BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
SB 955 (Beall) - State hospital commitment: compassionate
release
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|Version: April 26, 2016 |Policy Vote: HEALTH 7 - 2, PUB. |
| | S. 5 - 2 |
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|Urgency: No |Mandate: No |
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|Hearing Date: May 9, 2016 |Consultant: Jolie Onodera |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: SB 955 would establish a process for specified release
from the Department of State Hospitals (DSH) for a person who
has been committed to the DSH and meets the criteria of being
terminally ill or permanently medically incapacitated, as
specified, and the conditions under which the patient would be
released or receive treatment do not pose a threat to public
safety. This bill would restrict eligibility for release to DSH
patients committed as incompetent to stand trial (IST), not
guilty by reason of insanity (NGI), or mentally disordered
offenders (MDOs).
Fiscal
Impact:
DSH new process : One-time costs potentially in excess of
$150,000 (General Fund) to the DSH to develop internal
policies, training, and regulations for the new process.
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Ongoing administrative costs potentially in excess of $200,000
(General Fund) annually to evaluate patients for eligibility,
respond to patient and family requests for consideration of
release, and other activities related to patient release.
Board of Parole Hearings (BPH) : Negligible impact to receive
notification and records of MDO releases from the DSH.
Courts : Potentially significant increase in state costs
(General Fund*) for additional hearings for consideration of
potential dismissal of commitment from DSH.
Medi-Cal : Potential increase in Medi-Cal eligibility (Federal
Funds/General Fund) for treatment services to the extent a
patient is released who was previously ineligible for federal
reimbursement for services while in custody. Medi-Cal
generally provides 50 percent federal reimbursement for such
costs.
DSH commitment releases : While the number of DSH patients
potentially eligible to be released is unknown, to the extent
even five DSH commitments are released will result in
potential future cost savings (General Fund) to DSH for
custody, treatment, and services likely in the low millions of
dollars (General Fund) annually, given these patients likely
require the most intensive medical care.
*Trial Court Trust Fund
Background: Existing law provides that if the Secretary of the Department
of Corrections and Rehabilitation (CDCR) or the BPH or both
determine that a prisoner is either:
Terminally ill with an incurable condition caused by an
illness or disease that would produce death within six
months, as determined by a physician employed by the
department; or
The prisoner is permanently medically incapacitated with
a medical condition that renders him or her permanently
unable to perform activities of basic daily living, and
results in the prisoner requiring 24-hour total care,
including, but not limited to, coma, persistent vegetative
state, brain death, ventilator-dependency, loss of control
of muscular or neurological function, and that
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incapacitation did not exist at the time of the original
sentencing.
And in addition to the above criteria, that the conditions under
which the prisoner would be released or receive treatment do not
pose a threat to public safety, the Secretary of the CDCR or the
BPH may recommend to the court that the prisoner's sentence be
recalled and that the court shall have the discretion to
resentence or recall if the court finds that the facts described
above exist. (Penal Code §§ 1170 (e)(1) and (e)(2).)
This bill seeks to extend a similar process of release from
confinement, parole, or outpatient status to specified patients
committed to the DSH.
Proposed Law:
This bill would establish a process for the consideration of
release from confinement, parole, or outpatient status from the
DSH, permitting the release of persons determined to be
terminally ill or permanently medically incapacitated, and not
posing a threat to public safety, to apply in cases where a
patient has been committed to the DSH as a MDO, NGI, or IST.
Specifically, this bill:
Provides that should a DSH physician determine that a patient
meets the criteria established for compassionate release to
notify the medical director and the patient advocate of the
prognosis. If the medical director concurs with the diagnosis,
he or she shall immediately notify the Director of State
Hospitals. Within 72 hours of receiving notification, the
director or the director's designee shall notify the patient
of the discharge procedures and obtain the patient's consent
for discharge.
Provides that a DSH patient or his or her family member or
designee may contact the medical director or director at the
state hospital where the patient is located or the Director of
State Hospitals to request consideration for a recommendation
from the director to the court that the patient's commitment
be dismissed for compassionate release and the patient
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released from the department facility.
