BILL ANALYSIS Ó
AB 610
Page 1
Date of Hearing: April 24, 2013
ASSEMBLY COMMITTEE ON LOCAL GOVERNMENT
K.H. "Katcho" Achadjian, Chair
AB 610 (Achadjian) - As Amended: April 16, 2013
SUBJECT : State hospitals: involuntary treatment.
SUMMARY : Establishes responsibility for the payment of
non-treatment costs associated with any hearing for an order
seeking involuntary treatment of psychotropic medication for a
person confined in a state hospital. Specifically, this bill :
1)Requires the state to pay the non-treatment costs associated
with any hearing for an order seeking involuntary treatment
with psychotropic medication, or other medication that
requires an order, of a person confined in a state hospital.
2)Requires, beginning on January 1, 2014, the county of
commitment to pay the non-treatment costs associated with any
hearing for an order seeking involuntary treatment with
psychotropic medication, or other medication that requires an
order, for a mentally disordered offender whose commitment in
a state hospital has been extended beyond the expiration of
parole.
3)Defines "county of commitment" to mean the county seeking the
continued treatment of a mentally disordered offender (MDO)
pursuant to existing law.
4)Makes technical and clarifying changes.
EXISTING LAW :
1)Establishes the Mentally Disordered Offender Act.
2)Provides for the involuntary commitment of mentally ill
persons to a state hospital pursuant to various provisions of
the Welfare and Institutions Code for civil commitments and
the Penal Code, such as the patient is deemed incompetent to
stand trial (IST) or, not guilty by reason of insanity (NGI);
or the patient is an MDO.
3)States that a prisoner who is otherwise eligible for parole
may be committed for MDO treatment if the following criteria
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is met:
a) He or she has a serious mental disorder that is not in
remission or cannot be kept in remission without treatment;
b) The severe mental disorder was one of the causes of or
was an aggravating factor in the commission of a crime for
which the prisoner was sentenced to prison;
c) The prisoner has been in treatment for the severe mental
disorder for 90 days or more within the year prior to the
prisoner's parole or release;
d) Prior to the prisoner's release or parole, a practicing
psychologist or psychiatrist from the state Department of
Mental Health (DMH) have evaluated the prisoner and a chief
psychiatrist of the California Department of Corrections
and Rehabilitation (CDCR) has certified that the prisoner
has a severe mental disorder, that the disorder is not in
remission, or cannot be kept in remission without
treatment, that the severe mental disorder was one of the
causes or was an aggregating factor in the prisoner's
criminal behavior, that the prisoner has been in treatment
for the severe mental disorder for 90 days or more prior to
release, and that because of his or her severe mental
disorder the prisoner represents a substantial danger of
physical harm to others; and,
e) The prisoner was sentenced to a determinate sentence for
specified crimes.
4)Requires, if an MDO's parole period is about to expire and the
individual's severe mental disorder is not in remission or
cannot be kept in remission without treatment, the medical
director of a state hospital treating the parolee or CDCR to
submit to the district attorney of the county of commitment a
written evaluation.
5)Allows the district attorney, from the county of commitment,
upon receipt of the written evaluation to file a petition with
the superior court for continued involuntary treatment for one
year.
6)Requires the petition to be accompanied by affidavits
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specifying that treatment, while the prisoner was released
from prison on parole, have been provided by the Department of
State Hospitals. Also requires the petition to specify that
the person has a severe mental disorder and represents a
substantial danger of physical harm to others.
7)Entitles a city, county or superior court to reimbursement for
the reasonable and necessary costs connected with state
prisoners and any of the following:
a) Any crime committed in a state prison, whether by a
prisoner, employee, or other person;
b) Any crime committed by a prisoner in furtherance of an
escape, as specified;
c) Any hearing on any return of a writ of habeas corpus
prosecuted by or on behalf of a prisoner;
d) Any trial or hearing on the question of the sanity of a
prisoner:
e) Any costs not otherwise reimbursable related to
extradition of a prisoner;
f) Any costs incurred by a coroner in connection with the
death of a prisoner;
g) Any costs incurred in transporting a prisoner within the
host county or as requested by the prison facility or
incurred for extra security while the prisoner is outside a
state prison; or,
h) Any crime committed by a state inmate at a state
hospital for the care, treatment, and education of the
mentally disordered, as specified; and,
i) Any non-treatment costs, as specified.
8)States that a financial officer or other designated official
of a county shall make a statement of non-treatment and
treatment costs related to a hearing for specified prison or
state hospital related offenses, to be certified by the judge
of the superior court of that county, and sent to the
Controller for approval. Upon approval, the county shall be
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reimbursed for all non-treatment related costs from a fund
appropriated by the Legislature.
9)Provides that a person involuntarily confined for treatment of
mental illness as an MDO can be involuntarily treated with
antipsychotic medication in a non-emergency situation where
the MDO is determined by a court to be either a) incompetent
to refuse medication (unable to make rational medical
decisions); or, b) a danger to others within the meaning of
Welfare and Institutions Code section 5300 (In re Qawi, supra,
32 Cal.4th 1, 27-28).
10)Defines psychotropic medication or psychotropic drugs to mean
medications administered for the purpose of affecting the
central nervous system to treat psychiatric disorders or
illnesses. These medications include, but are not limited to,
anxiolytic agents, antidepressants, mood stabilizers,
antipsychotic medications, anti-Parkinson agents, hypnotics,
medications for dementia, and psychostimulants.
