BILL ANALYSIS                                                                                                                                                                                                    







                      SENATE COMMITTEE ON PUBLIC SAFETY
                           Senator Gloria Romero, Chair              S
                             2007-2008 Regular Session               B

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          SB 851 (Steinberg and Romero)                               
          As Amended April 18, 2007 
          Hearing date:  April 24, 2007
          Penal and Welfare and Institutions Codes
          AA:br


                          MENTALLY ILL DEFENDANTS AND INMATES  

                                       HISTORY

          Source:  California Council of Community Mental Health Agencies

          Prior Legislation: None

          Support: California Catholic Conference of Bishops; California  
                   Medical Association; California Opioid Maintenance  
                   Providers; California Psychiatric Association;  
                   Crestwood Behavioral Health, Inc.; Mental Health  
                   Association in California; Mental Health Association in  
                   Santa Barbara; Sylmar Health & Rehabilitation Center;  
                   California Society for Clinical Social Work; California  
                   Public Defenders Association; Peace Officers Research  
                   Association of California (PORAC)

          Opposition:Citizens Commission on Human Rights, Los  
          Angeles/Hollywood Chapter


                                         KEY ISSUE
           
          SHOULD the "Corrections Mental Health Act of 2007" BE ENACTED, AS  
          SPECIFIED?




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                                       PURPOSE

          The purpose of this bill is to enact numerous provisions  
          concerning how local law enforcement, the courts, and the state  
          correctional system should handle people who have serious mental  
          illnesses, including the following:  1) require peace officers  
          to contact the county mental health director to ascertain if  
          there is "available treatment capacity" if, based on certain  
          criteria, the officer suspects that a crime has been committed  
          by an individual with a serious mental illness which may include  
          a substance abuse condition and the person is willing to  
          participate in a treatment program; 2) require that, if there is  
          treatment capacity available, an arrested individual shall  
          receive services in accordance with the Mental Health Adult  
          System of Care, as specified; 3) provide that, if the individual  
          fails to remain in treatment, any pending criminal charges and  
          arrest that had been deferred pending treatment can proceed at  
          that time; 4) expressly and statutorily authorize courts to  
          implement "Mental Health Courts" for persons suffering from  
          mental illnesses, as specified, who are suspected of committing  
          a misdemeanor or felony, with locally-established case  
          eligibility criteria, as specified; 5) require CDCR to identify  
          inmates about to parole, and parolees, who are seriously  
          mentally ill, as specified; 6) require that all parolees with a  
          serious mental illness "receive comprehensive mental health and  
          supportive services comparable to the case management and  
          services available," as specified; 7) authorize CDCR to contract  
          with a Mental Health Court as a "referral court" for parolees  
          who are in violation of parole, as specified; 8) require CDCR to  
          train all persons responsible for the management and care of  
          inmates with serious mental illness to ensure that they are  
          trained in recovery-oriented rehabilitative services and that  
          those services are provided in prison; 9) require CDCR to  
          "ensure that all its correctional officers are trained in  
          dealing with inmates with mental illness"; 10) require CDCR, in  
          consultation DMH, to "establish service standards that ensure  
          that prisoners with a serious mental disorder are identified and  
          receive services;" 11) create an advisory committee, as  




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          specified; 12) enact specified funding provisions, as specified;  
          and 13) enact a multitude of additional, related provisions.

           Arrests of Persons with a "Serious Mental Illness"
           
           Current law  generally authorizes a peace officer to arrest a  
          person in obedience to a warrant, or, pursuant to the authority  
          granted to him or her, as specified, without a warrant, may  
          arrest a person whenever any of the following circumstances  
          occur:

            (1)   The officer has probable cause to believe that  
            the person to be arrested has committed a public  
            offense in the officer's presence.
            (2)   The person arrested has committed a felony,  
            although not in the officer's presence.
            (3)   The officer has probable cause to believe that  
            the person to be arrested has committed a felony,  
            whether or not a felony, in fact, has been committed.   
            (Penal Code  836.)

           Current law  generally requires an officer making an arrest  
          pursuant to a warrant to proceed with the arrested person as  
          commanded by the warrant.  (Penal Code  848.)

           Current law  generally requires that a person arrested without a  
          warrant be taken before a magistrate without unnecessary delay,  
          as specified.  (Penal Code  849 (a).)


           Current law  authorizes any peace officer to release from  
          custody any person arrested without a warrant whenever:

            (1)   He or she is satisfied that there are  
            insufficient grounds for making a criminal complaint  
            against the person arrested.
            (2)   The person arrested was arrested for intoxication  
            only, and no further proceedings are desirable.
            (3)   The person was arrested only for being under the  
            influence of a controlled substance or drug and such  




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            person is delivered to a facility or hospital for  
            treatment and no further proceedings are desirable.<1>   
            (Penal Code  849 (b).)

