BILL ANALYSIS Ó AB 610 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 610 (Achadjian) As Amended September 3, 2013 Majority vote ----------------------------------------------------------------- |ASSEMBLY: |70-0 |(May 16, 2013) |SENATE: |39-0 |(September 9, | | | | | | |2013) | ----------------------------------------------------------------- Original Committee Reference: L. GOV. SUMMARY : Requires the county of commitment to pay the non-treatment costs associated with any hearing for an order seeking involuntary treatment of psychotropic medication for a mentally disordered offender (MDO) whose commitment in a state hospital has been extended beyond the expiration of parole. The Senate amendments : 1)Narrow the provisions of the bill to establish responsibility with the county of commitment for the payment of non-treatment costs associated with any hearing for an order seeking involuntary treatment of psychotropic medication for an MDO whose commitment at a state hospital has been extended following the expiration of parole. 2)Require the appropriate financial officer or other designated official of the county in which the proceeding is held to make out a statement of all of the costs incurred by the county for the investigation, preparation, and conduct of the proceedings, and the costs of appeal, if any. Require the statement to be certified by a judge of the superior court of the county. Require the statement to then be sent to the county of commitment, which shall reimburse the county providing the services. 3)Clarify that the "county of commitment" is the county that committed the person to prison. 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 AB 610 Page 2 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 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. AB 610 Page 3 6)Requires the petition to be accompanied by specified affidavits and requires the petition to state 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 reimbursed for all AB 610 Page 4 non-treatment related costs from a fund appropriated by the Legislature. 9)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. AS PASSED BY THE ASSEMBLY , this bill: 1)Required 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)Required, 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)Defined "county of commitment" to mean the county seeking the continued treatment of a mentally disordered offender (MDO) pursuant to existing law. 4)Made technical and clarifying changes. FISCAL EFFECT : 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. COMMENTS : 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." AB 610 Page 5 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 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. Senate amendments narrowed the bill and removed the requirement that the state 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. 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. 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 AB 610 Page 6 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. 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." 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. Analysis Prepared by : Misa Yokoi-Shelton / L. GOV. / (916) 319-3958 FN: 0002313