BILL ANALYSIS                                                                                                                                                                                                    







                      SENATE COMMITTEE ON PUBLIC SAFETY
                             Senator Mark Leno, Chair                S
                             2009-2010 Regular Session               B

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          SB 1265 (Dutton)                                           5
          As Introduced February 19, 2010
          Hearing date:  April 6, 2010
          Welfare & Institutions Code
          JM:mc

                                 CONDITIONAL RELEASE: 

                              FORENSIC MENTAL PATIENTS  


                                       HISTORY

          Source:  County of San Bernardino and the City of Upland

          Prior Legislation: SB 1794 (Perata) - Ch. 486, Stats. 2004
                       AB 2450 (Canciamilla) - Ch. 425, Stats. 2004
                       AB 1881 (Gallegos) - Ch. 324, Stats. 2000

          Support: California State Sheriffs' Association; Upland Unified  
                   School District; City of Upland Police Department; San  
                   Bernardino Sheriff; San Bernardino County Board of  
                   Supervisors; San Bernardino County District Attorney;  
                   San Bernardino Area Chamber of Commerce; City of Rancho  
                   Cucamonga; League of California Cities Inland Empire  
                   Division; City of Highland; City of Ontario; City of  
                   Yucaipa; Block Captain, Bixby Way's Neighborhood Watch

          Opposition:Disability Rights California; Taxpayers for Improving  
                   Public Safety; California Public Defenders Association;  
                   Western Center on Law and Poverty






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                                                           SB 1265 (Dutton)
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                                      KEY ISSUES
           
          SHOULD A DIRECTOR OF A CONDITIONAL RELEASE PROGRAM (CONREP) FOR  
          TREATMENT OF FORENSIC MENTAL HEALTH PATIENTS (SPECIFIED PERSONS  
          WITH MENTAL DISORDERS IN THE CRIMINAL JUSTICE SYSTEM) BE  
          AUTHORIZED TO PROVIDE INFORMATION TO LOCAL LAW ENFORCEMENT  
          AGENCIES ABOUT PROGRAM PARTICIPANTS?
                                                                (CONTINUED)



          SHOULD THE FOLLOWING PROHIBITIONS APPLY TO CONREP PROGRAMS:

                 NO MORE THAN THREE PATIENTS CAN RESIDE IN AN INDEPENDENT  
               FACILITY;
                 ONLY ONE PATIENT PER-ROOM IN AN INDEPENDENT FACILITY; AND
                 CONREP PATIENTS CANNOT RESIDE WITHIN 2,000 FEET OF A SCHOOL?


                                       PURPOSE

          The purposes of this bill are to 1) authorize a conditional  
          release program (CONREP) providing outpatient treatment to  
          forensic mental health patients (generally, mentally disordered  
          persons placed in treatment from the criminal justice system) to  
          inform local law enforcement of the identity and address of a  
          person in a CONREP program; 2) prohibit placement of more than  
          three CONREP patients in a single facility and more than one  
          patient in a room; and 3) prohibit a CONREP patient from  
          residing within 2,000 feet of a school. 
           
           Mentally Disordered Offender Law (MDO)
           
          Existing law  , the Mentally Disordered Offenders Law (Penal Code  
          sections 2960-2981), sets forth the following criteria for the  
          involuntary commitment and treatment of an inmate alleged to be  
          a mentally disordered offender:

                 The inmate has a severe mental disorder.
                 The severe mental disorder was a cause of, or  




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               aggravating factor in, the crime for which the inmate was  
               committed to prison.
                 The inmate has been in psychiatric treatment for at  
               least ninety days in the prior year.
                 Mental health professionals from the Department of  
               Corrections and Rehabilitation (CDCR) and the Department of  
               Mental Health (DMH) have certified that the inmate has a  
               mental disorder and "represents a substantial danger of  
               harm to others."  If DOC and DMH professionals cannot  
               agree, two independent professionals  
               (psychologist/psychiatrist) shall evaluate the inmate.
                 The inmate was imprisoned for a crime in which he or she  
               used force or violence, caused serious bodily injury,  
               credibly threatened to use serious force or violence,  
               committed arson that posed a substantial danger of bodily  
               harm, used a firearm, used a dangerous weapon in a robbery  
               or carjacking, or committed a specified crime such as  
               murder, forcible sex crimes or kidnapping. 
                 If the inmate meets the criteria to be deemed an MDO,  
               the inmate shall be committed to an inpatient program,  
               unless DMH certifies that the MDO can be treated as an  
               outpatient.