           This bill  would add a new section to the Penal Code to require a  
          peace officer to "contact the county mental health director to  
          ascertain if there is available treatment capacity" if, based on  
          "Police Officer Standards and Training protocols," the peace  
          officer suspects that a crime has been committed by an  
          individual with a serious mental illness which may include a  
          substance abuse condition and the person is willing to  
          participate in a treatment program.

           This bill  requires that, if "there is treatment capacity  
          available, the individual shall receive services in accordance  
          with the Mental Health Adult System of Care set forth in Section  
          5806 of the Welfare and Institutions Code.  If the individual  
          fails to remain in treatment, any pending criminal charges and  
          arrest that had been deferred pending treatment can proceed at  
          that time."

           Mental Health Courts
           
           Current law  generally authorizes a trial court to "defer entry  
          of judgment" for eligible drug offenders, provided the offender  
          pleads guilty and completes an approved drug program, as  
          specified.<2>  (Penal Code  1000.)

          ---------------------------
          <1>  Any record of arrest of a person released pursuant to  
          paragraphs (1) and (3) enumerated in the text above is  
          required to include a record of release.  Thereafter, such  
          arrest shall not be deemed an arrest, but a detention only.   
          (Penal Code  849 (c).)
          <2>  "Prior to 1996, the procedure was known as 'pretrial  
          diversion' with no guilty plea requirement.  The essential  
          change in 1996 was the requirement of a guilty plea.  However,  
          the process remains essentially a form of 'diversion,' i.e.,  
          persons charged with specified drug offenses are diverted from  
          ordinary criminal procedures."  (4 Witkin Cal.Crim.Law  
          Pretrial  341 (citations omitted).)



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           Current law  generally authorizes pretrial diversion in  
          misdemeanor cases, as specified.  (Penal Code  1001.1 et  
          seq.; 1001.50 et seq.)
           
          Current law  generally provides for diversion for defendants with  
          cognitive developmental disabilities in misdemeanor cases.   
          (Penal Code  1001.20 et seq.)

           Current law  generally provides for diversion in bad check  
          cases, as specified.  (Penal Code  1001.60 et seq.)

           

          Current law  generally provides for diversion for parents accused  
          of contributing to the delinquency of a minor, as specified.   
          (Penal Code  1001.70 et seq.)

           Current law  provides for a variety of other special programs as  
          alternatives to traditional sentencing.<3>

           This bill  would enact the "Corrections Mental Health Act of  
          2007."

           This bill  would enact a new chapter to the Penal Code entitled,  
          "Diversion of Mentally Ill Offenders," as specified.

           This bill  would authorize superior courts "to develop and  
          implement Mental Health Courts," consistent with this bill.

           This bill  would require that a Mental Health Court have the  
          following objectives:

            (1)   Increase cooperation between the courts,  
            criminal justice, mental health, and substance  
            abuse systems.
            (2)   Creation of a dedicated calendar that will  
            lead to placement of as many mentally ill  
            offenders, including those with co-occurring  
            disorders, in community treatment, consistent with  


            --------------------
          <3>  See 4 Witkin Cal. Crim. Law Pretrial  356.



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            public safety.
            (3)   Improve access to necessary services and  
            support.
            (4)   Reduce recidivism.

           This bill  would require that a Mental Health Court "provide a  
          single point of contact where a defendant with a mental  
          disability or co-occurring disorder may receive court-ordered  
          treatment and support services in connection with a diversion  
          from prosecution, a sentencing alternative, or a term of  
          probation."

           This bill  would require a Mental Health Court to meet certain  
          criteria, as specified.

           Eligibility for Mental Health Court
           
           This bill  would provide that "defendants suffering from mental  
          illness shall be eligible to participate in a Mental Health  
          Court pursuant to this chapter if a complaint or citation for an  
          offense is pending in superior court."




           Defendant Assessment - Felony and Misdemeanor Cases
           
           This bill  would require each court, "with the input of local  
          stakeholders," to "establish a method for 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."

           This bill  would require each court, with the input of  
          stakeholders, to "establish case eligibility criteria  
          specifying what factors relating to the amenability of the  
          defendant to treatment and to the facts of the case as well as  
          prior criminal history and mental health and substance abuse  




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          treatment history will make the defendant eligible to  
          participate in a Mental Health Court."
           
          This bill  would provide that 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 defendant is an appropriate candidate for  
          treatment under the county eligibility criteria established  
          pursuant to" the provisions enumerated above.

           This bill  would provide that if "the defendant is found to be  
          suffering from mental illness, the district attorney or other  
          designee shall assess his or her case to determine whether it  
          meets the county eligibility criteria established pursuant to"  
          the provisions enumerated above.

