BILL ANALYSIS �
SENATE COMMITTEE ON PUBLIC SAFETY
Senator Loni Hancock, Chair S
2011-2012 Regular Session B
6
0
SB 60 (Evans)
As Amended March 24, 2011
Hearing date: May 3, 2011
Welfare and Institutions Code
JM:dl
STATE MENTAL HOSPITALS:
SECURITY
HISTORY
Source: The American Federation of State, County, and Municipal
Employees (AFSCME)
Prior Legislation: SB 391 (Solis) - Ch. 294, Stats. 1997
Support: Peace Officers Research Association in California;
California Association of Psychiatric Technicians; The
Board of Vocational Nursing and Psychiatric
Technicians; California Statewide Law Enforcement
Association
Opposition:Disability Rights California (unless amended);
California Nurses Association
KEY ISSUES
WHERE A PATIENT IS COMMITTED TO A DEPARTMENT OF MENTAL HEALTH
(DMH) HOSPITAL PURSUANT TO ANY PROVISION OF THE PENAL CODE,
SHOULD THE PATIENT BE EVALUATED FOR SECURITY AND VIOLENCE RISKS
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BEFORE ADMISSION TO THE HOSPITAL, AS SPECIFIED?
SHOULD A HIGH-RISK DMH PATIENT BE PLACED IN A TREATMENT UNIT
WITHIN A HOSPITAL, CORRECTIONAL FACILITY, PRISON PSYCHIATRIC
FACILITY, OR OTHER SECURE FACILITY TO ENSURE THE PROTECTION OF
THE PATIENT, OTHER PATIENTS AND STAFF, WHILE ALSO TREATING THE
UNDERLYING CAUSES OF THE RISK POSED BY THE PATIENT, AS
SPECIFIED?
(CONTINUED)
WHERE A DMH FORENSIC PATIENT, AS SPECIFIED, IS TRANSFERRED FROM DMH
TO A CDCR FACILITY BECAUSE THE PATIENT CAUSED THE DEATH, LIFE
THREATENING INJURY OR RAPE OF A PATIENT OR STAFF MEMBER, SHOULD THE
PATIENT NOT BE RETURNED TO DMH UNLESS A COURT DETERMINES THAT THE
PERSON NO LONGER REPRESENTS A SUBSTANTIAL RISK, AS SPECIFIED?
AFTER TRANSFER OF A SPECIFIED PATIENT FROM DMH TO CDCR FOR SECURITY
REASONS, SHOULD CDCR BE AUTHORIZED TO PETITION FOR RETURN OF THE
PATIENT TO DMH BECAUSE THE PATIENT NO LONGER REPRESENTS A THREAT?
PURPOSE
The purposes of this bill are to 1) require that each patient
committed to DMH pursuant to the Penal Code be evaluated for
security and violence risks; 2) require that high-risk patients
be placed in a treatment unit in a hospital, correctional
facility or prison psychiatric facility with sufficient security
while providing treatment of the causes for the security and
violence risks, as specified; 3) provide that where a specified
forensic patient is transferred to a CDCR facility because the
patient caused the death, life-threatening injury or rape of a
staff member or other patient, the patient may not be returned
to DMH unless a court determines that he or she no longer
represents a substantial danger, as specified; and 4) authorize
CDCR to petition the court to return the patient to DMH if the
patient no longer represents a threat, as specified.
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Persons Committed to DMH Pursuant to any Provision of the Penal
Code
Existing law includes statutory programs or schemes for the
involuntary commitment of mentally disordered persons to a state
mental hospital under the operation of the Department of Mental
Health (DMH). The major Penal Code commitment schemes include
the following:
Criminal Defendant Incompetent to Stand Trial (IST) - Penal Code
� 1368 et seq.
IST defendant cannot understand proceedings or assist in
presenting a defense.
IST defendants are committed to DMH, local facility, or
outpatient treatment.
