BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Tom Torlakson, Chairman
851 (Steinberg)
Hearing Date: 5/31/07 Amended: 5/2/07
Consultant: Nora Lynn Policy Vote: Health 7-3; Pub Saf
4-1
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BILL SUMMARY: SB 851 would create the Corrections Mental
Health Act of 2007, a comprehensive system of care for
individuals with serious mental illness (SMI) who are involved
in the state's criminal justice system. The bill would authorize
superior courts to develop and implement mental health courts,
requiring those that do opt in to establish a protocol to
determine the eligibility of defendants with SMI for
participation and subsequent diversion. SB 851 would also permit
parolees to participate in mental health courts, as specified,
and require mental health care for those incarcerated in state
prisons, on parole or completing parole. Several of the
provisions of SB 851 pose state-mandated local programs.
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Fiscal Impact (in thousands)
Major Provisions 2007-08 2008-09 2009-10 Fund
Mental health courts, Unknown, potentially significant costs
Various*
diversion to services,
parole services, reports,
training, mandate
CDCR: comprehensive Unknown, major costs General
parolee mental health
services
DMH: oversight of services Unknown, potentially significant
costs General
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* General, Trial Court Trust Fund (TCTF), Mental Health Services
Act (MHSA), Mentally Ill Offender Crime Reduction (MIOCR) grant,
Substance Abuse and Mental Health Services Administration
(SAMHSA) grant, and local funds
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STAFF COMMENTS: SUSPENSE FILE. AS PROPOSED TO BE AMENDED
Courts
There are currently 39 mental health courts (MHCs) operating in
31 counties. SB 851 does not require the creation of any
additional MHCs; to the extent courts elect to create additional
MHCs and divert SMI defendants to mental health resources under
SB 851 or modify existing MHCs to meet SB 851's standards,
however, costs would be substantial.
A preliminary survey conducted by the Administrative Office of
the Courts (AOC) of several of the existing MHCs indicated that
their average annual operating costs are approximately $239,000
each, including personnel, overhead, program development and
training. Start-up costs for a new MHC are approximately
$23,000. In comparison
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SB 851 (Steinberg)
to a standard court's operating costs, the added annual cost of
operating MHCs, taking into account only justice court
personnel, is approximately $108,000 per MHC. Staff notes that
if the MHCs surveyed by the AOC were found to be comparable to
the MHCs required in the bill, at that cost, if the remaining 27
counties were each to establish a single MHC, differential court
costs would exceed $3 million.
This cost differential departs somewhat from that outlined in an
analysis of SB 851 prepared at Sen. Steinberg's request by the
Legislative Analyst's Office (LAO), which the Senator's staff
has provided to committee staff. Among other assumptions the LAO
estimated MHC per-court costs would likely be less than standard
courtroom costs based on an AOC analysis of drug courts that
found their average operational cost was somewhat lower than the
traditional criminal court process for offenders in Superior
Courts.
SB 851 would further allow CDCR to contract with superior courts
to use MHCs as mental health referral courts for parolees with
SMI who are in violation of their parole or receiving new terms.
Parolees are the responsibility of CDCR; while the bill allows
for a contracting process between MHCs and CDCR, it will require
considerable levels of dedicated staff time for collaboration
among the courts, CDCR and the Board of Parole Hearings to work
out the interrelation of the systems and the paroling
authorities in place. In addition, reporting requirements placed
on courts dealing with parolees (Sec. 1001.134 of the bill) may
drive additional information technology needs on the courts who
accept contracts with CDCR for parolee screening, and that could
in turn increase contracting costs.
Services
SB 851 would require MHCs to use community mental health
providers and other agencies to offer defendants access to
appropriate treatment services and establish a treatment plan
for each defendant based on a formal assessment of the
defendant's mental health and substance abuse treatment needs.
Funding for these services would be provided through the MHSA.
SB 851 amends the MHSA funding prioritization to add, after
existing programs and then programs in counties with high
incidence of homeless SMI, funding for counties to serve those
subject to arrest or hospitalization, discharged from hospital
or jail, or successfully completing parole. Staff notes
treatment services to prison inmates and parolees are not
eligible for funding through this program. Staff further notes
that there are protocols required for use of MHSA funds
involving review and approval by DMH, stakeholders and the MHSA
Oversight and Accountability Commission that have to be
satisfied prior to the use of these funds.
Assuming for purposes of an estimate, as the LAO did in its
analysis, that SMI offenders would require at least the same
level of care as those classified in CDCR as needing Enhanced
Outpatient Program (EOP) or higher level of care, each
defendant's annual
treatment services would cost in the $20,000 range annually. If
3,500 individuals were to be diverted from standard criminal
dockets via MHCs to services described in SB 851, annual
treatment costs would be in the $70 million range annually.
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SB 851 (Steinberg)
As counties opt in, staff notes the Department of Mental Health
(DMH) and county mental health programs' staff resources,
programs and services will be increasingly
impacted. Requirements for information sharing for data
collection, evaluation, development of standards and regulations
are all significant, and for counties that elect MHCs, there
will infrastructure and personnel impacts that will be
potentially substantial and challenging.
CDCR
The Mental Health Association of California estimates that from
15 percent to 20 percent of CDCR's 172,000 prisoners and 117,000
parolees are SMI. The department is currently operating under a
series of federal lawsuits and settlements, one of which
addresses its management of mentally ill inmates, which the LAO
describes as follows in its Analysis of the 2007-08 Budget Bill:
The Coleman case, filed in 1992, involves allegations
that the state prison system provided
constitutionally inadequate psychiatric care for
inmates. A federal court found the state to be in
violation of federal constitutional standards for
inmate medical care and established a special master
in 1995 to monitor state efforts to remedy the
problems. The state implemented a series of remedial
actions, which are still continuing.
SB 851 requires all parolees with SMI to receive comprehensive
mental health care and supportive services; requires CDCR to
"ensure" the mental health needs of all parolees are in
accordance with community standards of mental health care; and
requires CDCR to establish service standards in consultation
with DMH for mentally ill inmates with SMI that ensure, upon
release, to reach their potential as productive citizens.
CDCR projects it will require an additional 197 staff an at
annual cost of between $11 million and $14 million General Fund
to comply with these requirements. To the extent these programs
reduce recidivism and, therefore, there are foregone
incarceration costs in the long term, costs could be offset to
some degree. SB 851 requires CDCR to provide training for all
persons responsible for management and care of persons with SMI
in the custody of the department and further requires it to
ensure "all correctional officers" are trained in dealing with
inmates with SMI. If 30,000 correctional peace officers were to
need a one-time four-hour training, costs to conduct the
training, including coverage using overtime to fill behind
staff, would be in excess of $7 million.
AS PROPOSED TO BE AMENDED:
Recast the mental health court provisions of the
measure;
Strike training requirements for CDCR;
Strike transition programming from prison-to-parole
requirements; and
Reduce expanded mental health services for parolees to a
300-parolee pilot while stating that CDCR shall "provide
for and ensure that" all parolees with SMI have their
mental health needs met in accordance with specified
standards.