           This bill  would provide that if "a defendant is determined to  
          be suffering from mental illness, designated as treatment  
          appropriate, and his or her case meets the county eligibility  
          criteria, he or she may participate in a Mental Health Court."

           Consent to Participation; Minimum of One Year on Probation
           
           This bill  would provide that if "a defendant is determined to  
          be eligible to participate in a Mental Health Court and  
          consents to participate, the defendant will be placed on  
          probation and will be required to participate in the program  
          for a minimum of one year."

           This bill  would require that the terms and conditions of  
          probation include "participation in a Mental Health Treatment  
          Program and, if he or she is on parole, the terms and  
          conditions of his or her parole."

           Program Failure
           
           This bill  would provide that if a defendant fails to  
          successfully complete the Mental Heath Treatment Program, the  
          court shall sentence the defendant for the current misdemeanor  
          or felony offense. 




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           Parolees
           
           This bill  would require the Department of Corrections and  
          Rehabilitation ("CDCR") to identify parolees suffering from a  




































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          serious mental illness, as specified,<4> "including parolees who  
          have a pending case before a superior court, as well as  
          prisoners within 90 days of their parole date."

           This bill  would authorize CDCR to "contract with a superior  
          court and county to utilize Mental Health Courts as a referral  
          court for parolees with serious mental illness who either  
          violate the terms of parole or receive new terms, as an  
          ---------------------------
          <4>  This provision would employ the definition in Welfare and  
          Institutions Code  5600.3 (b) (2) and (3), which states:  ". .  
          .  '(S)erious mental disorder' means a mental disorder which is  
          severe in degree and persistent in duration, which may cause  
          behavioral functioning which interferes substantially with the  
          primary activities of daily living, and which may result in an  
          inability to maintain stable adjustment and independent  
          functioning without treatment, support, and rehabilitation for a  
          long or indefinite period of time.  Serious mental disorders  
          include, but are not limited to, schizophrenia, as well as major  
          affective disorders or other severely disabling mental  
          disorders.  This section shall not be construed to exclude  
          persons with a serious mental disorder and a diagnosis of  
          substance abuse, developmental disability, or other physical or  
          mental disorder.  (3) Members of this target population shall  
          meet all of the following criteria: (A) The person has a mental  
          disorder as identified in the most recent edition of the  
          Diagnostic and Statistical Manual of Mental Disorders, other  
          than a substance use disorder or developmental disorder or  
          acquired traumatic brain injury (as specified) unless that  
          person also has a serious mental disorder as defined in  
          paragraph (2).  (B) (i) As a result of the mental disorder, the  
          person has substantial functional impairments or symptoms, or a  
          psychiatric history demonstrating that without treatment there  
          is an imminent risk of decompensation to having substantial  
          impairments or symptoms.  (ii) For the purposes of this part,  
          'functional impairment' means being substantially impaired as  
          the result of a mental disorder in independent living, social  
          relationships, vocational skills, or physical condition.  (C) As  
          a result of a mental functional impairment and circumstances,  
          the person is likely to become so disabled as to require public  
          assistance, services, or entitlements."



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          alternative to custody."

           This bill  would provide that if "the parolee successfully  
          completes the Mental Health Court program, parole or probation  
          will end."

           This bill  would provide that if the "parolee fails to  
          successfully complete the Mental Health Court program, he or she  
          will be sentenced by the judge according to existing law as to  
          any case pending in the superior court and (CDCR) will take any  
          action provided by law."

           This bill  would require that the "highest priority for referrals  
          of offenders shall be given to those offenders who are on active  
          parole and have a pending case in superior court."

           This bill  would require each Mental Health Court to report to  
          CDCR, "at a minimum, the savings in prison days, reduced  
          homelessness, involvement with local law enforcement, costs of  
          dual supervision by parole and probation, and other measures  
          identified by the department resulting from implementation of  
          the Mental Health Court in a manner consistent with the present  
          reporting system for the Comprehensive Drug Court Implementation  
          Act of 1999, as specified."

           This bill  would codify numerous statements pertaining to  
          parolees with serious mental illness and mental health care  
          services and requirements, as specified, including "(s)tate and  
          county government agencies each have responsibilities and fiscal  
          liabilities for seriously mentally disordered parolees."

           This bill  would require that all parolees with a serious mental  
          illness "receive comprehensive mental health and supportive  
          services comparable to the case management and services  










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          available," as specified.<5>

           This bill  would require CDCR to "ensure the mental health needs  
          of all parolees are met in accordance with community standards  
          of mental health care.  For those with a serious mental  
          disorder, as specified,<6> this bill would require that "all  
          services shall be in accordance with" the provisions of this  
          bill, as specified.

          This bill  makes numerous codified legislative findings regarding  
          mental health care for parolees, including what should be  
          included in that care and the adult system of care model, as  
          specified.