           Existing law  provides that an inmate found to be an MDO by DMH  
          and CDCR officials may demand a hearing by the Board of Parole  
          Hearings (BPH) to contest the determination.  If BPH finds that  
          the inmate is an MDO, he or she can demand a jury trial.  An MDO  
          can be held for treatment through the period of parole.  The  
          status of MDO parolees is reviewed annually.  Following parole,  
          an MDO can be held indefinitely, however, the District Attorney  
          must prove the person's MDO status, including that the person's  
          mental disorder is not in remission, beyond a reasonable doubt  
          in a jury trial each successive year.  (Pen. Code  2962-2972.)

           Existing law  provides that in a hearing for continued treatment  
          of an MDO following parole, the court may release the MDO on  
          outpatient status if the court finds that the MDO can be safely  
          and effectively treated in the community.  (Pen. Code  2972,  
          subd. (d).) 





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           Existing law  provides that an MDO shall be placed on outpatient  
          status for one year.  At the end of the year, the court shall  
          hold a hearing to determine whether the defendant should be  
          released from treatment, kept on outpatient status or placed in  
          an institution.  (Pen. Code  2972.1.) 

           Existing law  provides that before a court can place a person  
          held under a non-MDO form of forensic commitment (NGI, IST,  
          MDSO, SVP<1>) in outpatient treatment, the court must obtain a  
          recommendation of outpatient eligibility and a treatment plan  
          from the person's community program director.  In other regards,  
          the outpatient rules and procedures for persons in held under an  
          NGI, IST, MDSO or SVP commitment apply to a person treated as an  
          MDO.  (People v. May (2007) 155 Cal.App.4th 350, 355-363; Pen.  
          Code  1600-1620.)

           Existing law  requires a community program director or treatment  
          supervisor to prepare progress reports every 90 days on persons  
          placed on outpatient status and submit those reports to the  
          court, the prosecutor and defense counsel.  (Pen. Code  1605,  
          2972, subd. (d).)
           
          Existing law  provides that where an MDO on outpatient status can  
          be returned to inpatient custody after a hearing equivalent to  
          probation revocation.  (Pen. Code  1603, 1608, 1609, 2972.1.)

          Not Guilty by Reason of Insanity (NGI)
          
           Existing law  provides the following process for determining a  
          defendant to be not guilty by reason of insanity:  "In any  
          criminal [or delinquency] proceeding ? in which [the defendant  
          claims he or she is] not guilty by reason of insanity ? the  
          accused person [must] prove by a preponderance of the evidence  
          that he or she was incapable of knowing or understanding the  
          nature and quality of his or her act and of distinguishing right  
          from wrong at the time of the commission of the offense."  (Pen.  
          Code  25.)


          ---------------------------
          <1> MDSO refers to the former mentally disordered sex offenders  
          law.  SVP refers to the existing sexually violent predator law.



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           Existing decisional law  provides that an NGI defendant must  
          prove that at the time of the charged act he or she either was  
          incapable of knowing or understanding the nature and quality of  
          his/her act, or that he or she was incapable of distinguishing  
          right from wrong at the time of the commission of the offense.   
          (People v. Skinner (1985) 39 Cal.3d 765, 771-784.)

           Existing law  provides that any person committed to a state  
          hospital or other treatment facility after having been found  
          NGI, incompetent to stand trial, a mentally disordered sex  
          offender, or sexually violent predator, may be placed on  
          outpatient status from that commitment subject to specified  
          procedures.  (Pen. Code  1600.)

           Existing law  provides that "a person cannot be tried or adjudged  
          to punishment while that person is mentally incompetent."  A  
          person is mentally incompetent to stand trial (IST) or face  
          judgment where the person, as a result of a mental disorder or  
          developmental disability, is 1) unable to understand the nature  
          of the proceedings, or 2) unable to rationally assist counsel in  
          the presentation of a defense.  (Pen. Code  1367.)

