BILL ANALYSIS
SENATE HEALTH
COMMITTEE ANALYSIS
Senator Sheila J. Kuehl, Chair
BILL NO: SB 851
S
AUTHOR: Steinberg and Romero
B
AMENDED: March 27, 2007
REFERRAL: Health and Public Safety
8
HEARING DATE: April 11, 2007
5
FISCAL: Appropriations
1
CONSULTANT:
Tadeo/cjt
SUBJECT
Mentally ill offenders
SUMMARY
Authorizes Superior Courts to develop and implement Mental
Health Courts, for individuals suffering from serious
mental illness against whom a complaint or citation for a
misdemeanor or felony offense is pending.
Requires the Department of Corrections and Rehabilitation
(CDCR) to ensure that all parolees with serious mental
illness receive comprehensive mental health and support
services comparable to community standards established by
the Department of Mental Health (DMH).
Requires peace officers, under certain circumstances, to
determine if a suspect is suffering from a serious mental
health illness or substance abuse condition and to contact
the county mental health director to ascertain if treatment
is available, as specified.
CHANGES TO EXISTING LAW
Existing law:
Under existing law, the Council on Mentally Ill Offenders
Continued---
STAFF ANALYSIS OF SENATE BILL 851 (Steinberg and Romero)
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in the CDCR investigates and promotes cost-effective
approaches for long-term needs of adults and juveniles with
mental disorders who are likely to become offenders, or who
have a history of offending, by considering strategies to
improve service coordination among state and local mental
health, criminal justice and juvenile justice programs, as
specified. Existing law also establishes a procedure
whereby, if, in the opinion of the Director of the CDCR,
the rehabilitation of any mentally ill, mentally deficient,
or insane person confined in a state prison may be
expedited by treatment at any of the state hospitals, the
person may be evaluated to determine if he or she would
benefit from care and treatment in a state hospital.
Existing law requires, as a condition of parole, that a
prisoner with a treatable severe mental disorder which was
one of the causes of, or was an aggravating factor in, the
commission of the crime for which they are incarcerated, be
treated by the DMH, as specified.
In addition, the Adult and Older Adult Mental Health System
of Care Act provides for the establishment of service
standards to ensure that persons with serious mental
illness are identified, and that services are provided to
assist them to reach their potential as productive
citizens. Plans for services include, but are not limited
to, outreach to families, coordination and access to
medication, psychiatric and psychological services,
substance abuse services, supportive housing assistance
vocational rehabilitation and veterans' services.
This bill:
This bill would authorize Superior Courts in each county to
develop and implement Mental Health Courts, in coordination
with court, criminal justice, mental health and substance
abuse systems, through a collaborative process with
stakeholders, for individuals suffering from serious mental
illness, against whom complaints or citations for a
misdemeanor or felony offense are pending.
This bill would require the superior court to develop
standards for continuing participation in, and successful
completion of, the Mental Health Court program through a
collaborative process, and would establish procedures as
STAFF ANALYSIS OF SENATE BILL 851 (Steinberg and Romero)
Page 3
follows:
Each court, with the input of local stakeholders, would
be required to establish a method of assessing every
defendant for mental illness and co-occurring disorders,
at the time a complaint or citation is filed for a
misdemeanor or felony offense, or at another specified
time determined most appropriate by local stakeholders to
consider transferring the defendant to a Mental Health
Court.
Each court, with the input of local stakeholders, would
establish case eligibility criteria specifying those
factors relating to the amenability of the defendant to
treatment and to the facts of the case, as well as to the
prior criminal history and mental health and substance
abuse history which will make the defendant eligible to
participate in Mental Health Court.
If a defendant is suffering from serious mental illness,
subsequent evaluation by the local mental health director
or other designee would determine whether a defendant who
is suffering from mental illness is appropriate for
treatment under the county criteria, and the district
attorney or other designee would also assess the case to
determine whether it meets the eligibility criteria
established by the county.
If a defendant is determined to be eligible to
participate in a Mental Health Court and consents to
participate, the defendant would be placed on probation
and be required to participate in the program for a
minimum of one year.
