BILL ANALYSIS Ó AB 1907 Page 1 Date of Hearing: April 10, 2012 Counsel: Milena Blake ASSEMBLY COMMITTEE ON PUBLIC SAFETY Tom Ammiano, Chair AB 1907 (Lowenthal) - As Amended: April 9, 2012 SUMMARY : Provides that no individual sentenced to imprisonment in county jail for specified felonies shall be administered any psychiatric medication without his or her prior informed consent, unless specified circumstances are met. Additionally, makes conforming changes to the process by which inmates of the California Department of Corrections and Rehabilitation (CDCR) can be involuntarily medicated. Specifically, this bill : 1)States that a county department of mental health may seek to initiate the involuntary psychiatric medication of an individual sentenced to imprisonment in county jail for specified felonies if all of the following conditions have been met: a) A psychiatrist or psychologist has determined that the inmate has a serious mental disorder. b) A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medication, or is a danger to self or others. c) A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmate's disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient. d) The inmate has been advised of the risks and benefits of, and treatment alternatives to the psychiatric medication and refuses, or is unable to consent to, the administration of the medication. AB 1907 Page 2 e) The inmate is provided a hearing before a court-appointed hearing officer. f) The inmate is provided counsel at least 21 days prior to the hearing, unless emergency medication is being administered, as specified, in which case the inmate would receive expedited access to counsel. The hearing shall be held not more than 30 days after the filing of the notice with the superior court unless counsel for the inmate agrees to extend the date of the hearing. g) The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency medication is being administered, as specified, in which case the inmate would receive an expedited hearing. The written notice shall do all the following: i) Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication. ii) Advise the inmate of his or her the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to confidential sections of the inmate's central file which contain materials unrelated to medical treatment. iii) Inform the inmate of his or her right to contest the finding of the court-appointed hearing officer authorizing treatment with involuntary medication by filing a writ of administrative mandamus, as specified, and his or her right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health to continue treatment with involuntary medication after the court-appointed hearing officer has authorized treatment. AB 1907 Page 3 h) A court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness, the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmate's best medical interest. In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, the court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmate's counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default. i) The historical course of the inmate's mental disorder, as determined by available relevant information about the course of the inmate's mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as a result of the mental disorder. j) An inmate is entitled to file one motion for reconsideration following a determination that he or she may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. 2)States that nothing in this section is intended to prohibit a physician from taking appropriate action in an emergency. 3)Defines "emergency" as when there is a sudden and marked change in an inmate's mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others, and it is impractical, due to the seriousness of the emergency, to first obtain informed consent. 4)States that if psychiatric medication is administered in an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for AB 1907 Page 4 only so long as the emergency continues to exist. 5)Requires that, if the county department of mental health's clinicians identify a situation that jeopardizes the inmate's health or well-being as the result of a serious mental illness, and necessitates the continuation of emergency medication beyond the initial 72 hours pending the full mental health hearing, the county department give notice to the inmate and his or her counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing. The notice must be served upon the inmate and counsel at the same time the inmate is given written notice that the involuntary medication proceedings are being initiated and is appointed counsel. 6)Allows an ex parte order for the continued involuntary medication of the inmate to be issued upon a showing that, in the absence of the medication, there is a reasonable likelihood that the emergency conditions are likely to reoccur. 7)Requires the ex parte order for the continued involuntary medication of the inmate be supported by an affidavit from the psychiatrist or psychologist showing specific facts. 8)Gives the inmate and the inmate's counsel two business days to respond to the county department's ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the department's request. 9)Requires a court-appointed hearing officer to review the ex parte request and shall have three business days to determine the merits of the department's request. 10)If the ex parte order for the continued involuntary medication of the inmate is issued, the psychiatrist may continue the administration of the medication until a hearing before a court- appointed hearing officer. 