           Existing law  provides that any person charged with a specified  
          crime of violence (as defined in Pen. Code  1601) and found  
          incompetent, or any person found NGI for the commission of such  
          a crime, shall be placed on outpatient status if all of the  
          following conditions are met:

                 The director of the state hospital or other treatment  
               facility to which the person has been committed advises the  
               court that the defendant would no longer be a danger to the  
               health and safety of others, including himself or herself,  
               while under supervision and treatment in the community, and  
               will benefit from treatment.
                 The community program director advises the court that  
               the defendant will benefit from outpatient status, and  
               identifies an appropriate program of supervision and  
               treatment.
                 After actual notice to the prosecutor, defense counsel,  




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               victim, or next of kin when notice has been requested and,  
               after a hearing in court, the court specifically approves  
               the recommendation and plan.  (Pen. Code 1603, subd. (a).)

           Existing law  requires that evaluations and recommendations by  
          the state hospital or community program director as to  
          outpatient placement include consideration of complete  
          information regarding the circumstances of the criminal offense  
          and the person's prior criminal history.  (Pen. Code  1603,  
          subd. (c).)

           Existing law  provides that in any hearing where the court  
          considers a recommendation and plan for outpatient treatment of  
          a person found NGI, the court shall consider the circumstances  
          and nature of the criminal offense leading to the commitment and  
          shall consider the person's prior criminal history.  (Pen. Code  
           1604, subd. (c).)

           Existing law  provides that an application for release of an NGI  
          patient on grounds that sanity has been restored may be made  
          either by the patient, the medical director of the hospital to  
          which the person has been committed, or by the community program  
          director of the patient's outpatient program.  The court shall  
          give 15 days notice to the prosecuting attorney, the community  
          program director and the medical director of the facility  
          providing treatment as to the hearing date.  (Pen. Code   
          1026.2, subd. (a).)

           Existing law  requires the court to hold a hearing to determine  
          whether the person applying for restoration of sanity would be a  
          danger to the health and safety of others due to mental disease,  
          defect, or disorder if released under treatment and supervision  
          in the community.  If the court finds that the applicant will  
          not be a danger to the health and safety of others while under  
          supervision and treatment in the community, the court shall  
          order the applicant placed with an appropriate forensic  
          conditional release program for one year.  At the end of one  
          year, the court shall have a trial to determine if sanity has  
          been restored.  (Pen. Code  1026.2, subd. (e).)





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           Existing law  provides that the director of the hospital shall  
          notify the community program director of the county and the  
          chief law enforcement officer that a person who is NGI and  
          committed to a state hospital or mental facility is being  
          released or placed in an out-patient program.  (Pen. Code   
          1026.6.)
          
          Persons Found Mentally Incompetent to Stand Trial

           Existing law  provides that a person is incompetent to stand  
          trial (IST) where he or she, as a result of a mental disorder or  
          developmental disability, is either 1) unable to understand the  
          nature of the proceedings, or 2) unable to  assist counsel in  
          the presentation of a defense.  (Pen. Code  1367.)   

          Existing law  provides that where a court or counsel believes  
          that a criminal defendant may be incompetent to stand trial, the  
          defendant will be evaluated by experts and the matter set for a  
          hearing.  (Pen. Code  1367-1369.)  

          Existing law  provides that if a defendant is found incompetent,  
          the criminal trial or judgment is suspended until the person  
          becomes mentally competent.  (Pen. Code  1370 et seq.)

           Existing law  provides that the rules and procedures governing  
          outpatient treatment of persons found to be NGI shall also apply  
          to persons who are incompetent to stand trial.  (Pen. Code   
          1600-1620.)

           Existing law  provides:  "It is unlawful for any person for whom  
          registration is required pursuant to the Sex Offender  
          Registration Act to reside within 2,000 feet of any public or  
          private school, or areas of a park where children regularly  
          gather."  (Pen. Code  3000.5, subd. (b).)

           Existing law  requires the prosecutor to notify the victim or  
          next of kin of the victim about a hearing on the release of a  
          defendant who has been found not guilty by reason of insanity  
          from a treatment facility to an outpatient facility.  (Pen. Code  
           1603.)




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          Forensic Conditional Release Program (CONREP)
           
          Existing law  includes the Forensic Conditional Release Program  
          (CONREP), under which persons with mental disorders in the  
          criminal justice system are conditionally released into the  
          community and receive treatment on an outpatient basis.  (Welf.  
          & Inst. Code  4360.)  

