BILL ANALYSIS Ó
SB 651
Page 1
SENATE THIRD READING
SB 651 (Pavley and Leno)
As Amended September 6, 2013
Majority vote
SENATE VOTE :37-0
HUMAN SERVICES 7-0 HEALTH 19-0
-----------------------------------------------------------------
|Ayes:|Stone, Maienschein, |Ayes:|Pan, Logue, Ammiano, |
| |Ammiano, | |Atkins, Bonilla, Bonta, |
| |Ian Calderon, Garcia, | |Chesbro, Gomez, Roger |
| |Grove, Hall | |Hernández, Lowenthal, |
| | | |Maienschein, Mansoor, |
| | | |Mitchell, Nazarian, |
| | | |Nestande, V. Manuel |
| | | |Pérez, Wagner, |
| | | |Wieckowski, Wilk |
|-----+--------------------------+-----+--------------------------|
| | | | |
-----------------------------------------------------------------
APPROPRIATIONS 17-0
-----------------------------------------------------------------
|Ayes:|Gatto, Harkey, Bigelow, | | |
| |Bocanegra, Bradford, Ian | | |
| |Calderon, Campos, | | |
| |Donnelly, Eggman, Gomez, | | |
| |Hall, Holden, Linder, | | |
| |Pan, Quirk, Wagner, Weber | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
-----------------------------------------------------------------
SUMMARY : Establishes requirements for sexual assault
examinations of residents in state hospitals and developmental
centers, and establishes new penalties for failure of
developmental centers to report specified incidents.
Specifically, this bill :
1)Requires a developmental center to report a serious incident
involving major injury or death of a resident immediately, but
no later than within two hours of suspecting, observing or
obtaining knowledge of the incident.
SB 651
Page 2
2)Authorizes the Department of Public Health to assess a civil
penalty against the licensee of a general acute care hospital
or an acute psychiatric hospital that is part of a
developmental center of up to $100 for each day the licensee
fails to report an incident involving major injury or death of
a resident, as specified, to law enforcement.
3)Deems a developmental center's failure to report certain
incidents involving major injury or death of a resident in a
distinct part long-term health care facility, as defined, a
class B violation, as specified.
4)Requires designated investigators of state hospitals to
request a sexual assault forensic medical examination at an
appropriate facility off the grounds of the state hospital for
a resident who is a victim or reasonably suspected to be a
victim of sexual assault, as specified, and requires the
person performing the examination to obtain consent and notify
the local law enforcement agency that has jurisdiction over
the state hospital.
5)Authorizes the sexual assault forensic medical examination to
be performed at a state hospital by an independent sexual
assault forensic examiner if the state hospital is deemed
safer for the resident being examined than other facilities
and the state hospital is equipped with more adequate forensic
examination and evidence collection capacity than the
otherwise designated community examination facility, as
specified.
6)Requires designated investigators of developmental centers to
request a sexual assault forensic medical examination at an
appropriate facility off the grounds of the developmental
center for a resident who is a victim or reasonably suspected
to be a victim of sexual assault, as specified, and requires
the person performing the examination to obtain consent and
notify the local law enforcement agency that has jurisdiction
over the developmental center.
7)Authorizes the sexual assault forensic medical examination to
be performed at a developmental center by an independent
sexual assault forensic examiner if the developmental center
is deemed safer for the resident being examined than other
facilities and the developmental center is equipped with more
adequate forensic examination and evidence collection capacity
SB 651
Page 3
than the otherwise designated community examination facility,
as specified.
8)Double-joints this bill with AB 602 (Yamada) of the current
legislative session to avoid chaptering conflicts.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, costs associated with this legislation should be
minor and absorbable within existing Department of Developmental
Services (DDS) and Department of State Hospitals (DSH)
resources.
COMMENTS : This bill seeks to ensure that timely and appropriate
sexual assault examinations are performed by trained examiners
for victims and suspected victims of sexual assaults in
California's developmental centers and state hospitals.
Additionally, this bill imposes penalties for a developmental
center's failure to report specified crimes, including sexual
assault, to law enforcement. Penalties were not included in
prior legislation that created the reporting requirement.
Developmental services : The Lanterman Act guides the provision
of services and supports for Californians with developmental
disabilities. Each individual under the Lanterman Act,
typically referred to as a "consumer," is legally entitled to
treatment and habilitation services and supports in the least
restrictive environment. Lanterman Act services are designed to
enable all consumers to live more independent and productive
lives in the community. The term "developmental disability"
means a disability that originates before an individual attains
18 years of age, is expected to continue indefinitely, and
constitutes a substantial disability for that individual. It
includes intellectual disabilities, cerebral palsy, epilepsy,
and autism spectrum disorders (ASD). Other developmental
disabilities are those disabling conditions similar to an
intellectual disability that require care and management similar
to that required by individuals with intellectual disabilities.
DDS contracts with 21 regional centers, which are private
nonprofit entities, to carry out many of the state's
responsibilities under the Lanterman Act. The regional center
caseload is comprised of nearly 260,000 consumers who receive
services such as residential placements, supported living
services, respite care, transportation, day treatment programs,
work support programs, and various social and therapeutic
SB 651
Page 4
activities.
Developmental centers (DCs) : Over 1,400 regional center
consumers reside at one of California's four developmental
centers (Lanterman, Porterville, Sonoma, and Fairview) and one
state-operated, specialized community facility (Canyon Springs).
