BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                AB 610
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        CONCURRENCE IN SENATE AMENDMENTS
        AB 610 (Achadjian)
        As Amended  September 3, 2013
        Majority vote
         
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        |ASSEMBLY:  |70-0 |(May 16, 2013)  |SENATE: |39-0 |(September 9,  |
        |           |     |                |        |     |2013)          |
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         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  








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          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.  








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        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  








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          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."









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        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  








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        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                                                    


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