          Existing law  provides that "[a]ll information and records  
          obtained in the course of providing services [to forensic mental  
          health patients, as specified] to either voluntary or  
          involuntary             recipients of services shall be  
          confidential."  (Welf. & Inst. Code  5328.)

           Existing law  provides that information about persons in  
          specified forensic mental health and similar treatment programs  
          - including civilly committed persons who are gravely disabled,  
          prison inmates.  NGI patients, MDSO patients, IST patients and  
          SVP patients, but not including MDO patients - shall be reported  
          to the Department of Justice (DOJ).  DOJ shall include this  
          information in criminal history summaries and distribute such  
          information pursuant to the statutes concerning such  
          information.  (Welf. & Inst. Code  5382.1 and Pen. Code   
          11105 et seq.)

           Existing law  provides that information included in criminal  
          history files or data that concern persons in specified forensic  
          and civil commitment mental health treatment programs shall be  
          limited to the patient's name, address, fingerprints, date of  
          admission, date of discharge, date of escape or return from  
          escape, return from any home leave, parole or leave of absences.  
           (Welf. & Inst. Code  5382.1.)
           
           Existing law provides that the Attorney General (Department of  
          Justice - DOJ) shall maintain summary criminal history  
          information and shall furnish the information to specified  
          persons. (Pen. Code  11105.)

           This bill  provides, notwithstanding applicable medical privacy  
          rules for persons committed to mental health treatment programs,  




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          that CONREP programs may inform local law enforcement of  
          "program participants who reside within that agency's  
          jurisdiction."

           This bill  provides that each of the following shall apply to  
          CONREP programs:

                 No more than three participants (CONREP patients) may  
               reside in an independent group living facility;
                 Only one CONREP patient may be housed in a single room  
               in an independent group living facility; and
                 CONREP patients shall not reside within 2,000 feet of a  
               school.
          
          





























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                    RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION
          
          The severe prison overcrowding problem California has  
          experienced for the last several years has not been solved.  In  
          December of 2006 plaintiffs in two federal lawsuits against the  
          Department of Corrections and Rehabilitation sought a  
          court-ordered limit on the prison population pursuant to the  
          federal Prison Litigation Reform Act.  On January 12, 2010, a  
          federal three-judge panel issued an order requiring the state to  
          reduce its inmate population to 137.5 percent of design capacity  
          -- a reduction of roughly 40,000 inmates -- within two years.   
          In a prior, related 184-page Opinion and Order dated August 4,  
          2009, that court stated in part:

               "California's correctional system is in a tailspin,"  
               the state's independent oversight agency has reported.  
               . . .  (Jan. 2007 Little Hoover Commission Report,  
               "Solving California's Corrections Crisis: Time Is  
               Running Out").  Tough-on-crime politics have increased  
               the population of California's prisons dramatically  
               while making necessary reforms impossible. . . .  As a  
               result, the state's prisons have become places "of  
               extreme peril to the safety of persons" they house, .  
               . .  (Governor Schwarzenegger's Oct. 4, 2006 Prison  
               Overcrowding State of Emergency Declaration), while  
               contributing little to the safety of California's  
               residents, . . . .   California "spends more on  
               corrections than most countries in the world," but the  
               state "reaps fewer public safety benefits." . . .  .   
               Although California's existing prison system serves  
               neither the public nor the inmates well, the state has  
               for years been unable or unwilling to implement the  
               reforms necessary to reverse its continuing  
               deterioration.  (Some citations omitted.)

               . . .

               The massive 750% increase in the California prison  
               population since the mid-1970s is the result of  
               political decisions made over three decades, including  




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               the shift to inflexible determinate sentencing and the  
               passage of harsh mandatory minimum and three-strikes  
               laws, as well as the state's counterproductive parole  
               system.  Unfortunately, as California's prison
               population has grown, California's political  
               decision-makers have failed to provide the resources  
               and facilities required to meet the additional need  
               for space and for other necessities of prison  
               existence.  Likewise, although state-appointed experts  
               have repeatedly provided numerous methods by which the  
               state could safely reduce its prison population, their  
               recommendations have been ignored, underfunded, or  
               postponed indefinitely.  The convergence of  
               tough-on-crime policies and an unwillingness to expend  
               the necessary funds to support the population growth  
               has brought California's prisons to the breaking  
               point.  The
               state of emergency declared by Governor Schwarzenegger  
               almost three years ago continues to this day,  
               California's prisons remain severely overcrowded, and  
               inmates in the California prison system continue to  
               languish without constitutionally adequate medical and  
               mental health care.<2>

