BILL ANALYSIS Ó
SB 955
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SENATE THIRD READING
SB
955 (Beall)
As Amended August 1, 2016
Majority vote
SENATE VOTE: 24-13
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Health |10-3 |Wood, Bonilla, Burke, |Maienschein, |
| | |Campos, Roger |Steinorth, Waldron |
| | |Hernández, Lackey, | |
| | |Nazarian, | |
| | |Ridley-Thomas, | |
| | |Santiago, Thurmond | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Public Safety |6-1 |Jones-Sawyer, Lackey, |Melendez |
| | |Lopez, Low, Quirk, | |
| | |Santiago | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Appropriations |14-6 |Gonzalez, Bloom, |Bigelow, Chang, |
| | |Bonilla, Bonta, |Gallagher, Jones, |
| | |Calderon, Daly, |Obernolte, Wagner |
| | |Eggman, Eduardo | |
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| | |Garcia, Holden, | |
| | |Quirk, Santiago, | |
| | |Weber, Wood, Chau | |
| | | | |
| | | | |
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SUMMARY: Establishes a compassionate release process for a
person who has been committed to the Department of State
Hospitals (DSH) as a mentally disordered offender, has been
found not guilty by reason of insanity (NGI), or has been found
incompetent to stand trial or be adjudicated to punishment
(IST), but is now terminally ill, or permanently medically
incapacitated, as specified.
EXISTING LAW:
1)Requires a court to commit a person to a state hospital,
public or private treatment facility, or place him or her on
outpatient status if he or she is found to be NGI.
2)Requires the Director of DSH to notify the Board of Parole
Hearings (BPH) within the Department of Corrections and
Rehabilitation (CDCR), and requires DSH to discontinue
treating a parolee, if a prisoner's severe mental health
disorder is put into remission during the parole period and
can be kept in remission.
3)Authorizes the release of a prisoner from state prison, known
as "compassionate release," if the court finds that the
prisoner is terminally ill with an incurable condition caused
by an illness or disease that would result in death within six
months or is permanently medically incapacitated, as
determined by a physician employed by CDCR, and the prisoner's
release does not pose a threat to public safety.
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FISCAL EFFECT: According to the Assembly Appropriations
Committee, this bill is likely to result in an overall General
Fund (GF) cost savings as described below.
1)DSH and CDCR would likely incur minor and absorbable one-time
costs to promulgate regulations as well as minor and
absorbable ongoing costs to evaluate patients for eligibility
and perform other activities related to patient release. 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. 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.
2)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).
COMMENTS: According to the author, current law provides for a
compassionate release program for state prison inmates. The
program allows inmates who have six months left to live,
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including those receiving treatment in DSH, to be discharged to
spend their remaining time with family. However, other DSH
patients - such as NGI or IST patients - are not eligible for
such compassionate release. This creates a situation in which a
patient can be in a coma and unable to receive treatment, but
cannot be released to a more palliative care setting closer to
their loved ones.
The author states that this situation also keeps state hospital
beds from being used to treat patients that could benefit from
treatment. Currently, state hospitals have a waiting list of
more than 400 people. These individuals are languishing in
county jails, state prisons, and hospitals, while patients who
are unable to participate in treatment because they are
terminally ill or permanently incapacitated remain in state
hospitals because DSH has no compassionate release program.
The Union of American Physicians and Dentists, sponsor of the
bill and the American Federation of State, County and Municipal
Employees, American Federation of Labor and Congress of
Industrial Organizations (AFL-CIO), state that these patients do
not pose a threat to public safety and can no longer benefit
from mental health treatment. These patients are often
permanently and medically incapacitated patients and otherwise
terminally ill patients. By releasing these patients who fit
the compassionate release criteria, more resources are freed for
DSH to treat the growing list of patients waiting to be treated;
patients who can actually and truly benefit from treatment at
DSH. In authorizing DSH to petition for compassionate release,
this bill will allow a terminally ill patient to live out the
rest of their life in a less restrictive environment.
Disability Rights California (DRC) states in support that
compassionate release, when consented to by the patient and with
an adequate discharge plan, allows the person to live out their
final days in the community. Not all patients have community or
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family support so ensuring the patient consents, has adequate
community support, has patients' rights advocate involvement,
and is not removed from familiar surroundings against his or her
will is critical. This bill would establish compassionate
release provisions for a person committed to a state hospital if
the patient meets the criteria established by the bill for
release from the state hospital.
DRC further states that under existing law, if a defendant is
found to be NGI, the court is required to commit the person to a
state hospital, public or private treatment facility, or place
him or her on outpatient status. Existing law authorizes the
release of a prisoner from state prison if the court finds that
the prisoner is terminally ill with an incurable condition that
would produce death within six months and conditions under which
the prisoner would be released do not pose a threat to public
safety.
The California State Sheriffs' Association (CSSA) writes in
opposition to the bill that people who are committed to a state
hospital from the criminal justice system are dangerous and in
need of significant treatment. The desire to see such a person
enjoy a "compassionate" release because he or she is near the
end of life or meets a definition regarding his or her medical
condition should not trump the reason the person was committed
for treatment. CSSA argues that mechanisms exist to release
patients who no longer need care and that this bill goes beyond
that notion.
Analysis Prepared by:
Paula Villescaz / HEALTH / (916) 319-2097 FN:
0003810
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