BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: SB 651
AUTHOR: Pavley and Leno
AMENDED: April 22, 2013
HEARING DATE: May 1, 2013
CONSULTANT: Robinson-Taylor
SUBJECT : Developmental centers and state hospitals.
SUMMARY : Requires designated investigators of state
developmental centers and state hospitals to authorize a sexual
assault forensic medical examination for any resident who is a
victim or suspected victim of sexual assault, as defined.
Requires the medical examination to be performed at an
appropriate facility off the grounds of the state developmental
center or state hospital in accordance with specified
provisions.
Existing law:
1. Establishes the Department of Developmental Services
(DDS) and identifies the state's developmental centers as
being within its jurisdiction.
2. Establishes the Department of State Hospitals (DSH) and
identifies the state hospitals for the mentally disordered
as being within its jurisdiction.
3. Establishes an investigative force within each state
developmental center and state hospital for the purpose of
enforcing the rules and regulations of the facility,
preserving peace and order on the premises thereof, and
protecting and preserving the property of the state.
4. Requires a state developmental center to immediately
report specified incidents involving a resident to the
local law enforcement agency having jurisdiction over the
city or county where the developmental center is located.
5. Establishes that the Department of Public Health, which
licenses and regulates health facilities, including
long-term care facilities, as specified.
6. Establishes a series of fines and penalties to be levied
against skilled nursing facilities and intermediate care
Continued---
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facilities for each citation, as specified.
7. Requires the California Emergency Management Agency,
with the assistance of an advisory committee, to establish
a protocol for the examination and treatment of victims of
sexual assault and attempted sexual assault, including
child molestation, and the collection and preservation of
evidence therefrom.
8. Requires that each county designate at least one general
acute care hospital to perform examinations on victims of
sexual assault, including child molestation.
9. Requires that each county with a population of more than
100,000 arrange for professional personnel trained in the
examination of victims of sexual assault, including child
molestation, to be present or on call either in the county
hospital which provides emergency medical services or in
any general acute care hospital which has contracted with
the county to provide emergency medical services.
Requires, in a county with a population of 1,000,000
residents or more, the presence of these professional
personnel to be arranged in at least one general acute care
hospital for each 1,000,000 persons in the county.
This bill:
1.Requires that designated investigators at state developmental
centers and state hospitals authorize a sexual assault
forensic medical examination for any resident who is a victim
or suspected victim of sexual assault, as specified. Requires
the forensic medical examination to be performed at an
appropriate facility off the grounds of a state hospital.
2.Requires that the law enforcement agency having jurisdiction
over the city or county in which the state developmental
center or state hospital is located be notified, in accordance
with existing law, by the person performing the sexual assault
forensic medical examination.
3.Establishes that failure of a state developmental center to
report specified criminal incidents to local law enforcement
is a class B violation and subject up to a $2,000 penalty.
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
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COMMENTS :
1.Author's statement. SB 651 is designed to address the lack of
forensic evidence collection for sexual assault victims and
suspected sexual assault victims in state developmental
centers and state hospitals. The author argues that these
residents are vulnerable to sexual assault, but few, if any
receive timely forensic medical examinations by trained
independent sexual assault examiners. If there is any
follow-up, victims are interviewed and examined by untrained
staff physicians and internal facility investigators. The
author maintains that these individuals lack the expertise and
equipment necessary to conduct examinations and collect
physical evidence. Medical evidence is crucial in cases
involving individuals with disabilities who may lack the
ability to give testimony in court.
The author asserts that forensic medical examinations by trained
sexual assault nurse examiners are the best way to collect
physical evidence of a sexual assault. These examiners have
specialized training and expertise in recognizing the subtle
signs of sexual assault and interviewing sexual assault
victims. Such examinations often involve specialized
equipment (e.g. scopes with the capacity to take photographs
and procedures to ensure an unbroken chain of evidence). For
victims with cognitive intellectual disabilities, anatomical
dolls and drawings may be utilized. These resources and
expertise are not available at state facilities. SB 651 will
assist victims of sex crimes in these institutions to receive
timely and objective forensic medical examinations.
2.State Developmental Centers. DDS currently operates four
state developmental centers which care for approximately 1,800
people with developmental disabilities (Fairview in Orange
County, Lanterman in Los Angeles County, Porterville in Tulare
County, and Sonoma in Sonoma County). Each developmental
center has a mix of units that are licensed as skilled nursing
facilities, general acute care hospitals or intermediate care
facilities. Housing within the units is based on specific
resident needs. Additionally, the state operates a smaller,
state-leased community facility, Canyon Springs, in Riverside
County. Admission to state developmental centers requires a
court order and is based on a formal determination that the
developmental center is the most appropriate residential
setting available to ensure the individual's health and
safety. Referrals for admission are made through the 21
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developmental regional centers located throughout the state.
A developmental disability is defined as a severe and chronic
disability that is attributable to a mental or physical
impairment that begins before age 18. These disabilities
include intellectual disabilities, cerebral palsy, autism,
epilepsy and other similar conditions.