The terms and conditions of probation or parole would
include participation in a mental health treatment
program.
If the defendant fails to successfully complete the
mental health treatment program, the court would be
required to sentence the defendant for the current
misdemeanor or felony offense.
This bill would require Mental Health Courts to use
community mental health providers and other agencies to
offer defendants access to appropriate treatment services;
establish a treatment plan for each defendant based on a
formal assessment of the defendant's mental health and
substance abuse treatment needs; and, require the defendant
STAFF ANALYSIS OF SENATE BILL 851 (Steinberg and Romero)
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to complete the recommended treatment plan and meet any
other terms and conditions that would optimize the
likelihood that the defendant will complete the program.
This bill requires the CDCR to ensure that all parolees
with serious mental illness receive comprehensive mental
health and support services comparable to community
standards established by the Department of Mental Health
(DMH). Specifically, the CDCR would be required to:
Provide training in recovery oriented rehabilitation
services and make those services available in prison.
Establish multidisciplinary service standards in
consultation with DHM, for prisoners with serious mental
illness upon release and provide annual oversight of
these services.
Provide for services in accordance with the system of
care for parolees who meet the eligibility criteria.
Establish an advisory committee of various stakeholders
to review evaluation reports, make findings on
evidence-based best practices and recommendations, and
provide written comments on the performance of each of
the programs.
Apply for social security and Medi-Cal benefits for those
considered disabled, and veteran's benefits for those
eligible, at least six months before discharge of a
prisoner with a serious mental illness, as well as begin
vocational training, independent living assistance, and
development of other skills that will be needed during
parole and afterward.
Coordinate with a program, in the last 90 days before
release of a prisoner with a serious mental illness, that
will continue the medications and support services
provided to the prisoner by CDCR during parole and after
the period of incarceration.
Additionally, the bill provides that the CDCR may contract
with a superior court and county to utilize Mental Health
Courts as an alternative court for parolees with a serious
mental illness who either violate terms of parole or
receive new terms.
This bill would require DMH to continue to work with CDCR
and other interested parties to refine and establish client
STAFF ANALYSIS OF SENATE BILL 851 (Steinberg and Romero)
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outcome and interagency collaboration goals for prisoners
and parolees, including the expected level of attainment
with participating counties. In addition, DMH would be
required to provide training, consultation, and technical
assistance to CDCR.
This bill would also set the criteria for funding each
program and allow CDCR to enter into contracts with
counties or private providers for the provision of any of
the services described.
This bill would require funding for mental health services
for parolees to be provided at sufficient levels, and to
cover only those portions of costs that cannot be paid for
with other mental health, local, state and federal funds,
or public and private insurance.
This bill also states legislative findings and intent to
encourage each correctional facility to implement a system
of care, as described, for the delivery of mental health
services to parolees with a serious mental illness.
This bill would require the CDCR, in consultation with the
advisory committee, to provide an evaluation to the
Legislature, on or before May 1 of each year in which
additional funding is provided, of the effectiveness of the
strategies for parolees in reducing homelessness,
recidivism, involvement with local law enforcement, and
other measures identified by the CDCR.
This bill would provide that, in order to reduce the cost
of providing supportive housing for clients, parolee
clinics shall enter into contracts with sponsors of
supportive housing projects to the greatest extent
possible.
This bill would require peace officers to determine if a
suspect is suffering from a serious mental health illness
or substance abuse condition and contact the county mental
health director to ascertain if there is available
treatment capacity, if they believe the suspect would not
continue to engage in criminal behavior if appropriate
treatment is received. This bill would provide that if the
suspect is willing to participate, he or she may receive
services in accordance with the Mental Health Adult System
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of Care, in lieu of arrest. If the individual fails to
remain in treatment, the bill provides that any pending
criminal charges and arrest that had been deferred pending
treatment could proceed.
This bill would also make other conforming changes to
existing law.
FISCAL IMPACT
Unknown.