          The court stayed implementation of its January 12, 2010 ruling  
          pending the state's appeal of the decision to the U.S. Supreme  
          Court.  That appeal, and the final outcome of this litigation,  
          is not anticipated until later this year or 2011.

           This bill  does not appear to aggravate the prison overcrowding  
          crisis described above.


          ---------------------------
          <2>   Three Judge Court Opinion and Order, Coleman v.  
          Schwarzenegger, Plata v. Schwarzenegger, in the United States  
          District Courts for the Eastern District of California and the  
          Northern District of California United States District Court  
          composed of three judges pursuant to Section 2284, Title 28  
          United States Code (August 4, 2009).




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                                      COMMENTS

          1.  Need for This Bill  

          According to the author:

               A recent murder in Upland, CA has highlighted the need  
                                                                                 for increased oversight of CONREP program participants  
               residing in unlicensed facilities.

               The brutal murder took place in an unlicensed facility  
               that shared a fence with a local elementary school.   
               Seven CONREP participants were living in the facility  
               when one of the program participants stabbed another  
               participant multiple times.  Twelve hours after the  
               incident occurred, the victim's body was found lying  
               in a pool of blood in the garage by a fellow roommate.

               CONREP provides community-based services for specified  
               court-ordered forensic individuals, including: Not  
               Guilty by Reason of Insanity, Mentally Disordered  
               Offenders, and felony Incompetent to Stand Trial.  The  
               Department of Mental Health contracts with either  
               local governments or private vendors for services.   
               Program participants reside in licensed or unlicensed  
               facilities, depending on their level of care.   
               Although current law provides significant oversight  
               over licensed facilities, there is little, if any  
               oversight of unlicensed facilities.  
               
               The courts and CONREP program operators are currently  
               prohibited from informing local law enforcement when  
               CONREP program participants reside in their  
               jurisdiction.

               This bill would provide needed oversight of  
               Conditional Release Program (CONREP) participants  
               residing in unlicensed facilities.  In particular,  
               this bill would:





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                           Allow the courts or CONREP program  
                    operators to inform local police departments when  
                    CONREP program participants reside in their  
                    jurisdiction.
                           Limit the number of CONREP program  
                    participants residing together in an unlicensed  
                    facility.
                           Prohibit CONREP program participants from  
                    living within 2,000 feet of a school.

          2.  DMH Websites Describes the CONREP Programs  


                     Who Are CONREP Patients?

               CONREP [involves] judicially committed persons found  
               by the courts to be Not Guilty by Reason of Insanity  
               or Incompetent to Stand Trial (PC 1370);  ? Mentally  
               Disordered Sex Offenders; and Mentally Disordered  
               Offenders, who are inmates required to receive  
               treatment as a condition and ? parolees in CONREP who  
               have completed their sentence, but remain severely  
               mentally ill. 


               CONREP patients are typically young males (77% are  
               18-44 years old) with severe mental disorders (66%)  
               who have committed violent felonies (85%).  They have  
               moderate arrest histories (5.5 average prior arrests)  
               and most (885) have entered from state hospitals.   
               Many ? have been in and out of treatment for years.  
               Seventy percent (70%) have been served by the  
               community mental health system during the two years  
               prior to judicial commitment.


                     What Services Do Patients Receive?

               Virtually all patients ? in CONREP ? have experienced  
               long court-directed state hospitalizations.  Once  




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               psychiatric symptoms have been stabilized and they are  
               considered no longer to be a danger, eligible patients  
               may be referred for [conditional] outpatient treatment  
               ?  Patients must agree to follow a treatment plan  
               designed by the outpatient supervisor and approved by  
               the ? court.  The treatment plan includes provisions  
               for involuntary outpatient services.  In order to  
               protect the public, patients who do not comply with  
               treatment may be returned ? to inpatient status ?   
               CONREP patients have direct access to a full range of  
               mental health services ?, including individual and  
               group therapies, collateral contacts, home visits,  
               substance abuse screenings and psychological  
               assessments. 


