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 AB 610 (Achadjian) Page 1 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 AB 610 (Achadjian) Page 2 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.