BACKGROUND AND DISCUSSION
Need for the bill
The author states that people with mental illness are
overrepresented in prisons and jails. The U.S. Department
of Justice reported in September of 2006 that more than
half of all prison and jail inmates throughout the country
had a mental health problem. Without appropriate care,
these individuals continue to reenter the criminal justice
system, at a rate of 25 percent higher than for offenders
without mental illness. Although Californians are investing
as much as $1.6 billion in mental health services this year
through Prop 63, those resources are not available to
mentally ill offenders. While there are opportunities for
Prop 63 to assist with mentally ill offenders, they are
limited to assisting people not yet in the criminal justice
system. The author states that, now that community needs
are beginning to be addressed, and the prison population
has risen dramatically, it is time to address gaps in
community mental health services planning.
The author also cites the following gaps or breakdowns in
the current delivery of services to seriously mentally ill
offenders:
Pre-Booking: Access Community Services. If an officer
stops, detains, or is called into a situation with an
individual in need of mental health care, the officer has
few options. Other than jail, the only other option
available is a psychiatric emergency room for evaluation.
Many individuals are taken to county jails, not because
that is the preferred action, but simply because there is
STAFF ANALYSIS OF SENATE BILL 851 (Steinberg and Romero)
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no alternative.
Pre-Incarceration: Mental Health Courts. No state statute
specificially authorizes Mental Health Courts, which are
specialized diversion programs that offer defendants with
mental illnesses, when appropriate, the opportunity to
participate in court-supervised, community-based
treatment in lieu of typical criminal sanctions with the
goal of both recovery and reducing the chance of
repeating new crimes. A number of courts have been
funded in California with existing county and federal
funds; however, their capacity is limited.
In Prison: Recovery Oriented Methods. Current statutes do
not provide inmates with recovery-oriented treatment. The
CDCR has identified 32,000 severely mentally ill inmates,
comprising 19 percent of the total population. CDCR
serves these individuals with four programs in order of
increased severity. The Correctional Clinical Case
Management System serves inmates with the least severe
mental illnesses, comprising 16 percent of the
population. The Enhanced Outpatient Program serves
inmates with more severe mental illness, comprising two
percent of the population. The Crisis Beds serves inmates
through periods of crisis, when they are considered to be
more severely mentally ill. There are approximately 300
of these inmates. Finally, the DMH provides inpatient
care to inmates who are severely mentally ill. There are
currently 435 inmates in DMH hospitals.
Untreated mental illness among inmates is a threat to
their own and to other's safety. Mentally ill inmates
are charged with physical or verbal assaults on
correctional staff or other inmates at a rate of 71
percent higher than for offenders without mental illness.
Recovery-oriented treatment is known to move individuals
toward wellness. While CDCR may not have expertise in
these methods, community providers could work with CDCR
to adapt treatment systems to the prison environment.
Prison to Parole Transition: Provide Comprehensive
Preparation. Current law does not provide planning for
the full range of services needed by mentally ill
offenders once they are in the community on parole. CDCR
STAFF ANALYSIS OF SENATE BILL 851 (Steinberg and Romero)
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offers the Transitional Case Management Program for
mentally ill offenders, but 81 percent of eligible
inmates never appear on a list indicating their need for
these services, and if a parolee with a mental illness
makes it to the welfare office, there is still at least a
45-day wait for benefits and Medicaid.
On Parole: AB 2034 (Steinberg, 2000) Integrated Services.
Current law does not specify the administration of
proven, mental health services for parolees. Untreated
serious mental illness is a key hindrance to any
offender's rehabilitation. Untreated, the offenders are
likely to offend again. CDCR serves these offenders
through Parole Outpatient Clinics (POC). However, 45
percent never receive any POC services and only 12
percent received enough POC services to drastically
reduce the chances of being returned to custody.
Parole Violators: Reentry Courts. CDCR's only options for
mentally ill parole violators are to ignore the violation
or return them to prison. A CDCR study of parole
revocation for mentally ill offenders showed that 76
percent of them had been revoked on parole and returned
to prison within 12 months and that 94 percent of them
had returned within 24 months. This is primarily due to
untreated mental health needs resulting in technical
violations or criminal behavior. Allowing Mental Health
Courts jurisdiction over these violators will give these
parolees mental health support when needed in the
community, where it is more cost effective than in
prison.
