BILL ANALYSIS Ó
AB 1340
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ASSEMBLY THIRD READING
AB 1340 (Achadjian)
As Amended May 24, 2013
Majority vote
HEALTH 17-0 PUBLIC SAFETY 6-0
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|Ayes:|Pan, Logue, Atkins, |Ayes:|Melendez, Jones-Sawyer, |
| |Bonilla, Bonta, Chesbro, | |Mitchell, Quirk, Skinner, |
| |Gomez, Roger Hernández, | |Waldron |
| |Bocanegra, Maienschein, | | |
| |Mansoor, Nazarian, | | |
| |Nestande, | | |
| |V. Manuel Pérez, Wagner, | | |
| |Wieckowski, Wilk | | |
| | | | |
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APPROPRIATIONS 17-0
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|Ayes:|Gatto, Harkey, Bigelow, |
| |Bocanegra, Bradford, Ian |
| |Calderon, Campos, |
| |Donnelly, Eggman, Gomez, |
| |Hall, Ammiano, Linder, |
| |Pan, Quirk, Wagner, Weber |
| | |
| | |
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SUMMARY : Requires, beginning on July 1, 2015, and subject to
available funding, each of the five state mental hospitals
(state hospitals) to establish and maintain an enhanced
treatment unit (ETU) for the placement of aggressive patients
and requires any case of assault by a patient, as specified, to
be immediately referred to the local district attorney (DA).
Specifically, this bill :
1)Directs, starting on July 1, 2015, and subject to available
funding, each state hospital to establish and maintain an ETU
as part of its facilities for the placement of aggressive
patients and requires each hospital administrator to establish
procedures to provide an increased level of security for the
ETU.
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2)Requires, beginning on July 1, 2015, and subject to available
funding, any case of assault by a patient of a state hospital
that causes injury to or illness of, or has the potential to
cause future illness of, a state hospital employee or another
patient of the state hospital that rises to the level of a
misdemeanor or felony to be immediately referred to the local
DA.
3)Specifies that if, after referral to the local DA, the patient
is found guilty of a misdemeanor or felony assault, the local
DA declines prosecution, the patient is found to be
incompetent to stand trial, or the patient is found not guilty
by reason of insanity, the patient must be placed in the ETU
of the state hospital until such time as the individual is
deemed safe to return to the regular population of the
hospital.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, this bill would have costs of more than $10 million
for the Department of State Hospitals (DSH) to activate new ETUs
based on the model currently in place at Atascadero State
Hospital. Implementation is subject to the availability of
funding.
COMMENTS : According to the author, this bill is intended to
provide an alternative mechanism for dealing with violent and
aggressive offenders who threaten the safety of hospital staff
and other patients and disrupt the care and treatment needed by
other patients. The author states that this bill will help to
protect state hospital staff and patients and decrease the level
of violence in these facilities by requiring these offenders to
be removed from the general population to receive enhanced
treatment.
The five state hospitals in California currently serve
approximately 6,521 patients. The hospitals' population has
changed dramatically over time, and now approximately 92% of
their population is considered "forensic," meaning patients have
been committed to a hospital by the criminal justice system.
According to data obtained from DSH, there were a total of 4,283
incidents involving patient-on-patient aggression and 3,050
aggressive acts against staff system-wide in 2012.
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Atascadero State Hospital is currently implementing a pilot ETU
to address violence due to mental illness that does not respond
to standard treatment. The goal of the ETU is to decrease
psychiatric symptoms of some of the most violent patients, in
order to enable DSH to simultaneously assist the patients in
their recovery, thereby increasing the safety of the facility.
Patients must meet certain criteria, based on the patient's
mental illness and psychiatric symptoms, before being admitted
to the ETU.
Outcomes data from the ETU pilot show there have been 16
patients discharged since the unit opened in December 2011.
When patient aggression is compared 90 days before ETU admission
to 90 days post-discharge, 10 of 16 patients, or 71%,
demonstrated a reduction in acts of physical violence; one
patient was equally as aggressive before and after treatment in
the ETU; and, three patients were neither aggressive before
admission, or at follow-up. DSH reports there is no follow-up
data available for three other patients who were charged with
new offenses and returned to the Department of Corrections and
Rehabilitation.
Coalinga State Hospital operates a Specialized Services Unit
(SSU), which treats individuals committed under the Penal Code
who have severe and chronic aggressive behaviors. The
therapeutic goal of the SSU is to encourage compliance with
treatment and medication in order to decrease aggressive and
socially undesirable behaviors. DSH reports that although
Coalinga State Hospital is actively tracking outcomes since the
SSU opened in September 2011, the data is not readily available.
DSH also indicates that a patient's average stay in the SSU is
six to nine months.
In opposition, California Attorneys for Criminal Justice writes
that this bill would increase costs by interrupting treatment
and any progress a patient is making by mandating referral for
prosecution and requiring extensive and expensive special
housing, treatment, and supervision once the patient is returned
to the hospital.
Analysis Prepared by : Ben Russell / HEALTH / (916) 319-2097
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