BILL ANALYSIS �
AB 2531
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Date of Hearing: April 24, 2012
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
AB 2531 (Allen) - As Introduced: February 24, 2012
SUBJECT : State hospitals: prohibited items.
SUMMARY : Authorizes each of the five state hospitals under the
jurisdiction of the Department of Mental Health (DMH) to develop
a list of items that are deemed contraband and prohibited on
hospital grounds and requires each hospital to establish a
contraband committee, comprised of hospital management and
designated employees, to develop the list. Specifically, this
bill :
1)Permits each state hospital, for its safety and security, to
develop a list of items that are deemed contraband and
prohibited on hospital grounds, and control and eliminate
contraband on hospital grounds.
2)Requires each state hospital to form a contraband committee,
composed of hospital management and employees designated by
the hospital's director, to develop the list. Requires the
list to be developed with the participation of patient
representatives, or the patient government of the hospital, if
one exists, and the Office of Patients' Rights (OPR).
3)Makes the list subject to review and approval by the Director
of DMH or his or her designee.
4)Requires the list to be updated and subject to review and
approval by the Director of DMH or his or her designee at
least every six months.
5)Specifies that the list shall be posted prominently in every
unit of the hospital and throughout the hospital, and provided
to a patient upon request.
6)Authorizes each state hospital and DMH to implement,
interpret, or make specific the requirements of this bill
without taking regulatory action.
EXISTING LAW :
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1)Charges DMH with managing the care and treatment of mentally
ill patients at California's five state mental hospitals:
Atascadero (ASH); Coalinga (CSH); Metropolitan (MSH); Napa
(NSH); and, Patton (PSH).
7)Designates NSH and MSH to only treat low-to-moderate risk
patients and requires high-risk patients to only be treated at
ASH or PSH, a correctional facility, or other secure facility.
8)Requires DMH, in state regulation, to adopt uniform rules and
regulations for the conduct and management of the state
hospitals, including prohibiting patients from possessing
certain items.
2)Permits the Director of DMH to prohibit the possession or use
of tobacco products on the grounds of a state hospital, upon
receiving a request from the director of the state hospital,
as specified.
9)Prohibits, in state regulation, wireless communication
devices, as specified, within a state hospital.
10)Makes, with specified exceptions, a person who possesses with
the intent to deliver, or who delivers, to a patient in a
state hospital a wireless communication device, tobacco
products or currency, except as authorized, guilty of a
misdemeanor, punishable by a maximum fine of $1,000 for each
item.
FISCAL EFFECT : This bill has not yet been analyzed by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS BILL . DMH is sponsoring this bill to grant
each state hospital the ability to develop an individualized
list of contraband items that are forbidden for possession by
patients. DMH writes that an effective contraband policy was
routinely enforced at each of the five facilities until 2009
when the Office of Administrative Law (OAL) ruled that the
policy constituted an underground regulation. DMH rescinded
the policy in response to the OAL ruling and currently has no
contraband lists in effect. DMH states that each state
hospital must be able to prevent the possession of dangerous
or harmful items on hospital grounds in order to ensure the
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safety of staff, patients, and visitors. This bill seeks to
provide a mechanism for state hospitals to create, update, and
enforce their own contraband lists, independent of the
regulatory process.
2)BACKGROUND . DMH oversees the operation of the five state
hospital campuses as well as two acute psychiatric programs
that provide treatment to a combined patient population of
over 5,000. There has been a dramatic shift in the patient
population at state hospitals in the last decade as the number
of patients committed by way of the criminal justice system
has risen while the number of patients referred by counties
under civil commitments has declined. DMH reports that the
forensic population now comprises 92% of the state hospital
system.
DMH reports that contraband items are a constant and sizeable
problem within the state hospital system. In the 2010-11
fiscal year, more than 3,000 items of contraband were
confiscated system-wide, ranging from shanks, razors, and
lighters to illegal drugs, cigarettes, and alcohol.
Contraband items led to 123 hospital lockdowns over the same
period. DMH indicates that contraband items represent a
significant source of danger to staff and patients, not only
because some items may be used as weapons, but also because
contraband items are often the cause of incidents of
aggression between the patients and staff.
