BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 2531
                                                                  Page  1

          Date of Hearing:  April 24, 2012

                            ASSEMBLY COMMITTEE ON HEALTH
                              William W. Monning, Chair
                 AB 2531 (Allen) - As Introduced:  February 24, 2012
           
          SUBJECT  :  State hospitals: prohibited items.

           SUMMARY  :  Authorizes each of the five state hospitals under the 
          jurisdiction of the Department of Mental Health (DMH) to develop 
          a list of items that are deemed contraband and prohibited on 
          hospital grounds and requires each hospital to establish a 
          contraband committee, comprised of hospital management and 
          designated employees, to develop the list.  Specifically,  this 
          bill  : 

          1)Permits each state hospital, for its safety and security, to 
            develop a list of items that are deemed contraband and 
            prohibited on hospital grounds, and control and eliminate 
            contraband on hospital grounds.

          2)Requires each state hospital to form a contraband committee, 
            composed of hospital management and employees designated by 
            the hospital's director, to develop the list.  Requires the 
            list to be developed with the participation of patient 
            representatives, or the patient government of the hospital, if 
            one exists, and the Office of Patients' Rights (OPR).

          3)Makes the list subject to review and approval by the Director 
            of DMH or his or her designee.

          4)Requires the list to be updated and subject to review and 
            approval by the Director of DMH or his or her designee at 
            least every six months.

          5)Specifies that the list shall be posted prominently in every 
            unit of the hospital and throughout the hospital, and provided 
            to a patient upon request.

          6)Authorizes each state hospital and DMH to implement, 
            interpret, or make specific the requirements of this bill 
            without taking regulatory action.
           
           EXISTING LAW  :  









                                                                  AB 2531
                                                                  Page  2

          1)Charges DMH with managing the care and treatment of mentally 
            ill patients at California's five state mental hospitals: 
            Atascadero (ASH); Coalinga (CSH); Metropolitan (MSH); Napa 
            (NSH); and, Patton (PSH).

          7)Designates NSH and MSH to only treat low-to-moderate risk 
            patients and requires high-risk patients to only be treated at 
            ASH or PSH, a correctional facility, or other secure facility. 
             

          8)Requires DMH, in state regulation, to adopt uniform rules and 
            regulations for the conduct and management of the state 
            hospitals, including prohibiting patients from possessing 
            certain items.

          2)Permits the Director of DMH to prohibit the possession or use 
            of tobacco products on the grounds of a state hospital, upon 
            receiving a request from the director of the state hospital, 
            as specified.  
          9)Prohibits, in state regulation, wireless communication 
            devices, as specified, within a state hospital.  

          10)Makes, with specified exceptions, a person who possesses with 
            the intent to deliver, or who delivers, to a patient in a 
            state hospital a wireless communication device, tobacco 
            products or currency, except as authorized, guilty of a 
            misdemeanor, punishable by a maximum fine of $1,000 for each 
            item.

           FISCAL EFFECT  :  This bill has not yet been analyzed by a fiscal 
          committee.

           COMMENTS  :

           1)PURPOSE OF THIS BILL  .  DMH is sponsoring this bill to grant 
            each state hospital the ability to develop an individualized 
            list of contraband items that are forbidden for possession by 
            patients.  DMH writes that an effective contraband policy was 
            routinely enforced at each of the five facilities until 2009 
            when the Office of Administrative Law (OAL) ruled that the 
            policy constituted an underground regulation.  DMH rescinded 
            the policy in response to the OAL ruling and currently has no 
            contraband lists in effect.  DMH states that each state 
            hospital must be able to prevent the possession of dangerous 
            or harmful items on hospital grounds in order to ensure the 








                                                                  AB 2531
                                                                  Page  3

            safety of staff, patients, and visitors.  This bill seeks to 
            provide a mechanism for state hospitals to create, update, and 
            enforce their own contraband lists, independent of the 
            regulatory process. 

           2)BACKGROUND  .  DMH oversees the operation of the five state 
            hospital campuses as well as two acute psychiatric programs 
            that provide treatment to a combined patient population of 
            over 5,000.  There has been a dramatic shift in the patient 
            population at state hospitals in the last decade as the number 
            of patients committed by way of the criminal justice system 
            has risen while the number of patients referred by counties 
            under civil commitments has declined.  DMH reports that the 
            forensic population now comprises 92% of the state hospital 
            system.

          DMH reports that contraband items are a constant and sizeable 
            problem within the state hospital system.  In the 2010-11 
            fiscal year, more than 3,000 items of contraband were 
            confiscated system-wide, ranging from shanks, razors, and 
            lighters to illegal drugs, cigarettes, and alcohol.  
            Contraband items led to 123 hospital lockdowns over the same 
            period.  DMH indicates that contraband items represent a 
            significant source of danger to staff and patients, not only 
            because some items may be used as weapons, but also because 
            contraband items are often the cause of incidents of 
            aggression between the patients and staff.  