11)Requires that, if an inmate is being involuntarily administered psychiatric medication on an emergency basis, the county department of mental health file with the superior court, and serve on the inmate and his or her counsel, written notice unless the inmate gives informed consent to continue the medication or a psychiatrist determines that the AB 1907 Page 5 psychiatric medication is not necessary and administration of the medication is discontinued. If written notice is given, it must do the following: a) Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication. b) Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to confidential sections of the inmate's central file which contain materials unrelated to medical treatment. c) Inform the inmate of his or her right to contest the finding of the court-appointed hearing officer authorizing treatment with involuntary medication by filing a writ of administrative mandamus, as specified, and his or her right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health to continue treatment with involuntary medication after the court-appointed hearing officer has authorized treatment with involuntary medication. 12)Requires that, if an inmate is being involuntarily administered psychiatric medication on an emergency basis, a hearing before a court-appointed hearing officer commence within 21 days of the filing and service of notice, unless counsel for the inmate agrees to a different time. 13)Specifies that an inmate being involuntarily administered psychiatric medication on an emergency basis has the same due process protections as an inmate being involuntarily medicated under a court order, the county department of mental health must prove the same elements supporting involuntary medication, and the court-ordered hearing officers is required to make the same findings related to involuntary medication. 14)States that the determination that an inmate may receive AB 1907 Page 6 involuntary medication shall be valid for one year from the date of the determination, regardless of whether the inmate subsequently gives his or her informed consent. 15)States that the involuntary medication must be discontinued one year after the date of determination unless the inmate gives his or her informed consent to the administration of the medication or the county department of mental health files with the superior court, no less than 21 days prior to the expiration of the current order, a written notice indicating the department's intent to renew the involuntary medication order. The notice must also be served on the inmate and his or her counsel. 16)Specifies that the county department of mental health must provide the same due process protection as those given for the initial order. 17)States that renewal orders are valid for one year from the date of the hearing. 18)Requires that an order renewing an existing order be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding his or her need for the medication, such that it is unlikely that the inmate would be able to manage his or her own medication and treatment regimen. No new acts need to be alleged or proven. 19)Requires that if the county department of mental health wishes to add a basis to an existing order, the department must give the inmate and the inmate's counsel notice in advance of the hearing, specifying what additional basis is being alleged and what qualifying conduct within the past year supports the additional basis. This additional basis must be proved by the department by clear and convincing evidence to a hearing by a court-appointed hearing officer. 20)Requires the renewal hearing be conducted prior to the expiration of the current order. 21)Specifies that in the event of a conflict between this AB 1907 Page 7 section and provisions of the Administrative Procedures Act, as specified, this section controls. 22)Defines "counsel," for purposes of this section, to include a county patient rights advocate. 23)Clarifies that the process for involuntarily medicating an inmate of CDCR also applies to inmates housed within a state prison. 24)Clarifies that if an inmate of CDCR is administered psychiatric medication involuntarily on an emergency basis, he or she would receive an expedited hearing and must receive expedited access to counsel. 25)States that in the event of any statutory notice issues with either initial or renewal filings by the CDCR, the administrative law judge (ALJ) shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmate's counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default. 26)Removes the requirement that an inmate of CDCR who is involuntarily administered psychiatric medication on an emergency basis only be medicated for five days unless an ALJ issues an order authorizing the continuing involuntary medication of the inmate. 27) Requires that, if CDCR's clinicians identify a situation that jeopardizes the inmate's health or well-being as the result and a serious mental illness, and necessitates the continuation of emergency beyond the initial 72 hours pending the full mental health hearing, CDCR will give notice to the inmate and his or her counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing. The notice must be served upon the inmate and counsel at the same time the inmate is given written notice that the involuntary medication proceedings are being initiated and is appointed counsel. 28)Specifies that an ex parte order for emergency involuntary medication of an inmate of CDCR may be issued if there is a AB 1907 Page 8 showing that in the absence of medication, there is a reasonable likelihood that the emergency conditions are likely to reoccur and must be supported by an affidavit from the psychiatrist showing specific facts. 29)Specifies that once CDCR has requested an ex parte order for emergency involuntary medication of an inmate of CDCR, that inmate and his or her counsel have two business days to respond to the request and may present facts supported by an affidavit in opposition to the request. 30)Requires an ALJ to review the ex parte request and shall have three business days to determine the merits of the CDCR's request. 31)Clarifies that in order to renew an existing involuntary medication order, CDCR may file with the Superior Court of the Office of Administrative Hearings a written notice indicating the department's intent to new the existing order. 32)Specifies that an order to renew an existing involuntary medication order for an inmate of CDCR, there must clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, along with other specified findings. 