Report 2019-119 Recommendation 6 Responses

Report 2019-119: Lanterman-Petris-Short Act: California Has Not Ensured That Individuals With Serious Mental Illnesses Receive Adequate Ongoing Care (Release Date: July 2020)

Recommendation #6 To: Los Angeles County Department of Mental Health

To ensure that it connects patients who have been placed on multiple short-term holds to appropriate ongoing treatment, Los Angeles should, by no later than August 2021, adopt a systematic approach to identifying such individuals, obtaining available mental health history information about these individuals, and connecting these individuals to services that support their ongoing mental health.

1-Year Agency Response

LACDMH agreed in principal with this recommendation but only on the condition that data regarding short-term holds (5150's) currently in possession of DOJ be made available to LACDMH. This will require legislative action which to date has not occurred. Transparent access to data on short-term holds can further improve LACDMH's ongoing efforts to identify those in need of additional engagement interventions. In the meantime, LACDMH continues to utilize available data to identify individuals who qualify for specialty mental health services and voluntarily accept these services. LACDMH utilizes hospital liaisons, to the extent, these liaisons are available, to identify individuals who are placed on multiple short-term holds so they can be referred for outreach and engagement or linked to the clinically appropriate level of treatment.

California State Auditor's Assessment of 1-Year Status: No Action Taken

We maintain the county does not need to wait for state law to change to take the actions available to it to better serve individuals who are experiencing mental illness. As we have described, during our 2019 audit Los Angeles was expanding its hospital liaison efforts, but these efforts had only reached five of the 49 designated facilities in the county. By declining to implement our recommendation, the county loses an opportunity to improve connections to care for those in need.

6-Month Agency Response

6 Month Agency Response

LACDMH agreed in principal with this recommendation but only on the condition that data regarding short-term holds (5150's) currently in possession of DOJ be made available to LACDMH. This will require legislative action which to date has not occurred. Transparent access to data on short-term holds can further improve LACDMH's ongoing efforts to identify those in need of additional engagement interventions. In the meantime, LACDMH continues to utilize available data to identify individuals who qualify for specialty mental health services and voluntarily accept these services. LACDMH utilizes hospital liaisons, to the extent, these liaisons are available, to identify individuals who are placed on multiple short-term holds so they can be referred for outreach and engagement or linked to the clinically appropriate level of treatment.

California State Auditor's Assessment of 6-Month Status: Pending

It is important for the county to take the actions available to it to better serve individuals who are experiencing mental illness. As we describe in our report, during our 2019 audit Los Angeles was expanding its hospital liaison efforts, but these efforts had only reached five of the 49 designated facilities in the county. The county could better connect individuals to the care they need by continuing to expand its hospital liaison efforts. The county does not need to wait for any changes to state law to do so. We look forward to reviewing the county's progress in the one year update on this recommendation.

60-Day Agency Response

LACDMH agreed in principal with this recommendation but only on the condition that data regarding short-term holds (5150's) currently in possession of DOJ be made available to LACDMH. This will require legislative action. Transparent access to data on short-term holds can further improve LACDMH's ongoing efforts to identify those in need of additional engagement interventions. In the meantime, LACDMH continues to utilize available data to identify individuals who qualify for specialty mental health services and voluntarily accept these services. LACDMH utilizes hospital liaisons, to the extent these liaisons are available, to identify individuals who are placed on multiple short-term holds so they can be referred for outreach and engagement or linked to the clinically appropriate level of treatment.

California State Auditor's Assessment of 60-Day Status: Pending

It is important for Los Angeles to make progress in identifying individuals placed on multiple short-term holds. We did not condition our recommendation on changes to state law. In our report we describe how Los Angeles was expanding its hospital liaison efforts but that these efforts had only expanded to five of the 49 designated facilities in the county. Without additional information from Los Angeles, we cannot assess the progress it has made. We look forward to the six-month update on this recommendation.

All Recommendations in 2019-119

Agency responses received are posted verbatim.