           This bill  additionally states it is the intent of the  
          Legislature to accomplish the following:

               (1)      Encourage CDCR's Division of Adult Parole  
               Operations "to implement a system of care as  
               described in this legislation for the delivery of  
               mental health services to seriously mentally  
               disordered parolees.
               (2)      To promote system of care accountability  
               for performance outcomes that enable parolees with  
               severe mental illness to reduce symptoms that impair  
               their ability to live independently, work, maintain  
               community supports, care for their children, stay in  
               good health, not abuse drugs or alcohol, and not  
               commit crimes.
               (3)      Provide funds for mental health services  
               and related medications, substance abuse services,  
               supportive housing or other housing assistance,  
               vocational rehabilitation, and other nonmedical  
               ---------------------
          <5>  This provision cross-references Welfare and Institutions  
          Code  5806, which generally requires the state Department of  
          Mental Health to establish service standards to identify and  
          provide services for the target population which, under this  
          bill, would include individuals successfully completing parole  
          and mental health courts.
          <6>  See fn. 4.



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               programs necessary to stabilize mentally ill  
               prisoners and parolees, reduce the risk of being  
               homeless, get them off the street and into treatment  
               and recovery, or to provide access to veterans'  
               services that will also provide for treatment and  
               recovery."

           CDCR Training
           
           This bill  would require CDCR to "provide training for all  
          persons who will be responsible for the management and care of  
          persons with serious mental illness in the custody of the  
          department to ensure that they are trained in recovery oriented  
          rehabilitative services and that those services are provided in  
          prison."

           This bill  would require CDCR to "ensure that all its  
          correctional officers are trained in dealing with inmates with  
          mental illness."

           CDCR Inmates
           
           This bill  would require CDCR, in consultation with the State  
          Department of Mental Health ("DMH"), to "establish service  
          standards that ensure that prisoners with a serious mental  
          disorder, (as specified,<7>) are identified, and services are  
          provided to assist them to be able, upon release, to live  
          independently, work, and reach their potential as productive  
          citizens."

           This bill  would require CDCR to "provide annual oversight of  
          services pursuant to this part for compliance with these  
          standards."

           This bill  would enumerate numerous standards required by its  
          provisions, generally including service planning, delivery,  
          design planning and related matters, as specified.

           This bill  would require that each "client" have "a clearly  


          ---------------------------
          <7>  Id.



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          designated mental health personal services coordinator who may  
                                                                             be part of a multidisciplinary treatment team who is responsible  
          for providing or assuring needed services," with some  
          responsibilities specifically enumerated by this bill.

           This bill  would require that the "individual personal services  
          plan shall ensure that members of the target population involved  
          in the system of care receive age, gender, and culturally  
          appropriate services, to the extent feasible, that are designed  
          to enable recipients upon release to achieve enumerated goals,"  
          as specified.

           This bill  would require DMH to continue to work with CDCR "and  
          other interested parties to refine and establish client and cost  
          outcome and interagency collaboration goals including the  
          expected level of attainment with participating counties.  These  
          outcome measures should include specific objectives addressing  
          the following goals:

            (a)   Client benefit outcomes.
            (b)   Client and family member satisfaction.
            (c)   System of care access.
            (d)   Cost savings, cost avoidance, and  
            cost-effectiveness outcomes that measure short-term or  
            long-term cost savings and cost avoidance achieved in  
            public sector expenditures to the target population."

           This bill  would require DMH to provide training consultation,  
          and technical assistance to CDCR, and would require that  
          training to include the following:

            "(a)         Efforts to ensure that all of the  
            different programs are operating as well as they can.
            (b)   Information on which programs are having  
            particular success in particular areas so that they  
            can be replicated in other counties.
            (c)   Technical assistance to facilities in their  
            first two years of participation to ensure quality  
            and cost-effective service."





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           This bill  would require that services be available to parolees  
          who have a serious mental disorder who meet the eligibility  
          criteria, as specified.<8>

           This bill  would require CDCR to apply for social security,  
          Medi-Cal benefits for those considered disabled, and veteran's  
          benefits for those eligible, as well as beginning vocational  
          training, independent living assistance, and development of  
          other skills necessary for success during parole and afterward  
          at least six months before discharge of a prisoner with a  
          serious mental illness.

           This bill  would require CDCR to coordinate with a program that  
          will continue the medications and support services provided to  
          the prisoner by the department during parole, after the period  
          of incarceration, in the last 90 days before release of a  
          prisoner with a serious mental illness.  This provision also  
          would apply to CDCR prisoners under the jurisdiction of DMH, as  
          specified.

           Funding
           
           This bill  would require that funding "shall be provided at  
          sufficient levels to ensure that each facility and parolee  
          center can provide each parolee served pursuant to this part  
          with the medically necessary mental health services,  
          medications, and supportive services set forth in the applicable  
          treatment plan."

