedures shall require a facility to accept a minor.
O.
The minor may be admitted to the authorized facility within 15 calendar days
following the hearing.
5.
Facilities accepting minors under this procedure shall provide periodic review of the
minor's treatment program to assure that continued treatment is required.
Documentation of such review shall appear in the minor’s records at least monthly.
6.
Confidentiality shall be in accord with Section 5328 et seq. of the Welfare and
Institutions Code. The Hearing Officer shall be considered a “Court" as referenced in
Section 5328 (f) of the Welfare and Institutions Code.
7.
Records shall be maintained as provided by law.
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POLICY AND PROCEDURE GUIDE
DIVISION 32 – CHAPTER 4 – ITEM 4.32
8.
If admission is authorized, the Patient Advocate shall advise the minor of his/her right
to a Writ of Habeas Corpus hearing. If a request for release is filed, the Writ of
Habeas Corpus hearing shall be in the Superior Court Division under whose authority
the Hearing Officer has acted (i.e. the Court where the minor is a Ward or Dependent
of the Court, the Probate Court where the parent or guardian is the responsible
person).
9.
Nothing herein shall deprive the minor of his/her right to seek a Writ of Habeas Corpus.
DEFINITIONS:
Hearing Officer - the Certification Review Hearing Officer for inpatient facilities of the Human
Services System. This person is approved and appointed by the Superior Court of Fresno
County.
Facility - a hospital or psychiatric inpatient program licensed to provide acute care inpatient
psychiatric treatment.
Minor - Any person who is age 14 through 17 years of age who is not emancipated (Roger S) or
any child 10 through 17 years of age who is a Ward or Dependent Child of the Juvenile Court and
of whom the Court has physical Custody (Michael E).
Responsible person – A parent, guardian, public official or other person having legal custody of a
minor.
Patient Advocate - the designated Title IX Patients' Rights Advocate who will assure that minors
are informed of their rights to pre-admission hearings and assure that minors who waive the right
to a hearing have done so freely, voluntarily and intelligently.
Work Day(s) - judicial days (days when the Superior Court is open).
Public Facility - any facility owned or operated by the State of California or the County of Fresno.
Private Facility - any nonpublic facility which formally contracts with Fresno County Human
Services System for the provision of inpatient services.
Professional Person - a Psychiatrist; Psychologist; Licensed Clinical Social Worker; Licensed
Marriage, and Family Therapist or Registered Nurse.
TIME FRAMES:
Time limit for meeting between minor and advocate to discuss waiver
Within four (4) working days after advocate has been contacted unless admission postponed by
minor's responsible party.
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POLICY AND PROCEDURE GUIDE
DIVISION 32 – CHAPTER 4 – ITEM 4.32
Time limit for administrative hearing
Within four (4) working days after advocate discussed waiver with minor and minor has turned
down that option. If an independent psychiatric evaluation is sought, which will be rare, the
hearing may be postponed for an additional two (2) working days.
Length of time minor’s waiver of hearing is valid
Indefinitely, unless and until the minor revokes the waiver.
Length of time that must elapse before a rehearing can be requested if the original hearing
decided against hospitalization
Thirty (30) days and only then if there is a marked decline in the minor’s psychiatric condition
or a distinct increase in the likelihood that hospitalization will be of benefit.
Advance notice needed by advocate if minor will turn 14 while hospitalized and continued
inpatient treatment is planned
Two weeks before the minor’s 14th birthday.
Advance notice needed by advocate if hospital plans to change minor’s legal status from
involuntary to voluntary at the termination of a given detention period
Seven (7) days prior to the expiration date of the hold or in the case of a 5150, immediately
upon initiation of the hold.
Earliest time minor can request a writ
Five (5) days after hospitalization.
Time limit for patient advocate to meet with minor concerning writ
Phone contact within one working day. Face-to-face contact within two (2) working days.
Length of time between writ petition being filed and writ being heard in court
Seven (7) to ten (10) days
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