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Committee advances bill to let trained emergency physicians place involuntary psychiatric holds
Summary
AB 416 would authorize trained emergency physicians to place 72‑hour (5150) holds to help move patients out of crowded emergency departments; supporters said it would reduce dangerous delays, while disability advocates warned it could funnel more people into locked, for‑profit facilities without adequate county oversight.
The Assembly Health Committee voted to advance AB 416, which would authorize trained emergency physicians to place involuntary 72‑hour holds under Welfare and Institutions Code section 5150, a power that supporters said would reduce delays in emergency departments and speed transfers to psychiatric care when needed.
Assemblymember Krell, the bill's author, said patients in crisis sometimes wait hours or days for a law‑enforcement or county‑designated clinician to place a hold before they can be transferred to an inpatient psychiatric bed. “Emergency physicians are really well positioned to make these important decisions to determine whether a patient can care for themselves or is severely disabled,” Krell said.
Supporters included Dr. Kamara Graham, an emergency physician in Sacramento and board member of the California Chapter of the American College of Emergency Physicians, who described cases in which patients in acute crisis remained in emergency department hallways for prolonged periods because no one with authority to effect a transfer had placed a 5150. “One of the most frustrating pieces of my job is when I can't get care to the patients that need it in a timely fashion,” Dr. Graham said.
The Psychiatric Physicians Alliance of California also cosponsored the bill. Proponents said some counties already designate physicians for this role and that AB 416 would standardize and expand a process that includes training and continued county supervision.
Disability Rights California and other opponents argued AB 416 is the wrong fix. Samuel Jan of Disability Rights California warned the measure could increase unnecessary involuntary hospitalizations and channel people into locked, for‑profit psychiatric facilities with minimal county oversight and high costs. “It proposed to provide all emergency physicians the ability to write involuntary holds without any oversight from the county,” Jan said, adding that the result could be “a lot more unnecessary hospitalization and significant expense for the state and counties.”
County Behavioral Health Directors’ representatives said they are in respectful opposition but indicated willingness to continue discussions with the author about safeguards.
Committee members probed training, removal authority and county oversight. Supporters said the bill would require training and that clinicians designated to place holds would retain the ability to remove them. Members expressed concern about capacity at inpatient beds and about the rise of for‑profit psychiatric facilities; sponsors said those issues are separate but pledged to work with counties and advocates on guardrails.
The committee advanced AB 416 to the Assembly Judiciary Committee. Supporters and opponents said they expect further negotiation on training standards, county designation procedures and safeguards to avoid unnecessary institutionalization.
