BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                            



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                                    THIRD READING


          Bill No:  AB 610
          Author:   Achadjian (R)
          Amended:  9/3/13 in Senate 
          Vote:     21

           
           SENATE PUBLIC SAFETY COMMITTEE  :  6-0, 6/18/13
          AYES:  Hancock, Block, De León, Knight, Liu, Steinberg
          NO VOTE RECORDED:  Anderson

           SENATE APPROPRIATIONS COMMITTEE  :  7-0, 8/30/13
          AYES:  De León, Walters, Gaines, Hill, Lara, Padilla, Steinberg

           ASSEMBLY FLOOR  :  70-0, 5/16/13 (Consent) - See last page for  
            vote


           SUBJECT  :    State hospitals:  involuntary treatment

           SOURCE  :     San Luis Obispo County Board of Supervisors


           DIGEST  :    This bill provides 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.

           ANALYSIS  :  

          Existing law:
           
           1.Provides that a prisoner found to be an MDO can be required to  
            receive mental treatment as a condition of parole.  At the end  
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            of the parole period, if the person still meets the definition  
            of an MDO, he/she may be committed for treatment annually.  

          2.Provides that at the end of an MDO's parole, the state may  
            petition to extend the MDO commitment annually.  Annual  
            commitments must meet the same standards and include the same  
            trial procedures as an initial commitment during parole.  

          3.Provides that where an inmate who refused MDO treatment as a  
            condition of parole is due for release from prison without  
            parole, the California Department of Corrections and  
            Rehabilitation shall request the district attorney in the  
            county from which the inmate was sentenced to prison to seek  
            involuntary MDO commitment of the inmate.  The commitment is  
            for one year, which can be renewed annually under the same  
            procedures as the initial commitment.

          4.Provides, under the Lanterman-Petris-Short Act (LPS), that a  
            patient involuntarily confined for mental illness (as gravely  
            disabled or a danger to self or others) may refuse medication  
            unless (1) the person is unable to make rational decisions  
            about his/her medical treatment; (2) medication is  
            administered in an emergency; (3) the person is a demonstrated  
            danger (through prior conduct) and was recently dangerous.

          5.Entitles a city, county or superior court to reimbursement for  
            reasonable and necessary costs connected with state prisons or  
            prisoners, as specified. 

          6.States that no city, county, or other jurisdiction may file  
            for reimbursement more than six months after the close of the  
            month in which the costs were incurred.  

          7.States that a financial officer or other designate official of  
            a county shall make 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 reimbursed for  
            all non-treatment related costs from a fund appropriated by  
            the Legislature. 

          8.Provides that the state shall reimburse counties for  
            non-treatment (trial and hearing) costs for MDOs, as  

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            specified. 

          9.Requires, prior to the termination of parole or release from  
            prison, as specified, of a parolee or prisoner with a severe  
            mental disorder that is not in remission or cannot be kept in  
            remission without treatment, that a written evaluation on  
            remission be submitted to the district attorney of the county  
            in which the parolee is receiving outpatient treatment, or for  
            those in prison or in a state mental hospital, the district  
            attorney of the county of commitment.
           
           This bill:

          1.Requires 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.   

          2.Defines "county of commitment" to mean the county seeking the  
            continued treatment of an MDO pursuant to existing law.  

          3.Specifies that, in the case of a person who is in a prison or  
            in a state mental hospital, that the written evaluation on  
            remission be submitted to the district attorney of the county  
            of commitment to prison.

          4.Specifies that the appropriate financial officer or other  
            designated official of the county in which the proceeding is  
            held will make out a statement of all the costs incurred by  
            the county for the investigation, preparation, and conduct of  
            the proceedings, and the costs of appeal, if any.  The  
            statement will be certified by a judge of the superior court  
            of the county.  The statement will then be sent to the county  
            of commitment, which will reimburse the county providing the  
            services.

           Comments
           
          According to the author, "Under existing law, where a court  
          finds that an inmate pending parole has a severe mental  
          disorder, the State may commit him or her to a state hospital.   
          The county where the individual committed the crime may also  

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          request that the person be kept as patient in a state hospital  
          beyond parole.

          "Many patients treated in state hospitals must take medication.   
          However, in a case involving Kanuri Surgery Qawi, the California  
          Supreme Court ruled that a court must rule that patients are  
          incompetent to make medical decisions or are dangerous to  
          themselves or others, within the meaning of Welfare and  
          Institutions Code §5300 before being involuntarily medicated. 

          "Last year, the then Department of Mental Health filed  
          approximately 100 petitions seeking orders for involuntary  
          treatment with psychotropic medication for patients housed at  
          Atascadero State Hospital.  Although the counties with a state  
          hospital are not statutorily required to carry out these  
          hearings for involuntary treatment cases, it was determined that  
          it is in the best interest of the patient to hold the hearings  
          in the hospital because it minimizes disruption to the patient's  
          routine and reduces security and transportation issues.

          "While patients are guaranteed an attorney for these hearings,  
          there are no provisions in state law that make clear which  
          government entity is responsible for non-treatment costs when  
          the host county provides the services.  This lack of clarity  
          creates an unfair financial burden on counties with state  
          hospitals."

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee, 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. 

           SUPPORT  :   (Verified  8/29/13)

          San Luis Obispo County Board of Supervisors (source) 

           ASSEMBLY FLOOR  :  70-0, 5/16/13
          AYES:  Achadjian, Alejo, Ammiano, Atkins, Bigelow, Bloom,  

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            Blumenfield, Bocanegra, Bonilla, Bonta, Bradford, Brown, Ian  
            Calderon, Campos, Chau, Chávez, Chesbro, Conway, Cooley,  
            Dahle, Daly, Dickinson, Donnelly, Fong, Fox, Frazier, Garcia,  
            Gatto, Gomez, Gordon, Gorell, Gray, Hagman, Hall, Harkey,  
            Roger Hernández, Jones, Jones-Sawyer, Levine, Linder, Logue,  
            Lowenthal, Maienschein, Mansoor, Medina, Mitchell, Mullin,  
            Muratsuchi, Nazarian, Nestande, Olsen, Pan, Patterson, Perea,  
            V. Manuel Pérez, Quirk, Quirk-Silva, Rendon, Salas, Skinner,  
            Ting, Torres, Wagner, Waldron, Weber, Wieckowski, Wilk,  
            Williams, Yamada, John A. Pérez
          NO VOTE RECORDED:  Allen, Buchanan, Eggman, Beth Gaines, Grove,  
            Holden, Melendez, Morrell, Stone, Vacancy


          JG:nl  9/3/13   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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