           This bill  would provide that funding "shall only cover the  
          portions of those costs of services that cannot be paid for with  
          other funds including other mental health funds, public and  
          private insurance, and other local, state, and federal funds."

           This bill  would require CDCR Adult Parole Operations to provide  
          for services in accordance with the system of care for eligible  
          parolees, as specified.<9>


          ---------------------------
          <8>  Id.
          <9>  Id.



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           This bill  would require that "planning for services shall be  
          consistent with" specified "philosophies, principles, and  
          practices, . . . ."

           Criteria for Funding
          
          This bill  would require that the "criteria for the funding for  
          each program shall include, but not be limited to, all of the  
          following:

            (a)   A description of a comprehensive strategic plan  
            for providing prevention, intervention, and evaluation  
            in a cost appropriate manner.
            (b)   A description of the population to be served,  
            ability to administer an effective service program, and  
            the degree to which local agencies and advocates will  
            support and collaborate with program efforts for  
            parolees.
            (c)   A description of efforts to maximize the use of  
            other state, federal, and local funds or services that  
            can support and enhance the effectiveness of these  
            programs."

           CDCR Advisory Committee
           
           This bill  would require CDCR to "establish an advisory  
          committee, with specified representatives, for the purpose of  
          providing advice regarding the development of the identification  
          of specific performance measures for evaluating the  
          effectiveness of programs," as specified.

           This bill  would require the committee to "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 department written  
          comments on the performance of each of the programs."

           Parolee Outpatient Clinics
           
           This bill  would require "parolee outpatient clinics (to) enter  




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          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."

           This bill  would require CDCR to report to the Legislature and  
          evaluate the "effectiveness of the strategies for parolees in  
          reducing homelessness, recidivism involvement with local law  
          enforcement, and other measures identified by the department,"  
          as specified.

           This bill  would require that the "funding provided pursuant to  
          this article shall be sufficient to provide mental health  
          services, medically necessary medications to treat severe mental  
          illnesses, alcohol and drug services, transportation, supportive  
          housing and other housing assistance, vocational rehabilitation  
          and supported employment services, money management assistance  
          for accessing other health care and obtaining federal income and  
          housing support, accessing veterans' services, stipends, and  
          other incentives to attract and retain sufficient numbers of  
          qualified professionals as necessary to provide the necessary  
          levels of these services," as specified.
           
          This bill  would authorize CDCR to contract "with counties or  
          private providers for the provision of any of the services  
          described in this article."

           DMH System of Care
           
           Current law  requires DMH to establish service standards that  
          ensure that members of the target population are identified, and  
          services provided to assist them to live independently, work,  
          and reach their potential as productive citizens, as specified.   
          (WIC  5806.)

           Current law  specifies requirements for plans for services  
          including outreach, as specified.  (WIC  5805 (a)(2).)
           
          This bill  would add individuals successfully completing parole,  
          and mental health courts to these provisions.





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           Current law  sets forth funding priorities for funding adult  
          system of care programs, as specified, (WIC  5814.)

           This bill  would add, as a third priority following 1)  
          maintaining funding for the existing programs that meet adult  
          system of care contract goals and 2) finding for counties with a  
          high incidence of persons who are severely mentally ill and  
          homeless or at risk of homelessness, "the establishment of  
          capacity for all counties to be able to serve everyone who meets  
          the criteria (for these services otherwise) who are subject to  
          arrest or hospitalization, discharged from a hospital or jail,  
          or successfully completing parole."

                RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION ("ROCA")  
                                    IMPLICATIONS
          
          California currently faces an extraordinary and severe prison  
          and jail overcrowding crisis.  California's prison capacity is  
          nearly exhausted as prisons today are being operated with a  
          significant level of overcrowding.<10>  In addition,  
          California's jails likewise are significantly overcrowded.   
          Twenty California counties are operating under jail population  
          caps.  According to the State Sheriffs' Association, "counties  
          are currently releasing 18,000 pre and post-sentenced inmates  
          every month and many counties are so overcrowded they do not  
          accept misdemeanor bookings in any form, . . . ."<11>  In  
          January of this year the Legislative Analyst's office summarized  
          the trajectory of California's inmate population over the last  
          two decades:

              During the past 20 years, jail and prison  
              populations have increased significantly.  County  
              jail populations have increased by about 66  
              percent over that period, an amount that has been  
              limited by court-ordered population caps.  The  
              --------------------
          <10>  Analysis of the 2007-08 Budget Bill:  Judicial and  
          Criminal Justice, Legislative Analyst's Office (February 21,  
          2007).
          <11>  Memorandum from CSSA President Gary Penrod to Governor,  
          February 14, 2007.