           3)PRIOR CONTRABAND POLICY  .  Prior to the OAL determination in 
            2009, DMH's contraband policy specified that any item 
            constituting safety or security concerns could be denied or 
            confiscated and any item received that was not included on an 
            allowable property or contraband list was subject to return to 
            sender or donation to charity.  The system-wide policy 
            required all allowable items to be from an approved source 
            based on a thorough inspection by hospital staff.  At the 
            time, each hospital maintained its own contraband list as each 
            facility's needs varied based on the patient population and 
            the physical infrastructure of the hospital campus.  For 
            example, DMH points out that the safety and security 
            priorities at CSH, a closed campus with a patient population 
            comprised primarily of sexually violent predators, differ from 
            those at NSH, an open campus whose population largely consists 
            of low-to-moderate risk criminal offenders.  As a result, each 
            hospital had different methods and timing for updating its 








                                                                  AB 2531
                                                                  Page  4

            list, ranging from once per year (ASH) to as often as once per 
            month (CSH).  However, DMH adds that each hospital retained 
            the ability to update its list as needed in the event of an 
            emergency.  DMH asserts that, in order to provide a safe, 
            secure and therapeutic environment, the state hospital system 
            must have an effective way to control the items possessed by 
            patients.  

          DMH states that it is pursuing the authority for each hospital 
            to establish contraband policies through legislation rather 
            than the regulatory process because the administrative process 
            of enacting regulations is often lengthy, usually a year or 
            more, and each hospital needs flexibility to develop and 
            continuously update its own contraband list, rather than going 
            through the process of enacting a regulation each time a new 
            item needs to be added to the list.  DMH also notes that, 
            unlike the regulatory process, this bill provides for the 
            direct involvement of patients and patients' rights groups in 
            the development of the contraband policies. 

          4)OPR  .  The OPR provides investigative and advocacy services to 
            persons with mental disabilities who are receiving treatment 
            in a facility under the jurisdiction of DMH.  The OPR provides 
            direct advocacy services in the state hospitals as well as 
            training and technical assistance to all county patients' 
            rights advocates.  OPR is charged with ensuring that all 
            patients are informed of their rights in a language and manner 
            that is easily understood by the patient upon admission to a 
            facility and annually thereafter; when there is a change in 
            the patient's legal status; and, when the patient is 
            transferred to another unit or facility. 

           5)PROPOSED DEPARTMENT OF STATE HOSPITALS  .  The Governor's 
            2012-13 State Budget proposes to eliminate DMH and create a 
            new Department of State Hospitals.  The Governor's plan would 
            shift community mental health programs and related state 
            functions to other departments, offices, and commissions and 
            eliminate some programs entirely.  Under the Governor's plan, 
            the workload that would remain at DMH would mainly be the 
            administration of the state hospitals.  The Governor's 
            Administration states that a new and separate department is 
            needed to oversee these facilities in order to comprehensively 
            focus on mitigating significant health and public safety 
            issues, centralize administrative functions, and address core 
            patient population management and fiscal administration.  It 








                                                                  AB 2531
                                                                  Page  5

            is unknown how the proposal to establish this new department 
            will interact with this bill.  

           6)SUPPORT  .  The California Association of Psychiatric 
            Technicians, which represents direct care mental health 
            nursing professionals at state hospitals, writes in support 
            that this bill improves safety and security by allowing each 
            facility to create and update a consistent list of contraband 
            and to establish facility-specific committees aimed at 
            eliminating the dangers posed by contraband.  The California 
            Statewide Law Enforcement Association writes that the 
            introduction of dangerous items and substances in these 
            facilities has significantly increased as a result of the 
            forensic nature of the patient population and DMH needs the 
            flexibility provided in this bill to ban or restrict specific 
            items from these facilities to improve safety. The California 
            Psychological Association adds that this bill is a positive 
            step toward providing a safer work environment for employees.  
             

           7)RELATED LEGISLATION  .  AB 2399 (Allen) requires each of the 
            state hospitals to update its injury and illness prevention 
            plan (IIPP) at least once a year and establish an IIPP 
            committee to provide recommendations for updates to the plan.  
            AB 2399 was heard in this committee on April 17, 2012, and 
            passed with a vote of 10-0.

           8)PRIOR LEGISLATION  .  

             a)   SB 796 (Blakeslee), Chapter 201, Statutes of 2011, makes 
               the delivery of wireless communication devices, tobacco, 
               and money to state hospital patients a misdemeanor, 
               punishable by a fine of up to $1,000 per prohibited item. 
                
             b)   AB 3010 (Blakeslee), Chapter 505, Statutes of 2008, 
               permits DMH to ban the sale and use of tobacco products on 
               state hospital grounds.

           9)AUTHOR'S AMENDMENT  .  The author will be accepting an amendment 
            in committee to require the contraband list to be posted on 
            each facility's Internet Website.
           
           REGISTERED SUPPORT / OPPOSITION  :  

           Support 








                                                                 AB 2531
                                                                  Page  6

           
          Department of Mental Health (sponsor)
          California Association of Psychiatric Technicians
          California Psychological Association
          California Statewide Law Enforcement Association

           Opposition 
           
          None on file.
           

          Analysis Prepared by  :    Cassie Royce / HEALTH / (916) 319-2097