BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 1114
                                                                  Page  1

          Date of Hearing:   May 18, 2011

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                  AB 1114 (Lowenthal) - As Amended:  April 28, 2011 

          Policy Committee:                              Public 
          SafetyVote:  6-0
                        Judiciary                                      9-0

          Urgency:     No                   State Mandated Local Program: 
          No     Reimbursable:               

           SUMMARY  

          This bill creates, as an alternative to the process specified by 
           Keyhea v. Rushen  , procedural requirements for involuntary 
          administration of psychotropic medication to state prison 
          inmates that eliminate the certification review hearing under 
           Keyhea,  while safeguarding due process protections for inmates 
          contesting involuntary medication. Specifically, this bill: 

          1)Deletes provisions of law that prohibit involuntary 
            administration of psychotropic medication to state prison 
            inmates unless the process specified in the permanent 
            injunction in the matter of Keyhea v. Rushen is followed.

          2)Prohibits administration of psychotropic medication without 
            informed consent, absent specified procedures and 
            requirements.   

          3)Provides, if a psychiatrist determines an inmate should be 
            treated with psychotropic medication, but the inmate does not 
            consent, the Department of Corrections and Rehabilitation 
            (CDCR) may seek to initiate involuntary medication on a 
            nonemergency basis if specified conditions are met, including: 


             a)   A psychiatrist has determined the inmate has a serious 
               mental disorder, and as a result, is gravely disabled or a 
               danger to self or others, and does not have the capacity to 
               refuse treatment with psychotropic medications.
             b)   The inmate is provided a hearing before an 
               administrative law judge (ALJ) and is provided counsel at 








                                                                  AB 1114
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               least 21 days before the hearing, which shall not be held 
               more than 30 days after the filing of the notice of 
               hearing.  
             c)   An ALJ determines involuntary medication is warranted by 
               clear and convincing evidence, and the historical course of 
               the inmate's mental disorder is considered.   

          4)Specifies that nothing in this act is intended to prohibit a 
            physician from taking appropriate action in an emergency, as 
            defined, and specifies conditions under which psychotropic 
            medication may be administered to an inmate in an emergency, 
            including that the medication is required to treat the 
            emergency and for only so long as the emergency exists, but in 
            no event longer than five days, unless CDCR obtains an order 
            authorizing continued medication.

          5)Specifies involuntary medication, on an emergency or 
            nonemergency basis, must discontinue  one year  from the date of 
            determination, unless the inmate gives her or her informed 
            consent or CDCR follow specified procedures for a renewal 
            hearing.

           FISCAL EFFECT  

          1)Ongoing annual GF savings to CDCR in the range of $2 million, 
            based largely on extending the renewal interval for many of 
            the involuntary medication cases from 180 days to 365 days. 
            Savings would be the result of reduced legal expenditures and 
            less frequent psychiatric evaluations for determining the need 
            for involuntary medication. 

          2)Unknown annual GF court savings, likely in the hundreds of 
            thousands of dollars. 
           
          COMMENTS  

           1)Rationale.  This bill intends to create, as an alternative to 
            the Keyhea v. Rushen process, new procedural requirements for 
            involuntary administration of psychotropic medications to 
            state prisoners with mental disorders. This bill codifies much 
            of the current Keyhea process with some exceptions. 

            The most significant differences are (a) the bill shortens the 
            process to ensure that an inmate has a hearing before an ALJ 
            to discontinue involuntary medication, (b) extends the 








                                                                  AB 1114
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            duration for involuntary medication to 365 days for all 
            orders, whereas under Keyhea, the authorization for an inmate 
            determined to be a threat to self or others is 180 days, and 
            365 days for an inmate considered gravely disabled. 

            For purposes of context, however, in 2010 CDCR sought 1,035 
            involuntary medication renewals at six months for persons 
            considered a danger to self or others. Only 17 of these were 
            not renewed for a full year. The committee has asked for 
            similar data for additional years.

            According to the author, CDCR (which is officially neutral on 
            the bill), and inmate rights representatives, this bill 
            reflects a carefully crafted agreement intended to provide due 
            process protections to inmates, while expediting the Keyhea 
            process.

           2)There is no known opposition to this measure  . 


           
           
           Analysis Prepared by  :    Geoff Long / APPR. / (916) 319-2081