               ? DMH has ? set minimum treatment and supervision  
               levels for all CONREP patients.  Pre-placement  
               evaluations and assessments are done during the period  
               of state hospitalization, upon entry into the  
               community and throughout CONREP treatment.  ? CONREP  
               staff participate in state hospital and court liaison  
               activities.  Specialized forensic mental health  
               clinicians are essential to the effective management  
               of CONREP patients in the community. 


                     What Is The Need For This Service System?

               27% of a sample of persons released from state  
               hospitals without going to CONREP re-offend within 2  
               years.  CONREP patients have a very low level of  
               re-offense (6%).  ? and demonstrate significant  
               improvement in employment, social support and  
               independence ratings after one year ? of treatment.   
               CONREP patients demonstrate very low levels of  
               substance abuse while in the program.  These positive  
               results are possible because CONREP invests community  
               programs with greater authority and specialized  
               resources to implement a comprehensive community  




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               outpatient system of assessment, treatment and  
               supervision services. 


                     How Is The CONREP Program Administered?

               The state ? provides 100% of the funding for CONREP?   
               DMH contracts with county mental health programs,  
               experienced private agencies or non-profit contractors  
               to provide ? CONREP services. 

          3.  Difficulties in Finding Residences for Patients in Forensic  
          Mental Health Programs  

          DMH and other entities must find residences for patients in  
          CONREP programs.  These patients must have access to treatment  
          services, including counseling, psychotropic medicine  
          prescribing and review, drug treatment, employment services and  
          education.  

          Particularly with CONREP patients in the SVP program, DMH faces  
          substantial, and often vehement, resistance to the placement of  
          CONREP patients in the community.  Local officials and law  
          enforcement often face severe pressure to oppose or thwart  
          placements in their communities.  For example, DMH moved SVP  
          patient Cary Verse on a virtually daily basis.  Other SVP CONREP  
          patients have been housed on state prison grounds, although not  
          within the fenced or secured area of the institution.  

          The prohibition enacted by Proposition 83 (Jessica's Law) on the  
          placement of registered sex offenders within 2,000 feet of a  
          school or park where children congregate has essentially  
          prevented CDCR from finding residences for sex offender parolees  
          in many urban areas.  Under specific CDCR policy, sex offender  
          parolees in San Francisco are released by CDCR as homeless.  The  
          recent report by the California Sex Offender Management Board  
          warned that homeless placements were dangerous, as life  
          instability is a great contributor to recidivism.  

          Prohibiting the placement of non-sex offender CONREP patients  




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          within 2,000 feet of a school could substantially limit the  
          ability of DMH to find suitable residences for CONREP patients.   
          As the statistics set out on the DMH website indicate, CONREP  
          programs have been effective in reducing recidivism,  
          particularly among the MDO population.  Many MDOs suffer from  
          psychoses and other psychiatric disorders that respond very  
          favorable to medication.  It appears that laws that make it more  
          difficult to find stable residences for CONREP patients could  
          substantially impair the benefits of the CONREP program.  For  
          example, placing MDO patients where they would have difficulty  
          getting to doctors' appointments and difficulty obtaining and  
          refilling prescriptions could quickly cause a patient to  
          decompensate and fail on CONREP.  An MDO patient who has begun  
          to decompensate could pose a serious threat to the physical  
          safety of people in the community and the MDO.

          In some cases it may be inadvisable to place more than three  
          CONREP patients in a single facility, or to place more than one  
          patient in a single room.  However, in other cases, CONREP  
          patients may greatly benefit from the support and companionship  
          of other patients.  Arguably, a statute that arbitrarily limits  
          the number of patients in a facility or room could be  
          counterproductive.  Perhaps relevant law could direct the court,  
          DMH and the program director to consider whether a particular  
          CONREP patient should be placed in a residence with more than  
          two other patients, or in a room with another patient. 

          WOULD PROHIBITING RESIDENTIAL PLACEMENT OF CONREP PATIENTS  
          WITHIN 2,000 FEET OF A SCHOOL SUBSTANTIALLY LIMIT THE ABILITY OF  
          DMH TO FIND SUITABLE RESIDENCES FOR CONREP PATIENTS?














