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Committee backs AB 416 to let emergency physicians initiate 5150 holds, supporters say it will ease ER overcrowding
Summary
AB 416 would authorize emergency room physicians to initiate 72‑hour psychiatric holds under Welfare & Institutions Code 5150 in counties that choose to designate them; supporters argued it will speed care and free beds, while counties and behavioral health directors expressed concerns.
AB 416, sponsored by Assemblymember Krell, would allow emergency department physicians to initiate 72‑hour psychiatric holds (commonly known as “5150” holds under state law) in counties that designate them as authorized professionals. The Assembly Judiciary Committee passed the measure after testimony from emergency-medicine groups, psychiatric physicians and county behavioral-health officials.
Krell told the committee that emergency departments face severe overcrowding and long waits for psychiatric placement because only certain county-designated professionals or law enforcement can now place a person on a 5150 hold. “AB 416 authorizes emergency room physicians to initiate the 5150 holds, which will allow patients in crisis to get the specialized care that they need faster,” she said.
Tim Madden, representing the California chapter of the American College of Emergency Physicians and a co-sponsor, said emergency physicians already assess behavioral-health crises and that giving them authority — where counties opt in — would shorten delays in finding LPS‑designated beds and ease ER bottlenecks.
Opponents included representatives of the California State Association of Counties, the County Behavioral Health Directors Association and rural county groups, which said they appreciated amendments but remained concerned about implementation, training and county-level control. One county representative said the provisions as amended did not address all rural capacity and process concerns.
Committee members acknowledged the trade-offs. Some members expressed concern about overuse of involuntary holds, particularly for juveniles, but said the bill’s county opt-in structure and added guardrails made them more comfortable. The committee approved AB 416 and sent it forward.