Upon receipt of a notification or request as described above,
authorizes DSH to recommend to the court that the patient's
commitment be dismissed for compassionate release and the
patient released from the department facility.
Provides that the court shall have the discretion to dismiss
the commitment for compassionate release and release the
patient if the court finds that the facts described in (1) and
(2), or (2) and (3), exist:
(1) The patient is terminally ill with an incurable condition
caused by an illness or disease that would likely produce
death within six months, as determined by a physician employed
by the department.
(2) The conditions under which the patient would be released
or receive treatment do not pose a threat to public safety.
(3) The patient is permanently medically incapacitated and
requires 24-hour total care, and the medical director
responsible for the patient's care and the Director of State
Hospitals both certify that the patient is incapable of
receiving mental health treatment.
Requires the court to hold a noticed hearing within 10 days of
receipt of a recommendation for release by the director to
consider whether the patient's commitment should be dismissed
and the patient released.
Requires the recommendation for dismissal submitted to the
court to include at least one medical evaluation, a discharge
plan, a postrelease plan for the relocation and treatment of
the patient, and the physician's and medical director's
determination that the patient meets the specified criteria.
Requires the court to order the medical director to send
copies of all medical records reviewed in developing the
recommendation to all of the following parties:
(1) The district attorney of the county from which the patient
was committed.
(2) In the case of a MDO on parole, the district attorney of
the county from which the patient was committed to the state
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prison.
(3) The public defender of the county from which the patient
was committed, or the patient's private attorney, if one is
available.
(4) In the case of a MDO on parole, the public defender of the
county from which the patient was committed to the state
prison, if one is available, or the patient's private
attorney, if applicable.
(5) If the patient is a MDO on parole, the BPH.
(6) If the patient is on mandatory supervision or postrelease
community supervision and has been found incompetent to be
adjudged to punishment, the county entity designated to
supervise him or her.
Specifies venue for court hearings.
Requires a patient's commitment to be dismissed and the
patient to be released by the DSH within 72 hours of receipt
of the court's order, unless a longer time period is requested
by the director and approved by the court.
Requires the DSH director or his or her designee to ensure
that upon release, the patient has each of the following in
his or her possession, or the possession of the patient's
representative: A discharge plan, discharge medical summary,
medical records, identification, all necessary medications,
any property belonging to the patient.
Requires that after discharge, any additional records shall be
sent to the patient's forwarding address.
Authorizes the DSH to adopt regulations to implement this
section, as specified.
Provides that nothing in the bill precludes a patient who is
released pursuant to the bill's provisions from being
committed to a state hospital under the same commitment or
another commitment.
Prior
Legislation: SB 1462 (Leno) Chapter 837/2012 provided for the
medical parole or compassionate release of persons incarcerated
in county jails.
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SB 1399 (Leno) Chapter 495/2010 provided for the medical parole
of permanently medically incapacitated state prison inmates.
AB 29 (Villaraigosa) Chapter 751/1997 provided for the
compassionate release of state prison inmates with an incurable
condition caused by an illness or disease that would produce
death within six months.
Staff
Comments: The DSH will likely incur one-time costs potentially
in excess of $150,000 to develop internal policies, provide
training, and adopt regulations for this process. Ongoing
operational costs as required by the provisions of the bill
could additionally result in workload that is not absorbable
within existing resources.
The BPH has indicated negligible fiscal impact associated with
this measure, as the bill just requires the DSH to notify the
BPH upon the release of an MDO and send copies of all medical
records reviewed in developing the recommendation to the BPH.
Recommended Amendments: The use of the term "compassionate
release" in this bill may cause confusion with existing
provisions of law. The release of a prison or jail inmate
diagnosed with a terminal illness is generally referred to as
"compassionate release," and existing law specifically refers to
this term in Government Code § 26605.6 as it relates to jail
prisoners. The release of a prison or jail inmate determined to
be in a state of permanent medical incapacitation has generally
been referred to as "medical parole," although that term would
not be applicable for DSH patients. For clarity, the author may
wish to consider an amendment to define the new process, as
follows:
"For purposes of this section, 'compassionate release' means
release of patients who are either terminally ill, or
incapacitated and untreatable, where the other criteria for
release are met."
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