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          IF DMH IS UNABLE TO FIND SUITABLE RESIDENCES FOR NUMEROUS CONREP  
          PATIENTS, WOULD THE EFFECTIVENESS OF THE CONREP PROGRAM BE  
          LIMITED AND THE SAFETY OF THE PUBLIC COMPROMISED?

          INSTEAD OF AN ARBITRARY LIMIT ON THE NUMBER OF CONREP PATIENTS  
          IN A FACILITY OR ROOM, WOULD THE EFFECTIVENESS AND SAFETY OF  
          CONREP PLACEMENTS BE ADVANCED BY DIRECTING COURTS, DMH AND  
          PROGRAM DIRECTORS TO CONSIDER SUCH FACTORS IN MAKING PLACEMENT  
          AND TREATMENT DECISIONS?

          4.  Extent of Information Provided to Local Law Enforcement by a  
            CONREP Program About Patients in an Outpatient Program  

          Medical information, including information concerning the  
          treatment program of a CONREP patient, is generally  
          confidential.  This bill states that, "notwithstanding Section  
          5328," a CONREP program can "inform local law enforcement  
          agencies of program participants who reside within that agency's  
          jurisdiction."

          Arguably, there is a strong public policy for maintaining  
          confidentiality of information about treatment of CONREP  
          patients.  Patients who are not assured of confidentiality would  
          likely be reluctant to engage in treatment.  This could be  
          particularly problematic as concerns MDO CONREP programs, which  
          are widely understood to be effective.  On the other hand, there  
          is a strong public policy for assuring public safety, especially  
          as concerns a program for the supervision and treatment of  
          persons who have committed violent acts.
            
          The bill does not define what information "of program  
          participants" would include.  This could be interpreted to mean  
          simply to inform law enforcement that a particular person is in  
          a program.  This could perhaps also be interpreted to mean  
          information about the program, including the kind of treatment  
          provided to the patient and other details about the patient.   
          Section 5328 of the Welfare and Institutions Code, the  
          confidentiality statute as to which this bill creates an  
          exception, generally provides that treatment information is  




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                                                           SB 1265 (Dutton)
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          confidential.  One who focuses on the fact that this bill  
          creates an exception to medial confidentiality rules could read  
          the bill expansively.  One who focuses on the reference to  
          information "of program participants" could read the bill to  
          only narrowly allow the CONREP program to tell law enforcement  
          the name of the participant.

          It is recommended that the bill specifically state what  
          information a CONREP program can give to local law enforcement  
          about CONREP patients.  It appears that if a local law  
          enforcement official knows the identity of a CONREP patient, the  
          official can obtain criminal history information about the  
          patient from the database maintained by the Department of  
          Justice.

          Finally, existing law requires very specific and detailed notice  
          to law enforcement and prosecutors about SVP CONREP patients.   
          (Welf. & Inst. Code  6609-6609.1.)  Including SVP patients in  
          this bill could be confusing for service providers.  A service  
          provider could conceivably conclude that the program need only  
          provide information under this bill.  The author may wish to  
          consider whether or not to include a statement in the bill that  
          providing notice under Welfare and Institutions Code section  
          4360 does not excuse failure to comply with Welfare and  
          Institutions Code sections 6609 and 6609.1, and other relevant  
          provisions, concerning required notice in the case of a  
          conditionally released SVP patient.

          SHOULD THIS BILL BE AMENDED TO SPECIFY THAT A CONREP PROGRAM MAY  
          INFORM LAW ENFORCEMENT ONLY ABOUT THE IDENTITY AND ADDRESS OF A  
          CONREP PATIENT?

          SHOULD THE BILL SPECIFICALLY STATE THAT PROVIDING NOTICE AS  
          AUTHORIZED UNDER WELFARE AND INSTITUTIONS CODE SECTION 4360 DOES  
          NOT EXCUSE FAILURE TO COMPLY WITH NOTICE REQUIREMENTS IN WELFARE  
          AND INSTITUTIONS CODE SECTIONS 6609 AND 6609.1 CONCERNING  
          CONDITIONALLY RELEASED SVP PATIENTS? 


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                                                           SB 1265 (Dutton)
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