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              prison population has grown even more dramatically  
              during that period, tripling since the  
              mid-1980s.<12>






          The level of overcrowding, and the impact of the population  
          crisis on the day-to-day prison operations, is staggering:

              As of December 31, 2006, the California Department  
              of Corrections and Rehabilitation (CDCR) was  
              estimated to have 173,100 inmates in the state  
              prison system, based on CDCR's fall 2006  
              population projections.  However, . . . the  
              department only operates or contracts for a total  
              of 156,500 permanent bed capacity (not including  
              out-of-state beds, . . . ), resulting in a  
              shortfall of about 16,600 prison beds relative to  
              the inmate population.  The most significant bed  
              shortfalls are for Level I, II, and IV inmates, as  
              well as at reception centers.  As a result of the  
              bed deficits, CDCR houses about 10 percent of the  
              inmate population in temporary beds, such as in  
              dayrooms and gyms.  In addition, many inmates are  
              housed in facilities designed for different  
              security levels.  For example, there are currently  
              about 6,000 high security (Level IV) inmates  
              housed in beds designed for Level III inmates.

              . . .  (S)ignificant overcrowding has both  
              operational and fiscal consequences.  Overcrowding  
              and the use of temporary beds create security  
              concerns, particularly for medium- and  
              high-security inmates.  Gyms and dayrooms are not  
              designed to provide security coverage as well as  

              --------------------
          <12>  California's Criminal Justice System:  A Primer.   
          Legislative Analyst's Office (January 2007).



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              in permanent housing units, and overcrowding can  
              contribute to inmate unrest, disturbances, and  
              assaults.  This can result in additional state  
              costs for medical treatment, workers'  
              compensation, and staff overtime.  In addition,  
              overcrowding can limit the ability of prisons to  
              provide rehabilitative, health care, and other  
              types of programs because prisons were not  
              designed with sufficient space to provide these  
              services to the increased population.  The  
              difficulty in providing inmate programs and  
              services is exacerbated by the use of program  
              space to house inmates.  Also, to the extent that  
              inmate unrest is caused by overcrowding,  
              rehabilitation programs and other services can be  
              disrupted by the resulting lockdowns.<13>

          As a result of numerous lawsuits, the state has entered into  
          several consent decrees agreeing to improve conditions in the  
          state's prisons.  As these cases have continued over the past  
          several years, prison conditions nonetheless have failed to  
          improve and, over the last year, the scrutiny of the federal  
          courts over California's prisons has intensified.

          In February of 2006, the federal court appointed a receiver to  
          take over the direct management and operation of the prison  
          medical health care delivery system from the state.   Motions  
          filed in December of 2006 are now pending before three federal  
          court judges in which plaintiffs are seeking a court-ordered  
          limit on the prison population pursuant to the federal Prison  
          Litigation Reform Act.  Medical, mental health and dental care  
          programs at CDCR each are "currently under varying levels of  
          federal court supervision based on court rulings that the state  
          has failed to provide inmates with adequate care as required  
          under the Eighth Amendment to the U.S. Constitution.  The courts  
          found key deficiencies in the state's correctional programs,  
          including:  (1) an inadequate number of staff to deliver health  
          care services, (2) an inadequate amount of clinical space within  
          prisons, (3) failures to follow nationally recognized health  


          ---------------------------
          <13>  Analysis 2007-08 Budget Bill, supra, fn. 1.



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          care guidelines for treating inmate-patients, and (4) poor  
          coordination between health care staff and custody staff."<14>

           This bill  does not appear to aggravate the prison and jail  
          overcrowding crisis outlined above.

                                      COMMENTS

          1.  Stated Need for This Bill
           
          The author states:

               The missing element of corrections reform is mental  
               health care.  This bill looks at the continuum of an  
               offender's experience from pre-booking to  
               post-parole and provides for mental health needs  
               when appropriate.  The proposed remedies are based  
               on importing the Systems of Care approach, which has  
               been proven effective by objective evaluation and  
               solid performance measures.  The solution in SB 851  
               is in routing mentally ill offenders into services  
               as early as possible, thereby treating their needs,  
               stabilizing their illness, increasing their ability  
               to fully incorporate into the living situation  
               around them, and reducing the likelihood that they  
               will reoffend.

          2.  What This Bill Would Do
           
          This is an extensive and complex measure regarding how local law  
          enforcement, the courts, and the state correctional system  
          should handle people who have serious mental illnesses.  This  
          bill would:

                 Require peace officers to contact the county mental  
               health director to ascertain if there is "available  
               treatment capacity" if, based on certain criteria, the  
               officer suspects that a crime has been committed by an  
               individual with a serious mental illness which may include  


             --------------------------
          <14>  Primer, supra, fn. 4.



