BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2397
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          ASSEMBLY THIRD READING
          AB 2397 (Allen)
          As Amended May 25, 2012
          Majority vote 

           HEALTH              14-5        APPROPRIATIONS      12-5        
           
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          |Ayes:|Monning, Ammiano, Atkins, |Ayes:|Fuentes, Blumenfield,     |
          |     |Bonilla, Eng, Gordon,     |     |Bradford, Charles         |
          |     |Hayashi,                  |     |Calderon, Campos, Davis,  |
          |     |Roger Hern�ndez, Bonnie   |     |Gatto, Ammiano, Hill,     |
          |     |Lowenthal, Mitchell,      |     |Lara, Mitchell, Solorio   |
          |     |Nestande, Pan,            |     |                          |
          |     |V. Manuel P�rez, Williams |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Logue, Garrick, Mansoor,  |Nays:|Harkey, Donnelly,         |
          |     |Silva, Smyth              |     |Nielsen, Norby, Wagner    |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Requires the Department of Mental Health (DMH) to 
          reimburse an independent entity for the purposes of conducting a 
          review and analysis of staffing ratios to determine the 
          appropriate levels for effective patient treatment in state 
          hospitals.  Specifically,  this bill  :   

          1)Requires, to the extent permitted by existing law, DMH to 
            reimburse an independent entity for the purposes of conducting 
            a review and analysis of staffing ratios to determine the 
            appropriate levels for effective patient treatment.

          2)Requires DMH to provide information to this entity as 
            necessary for it to complete its analysis and provide 
            recommendations.  

          3)Maintains that it is the intent of the Legislature that DMH 
            request the independent entity to complete this analysis by 
            March 1, 2013.  

          4)Requires a report to be submitted to the Legislature by August 
            1, 2013, regarding the independent entity's findings to ensure 
            state hospitals are making progress and to enable the 
            Legislature to consider further action that may be necessary 








                                                                  AB 2397
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            during the subsequent legislative year.

          5)Repeals the provisions of this bill on January 1, 2015, unless 
            a later enacted statute, that is enacted before January 1, 
            2015, deletes or extends that date.

           EXISTING LAW  establishes state hospitals, under the jurisdiction 
          of DMH, to provide for the care, treatment, and education of 
          mentally disordered persons.  Authorizes DMH to adopt 
          regulations regarding the conduct and management of these 
          facilities.

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee, this bill will result in one-time costs of at least 
          $300,000 General Fund for an independent analysis of staffing 
          ratios. 

           COMMENTS  :  According to a March 1, 2012, brief by the 
          Legislative Analyst's Office regarding the oversight and 
          accountability of state hospitals, DMH oversees the operation of 
          the following five state hospitals that provide inpatient 
          psychiatric care to more than 5,000 individuals committed to the 
          hospitals civilly or in connection with criminal proceedings:
          1)Atascadero State Hospital (ASH) located in the Central Coast 
            treats an all-male maximum security forensic patient 
            population and houses over 1,000 patients;

          2)Coalinga State Hospital, located in the City of Coalinga, 
            houses over 900 patients, most of whom are sexually violent 
            predators;

          3)Metropolitan State Hospital (MSH), located in the City of 
            Norwalk houses over 400 individuals who have a history of 
            escape from a detention center, a charge or conviction of a 
            sex crime, or one convicted murder;

          4)Napa State Hospital (NSH), located in the City of Napa, is 
            classified as a low-to-moderate-security level state hospital 
            with slightly less than 1,000 patients; and,

          5)Patton State Hospital (PSH), located in San Bernardino County, 
            treats approximately 1,500 patients and is primarily a 
            forensic hospital.









                                                                  AB 2397
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          In May 2006, four out of five of the state hospitals were found 
          to be in violation of the Federal Civil Rights of 
          Institutionalized Persons Act.  The investigation found that 
          these hospitals failed to provide a safe environment for its 
          patients, failed to provide complete psychiatric assessments, 
          and in some cases neglected to regularly review a patient's 
          needs before prescribing medication.  The United States 
          Department of Justice (USDOJ) and the state reached a 
          settlement, through a consent judgment, which required MSH, NSH, 
          PSH, and ASH to implement an "Enhancement Plan" (EP) to improve 
          conditions.  The extensive reforms required by the EP were 
          intended to ensure that individuals in the hospitals are 
          adequately protected from harm and provided adequate services to 
          support their recovery and mental health.  A court monitor and a 
          team of clinical experts were appointed to review the compliance 
          of each hospital.  

          In November 2011, the USDOJ released PSH and ASH from oversight, 
          deeming them in compliance with the majority of the EP's 
          demands.  However, USDOJ officials asked for an extension of 
          federal oversight of NSH and MSH, finding that these facilities 
          have failed to comply with critical provisions of the EP.


           Analysis Prepared by  :  Tanya Robinson-Taylor / HEALTH / (916) 
          319-2097 


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