Criminal proceedings reinstated after competence
restored.
If competence not restored by specified time - the
shorter of three years or the maximum sentence for
underlying offense, conservatorship can be established.
Mentally Disordered Offenders - Penal Code � 2960 et seq.
MDO is a prisoner pending parole who has a "severe
mental disorder."
Disorder was a cause or factor in the violent commitment
offense.
Prisoner was in treatment for at least 90 days preceding
year.
Experts found that the prisoner poses a substantial
danger of physical harm if released.
At end of parole, state can petition to extend
commitment annually.
Many MDOs are placed in the conditional release (CONREP)
program.
Many MDOs are treatable in the community with
psychotropic medication. Hospitalized MDO patients could
well be floridly psychotic.
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Not Guilty by Reason of Insanity (NGI) - Penal Code � 1026 et
seq.
NGI standard: Defendant either was 1) incapable of
knowing or understanding the nature and quality of his or
her act, or 2) incapable of distinguishing right from
wrong.
Defendant found NGI committed to DMH, community facility
or outpatient treatment.
NGI patient released upon expiration of maximum term of
commitment; or released if sanity has been restored; or
court can place non-dangerous patient in treatment on
conditional release program for one year. At end of year,
trial held to determine if sanity has been restored.
NGI patients can be committed after normal maximum
period in two-year increments.
Existing law provides that prior to admission of a patient
committed as NGI or IST to Napa or Metropolitan State Hospital,
DMH shall evaluate each patient for risk. Any high-risk patient
shall be treated in DMH's most secure facilities. (Welf. & Inst.
Code � 7228.)
Existing law provides that high-risk patients shall be treated
at the hospital at Atascadero or Patton, a correctional
facility, or other secure facility, but shall not be treated at
Napa or Metropolitan. Metropolitan and Napa shall only treat
low-to-moderate risk patients. (Welf. & Inst. Code � 7230.)
Existing law provides that where the director of DMH opines, and
the CDCR director agrees, that a person who was committed to DMH
pursuant to a Penal Code provision, or who is under observation
pursuant to the (now repealed) mentally disordered sex offenders
law, needs treatment under custodial security, the person may be
transferred to CDCR. (Welf. & Inst. Code � 7301.)
Existing law provides that DMH patients transferred to a CDCR
facility are not subject to prosecution under statutes covering
assaults by prison inmates (Pen. Code �� 4500-4502) and escapes
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by prison inmates (Pen. Code �� 4530 and 4531<1>). (Welf. &
Inst. Code � 7301.)
This bill provides that before a patient is admitted to any
state mental hospital pursuant to any provision of the Penal
Code, DMH shall assess the patient's security and violence risk.
This bill provides that security and clinical staff shall
complete the violence and security assessment of any patient
admitted to DMH pursuant to a Penal Code provision. The
assessment shall include a review of the patient's criminal
history, psychological factors and incidents of aggression and
elopement (escape) since being criminally incarcerated or
committed to DMH.
This bill provides that a patient determined to be a security or
violence risk shall be placed in a treatment unit within a state
hospital, correctional facility, prison psychiatric facility or
other secure facility. Each such facility shall have enough
enhanced security and treatment options to ensure the security
of the patient, other patients and facility staff, as well as
provide treatment to appropriately address causes of the
security risk Treatment shall be consistent with accepted
professional standards.
This bill provides that the security assessment shall be done at
the time of commitment, prior to a transfer and after any
"serious" security incident.
This bill provides that where a DMH patient who was committed
pursuant to a provision of the Penal Code or the former MDSO
law<2> is transferred to a CDCR facility because the patient
committed an act resulting in the death, serious injury or rape
of another patient or hospital staff member, the following shall
---------------------------
<1> Penal Code � 4531 was repealed in 1963 and its provisions
placed in 4530.
<2> These are patients committed as NGI (Pen. Code � 1026), IST
(Pen. Code � 1370), MDO (Pen. Code �2962) or MDSO (former Welf.
