BILL ANALYSIS Ó
SB 955
Page 1
Date of Hearing: August 3, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
SB 955
(Beall) - As Amended August 1, 2016
-----------------------------------------------------------------
|Policy |Health |Vote:|10 - 3 |
|Committee: | | | |
| | | | |
| | | | |
|-------------+-------------------------------+-----+-------------|
| |Public Safety | |6 - 1 |
| | | | |
| | | | |
-----------------------------------------------------------------
Urgency: No State Mandated Local Program: NoReimbursable: No
SUMMARY:
This bill establishes a compassionate release process for a
person who has been committed to, or is in the care of, the
Department of State Hospitals (DSH) but is now terminally ill or
permanently medically incapacitated.
SB 955
Page 2
It 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). It also authorizes the adoption of regulations by DSH
to implement the process, and requires DSH to adopt regulations
pertaining to reinstatement of a commitment order suspended for
compassionate release.
FISCAL EFFECT:
This bill is likely to result in an overall GF cost savings as
described below.
1)The Department of State Hospitals (DSH) and California
Department of Corrections and Rehabilitation (CDCR) would
likely incur the following fiscal impacts:
a) Minor and absorbable one-time costs to promulgate
regulations, develop processes, and train staff, as well as
minor and absorbable ongoing costs to evaluate patients for
eligibility and perform other activities related to patient
release.
SB 955
Page 3
b) DSH anticipates 20-30 patients a year may be eligible
for this program. Although patients may be released under
this bill, it is not likely to result in fewer commitments,
given a waiting list for beds. Therefore there is no
supervision cost savings to DSH, because it will still be
operating at capacity. If individuals are transferred from
state prison to DSH, however, it could result in a
reduction in costs to CDCR commensurate with the number of
transferees.
c) Although there will not be fewer patients served, there
is a projected reduction in costs associated with the
likely differential in health care costs between released
and new patients. To the extent persons released under this
bill have significantly higher health care costs than an
average patient, significant ongoing reductions in health
care costs, potentially in the low millions are possible.
Those persons eligible for release include those close to
the end of life or permanently medically incapacitated, who
tend to have high health care costs. For context, the
Department of Health Care Services reports the top 1% of
highest-utilizing Medi-Cal enrollees have costs of over
$100,000 per year.
1)Potential cost pressure to the Medi-Cal program for enrollment
of persons released under the program. Persons released may
also be eligible for Medicare due to age or disability, which
is paid by the federal government and would cover a
significant portion of hospital and medical costs. If persons
released pursuant to this bill are childless adults under age
65, the Medi-Cal costs would be largely paid for through
federal funds. To the extent individuals required skilled
nursing services, Medi-Cal would likely be the primary payer
(GF/federal).
SB 955
Page 4
COMMENTS:
1)Purpose. This bill creates a compassionate release process for
DSH patients, which is a suspension of their commitment. The
author explains the bill establishes parity with a similar
process for correctional inmates in order to allow patients to
spend their last days in a more restrictive setting or with
their family. According to the author, it will also free up
beds for patients who could benefit from treatment and are
currently in county jails, state prisons, and hospitals
waiting for treatment capacity.
2)Background. To be eligible for compassionate release from the
prison system, a prisoner must be "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 CDCR." Compassionate release may also be available
to a prisoner who is permanently incapacitated by a medical
condition and unable to perform activities of daily living,
requiring 24-hour care. The court must also make a finding
that the conditions under which the prisoner would be released
or receive treatment do not pose a threat to public safety.
Under SB 955, in order to be eligible for compassionate
release, a patient would have to be terminally ill or
permanently medically incapacitated, and DSH would have to
certify that the patient does not pose a threat to public
safety and can no longer benefit from the mental health
treatment provided at state hospitals. Patients would be
required to meet specific criteria, a discharge treatment plan
would need to be in place, and petitions for compassionate
release would be court-approved. Recent amendments clarify
that a patient whose commitment has been suspended for
compassionate release is not under the custody or
responsibility of DSH, and also require a process for
reinstatement of a suspended commitment order based on changed
SB 955
Page 5
circumstances, such as a finding that the individual poses a
threat to public safety.
3)Eligible commitments. An MDO commitment is a post-prison civil
commitment, whereby an inmate who is about to be released on
parole is deemed to have a mental illness which contributed to
the commission of a violent crime. Persons who are incompetent
to stand trial (IST) lack the mental competency required to
participate in legal proceedings. Finally, persons who are
not guilty by reason of insanity (NGI) have been deemed insane
at the time an offense was committed.
4)Related Legislation. SB 6 (Galgiani) exempts from medical
parole and compassionate release eligibility a prisoner who
was convicted of the murder of a peace officer, as provided,
and applies the provisions of this bill retroactively. SB 6
is also on today's calendar.
5)Prior Legislation. AB 1156 (Brown), Chapter 378, Statutes of
2015, among other provisions, extended compassionate release
to eligible inmates sentenced to county jail under the 2011
Realignment Act.
Analysis Prepared by:Lisa Murawski / APPR. / (916)
319-2081