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               a substance abuse condition and the person is willing to  
               participate in a treatment program;
                 Require that, if "there is treatment capacity available,  
               an arrested individual shall receive services in accordance  
               with the Mental Health Adult System of Care," as specified;
                 Provide that, if the individual fails to remain in  
               treatment, any pending criminal charges and arrest that had  
               been deferred pending treatment can proceed at that time;

                 Expressly and statutorily authorize courts to implement  
               "Mental Health Courts" for persons suffering from mental  
               illnesses, as specified, who are suspected of committing a  
               misdemeanor or felony, with locally-established case  
               eligibility criteria, as specified;
                 Require CDCR to identify inmates about to parole, and  
               parolees, who are seriously mentally ill, as specified;
                 Require that all parolees with a serious mental illness  
               "receive comprehensive mental health and supportive  
               services comparable to the case management and services  
               available," as specified;
                 Authorize CDCR to contract with a Mental Health Court  
               for as a "referral court" for parolees who are in  
               violation, as specified;
                 Require CDCR to train all persons responsible for the  
               management and care of inmates with serious mental illness  
               in the custody of the department to "ensure that they are  
               trained in recovery oriented rehabilitative services and  
               that those services are provided in prison";
                 Require CDCR to "ensure that all its correctional  
               officers are trained in dealing with inmates with mental  
               illness";
                 Require CDCR, in consultation DMH, to "establish service  
               standards that ensure that prisoners with a serious mental  
               disorder are identified and receive services";
                 Create an advisory committee, as specified;
                 Enact specified funding provisions, as specified; and
                 Enact a multitude of additional, related provisions.

          3.  Mental Health Court:  Eligible Offenses
           




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          As explained above, this bill would appear to authorize some  
          form of diversion or deferred entry of judgment for mentally ill  
          offenders based upon locally-established assessments and  
          criteria.  It would appear that both misdemeanors and felonies  
          could be eligible for these courts.  Members may wish to discuss  
          whether there may be some category of offenses for which the  
          program contemplated by this bill may not be appropriate.  For  
          example, there may be serious crimes against the person which  
          would be beyond the scope of this kind of court.

          SHOULD ANY PARTICULAR CATEGORY OF CRIME BE STATUTORILY  
          INELIGIBLE FOR THE MENTAL HEALTH COURT CONTEMPLATED BY THIS  
          BILL?

          OR, SHOULD THIS BE LEFT UP TO INDIVIDUAL COURTS?

          4.  Diversion or Deferred Entry of Judgment  

          As explained above, this bill would provide that if a defendant  
          fails to successfully complete the Mental Heath Treatment  
          Program, the court would be required to sentence the defendant  
          for the current misdemeanor or felony offense.  (7:28-30.)  This  
          bill also provides, however, that, if "there is treatment  
          capacity available, the individual shall receive services in  
          accordance with the Mental Health Adult System of Care . . . .   
          If the individual fails to remain in treatment, any pending  
          criminal charges and arrest that had been deferred pending  
          treatment can proceed at that time." (5:9-11; emphasis added.)

          Technically, the bill is not entirely clear with respect to  
          whether it would create a deferred entry of judgment process,  
          where an offender pleads guilty and then engages in the approved  
          program, or a diversion program, where the criminal proceedings  
          are suspended as the person engages in treatment.  Current law  
          contains a diversion program for defendants with cognitive  
          developmental disabilities.  That statutory scheme provides for  
          the suspension of criminal proceedings as the person is  
          undergoing the court-ordered programming.  This true diversion  
          approach, set forth in Penal Code Section 1001.20 et seq.,  
          contains procedural elements necessary in criminal law, such as  




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          the defendant's consent and waiving of his or her right to a  
          speedy trial.  The author may wish to consider replicating these  
          sections to achieve the purposes intended in this bill.

          SHOULD THIS BILL BE REVISED TO PROVIDE FOR A TRUE DIVERSION  
          PROGRAM?

          OR, SHOULD THIS BILL BE AMENDED TO CLARIFY ITS PROVISIONS TO  
          ENACT A DEFERRED ENTRY OF JUDGMENT SCHEME FOR SERIOUSLY MENTALLY  
          ILL OFFENDERS?

          5.  Arrest  
            
          As explained above, current law sets forth provisions concerning  
          arrest powers of peace officers.  This bill would require a  
          peace officer to "contact the county mental health director to  
          ascertain if there is available treatment capacity" if, based on  
          "Police Officer Standards and Training protocols," the peace  
          officer suspects that a crime has been committed by an  
          individual with a serious mental illness which may include a  
          substance abuse condition and the person is willing to  
          participate in a treatment program.

          It appears this bill contemplates individual officers contacting  
          the county mental health director in each arrest circumstance  
          involving a person believed to be seriously mentally ill.  The  
          author may wish to work with law enforcement to ensure that this  
          provision, as a matter of practice in the field, is operable.