33)Requires that if CDCR wishes to add a basis to an existing order, the department must give the inmate and the inmate's counsel notice in advance of the hearing, specifying what additional basis is being alleged and what qualifying conduct within the past year supports the additional basis. This additional basis must be proved by the department by clear and convincing evidence by a hearing by an ALJ. 34)Requires CDCR to adopt regulations to fully implement this section. 35)Replaces references to "psychotropic" medications with "psychiatric" medications. EXISTING LAW : 1)States that, except for where allowed by law, no person sentenced to imprisonment in a state prison shall be administered any psychotropic medication without his or her AB 1907 Page 9 prior informed consent. ÝPenal Code Section 2602(a).] 2)States that if a psychiatrist determines that an inmate should be treated with psychotropic medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either an emergency or nonemergency basis, as specified. ÝPenal Code Section 2602(b).] 3)Allows CDCR to seek to initiate involuntary medication on a nonemergency basis only if all of the following conditions have been met ÝPenal Code Section 2602(c)]: a) A psychiatrist has determined that the inmate has a serious mental disorder. b) A psychiatrist has determined that, as a result of that mental disorder, the inmate is gravely disabled or a danger to self or others and does not have the capacity to refuse treatment with psychotropic medications. c) A psychiatrist has prescribed one or more psychotropic medications for the treatment of the inmate's disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient. d) The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychotropic medication and refuses or is unable to consent to the administration of the medication. e) The inmate is provided a hearing before an ALJ. f) The inmate is provided counsel at least 21 days prior to the hearing. The hearing shall be held not more than 30 days after the filing of the notice with the Office of Administrative Hearings, unless counsel for the inmate agrees to extend the date of the hearing. g) The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing. The written notice shall do all of the following: AB 1907 Page 10 i) Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychotropic medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication. ii) Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential sections of the inmate's central file which contain materials unrelated to medical treatment. iii) Inform the prisoner of his or her right to contest the finding of an ALJ authorizing treatment with involuntary medication by filing a petition for writ of administrative mandamus, as specified, and his or her right to file a petition for writ of habeas corpus with respect to any decision of the CDCR to continue treatment with involuntary medication after the ALJ has authorized treatment with involuntary medication. h) The ALJ determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychotropic medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmate's best medical interest. i) The historical course of the inmate's mental disorder, as determined by available relevant information about the course of the inmate's mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to themselves or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder. j) An inmate is entitled to file one motion for reconsideration following a determination that he or she may receive involuntary medication, and may seek a hearing AB 1907 Page 11 to present new evidence, upon good cause shown. 4)States that nothing in this section is intended to prohibit a physician from taking appropriate action in an emergency. ÝPenal Code Section 2602(d).] 5)Defines an "emergency" as a sudden and marked change in an inmate's mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others, and it is impractical, due to the seriousness of the emergency, to first obtain informed consent. ÝPenal Code Section 2602(d).] 6)States that if psychotropic medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist, but in no event longer than five days after the written notice and counsel are provided, as specified, unless the department first obtains an order from an ALJ authorizing the continuance of medication beyond five days. ÝPenal Code Section 2602(d).] 7)Allows the order for involuntarily medicating an inmate to be issued ex parte upon a showing that in the absence of the medication the emergency is likely to recur, supported by an affidavit showing specific facts. ÝPenal Code Section 2602(d).] 8)States that the inmate may present facts supported by an affidavit in opposition to the request for an ex parte involuntary medication order. ÝPenal Code Section 2602(d).] 9)Allows for the continued administration of psychotropic medications on an emergency basis until a hearing before an ALJ, as specified. ÝPenal Code Section 2602(d).] 10)Requires CDCR, if an inmate is being involuntarily administered psychiatric medication on an emergency basis, file with Office of Administrative Hearings, and serve the inmate and his or her counsel, written notice within 72 hours unless the inmate gives informed consent to continue the medication or a psychiatrist determines that the psychiatric mediation is not necessary and administration of the medication is discontinued. If written notice is given, it AB 1907 Page 12 must do the following ÝPenal Code Section 2602(d)(1)]: a) Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychotropic medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication. b) Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential sections of the inmate's central file which contain materials unrelated to medical treatment. c) Inform the prisoner of his or her right to contest the finding of an ALJ authorizing treatment with involuntary medication by filing a petition for writ of administrative mandamus pursuant, as specified, and his or her right to file a petition for writ of habeas corpus with respect to any decision of the Department of Corrections and Rehabilitation to continue treatment with involuntary medication after the ALJ has authorized treatment with involuntary medication. 