Parole to Community Transition: Identify Community
Service Support
There is no statutory direction to plan for the care of
mentally ill individuals who are leaving parole. As
parolees leave CDCR's jurisdiction, there should be a
plan for community services so individuals can benefit
from a continuity of care by requiring counties receiving
Prop 63 funds to plan for the incorporation of seriously
mentally ill offenders leaving parole and transitioning
into community-based services.
Prior legislation
STAFF ANALYSIS OF SENATE BILL 851 (Steinberg and Romero)
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AB 34 (Steinberg, 1999) Revises existing county
demonstration programs serving severely mentally ill adults
and established a grant program for counties with
significant numbers of homeless mentally ill adults.
Chapter 617, Statutes of 1999.
AB 2034 (Steinberg, 2000) Continues and expands a
demonstration program initiated by AB 34 (Steinberg, 1999.)
Funds three pilot programs in Los Angeles, Sacramento, and
Stanislaus Counties to provide extended community mental
health service and outreach to mentally ill adults who are
homeless or at risk of homelessness. Established
Comprehensive Systems of Care and reduced hospitalizations
by 52 percent and incarcerations by 72 percent. Chapter
518, Statutes of 2000.
Proposition 63, enacted in 2004 Provides funds to counties
to expand services and develop innovative programs and
integrated service plans for mentally ill children, adults
and seniors with a tax on personal income above $1 million.
SB 1469 (Cedillo, 2006) Requires a county juvenile
detention facility to provide specified information
relating to a ward of the county who is scheduled to be
released to the appropriate county welfare department and
requires the county to initiate an application and
determine the individual's eligibility for the Medi-Cal
program. Chapter 657, Statutes of 2006
Arguments in support
Supporters state that this bill will give prisoners
recovery-oriented services and give parolees the
comprehensive AB 2034 model of "whatever it takes" care.
While this may increase parole mental health costs, the
success of AB 2034 programs in reducing incarceration
proves that it will significantly reduce recidivism and
reap savings far outweighing those costs.
Supporters further state that this bill would provide
incentives for the expansion of Mental Health Courts, which
would provide for post-booking diversion of eligible
mentally ill defendants, and treatment in the community
STAFF ANALYSIS OF SENATE BILL 851 (Steinberg and Romero)
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under deferred sentencing arrangements by the court. The
structure provided by court supervision is often the only
way to reverse patterns of repeat offenses,
hospitalization, or violence in the community for some
individuals with a mental illness.
Supporters also argue that Mental Health Courts will help
overcome prison crowding conditions by addressing the
situation of prisoners with mental illness, many of whom
would not be in prison if they had access to effective
community based mental health treatment.
Finally, supporters state that Mental Health Courts offer a
way out of revolving door arrest, incarceration,
hospitalization, and in some cases, violence, and offer
individuals a chance to reclaim their lives from untreated
mental illness.
COMMENTS AND QUESTIONS
1.Protocol for assessing mental health conditions and
substance abuse by law enforcement officials. Under
existing law, peace officers are responsible for
determining if a suspect is suffering from a serious
mental illness by observing specific behaviors, and
following procedures in which they are trained, to detect
and determine the condition of the individual. This bill
goes further and requires a peace officer to make a
mental health diagnosis and predict behavioral outcomes.
Additionally, the language in this bill does not provide
for an assessment of substance abuse.
Suggested amendments:
Page 4, lines 4 - 10, and page 5, lines 1 - 2:
SEC. 2. Section 851.95 is added to the Penal Code, to
read:
851.95. (a) Based on Police Officer Standards and
Training protocols, if a law enforcement official peace
officer suspects that a crime has been committed by an
individual with a severe serious mental health illness ,
and believes that with mental health or substance abuse
STAFF ANALYSIS OF SENATE BILL 851 (Steinberg and Romero)
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treatment, criminal behavior would not, in all
likelihood, continue which may include a substance abuse
condition, and the person is willing to participate in a
treatment program, the law enforcement official peace
officer shall contact the county mental health director
to ascertain if there is available treatment capacity.