& Inst. Code �6300).
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apply:
The patient shall not be returned to a DMH hospital
until a court has determined in a hearing that the person
does not represent a substantial risk of harm to the
transferred patient or others.
CDCR shall regularly assess the transferred patient to
determine if he or she remains a substantial danger to self
or others such that he or she cannot be returned to a DMH
hospital
If CDCR determines that the patient is no longer a
threat to self or others, CDCR may petition the court to
order his or her return to a DMH hospital that has
sufficient security to protect the patient, other patients
and hospital staff.
RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION
For the last several years, severe overcrowding in California's
prisons has been the focus of evolving and expensive litigation.
As these cases have progressed, prison conditions have
continued to be assailed, and the scrutiny of the federal courts
over California's prisons has intensified.
On June 30, 2005, in a class action lawsuit filed four years
earlier, the United States District Court for the Northern
District of California established a Receivership to take
control of the delivery of medical services to all California
state prisoners confined by the California Department of
Corrections and Rehabilitation ("CDCR"). In December of 2006,
plaintiffs in two federal lawsuits against CDCR sought a
court-ordered limit on the prison population pursuant to the
federal Prison Litigation Reform Act. On January 12, 2010, a
three-judge federal panel issued an order requiring California
to reduce its inmate population to 137.5 percent of design
capacity -- a reduction at that time of roughly 40,000 inmates
-- within two years. The court stayed implementation of its
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ruling pending the state's appeal to the U.S. Supreme Court.
On Monday, June 14, 2010, the U.S. Supreme Court agreed to hear
the state's appeal of this order and, on Tuesday, November 30,
2010, the Court heard oral arguments. A decision is expected as
early as this spring.
In response to the unresolved prison capacity crisis, in early
2007 the Senate Committee on Public Safety began holding
legislative proposals which could further exacerbate prison
overcrowding through new or expanded felony prosecutions.
This bill does not appear to aggravate the prison overcrowding
crisis described above.
COMMENTS
1. Need for This Bill
According to the author:
(This bill) will significantly enhance worker,
patient, and public safety at the Department of Mental
Health-administered state hospitals.
There has been a profound change in the composition of
the patient population at state hospitals since Napa
State Hospital was founded 137 years ago. However,
statute and operations at state hospitals have yet to
fully evolve to reflect this new reality. Facilities
such as Napa State Hospital were initially situated in
park-like settings to care for mentally ill patients
who were wards of the state, today more than 90% of
all individuals being treated in the state hospital
system have been forensically-committed. In fact,
fewer than 500 individuals in the entire system have
been placed in a state hospital by non-forensic means.
This has resulted in the dramatic shift in the
population make-up at state hospitals. The tragic
murder of psychiatric technician Donna Gross at Napa
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State Hospital by a patient last fall and the on-going
daily occurrence of dozens of assaults upon workers
and individuals receiving treatment at state hospitals
reflect this new reality at our state hospitals that
we cannot allow to continue.
Senate Bill 60 addresses this new reality by requiring
an individual who is proposed to be placed at a state
hospital be evaluated prior to commitment as to their
criminal history, psychological factors, propensity
for violence, and other factors and - as a result of
the assessment - be placed in an appropriately-secure
facility for treatment. The bill also allows for
those individuals placed at a state hospital who
commit a violent act against another at that facility
to be remanded to the CDCR for custodial treatment.
An omnipresent threat of violence should not be a
required condition for those who work or those being
treated at our state hospitals. We need the
common-sense approach that includes the assessment and
appropriate placement embodied in SB 60 to end this
being the situation.
2. DMH Patients Subject to this Bill Do not Include Sexually
Violent Predators
This bill applies to a patient committed to DMH "pursuant to any
provision of the Penal Code." This excludes sexually violent
predators, who are committed under the Welfare and Institutions
Code. While SVPs are forensic patients, in the sense that they
are committed from the prison system, they are not committed
pursuant to the Penal Code. If the author intends that SVPs
should be subject to this bill, the bill may need to be amended
to accomplish that intent.