11)Specifies that if an inmate is being involuntarily medicated on an emergency basis, the hearing before an ALJ shall commence within 21 days of the filing and service of the notice, unless counsel for an inmate agrees to a longer period of time. ÝPenal Code Section 2602(d)(2).] 12)Specifies that an inmate being involuntarily administered psychiatric medication on an emergency basis has the same due process protections as an inmate being involuntarily medicated under a court order, CDCR must prove the same elements supporting involuntary medication, and the ALJ is required to make the same findings related to involuntary medication. ÝPenal Code Section 2602(d)(3).] 13)States that the determination that an inmate may receive involuntary medication shall be valid for one year from the date of the determination, regardless of whether the inmate AB 1907 Page 13 subsequently gives his or her informed consent. ÝPenal Code Section 2602(e).] 14)States that if a determination has been made to involuntarily medicate an inmate, the medication shall be discontinued one year after the date of that determination, unless the inmate gives his or her informed consent to the administration of the medication, or unless a new determination is made, as specified. ÝPenal Code Section 2602(f).] 15)States that to renew an existing order allowing involuntary medication, CDCR shall file with the Office of Administrative Hearings, and shall serve the inmate and his or her counsel, the written notice, as specified, and shall state that the request is for a renewal. ÝPenal Code Section 2602(g).] 16)Requires that the request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication. ÝPenal Code Section 2602(g)(1).] 17)Requires that, to obtain a renewal order, CDCR must provide the same due process protection as given during the initial certification, prove the same elements supporting involuntary medication, and the ALJ is required to make the same findings related to involuntary medication. ÝPenal Code Section 2602(g)(2).] 18)States that renewal orders are valid for one year from the date of the hearing. ÝPenal Code Section 2602(g)(3).] 19)Requires that an order renewing a prior order may be granted based on clear and convincing evidence that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding his or her need for the medication, such that it is unlikely that the inmate would be able to manage his or her own medication and treatment regimen. No new acts need be alleged or proven. ÝPenal Code Section 2602(g)(4).] 20)Requires the hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order. ÝPenal Code Section 2602(g)(5).] AB 1907 Page 14 21)Specifies that in the event of a conflict between this section and provisions of the Administrative Procedures Act, as specified, this section controls. ÝPenal Code Section 2602(h).] FISCAL EFFECT : Unknown COMMENTS : 1)Author's Statement : According to the author, "AB 1907 extends the streamlined process that currently applies only to inmates in state prison to inmates sentenced to county jails, thereby shortening the time frame from 45 days to no more than 30 days for an inmate in a county jail to receive long-term medication to improve their mental health if they are either gravely disabled or a danger to themselves or others. "In addition, AB 1907 unifies the renewal timeline for involuntary treatment orders and simplifies the process and terminology to ensure that the inmate is provided with appropriate mental health treatment consistent with his or her due process rights, and ensured that officials take into account the inmate's mental health history when determining whether or not the prisoner is gravely disabled or a danger to themselves or others." 2)Background : According to information provided by the author, "AB 1907 is follow-up legislation to AB 1114 (B. Lowenthal) Chapter 665, Statutes of 2011 which streamlined the process for inmates sentenced to state prisons. While AB 1114 originally included inmates sentenced to state prison OR county jails, an amendment taken in Senate Public Safety limited the bill to only state prisons. "AB 1114 changed the procedure for the involuntary administration of psychotropic medication pursuant to the Keyhea v. Rushen court decision of 1986 by removing the certification review hearing that precedes the formal adversarial hearing and simplifying that process, along with the terminology used, to ensure that the prisoner is provided with appropriate, necessary, and beneficial mental health treatment that is also consistent with his or her due process rights. AB 1907 Page 15 "The Keyhea court held that equal protection required that prisoners subject to involuntary psychotropic medication be afforded the same rights as non-prisoners. At the time of the Keyhea decision, however, there were no statutes defining the rights of non-prisoners subject to involuntary medication. Therefore, the court adopted the procedures used when a court civilly commits a person as gravely disabled or a danger to self or others. These procedures include an increasingly stringent set of reviews and hearings depending on the length of the commitment sought. The Keyhea injunction also adopted statutes that define terms utilized to determine whether a person should be removed from society for commitment to a mental hospital. "Prior to AB 1114, California Penal Code (PC) Section 2600 incorporated the Keyhea permanent injunction, which sets forth the requirements and procedures the California Department of Corrections and Rehabilitation (CDCR) must comply with prior to involuntarily medicating mentally disordered inmates with psychotropic medication. "The Keyhea injunction essentially required that a prisoner being treated for a serious mental illness must meet the standard for a long term civil commitment in order to be provided with long term involuntary psychotropic medication. This