2.Source of referral to Mental Health Courts. The bill
specifies that defendants may be referred to the Mental
Health Courts by a variety of sources, including, but not
limited to, judges within the court, police, attorneys,
family members, probation officers, the district
attorney, the public defender and jail personnel. It
would be more appropriate to have the referral come
exclusively from the courts.
Suggested amendments:
Page 5, lines 34 - 38
1001.130 (d) A Mental Health Court shall meet the
following criteria:
(1) Defendants may shall be referred to the Mental Health
Court from a variety of sources, including, but not
limited to, by judges within the superior court, police,
attorneys, family members, probation officers, the
district attorney, the public defender, and jail
personnel. and such other sources as approved by the
court.
3.Suggested technical amendments:
i. Terminology needs to be consistent. In order to
ensure consistent terminology and reflect the author's
intent, where terms other than "serious mental
illness" are used to describe mental health conditions
in the bill, change the reference to "serious mental
illness":
page 5, line 30 "mental disability"
page 6, line 30, "mental illness"
page 6, line 36, "mental illness"
page 7, line 12, "mental illness"
page 7, line 16, "mental illness"
page 8, line 39, "mental illness"
STAFF ANALYSIS OF SENATE BILL 851 (Steinberg and Romero)
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page 10, line 11, "severe and persistent mental
illness"
page 10, line 16, "severe and persistent mental
illness"
page 10, line 18, "severe mental illness"
page 10, line 22, "severe mental illness"
page 10, line 32, "severe mental illness"
page 10, line 36, "severe and persistent mental
illness"
page 11, line 6, "disordered" change to "ill"
page 11, line 22, "serious mental disorder"
page 14, line 22, "serious mental disorder"
ii. on page 7, lines 7 - 11:
(c) If the defendant is found to be suffering from
mental illness, subsequent evaluation by the local
mental health director or his or her designee shall
determine whether a the defendant who is suffering
from mental illness is an appropriate candidate for
treatment under the county eligibility criteria
established pursuant to subdivision (b).
iii. on page 8, lines 5 - 9:
(b) The Secretary of the Department of Corrections and
Rehabilitation may contract with a superior court and
county to utilize Mental Health Courts as a reentry
referral court for parolees with serious mental illness
who either violate the terms of parole or receive new
terms , as an alternative to custody .
iii. on page 15, lines 9 -18:
2687.8. (a) The Director Secretary of the
Department of Corrections and Rehabilitation shall
establish an advisory committee for the purpose of
providing advice regarding the development of the
identification of specific performance measures for
evaluating the effectiveness of programs. The committee
shall review evaluation reports and make findings on
evidence-based best practices and recommendations. At
not less than one meeting annually, the advisory
committee shall provide to the director secretary
STAFF ANALYSIS OF SENATE BILL 851 (Steinberg and Romero)
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Department of Corrections and Rehabilitation written
comments on the performance of each of the programs.
iv. on page 16, lines 8 - 12:
2687.10. In order to reduce the cost of providing
supportive housing for clients, parolee centers
outpatient clinics shall enter into contracts with
sponsors of supportive housing projects to the greatest
extent possible. Centers are encouraged to commit a
portion of their funds to rental assistance.
5) Change location of Section 3 of the bill from
Chapter 2.73 (commencing with Section 1001.130) in
Title 6 part 2 of the Penal Code, to Chapter 2.8
(commencing with Section 1001.350) in Title 6 part 2 of
the Penal Code, - immediately following Section 1001.34
- as follows:
Chapter 2.73 becomes Chapter 2.8
1001.130 becomes 1001.350
1001.131 becomes 1001.351
1001.132 becomes 1001.352
1001.133 becomes 1001.353
1001.134 becomes 1001.354
1001.135 becomes 1001.355
POSITIONS
Support: California Catholic Conference
California Council of Community Mental
Health Agencies (sponsor)
California Medical Association
California Opioid Maintenance Providers
California Psychiatric Association
Mental Health Association in California
Sylmar Health and Rehabilitation Center
Oppose: None Received
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