3. Basic Constitutional Issues in Mental Health Commitments
Commitment to a mental hospital involves a "massive curtailment
of liberty." (Humphrey v. Cady (1972) 405 U.S. 504, 509.) Such
commitment also create severe social stigma. As such, due
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process is required and proof must be by clear and convincing
evidence. (Addington v. Texas (1978) 441 U.S. 418, 425-433.)
However, "consistent with 'substantive' due process ? the state
may involuntarily commit persons who, as the result of mental
impairment, are unable to care for themselves or are dangerous
to others. Under these circumstances, the state's interest in
providing treatment and protecting the public prevails over the
individual's interest in being free from compulsory
confinement." (Hubbart v. Superior Court (1999) 19 Cal.4th
1138, 1151, citing Addington and other cases.) Nevertheless,
civilly committed persons are not subject to punishment.
(Kansas v. Hendricks (521 U.S. 346, 361-371.) While a
commitment statute is not invalidly punitive if treatment for a
person's is unavailable, treatment shall be provided or
attempted. (Kansas v. Hendricks (1997) 521 U.S. 346, 361-369;
Hubbart v. Superior Court, supra, 19 Cal.4th at pp. 1164-1178.)
Procedural due process must generally be given to civilly
committed persons for changes in commitment status, confinement
or treatment. Due process typically involves hearings and
opportunities to object to proposed changes. (Vitek v. Jones
(1980) 445 U.S. 480, 492-493 - commitment to mental hospital
from prison; Sell v. U.S. (2003) 539 U.S. 166 - involuntary
administration of anti-psychotic drugs to incompetent defendant.
)
4. Composition of State Hospital Population
Most of the DMH patients are forensic patients. Forensic
patients come from the criminal justice system, although the DMH
commitment is civil. Only a small minority of DMH patients,
generally so-called 5150 patients, do not come from jails,
prisons or criminal proceedings. A recent Budget Committee
analysis describes the 2011-2011 population in DMH treatment:
Patients in DMH Facilities
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-----------------------------------------------------------------
|Total patients |6342 |
|--------------------------------+--------------------------------|
|Acute psychiatric programs at |766 |
|CDCR facilities at | |
|CMF-Vacaville and Salinas | |
|Valley Prison | |
| | |
|--------------------------------+--------------------------------|
|State hospital patients |5,558 |
| | |
|--------------------------------+--------------------------------|
|Civil commitments |471 (8.5% of state hospital |
| |pop.) |
|--------------------------------+--------------------------------|
|Forensic commitments |5087 (91.5% of state hospital |
| |pop.) |
|--------------------------------+--------------------------------|
|Forensic commitments and |5853 (92.3% of total DMH |
|treated inmates |patients) |
-----------------------------------------------------------------
5. Violence is Relatively Common in DMH Hospitals despite
Existing Assault, Battery and other Crime Statutes
According to myriad media reports, court filings and monitor
reviews and other studies, serious violence is relatively
common, if not rampant, in the state hospitals.
NPR Report<3> on Aggressive Incidents per 100 Patients at
Atascadero (US DOJ Stats.)
-----------------------------------------------------------------
|1990 |44.7 |
---------------------------
<3> Ina Jaffe NPR;
http://www.npr.org/2011/04/07/134961467/at-california-mental-hosp
itals-fear-is-part-of-the-job
http://www.npr.org/2011/04/08/134961895/violence-surges-at-hospit
al-for-mentally-ill-criminals.
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|--------------------------------+--------------------------------|
|1995 |45-7 |
|--------------------------------+--------------------------------|
|2000 |50.7 |
|--------------------------------+--------------------------------|
|2007 |96.7 |
|--------------------------------+--------------------------------|
|2008 |116.2 |
-----------------------------------------------------------------
NPR Report on Physical Assaults at Napa - Patient Assaults on
other Patients (DOJ Stats.)