required, for example, that a prisoner must be gravely disabled to obtain an order for one year of treatment with involuntary medication. "In addition, Keyhea required a certification review hearing to provide a prisoner with involuntary medication for up to 47 days. It then required an adversarial hearing with representation by counsel before an Administrative Law Judge (ALJ) to provide the prisoner with long term medication. The certification review hearing meets the constitutional due process standard established by the United States Supreme Court in Washington v. Harper. However, because California provided the prisoner with an ALJ hearing that far exceeded basic due process requirements; the certification review hearing was viewed as unnecessary. "Due to a prior court decision in 1982, De Lancie v. Superior Court Ý31 Cal. 3d 865], which determined that county jails are also subject to PC Section 2600, county jails are also, or had been prior to AB 1114, subject to the protocols in the Keyhea AB 1907 Page 16 injunction. While AB 1114 incorporated the new process into the Penal Code, it also eliminated the reference to the Keyhea injunction, leaving state law silent on the appropriate involuntary treatment process for inmates sentenced to county jails. "AB 1907 ensures that the streamlined process the currently applies to state prisons as a result of AB 1114 will also apply to an inmate in need of involuntary treatment in a county jail." 3)Involuntary Medication and Inmates : The United States Supreme Court has held that a state department of prisons has the authority to involuntarily administer psychiatric medications to inmates who are gravely disabled or a danger to self or others because of mental illness. ÝWashington v. Harper, 494 U.S. 210 (1990).] The plaintiff in that case, an inmate in the Washington State Penitentiary, was diagnosed with manic-depressive disorder and was sent to the Special Offender Center, a correctional institute to diagnose and treat convicted felons with serious mental disorders. While there, he was involuntarily medicated with psychiatric medications, and challenged the state's authority to medicate him without his consent, arguing that such involuntary medication violated both substantive and procedural due process. Addressing the substantive due process claim first, the court held that while the plaintiff did have a right to refuse medication, that right must be balanced with the state's legitimate penological interests. (494 U.S. at 224-5.) The state had a legitimate interest in protecting that inmate and other inmates from harm, and involuntarily medicating the plaintiff was reasonably related to that interest. (494 U.S. at 225.) The court also held that the hearing process implemented by the state department of corrections satisfied procedural due process requirements. (Id. at 228.) The procedure for involuntarily administering psychiatric medications to an inmate had four parts. First, a psychiatrist must determine that the inmate should be treated with psychiatric medication if the inmate suffers from a mental disorder or is gravely disabled and is a danger to self or others. (Id. at 215.) Second, the inmate is entitled to a hearing before a committee of health professionals not involved in his or her treatment, AB 1907 Page 17 in which the committee determines by a majority vote that the inmate suffers from a mental disorder and is gravely disabled or dangerous. (Id.) Third, the inmate is given certain procedural rights, including at least 24-hour notice of the hearing, notice of the tentative diagnosis, notice of the factual basis for the diagnosis, and explanation by the staff as to why they believe the medication is necessary. (Id. at 216.) At the hearing, the inmate is entitled to attend, present evidence and witnesses, cross-examine staff witnesses, and to the assistance of a lay advisor who has not been involved in the inmate's case, but understands the psychiatric issues. (Id.) Fourth, there must be periodic review of the involuntary medication order. (Id.) The procedures set forth in this bill meet, and in some case exceed, the requirements in Washington v. Harper. The initial order for involuntary medication is made by a psychiatrist upon a determination that the inmate is gravely disabled or is a danger to self or others because of mental illness. The inmate is entitled to a hearing, but with greater due process protections, including an ALJ or court-appointed hearing officer presiding over the hearing. The inmate is entitled to all the procedural rights, in addition to counsel, which the Court specifically stated was not required. (Id. at 228.) Finally, the involuntary medication order is subject to review every year by an ALJ or court-appointed hearing officer. 4)Related Legislation : a) AB 1114 (Lowenthal), Chapter 665, Statutes of 2011, changed the procedures for involuntarily medicating inmates of CDCR. b) SB 795 (Blakeslee) would have changed the process for involuntary medication of defendants found mentally incompetent during the criminal process. SB 795 heard by the Senate Public Safety Committee. 5)Previous Legislation : a) AB 2380 (Dymally), of the 2005-06 Legislative Session, would have clarified that "treatment" for medically disordered offenders paroled to other facilities for treatment includes involuntary medication. AB 2380 failed passage in this Committee. AB 1907 Page 18 b) AB 1424 (Thompson), Chapter 506, Statutes of 2001, related to the involuntary medication for individuals under the Lanterman-Petris-Short Act. c) AB 2798 (Thompson), of the 1999-2000 Legislative Session, would have authorized a judicially committed forensic patient in a state hospital to be medicated involuntarily with antipsychotic mediation in accordance with specified procedures. AB 2798 was never heard by this Committee. REGISTERED SUPPORT / OPPOSITION : Support National Association of Social Workers California Psychiatric Association California Council of Community Mental Health Agencies Opposition None Analysis Prepared by : Milena Blake / PUB. S. / (916) 319-3744