BILL ANALYSIS Ó
AB 1340
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 1340 (Achadjian)
As Amended August 20, 2014
Majority vote
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|ASSEMBLY: | |(May 30, 2013) |SENATE: |36-0 |(August 21, 2014) |
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(vote not relevant)
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|COMMITTEE VOTE: |16-0 |(August 26, 2014) |RECOMMENDATION: |concur |
|(Health) | | | | |
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Original Committee Reference: HEALTH
SUMMARY : Permits the Department of State Hospitals (DSH) to
establish and administer a pilot enhanced treatment program (ETP)
at each state hospital, for the duration of five calendar years,
for testing the effectiveness of treatment for patients who are at
high risk of the most dangerous behavior. Authorizes ETPs to be
licensed under the same requirements as acute psychiatric hospital
licensing requirements, and makes significant changes to current
requirements and procedures related to the admission of patients
and the administration of care.
FISCAL EFFECT : According to the Senate Appropriations Committee,
one-time costs likely in the low hundreds of thousands to develop
policies and regulations by DSH, one-time costs likely in the tens
of millions for the construction of new ETP facilities, significant
costs to renovate portions of current state hospital facilities to
create units for the new ETPs, increased staffing costs of about
$2.5 million per year to comply with the higher staff-to-patient
ratio required in the bill, ongoing costs of $800,000 per year for
a contracted patient advocate for ETPs and minor additional costs
for licensing of ETPs by the Department of Public Health.
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
AB 1340
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violence in these facilities by requiring these offenders to be
removed from the general population to receive enhanced treatment.
DSH oversees a total of five state hospitals for the care,
treatment, and education of severely mentally ill individuals.
Those hospitals are the Metropolitan State Hospital, Atascadero
State Hospital, Napa State Hospital, Patton State Hospital, and
Coalinga State Hospital. 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.
Atascadero State Hospital is currently implementing a pilot
enhanced treatment unit (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. Unlike the pilot ETPs authorized by this
bill, the Atascadero State Hospital Pilot does not permit ETU's to
have locked doors.
SB 852 (Leno), Chapter 25, Statutes of 2014, appropriated $2.1
million in funds available for encumbrance and expenditure until
June 30, 2016, and are authorized for the development of
preliminary plans and working drawings to implement enhanced
treatment units at state hospitals. DSH cannot proceed with the
construction phase of this project until legislation is enacted
authorizing the use of ETUs.
According to the sponsor of the bill, California Association of
Psychiatric Technicians, this urgently needed bill would provide
additional individualized care and treatment to patients with
histories of highly assaultive behavior until they are deemed safe
to return to general state-hospital units.
The Service Employees International Union, Local 1000, writes in
support that this bill provides an added protection for patients
and staff in an environment where 1% of the population commits 40%
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of the violent acts. They further state that their members are on
the ground and risk their lives every day to do this work that is
so vital to the state and the patients they serve.
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 : Paula Villescaz / HEALTH / (916) 319-2097
FN: 0005486