-----------------------------------------------------------------
|Sept. 2008 - Feb. 2009 |220 |
|--------------------------------+--------------------------------|
|March 2009 - Aug. 2009 |300 |
|--------------------------------+--------------------------------|
|Sept. 2009 - Feb. 2010 |486 |
| | |
-----------------------------------------------------------------
NPR Report on Physical Assaults at Napa - Patient Assaults on
Staff (DOJ Stats.)
-----------------------------------------------------------------
|Sept. 2008 - Feb. 2009 |75 |
|--------------------------------+--------------------------------|
|March 2009 - Aug. 2009 |165 |
|--------------------------------+--------------------------------|
|Sept. 2009 - Feb. 2010 |287 |
| | |
-----------------------------------------------------------------
The rising rate of violence at state hospitals has occurred
despite numerous felonies for assault, battery and sex crimes.
The existence of these statutes arguably has not significantly
limited the violence in DMH hospitals.
6. CRIPA (Constitutional Rights of Institutionalized Persons Act)
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U.S. Department of Justice (DOJ) Consent Decree and Monitoring
of all DMH Hospitals except Coalinga
The Senate Budget and Fiscal Review Committee has prepared the
following summary of the ongoing U.S. DOJ investigation and
litigation under the Constitutional Rights of Institutionalized
Persons Act concerning conditions and treatment in DMH:
CRIPA Plan Generally: In July 2002, the U.S. DOJ
completed a review of conditions at Metropolitan State
Hospital. Recommendations for improvements at
Metropolitan in the areas of patient assessment,
treatment, and medication were provided to DMH.
Since this time, the U.S. DOJ identified similar
conditions at Napa, Patton, and Atascadero �but not
Coalinga]. The Administration and US DOJ reached a
Consent Judgment for an "Enhanced Plan"? on May 2,
2006.
The �judgment] also appointed a Court Monitor to
review implementation of the plan and to ensure
compliance. Failure to comply with the Enhanced Plan
�could] result in ? receivership. ? DMH has until
November 2011 to fully comply with the �plan].The
�plan] provides a timeline for the Administration to
address the CRIPA deficiencies and included agreements
related to treatment planning, patient assessments,
patient discharge planning, patient discipline, and
documentation requirements. It also addresses issues
regarding quality improvement, incident management and
safety hazards in the facilities.
Wellness and Recovery Model Support System: DMH has
developed and implemented the Wellness and Recovery
Model Support System (WaRMSS), a real-time application
used to assist with treatment and CRIPA
implementation. WaRMSS allows clinical teams to
tailor individualized treatment plans, document
patient goals, document progress toward goals, and
modify treatment plans as needed. The DMH states that
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WaRMSS will enable them to assume an effective long
term self-monitoring and oversight role. �WaRMSS
includes provisions to reduce redundant data and
standardize business procedures as all hospitals.]
7. Some DMH Staff Argue the CRIPA Plan has Made DMH
Facilities More Dangerous
Media reports have noted numerous complaints from staff members
that the CRIPA plan has increased violence in the hospitals.
Stories about the treatment plan and hospital violence,
particularly at Atascadero and Napa, were prominently featured
on NPR's Morning Edition in the week of April 3rd. Staff
members have objected to increased documentation requirements
that decrease time for treatment and observation of patients.
There have been numerous complaints that the plan is too
deferential to patients and does not recognize that DMH forensic
patients may be particularly dangerous. Some staff have
complained that patients do not face negative consequences for
violent behavior. <4>
Regardless of any possible deficiencies in the CRIPA plan,
reports of the violence in DMH hospitals demonstrates that DMH
facilities and procedures are inherently insecure and dangerous.
