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 Page 2 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 Page 3 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