BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          AB 610 (Achadjian) - Mentally disordered offenders:  
          reimbursement for hearings on involuntary medication.
          
          Amended: June 25, 2013          Policy Vote: Public Safety 6-0
          Urgency: No                     Mandate: No (See Staff Comments)
          Hearing Date: August 30, 2013                           
          Consultant: Jolie Onodera       
          
          SUSPENSE FILE. AS PROPOSED TO BE AMENDED.


          Bill Summary: AB 610 would provide for the reimbursement, as  
          specified, of the nontreatment costs for involuntary medication  
          hearings for mentally disordered offenders (MDOs) and other  
          commitment types confined in state hospitals.

          Fiscal Impact (as proposed to be amended): 
              No net state costs for the reimbursement of the  
              nontreatment costs of MDO involuntary medication hearings.  
              As the state is currently mandated to reimburse these  
              nontreatment costs to the county in which the costs are  
              incurred, this bill is estimated to result in a shift of  
              existing state costs to instead reimburse the county seeking  
              continued treatment of the MDO. 

          Background: Existing law under Welfare and Institutions Code  
          (WIC) § 4117 provides that whenever a hearing is conducted on a  
          petition under Penal Code (PC) §§ 2966 or 2972 (for the  
          continued involuntary treatment of MDOs), the financial officer  
          or other designated official of the county in which the hearing  
          takes place shall make out a statement of all mental health  
          treatment costs and shall make out a separate statement of all  
          nontreatment costs incurred by the county for investigation and  
          other preparation for the hearing, the actual hearing, all costs  
          of maintaining custody of the patient and transporting him or  
          her to and from the hospital, and costs of appeal, to be  
          certified by the judge of the superior court of the county and  
          be sent to the Controller for approval. Upon approval, the  
          county shall be reimbursed for all nontreatment related costs  
          from funds appropriated by the Legislature for this purpose. 

          The Commission on State Mandates (COSM) previously issued  








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          statements of decision finding that costs incurred by counties  
          for implementing the civil commitment procedures (nontreatment  
          costs) for the continued involuntary treatment of persons with  
          severe mental disorders imposed a state-mandated program subject  
          to reimbursement by the state. 

          Proposed Law: This bill would provide that commencing January 1,  
          2014, the nontreatment costs associated with any hearing for an  
          order seeking involuntary treatment with psychotropic  
          medication, or any other medication for which an order is  
          required, of a person confined in a state hospital pursuant to  
          PC § 2970, are to be paid by the county seeking continued  
          treatment of the patient. In addition, this bill:
              Provides that whenever a hearing is conducted for an order  
              seeking involuntary treatment of a person confined in a  
              state hospital (not exclusive to MDOs) with psychotropic  
              medication or other medication for which an order is  
              required, the county in which the hearing is conducted must  
              make out a statement of all treatment and nontreatment costs  
              incurred by the count, as specified.
              Requires the statement all nontreatment costs to be sent to  
              the State Controller for approval and payment, out of money  
              appropriated by the Legislature, to the county treasurer of  
              the county where the trial or hearing took place.

          Prior Legislation: AB 1016 (Achadjian) Chapter 660/2011 required  
          counties to be reimbursed for specified nontreatment costs  
          incurred for MDO trials by the Department of Corrections and  
          Rehabilitation, as specified. 

          Staff Comments: By mandating reimbursement to counties for the  
          nontreatment costs of involuntary medication hearings for all  
          DSH commitment types, the provisions of this bill could result  
          in additional state costs. The DSH has indicated approximately  
          450 hearings (excluding MDO hearings) per year. Assuming  
          nontreatment costs per patient of $1,650 (including costs for a  
          judge, court clerk, court transcriber, and public defender),  
          additional state costs of about $742,000 per year could be  
          incurred. Staff notes the bill does not specify which state  
          entity would be responsible for reimbursing the counties, but  
          provides that the Controller shall cause the amount of all  
          nontreatment costs, "to be paid out of the money appropriated by  
          the Legislature." To the extent there is no appropriation in the  
          State Controller's budget for this reimbursement, it is assumed  








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          the DSH would be billed by the State Controller for these costs.

          With regard to the state-reimbursable mandated costs related to  
          MDOs previously approved by the COSM, staff notes there is  
          currently no appropriation provided for nontreatment costs  
          pursuant to several PC and WIC sections cited within WIC § 4117.  
          Although mandate claims were previously approved for specified  
          costs, these mandates have not been funded for several years and  
          are currently suspended. 
          
          This bill specifies that commencing January 1, 2014, the  
          nontreatment costs associated with any hearing for an order  
          seeking involuntary medication treatment of an MDO confined in a  
          state hospital are to be paid by the county seeking continued  
          treatment of the MDO. Because the COSM determined that the state  
          must reimburse these nontreatment costs to the county in which  
          the costs are incurred, this provision is not estimated to  
          result in increased state costs but rather a shift of existing  
          state costs that are currently paid to the county that incurred  
          the costs to the county seeking continued treatment of the MDO. 
          
          The proposed author amendments would narrow the provisions of  
          the bill to reimbursement for the nontreatment costs of  
          involuntary medication hearings for MDO commitments only,  
          thereby reducing costs.