          AS CURRENTLY DRAFTED, WOULD THE ARREST PROVISIONS OF THIS BILL  
          BE OPERATIONAL IN THE FIELD?

          6.  Parolees in Mental Health Courts  

          As currently drafted, this bill would provide that if "the  
          parolee successfully completes the Mental Health Court program,  
          parole or probation will end."  It is unclear how this provision  
          would affect the paroling authority of CDCR or the Board of  
          Parole Hearings.  The author may wish to clarify how these two  
                                                      systems would interrelate.




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          7.  Inmates and Parolees - Systems of Care
           
          As described above, this bill contains extensive requirements  
          concerning the assessment and care of seriously mentally ill  
          inmates and parolees.  As noted above, there are several federal  
          court cases against CDCR concerning prison conditions and inmate  
          care.  In conjunction with the Plata case, last year a receiver  
          was appointed to take control of CDCR's medical system.  The  
          receiver has proposed the construction of several thousand  
          mental health beds.  The author and the Committee may wish to  
          discuss how this measure would interrelate to remedial efforts  
          concerning the Plata lawsuit, and ongoing budget discussions  
          regarding mental health care in CDCR institutions.

          HOW DOES THIS PROPOSAL RELATE TO CURRENT BUDGET DISCUSSIONS AND  
          PROPOSALS CONCERNING MENTALLY ILL INMATES AND PAROLEES?























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          8.  Existing Mental Health Courts
           
          California currently has mental health courts.  As explained by  
          the Judicial Council:

               Crises in community mental health care and the  
               long-term effects of de-institutionalization, the  
               drug epidemic of the 1980s and 1990s, the dramatic  
               increase in homelessness over the last two decades,  
               and widespread jail overcrowding have all led to an  
               increase in mental health courts. . . .

               Like drug courts, mental health courts focus on  
               treatment to restore health and reduce criminal  
               activity.  They focus on providing mentally ill  
               offenders with better access to treatment,  
               consistent supervision, and support to reconnect  
               with their families.  The biggest challenges in  
               mental health courts are in the areas of training,  
               funding, and the management of complex cases.   
               Thirteen California trial court systems reported  
               having mental health courts in operation or planned  
               as of July 2002.

               . . .

               . . .  Several types of mental health court models  
               have developed. . . .  In 2001 Los Angeles  
               implemented a mental health court for misdemeanor  
               cases, including typical quality-of-life crimes such  
               as possessing a shopping cart.  After arrest, a  
               mental health service provider conducts an  
               assessment to determine general needs and whether  
               the defendant is homeless.  Unlike drug courts, once  
               the defendant is accepted into the program, he or  
               she participates in "status hearings" with the  
               provider, not with the court.  The only time the  
               defendant shows up at court is when, after a year of  
               being clean and sober and not committing a new  




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               offense, his or her case is dismissed.  The mental  
               health court has created linkages with a variety of  
               social services, such as job training and GED exam  
               preparation.

               In January 1999, San Bernardino County's mental  
               health court began as a pilot program in the  
               superior court, with the Supervised Treatment After  
               Release (STAR) Program as its primary component. . .  
               .

               On January 4, 2001, Riverside County began a mental  
               health court in the Hall of Justice in downtown  
               Riverside. . . .

               In a mental health court, the two systems work  
               together to ensure that each defendant has the best  
               possible opportunity to comply with his or her terms  
               of probation and stay with the medical treatment  
               program.  Mental health treatment terms (such as  
               medication, substance abuse placement, psychiatric  
               visits, and counseling) are made mandatory probation  
               terms.  The defendant is made aware that failure to  
               comply means further incarceration.  All defendants  
               are placed on formal probation, and the probation  
               officer is aware of all the mental health treatment  
               terms and receives a copy of the defendant's mental  
               health evaluation.

               . . .

               The mental health court in Santa Clara County was  
               established in 1999 to serve preconviction and  
               postconviction defendants. . . .

               Both Los Angeles County and Santa Clara County also  
               have juvenile mental health courts in addition to  
               their adult mental health courts. . . .

                Funding












                                                         SB 851 (Steinberg)
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               In 2002 the Substance Abuse and Mental Health  
               Services Administration (SAMHSA) offered $8 million  
               in grant funding for mental health courts.  Other  
               funding for these court programs is provided through  
               the California Board of Corrections' Mentally Ill  
               Offender Crime Reduction (MIOCR) grant program,  
               grants for mentally ill homeless under California  
               Assembly Bill 2134, and through grants from the  
               Administrative Office of the Courts.

          IF MENTAL HEALTH COURTS ALREADY EXIST IN CALIFORNIA, WHY IS THIS  
          BILL NECESSARY?

          9.  Double-Referral from Health Committee
           
          This bill was heard and passed by the Senate Health Committee on  
          April 11, 2007.



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