These facilities provide 24-hour habilitation and medical and
social treatment services. While some residents in these
facilities were voluntarily placed there by relatives and
conservators due to acute medical needs and other special needs
that make it unsafe for them to live in the community, some
residents have experienced involuntary placements due to court
orders (e.g., forensic placements at Porterville DC).
State hospitals : There are eight facilities in California under
the jurisdiction of the Department of State Hospitals (DSH);
five state hospitals and three psychiatric treatment facilities,
one of which (Stockton) received its first patients in July of
this year. The cumulative in-patient population of the eight
facilities is expected to be 6,560 in the 2013-14 fiscal year,
according to DSH budget estimates. Unlike developmental
centers, where residents' primary diagnoses are developmental
disabilities, most patients in state hospitals are diagnosed
with serious mental illnesses. Many of them have been
involuntarily committed because they have been deemed to be
harmful to themselves or others, or because they have committed
crimes due wholly or in part to their mental illness. The
projected top two commitment types in state hospitals during the
2013-14 fiscal year, accounting for over 40% of the population,
will be mentally disordered offenders (e.g., patients with
severe mental disorders that are not in remission, which led to
the commission of their crimes) and patients who, when
prosecuted, pled not guilty by reason of insanity.
Facility police services : The Office of Protective Services
(OPS) at developmental centers and the Department of Police
Services at state hospitals consist of on-site police officers
and investigators charged with preserving the peace, enforcing
laws and regulations, and maintaining and protecting facility
residents and their rights. The investigators and officers
within OPS are charged with duties within the facilities similar
to those of peace officers in the community, including
responding to allegations of sexual assault. However, incidents
brought to light in 2012 show that OPS investigators in the
state's developmental centers were not handling reports of
SB 651
Page 5
sexual assault appropriately for a number of years. According
to numerous reports from the state's protection and advocacy
organization, Disability Rights California, developmental center
residents accused facility caretakers of rape and molestation 36
times from 2009 to 2012, but none of those residents were sent
out for an independent examination by a trained medical
professional, nor were they even examined using a sexual assault
response team (SART) exam, also known as a "rape kit," which is
standard law enforcement practice in the community. Since these
reports of abuse, two pieces of legislation, SB 1051 (Liu and
Emmerson), Chapter 660, and SB 1522 (Leno), Chapter 666, were
both signed into law in 2012, resulting in more stringent
requirements for police officers and other staff within
developmental centers and state hospitals to report certain
incidents to law enforcement, including sexual assault
allegations. As a result, developmental centers and state
hospitals have had to tighten their processes with respect to
responding to and reporting allegations of sexual assault, which
has led to more cases being referred out of facilities for
appropriate exams, and more reports being made to Disability
Rights California, as required by law.
Sexual assault forensic medical exams : Under current law,
counties are required to have a medical professional trained in
sexual assault examinations present or on call, at all times, in
a designated county hospital. Counties with fewer than 100,000
residents are authorized to partner with the trained exam team
in a nearby county to meet this requirement. Statute defines a
medical evidentiary examination as the process of evaluating,
collecting, preserving and documenting evidence, interpreting
findings, and documenting examination results. The health care
professionals qualified to perform medical evidentiary
examinations, pursuant to Penal Code Section 13823.5(e), are
physicians and surgeons or nurses working in conjunction with a
physician and surgeon. Forensic medical examiners are trained
by the California Clinical Forensic Medical Training Center and
follow specific protocols with respect to performing the exams.
While the examination can include the collection of physical
evidence, an observation and evaluation through an interview of
the victim is also essential. The interview might include
communication through the use of anatomical dolls or drawings,
or other means that allow victims to provide information if they
are unable to talk about their assault. Examiner training in
SB 651
Page 6
specialized methods of collecting evidence can be especially
important for residents of state hospitals or developmental
centers that may have difficulty communicating verbally, either
due to their condition or emotional state. Additionally, a
thorough examination that does not simply rely on what a
resident can verbally say about their assault is essential in
cases in which residents are unable to provide testimony in
court.
Facility citations : Class AA, A and B citations are issued to
long-term health care facilities when it is found that patient
or resident rights or facility protocols have been violated,
leading to imminent danger, physical or emotional harm, or death
of a patient or resident. Class B citations for skilled nursing
and intermediate care facilities, which carry the lowest penalty
amount of $100 to $2,000, are issued when it is determined that
a long-term care patient's or resident's rights have been
violated in a manner that will likely cause significant
humiliation, indignity, anxiety or other emotional trauma to the
patient or resident (Health and Safety Code (HSC) Section 1424).
Need for the bill : This bill sets forth a standard, objective
process for developmental centers and state hospitals to follow
with respect to sexual assault examinations of their residents
in order to facilitate a higher degree of accuracy, better
outcomes for sexual assault victims, and increased
accountability within the facilities. As proposed, this bill
will still allow developmental center and state hospital
investigators to base their referrals to outside sexual assault
examiners on information they have gathered that indicates that
a resident is a victim or is reasonably suspected to be a victim
of sexual assault. However, by requiring that the interviewing
and examining duties only be carried out by qualified, trained
forensic medical examiners, the bill may help reduce bias in
evidence collection and documentation, and can mitigate the
potential to lose or degrade evidence. The processes
established in this bill may shed more light on sexual abuse
occurring in these facilities in a way that allows for better
follow-up care and treatment for victims, in addition to steps
the facilities can take to prevent future occurrences.
Analysis Prepared by : Myesha Jackson / HUM. S. / (916)
319-2089
SB 651
Page 7
FN: 0002417