3.State Hospitals. DSH oversees the operation of the following
five state hospitals that provide inpatient psychiatric care
to more than 5,000 individuals committed to the hospitals
civilly or in connection with criminal proceedings:
Atascadero State Hospital located in the Central Coast;
Coalinga State Hospital, located in the city of Coalinga;
Metropolitan State Hospital, located in the City of Norwalk;
Napa State Hospital, located in the City of Napa; and, Patton
State Hospital, located in San Bernardino County.
Also under DSH and subject to the requirements of this bill
are three Department of Corrections and Rehabilitation medical
facilities that have mental health units which include:
Salinas Valley Psychiatric Program; Vacaville Psychiatric
Program; and, Stockton Psychiatric Program.
4.Sexual assault investigative concerns. In February 2012, a
series of reports by California Watch (an independent,
non-profit online investigative reporting center) outlined
questionable practices in several major crime investigations
at various state developmental centers. The series questioned
the training qualifications of developmental center
investigators and cited cases in which charts were altered and
also pointed to poor police work as a reason for a lack of
prosecutions in major cases.
An investigation requested in March 2012 by DDS and undertaken
by Disability Rights of California (DRC), the sponsor of this
bill, found 36 cases of alleged molestation of residents at
California's developmental centers by caretakers during the
last three years, but on-site police charged to protect
residents did not complete even basic forensic evidence
collections. The Office of Protective Services, the police
force at California's five developmental centers, failed to
order a single rape exam during this period. In response to
increasing concerns about DDS' failure to protect residents
from various forms of abuse, DDS announced on March 13, 2013,
that they will institute new protection for residents of the
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state's developmental centers. These measures and protocols
include actions recommended by DRC.
5.Sexual assault forensic exams. For the general population,
California law requires that a sexual assault victim be
examined by a forensic medical examiner who is required to
document findings, including the collection of evidence, by
using a series of standard state forensic medical report
forms. Examiners also are trained to adhere to specific
protocols. State law also requires each county to designate
at least one general acute hospital to perform examinations
for sexual assault victims. Counties with populations of
100,000 residents or more are required to have a medical
professional trained in sexual assault examinations present or
on call at all times in the designated county emergency
medical services hospital. Counties with fewer than 100,000
residents may contract or partner with a Sexual Assault
Forensic Exam team in a nearby county.
6.Double referral. This bill was heard in the Senate Human
Services Committee on April 9, 2013, and passed with a 6-0
vote.
7.Related legislation. AB 602 (Yamada) requires the Commission
on Peace Officer Standards and Training to update its training
to include information on handling persons who are
developmentally or intellectually disabled. Requires peace
officers who deal with these populations to take this
training. This bill is currently in the Assembly
Appropriations Committee.
8.Prior legislation. SB 1522 (Leno), Chapter 578, Statutes of
2012, requires state developmental centers to immediately
report serious incidents of abuse or criminal conduct to law
enforcement and requires the state developmental center to
submit a written report of the incident to the local law
enforcement agency within two working days of any telephone
report to that agency.
SB 1051 (Liu),Chapter 660, Statutes of 2012, requires DSH and
state developmental centers to report suspected abuse to the
designated protection and advocacy agency.
AB 430 (Cardenas), Chapter 171, Statutes of 2001, mandates that
each developmental center immediately report all resident
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deaths and serious injuries of unknown origin to the
appropriate law enforcement agency that may, at its
discretion, conduct an independent investigation.
9.Support. DRC writes in support that people with developmental
and psychiatric disabilities are at much greater risk for
sexual assault than their non-disabled peers, and are often
repeatedly victimized. According to DRC, conservative
estimates are 80 percent of women and nearly 40 percent of men
with developmental disabilities will be sexually assaulted at
least once in their lifetime. Of these, DRC asserts, 50
percent will be assaulted 10 or more times. People who have
psychiatric disabilities are 23 times more likely to be raped
than those who do not and, additionally, the risk of sexual
assault is two to four times higher in institutions than in
the community, according to DRC. DRC maintains that this bill
will increase the collection of forensic evidence and victim
statements to support criminal prosecution of sexual assaults
in facilities that serve people with disabilities.
The California Coalition Against Sexual Assault (CALCASA) writes
that, unlike sexual assault victims in the community, few, if
any, sexual assault victims who reside in state developmental
centers and state hospitals are sent for outside medical
forensic examinations. Instead, CALCASA maintains, they are
examined by doctors and nurses on duty at state developmental
centers and state hospitals. These clinicians lack the
specialized training and equipment to conduct proper
examinations and collect evidence.
SUPPORT AND OPPOSITION :
Support: Disability Rights California (sponsor)
California Alliance for Retired Americans
California Association of Psychiatric Technicians
California Coalition Against Sexual Assault (CALCASA)
California District Attorneys Association
California Statewide Law Enforcement Association
East Bay Developmental Disabilities Legislative
Coalition
The ARC/United Cerebral Palsy
The Alliance - Supporting People with Intellectual and
Developmental Disabilities
Oppose: None Received
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