FISCAL EFFECT : Unknown
COMMENTS :
1)According to CDCR, the MDO program established in 1986,
"provides a mechanism to detain and treat severely mentally
ill prisoners who reach the end of a determinate prison term
and are dangerous to others as a result of a severe mental
disorder. MDO is a two-phase commitment. The first phase is a
certification by the [CDCR] Chief Psychiatrist and a parole
condition imposed by the Board of Parole Hearing. The second
phase continues MDO treatment after the parolee is discharged
from CDCR which is a civil commitment for involuntary
treatment."
2)Existing law entitles a city, county, or superior court to
reimbursement for reasonable and necessary costs connected
with state prisons or prisoners which include non-treatment
costs, as specified. This includes reimbursement from the
state for all the non-treatment costs of the hearings, if
requested by the defendant, when an MDO is paroled into a
state hospital instead of serving parole time in the
community. When an MDO's parole period is about to expire,
existing law permits the district attorney, from the county of
the original conviction of the defendant (county of
commitment), to file a petition seeking a one-year extension
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of the MDO commitment to the state hospital, for which the
state also provides for reimbursement to counties for the
non-treatment costs of these hearings for continued treatment.
This bill builds upon current law which defines reimbursement
for counties with state hospitals by requiring reimbursement
to be made for the non-treatment costs of a hearing for an
order seeking involuntary treatment of psychotropic medication
for a person confined in a state hospital. This bill requires
the state to pay for the non-treatment costs of a hearing for
an order seeking involuntary treatment of psychotropic
medication for a person confined in a state hospital.
Beginning January 1, 2014, this bill requires the county of
commitment to pay for non-treatment costs associated with a
hearing for an order seeking involuntary treatment of
psychotropic medication for an MDO whose commitment at the
state hospital was extended following the expiration of
parole. This bill is sponsored by the San Luis Obispo County
Board of Supervisors.
3)The Supreme Court of California decision in Kanuri Surgury
Qaui found that a person involuntary confined for treatment of
mental illness as an MDO can be involuntarily treated with
antipsychotic medication in a non-emergency situation where
the MDO is determined by a court to be either a) incompetent
to refuse medication (unable to make rational medical
decisions); or, b) a danger to others within the meaning of
Welfare and Institutions Code section 5300 (In re Qawi, supra,
32 Cal.4th 1, 27-28).
According to the author and sponsor, as a result of this
Supreme Court ruling approximately 100 petitions were filed
last year by the DMH, seeking orders for involuntary treatment
with psychotropic medication for patients housed at Atascadero
State Hospital (ASH), in San Luis Obispo County. Since
current law does not designate which entity is responsible for
the payment of non-treatment costs associated with these
hearings, the county engaged in a dispute with the state over
whose responsibility it was to provide for the cost of public
defender services to represent these 100 mentally disordered
offenders at these hearings.
It was ultimately decided by the courts that the
responsibility for the non-treatment costs for these 100 cases
would be with the state and the county of commitment.
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The sponsor argues, "Because statute is unclear, however, it
is possible for the State or a county of commitment to
challenge the County's right to obtain reimbursement from the
State or another county for the costs of public defender
services for mentally disordered offenders housed at ASH. The
County's concerns is that being a 'hosting' county of a state
mental hospital should not result in the county shouldering
the financial burden of paying for certain costs resulting
from the commitment of persons to ASH who are not residents of
San Luis Obispo County, nor persons who committed crimes
within our jurisdiction. For example, in addition of the
$25,000 incurred last spring, the County expects to expend
approximately $40,000 in the current fiscal year on contract
public defense attorneys for involuntary medication hearings."
4)According to the sponsor, only ASH and Coalinga in Fresno
County have MDO patients. According to a March 1, 2012 report
by the Legislative Analyst's Office (LAO) regarding the
oversight and accountability of state hospitals, five state
hospitals provide inpatient psychiatric care to more than
5,000 individual patients under several forensic commitment
classifications, including Not Guilty by Reason of Insanity,
Incompetent to Stand Trial (IST), sexually violent predator
(SVPs), and MDOs. DMH reports the forensic population is now
approximately 92 percent of the state-wide hospital system.
5)Support arguments : Supporters argue that the lack of clarity
in current law creates an unfair financial burden on counties
with state hospitals that treat MDOs, and that this bill will
ensure these counties are reimbursed for costs incurred as a
consequence of having these hospitals located within their
jurisdiction.
Opposition arguments : None.
REGISTERED SUPPORT / OPPOSITION :
Support
San Luis Obispo County Board of Supervisors [SPONSOR]
AB 610
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Opposition
None on file
Analysis Prepared by : Misa Yokoi-Shelton / L. GOV. / (916)
319-3958