3)PRIOR CONTRABAND POLICY . Prior to the OAL determination in
2009, DMH's contraband policy specified that any item
constituting safety or security concerns could be denied or
confiscated and any item received that was not included on an
allowable property or contraband list was subject to return to
sender or donation to charity. The system-wide policy
required all allowable items to be from an approved source
based on a thorough inspection by hospital staff. At the
time, each hospital maintained its own contraband list as each
facility's needs varied based on the patient population and
the physical infrastructure of the hospital campus. For
example, DMH points out that the safety and security
priorities at CSH, a closed campus with a patient population
comprised primarily of sexually violent predators, differ from
those at NSH, an open campus whose population largely consists
of low-to-moderate risk criminal offenders. As a result, each
hospital had different methods and timing for updating its
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list, ranging from once per year (ASH) to as often as once per
month (CSH). However, DMH adds that each hospital retained
the ability to update its list as needed in the event of an
emergency. DMH asserts that, in order to provide a safe,
secure and therapeutic environment, the state hospital system
must have an effective way to control the items possessed by
patients.
DMH states that it is pursuing the authority for each hospital
to establish contraband policies through legislation rather
than the regulatory process because the administrative process
of enacting regulations is often lengthy, usually a year or
more, and each hospital needs flexibility to develop and
continuously update its own contraband list, rather than going
through the process of enacting a regulation each time a new
item needs to be added to the list. DMH also notes that,
unlike the regulatory process, this bill provides for the
direct involvement of patients and patients' rights groups in
the development of the contraband policies.
4)OPR . The OPR provides investigative and advocacy services to
persons with mental disabilities who are receiving treatment
in a facility under the jurisdiction of DMH. The OPR provides
direct advocacy services in the state hospitals as well as
training and technical assistance to all county patients'
rights advocates. OPR is charged with ensuring that all
patients are informed of their rights in a language and manner
that is easily understood by the patient upon admission to a
facility and annually thereafter; when there is a change in
the patient's legal status; and, when the patient is
transferred to another unit or facility.
5)PROPOSED DEPARTMENT OF STATE HOSPITALS . The Governor's
2012-13 State Budget proposes to eliminate DMH and create a
new Department of State Hospitals. The Governor's plan would
shift community mental health programs and related state
functions to other departments, offices, and commissions and
eliminate some programs entirely. Under the Governor's plan,
the workload that would remain at DMH would mainly be the
administration of the state hospitals. The Governor's
Administration states that a new and separate department is
needed to oversee these facilities in order to comprehensively
focus on mitigating significant health and public safety
issues, centralize administrative functions, and address core
patient population management and fiscal administration. It
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is unknown how the proposal to establish this new department
will interact with this bill.
6)SUPPORT . The California Association of Psychiatric
Technicians, which represents direct care mental health
nursing professionals at state hospitals, writes in support
that this bill improves safety and security by allowing each
facility to create and update a consistent list of contraband
and to establish facility-specific committees aimed at
eliminating the dangers posed by contraband. The California
Statewide Law Enforcement Association writes that the
introduction of dangerous items and substances in these
facilities has significantly increased as a result of the
forensic nature of the patient population and DMH needs the
flexibility provided in this bill to ban or restrict specific
items from these facilities to improve safety. The California
Psychological Association adds that this bill is a positive
step toward providing a safer work environment for employees.
7)RELATED LEGISLATION . AB 2399 (Allen) requires each of the
state hospitals to update its injury and illness prevention
plan (IIPP) at least once a year and establish an IIPP
committee to provide recommendations for updates to the plan.
AB 2399 was heard in this committee on April 17, 2012, and
passed with a vote of 10-0.
8)PRIOR LEGISLATION .
a) SB 796 (Blakeslee), Chapter 201, Statutes of 2011, makes
the delivery of wireless communication devices, tobacco,
and money to state hospital patients a misdemeanor,
punishable by a fine of up to $1,000 per prohibited item.
b) AB 3010 (Blakeslee), Chapter 505, Statutes of 2008,
permits DMH to ban the sale and use of tobacco products on
state hospital grounds.
9)AUTHOR'S AMENDMENT . The author will be accepting an amendment
in committee to require the contraband list to be posted on
each facility's Internet Website.
REGISTERED SUPPORT / OPPOSITION :
Support
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Department of Mental Health (sponsor)
California Association of Psychiatric Technicians
California Psychological Association
California Statewide Law Enforcement Association
Opposition
None on file.
Analysis Prepared by : Cassie Royce / HEALTH / (916) 319-2097