LOS ANGELES COUNTY
DEPARTMENT OF MENTAL HEALTH
  Policy 307.01 Persons Authorized to Initiate Involuntary Lanterman-Petris-Short Detention
 
  PROCEDURES
  1. Individuals eligible to initiate applications for involuntary 72-hour period of evaluation and treatment are:
     
    1. An individual licensed in a mental health discipline by the State of California who is on the psychiatric professional staff of a Lanterman-Petris-Short (LPS) designated facility or has completed or is enrolled in an approved psychiatric residency training program in a LPS designated facility in Los Angeles County.
       
      1. It shall be the responsibility of the facility’s Medical Director to:
         
        1. Provide written attestation that the individual has been selected by the facility for said authority and meets the minimum DMH mental health experience requirements.
        2. Ensure the individual is a member of the psychiatric professional staff as defined by the facility’s staff by-laws and employment policies and 9 CCR § 823 or has completed or is enrolled in an approved psychiatric residency training program.
        3. Ensure the individual is appropriately trained to exercise said authority.
        4. Ensure the individual within the inpatient setting is proctored and monitored while exercising said authority.
        5. Maintain and make available to DMH the individual’s record with the following:
           
          • Verified licensure
          • Experience and training
          • Identification badge
          • Professional staff membership or psychiatric resident status
          • Privilege approval
          • Inquiries as to prior restrictions or loss of privileges
          • Judgments or settlements involving the individual’s practice in the mental health field
          • DMH authorization
          • Proctoring and monitoring data
             
        6. Ensure that a roster of staff members authorized to initiate applications for involuntary 72-hour period of evaluation and treatment is complete and current.
           
    2. An individual licensed, or license-waivered (completed hours, license eligible), as a mental health professional by the State of California who is employed by DMH or a DMH contracted agency (e.g., Full Service Partnership).
       
      1. It shall be the responsibility of the professional person in charge of the employee’s facility, or designee, to ensure each candidate for this authority meets the following requirements:
         
        1. Is nominated for designation authority in writing;
        2. Is appropriately qualified, trained, and supervised;
        3. Meets DMH quality standards regarding employment and scope of practice; and,
        4. Meets DMH quality standards for contracted agencies.
           
    3. An individual is made eligible for this authority at the discretion of the Local Mental Health Director (LMHD). Such individual may be recommended for authorization by the Medical Director/Professional Person in Charge of their employing facility. Criteria for final DMH approval will be determined by the LMHD.
       
  2. All licensed professionals desiring LPS authorization must receive authorization training (except for professional staff with admitting privileges, who may elect to do so) and achieve a passing score on a written proctored examination administered by DMH representatives.
     
    1. DMH psychiatrists are excluded from having to take the written examination and are automatically LPS certified.
       
    2. Los Angeles County Department of Health Services (DHS) psychiatrists, including all psychiatric residents in good standing within DHS-sponsored/hosted Accreditation Council for Graduate Medical Education (ACGME) - accredited psychiatric training programs, shall be excluded from taking the written exam and will automatically be LPS certified.
       
  3. Persons will be granted authority to initiate applications for involuntary 72-hour period of evaluation and treatment according to the needs of DMH. Following approval, the designated facility or County service organization will be issued a written authorization specifying the individual authorized and the authorization period. Minimum conditions for consideration are as follows:
     
    1. A completed DMH Initial and Renewal Authorization Application (Page 1) signed by the applicant and the professional person in charge of the designated facility or program supervisor must be submitted to the LMHD or designee for signature.
       
    2. A completed DMH Attestation for LPS Authorized Applicants (Page 2) signed by the applicant, or the applicant and the program supervisor, or the applicant and the professional person in charge of the employing facility must be submitted to the appropriate DMH designee.
       
    3. The individual must complete authorization training (elective for professional staff with admitting privileges) and, except for DMH psychiatrists, receive a passing score on the authorization training proctored examination.
       
      1. Authorization training will be provided by DMH. Topics will include, but not be limited to, the following:
         
        1. Relevant LPS codes, selected patients’ rights and DMH applicable policies and procedures, probable cause assessment, and documentation;
        2. Ethical issues as they relate to involuntary detention; and
        3. Components of the application for involuntary 72-hour period of evaluation and treatment. 
           
    4. The individual must be supplied with a facility identification badge as specified by DMH.
       
    5. The application must be reviewed by the appropriate DMH executive staff.
       
  4. The LMHD shall authorize individuals for a specified period, after which time further authorization requires attendance at a DMH-approved LPS training course and testing session.
     
    1. The LMHD may, at their discretion, use renewal of professional staff’s privilege to initiate applications for involuntary 72-hour period of evaluation and treatment, along with the application for re-authorization and signed attestation, in lieu of training or retesting as a basis for reauthorization for the next reauthorization period.
       
  5. Approval may be withdrawn by DMH upon written notification, for the following reasons:
     
    1. Failure to abide by all provisions of the WIC §§ 5150 and 5585; patients’ rights, due process, and accompanying regulations (9 CCR § 823; 22 CCR; BPC § 650) regarding compensation for referrals; and DMH policies concerning treatment and evaluation, patients’ rights, and due process.
       
    2. Misuse of the involuntary detention authority (i.e., use that is inappropriate, excessive, corrupt and/or unjust, including improper conduct during evaluations initiated on or off facility premises, such as actions or behavior not conforming to conventional standards of propriety, tact, and decency).
       
    3. Failure to meet criteria for professional staff membership and clinical privileges as required by Section A.1 of this policy (designated facility staff only).
       
    4. Failure to properly implement, complete, and document evaluation activities, applications, and/or verbal or written advisements and logs for 72-hour evaluation and treatment.
       
    5. Loss of professional license for any reason.
       
    6. Transfer to an assignment where authorization is deemed unnecessary by the Professional Person in Charge of the employee’s facility, or their designee.
       
    7. Resignation or transfer from the designated facility or Los Angeles County service organization that nominated the individual to receive this authority.
       
    8. In the event the individual is seeking authorization at a single designated facility and involuntary detention authorization has been previously revoked at that or any other designated facility, the LMHD may, in their sole discretion, withhold approval of the individual’s involuntary detention authority.
       
  6. The authority to initiate applications for involuntary 72-hour period of evaluation and treatment is confined to the geographic boundaries of Los Angeles County unless specific permission for cross-county applications has been granted in writing by the LMHDs of the counties involved.
     
  7. Authority to initiate applications for involuntary 72-hour period of evaluation and treatment is DMH site and function-specific. Authority granted under Section A.2 of this policy may not be transferred to private sector employment or otherwise exercised during the period the individual is considered by their DMH employer to be off-duty.