BILL ANALYSIS Ó
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
AB 1114 (B. Lowenthal)
Hearing Date: 08/15/2011 Amended: 08/15/2011
Consultant: Jolie Onodera Policy Vote: Public Safety 7-0
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BILL SUMMARY: AB 1114 would define a new procedure under which
the Department of Corrections and Rehabilitation (CDCR) may
obtain an order from an administrative law judge (ALJ) to
authorize involuntary administration of psychotropic medication
to an inmate.
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Fiscal Impact (in thousands)
Major Provisions 2011-12 2012-13 2013-14 Fund
New procedures for Potential savings of up to $2,200 General
involuntary administration annually ongoing to CDCR
of psychotropic medication
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STAFF COMMENTS:
Existing law prohibits the involuntary administration of
psychotropic medication to a state prison inmate unless the
process specified in the permanent injunction in the matter of
Keyhea v. Rushen (1986) Cal. App. 3d 526, has been followed.
This bill would delete the provision of state law that expressly
requires the CDCR to abide by the permanent injunction in Keyhea
and creates new procedural requirements to be followed for the
involuntary administration of psychotropic medication.
This bill prohibits the administration of psychotropic
medication to an inmate sentenced to imprisonment in a state
prison without informed consent but provides that if a
psychiatrist determines that an inmate should be treated with
psychotropic medication, CDCR may seek to initiate involuntary
medication on a nonemergency basis if specified conditions are
met, including:
The inmate has a serious mental disorder, and that as a
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result of that disorder, the inmate is gravely disabled or
is a danger to self or others and does not have the
capacity to refuse treatment with psychotropic medication;
The inmate is provided a hearing before an ALJ;
The inmate is provided counsel at least 21 days before
the hearing, which shall not be held more than 30 days
after the filing of the notice of hearing, as specified;
An ALJ determines that involuntary medication is
warranted by clear and convincing evidence, and the history
of the inmate's mental disorder is considered;
The inmate is entitled to file one motion for
reconsideration following a determination, and may seek a
hearing to present new evidence upon good cause shown.
This bill further specifies that nothing in the act is intended
to prohibit a physician from taking appropriate action in an
emergency, as defined, and specifies conditions under which
medication may be administered to an inmate in an emergency and
for only so long as the emergency exists, but in no event longer
than five days, unless CDCR first obtains an order from an ALJ
authorizing continuance of medication.
Under existing law pursuant to Keyhea, the duration for
involuntary medication authorized for an inmate determined to be
a threat to self or others is 180 days and one year for an
inmate considered to be gravely disabled. This bill extends the
duration for involuntary medication, on an emergency or
nonemergency basis, to one year for all orders from the date of
determination, unless the inmate gives his or her informed
consent, or CDCR follows specified procedures for a renewal
hearing. In 2010, CDCR sought involuntary medication renewals at
180 days for 1,035 inmates considered a threat to self or
others. Of the total, only 17 inmates (1.6 percent) were not
renewed.
By extending the renewal interval for involuntary medication
cases authorized due to a determination of being a threat to
self or others from 180 days to one year, significant savings to
the CDCR may be realized. The CDCR indicates of the
approximately 1,290 inmates subject to involuntary medication,
840 inmates (65 percent) are medicated on the basis of being a
danger to self or others and must be brought before an ALJ and
provided with counsel twice a year, all at a cost to the CDCR.
By reducing the number of hearings to once per year will result
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in significantly reduced costs for ALJs, inmate counsel,
psychiatrists, prison staffing, and court fees. Estimated
savings of $0.7 million in psychiatric resources, $0.8 million
in staff resources, and $0.45 million in court costs could be
reduced, totaling nearly $2 million in annual ongoing savings.
To the extent some of the inmates choose to file for
reconsideration would reduce the estimated savings, but would be
dependent on the number of reconsiderations sought and granted
upon good cause shown.
This bill removes the current requirement to hold a
certification review hearing at the time medication is first
initiated (CDCR indicates nearly all cases move forward) but
shortens the timeframe within which an inmate has a hearing
before an ALJ to discontinue involuntary medication. Under the
current process, the formal hearing is typically not held until
the 47th day after involuntary medication is initiated. This
bill shortens the timeframe for a formal hearing to be held no
later than 21 days after administration of emergency medication,
or no later than 30 days if medication is administered on a
nonemergency basis. The CDCR estimates the removal of the
certification review hearing will result in annual savings of
approximately $162,500. Further, to the extent the provisions of
this bill result in earlier intervention in an inmate's mental
health issues may result in cost savings in reduced utilization
of mental health crisis beds and resources.
The Office of Administrative Hearings estimates no ongoing
fiscal impact due to the provisions of this bill. Any additional
workload during the implementation phase of the revised process
would be minor and absorbable within existing resources.
Staff notes this bill incorporates changes to Section 2600 of
the Penal Code (PC) made by AB 109 (Committee on Budget) 2011,
the criminal justice alignment trailer bill, which has been
chaptered but is not operative at this time. AB 109 amended PC
Section 2600 to reference not only persons sentenced to
imprisonment in state prisons, but also persons sentenced to
local jails pursuant to subdivision (h) of PC Section 1170. In
order to clearly state the new procedures should apply only to
inmates under CDCR custody and avoid any confusion or potential
reimbursable state mandate on local jails, this bill's
provisions apply only to those persons sentenced to imprisonment
in state prison.
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