For example, Napa is an open campus of 138 acres with isolated
areas. Donna Gross, the psych tech who was murdered by patient
Jess Massey in October 2010, came upon Massey along a path
outside in the campus. Massey, despite his serious criminal
history, could walk unsupervised on hospital grounds. Reports
state that Massey dragged Gross over a wall where they could not
be seen. Because Gross was outside, her personal alarm did not
work.
8. DMH Evaluation of Security Needs and Plans for Security
---------------------------
<4>
http://www.npr.org/2011/04/08/134961895/violence-surges-at-hospit
al-for-mentally-ill-criminals.
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Enhancements
DMH has recently issued the 2010 report of security needs
throughout DMH hospital facilities.
Arguably, implementation of the security recommendations could
significantly improve security and safety in the state
hospitals. Because security in DMH hospitals appears to be
substantially compromised, perhaps the Legislature should
require DMH to report to the Legislature on implementation of
security recommendations.
The report noted that some forensic patients typically present
more danger than others. Schizophrenic patients are more
amenable to treatment, especially treatment with medication.
Patients diagnosed with anti-social personality disorders do not
typically improve with medication and often do not respond to
therapeutic treatment. Symptomatically, anti-social personality
patients display disregard for the rights of other, lack remorse
and require more security and closer observation. (2010 DMH
Security Report, pp. 5-6.)
Recommendations for Specialized Treatment Units for Aggressive
Patients
These units would house aggressive patients with a
propensity for violence.
Specialized units would have a higher staff to patient
ratio than other units.
Physical restraints would be used when patients enter or
exit rooms.
Patient rooms would have high-security doors with food
ports to limit assaults.
Salinas Valley Psychiatric Program uses these methods.
Atascadero State Hospital plans to modify rooms and
assign hospital police to a specialized treatment unit of
about 20-25 patients.
Open Campus Security Issues at Napa, Metropolitan and Patton
Napa, Metropolitan and Patton have open campuses that were
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intended to house and treat non-forensic patients. These
following security changes have been recommended for these
facilities:
Additional interior and exterior lighting.
Additional fencing
Increased use of boundaries and exclusion areas
Teams to monitor grounds, including psych techs to
monitor patient behavior and hospital police to address
security and law enforcement
Increased hospital police staffing
Statewide Security Recommendations
Video surveillance equipment to monitor patients and
prevent escape
Upgrade alarm systems
Keyboard controls
New doors with windows for patient monitoring
Furniture that can't be used as weapons,
Training of staff in security and safety
WOULD THE RECOMMENDATIONS IN THE 2010 DMH SECURITY REPORT
SIGNIFICANTLY INCREASE SAFETY IN DMH HOSPITALS?
SHOULD DMH BE DIRECTED TO SUBMIT A REPORT TO THE LEGISLATURE
CONCERNING PROGRESS IN INCREASING SAFETY IN DMH HOSPITALS?
9. Issues Raised by Disability Rights California
Disability Rights California is an advocacy organization for
persons who have various disabilities. The organization was
created by federal legislation in 1975. Later legislation
specifically considered the rights of persons under mental
health treatment. DRC engages in litigation and legislative
advocacy. DRC funding is from the federal and state government
sources, the State Bar attorney fees and other sources. (DRC
2009 Annual Report, p.28.) DRC engages in substantial and
significant litigation concerning the rights of disabled
persons, including patients in mental hospitals.
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The term "security" is not defined in the bill and could have
conflicting meanings in practice.
The bill requires that patients being admitted to state
hospitals pursuant to any provision of the Penal Code shall be
evaluated for security and violence risk. DCR submits that a
"patient's security risk" could mean that the patient presents a
risk to the security of other patients or the staff. Such a
patient should arguably be house or placed so that other
patients and staff members are not endangered.
The patient's security risk could also mean that the patient
could be at risk of being preyed upon by other patients or that
the patient cannot defend himself or herself, or that the
patient could not effectively communicate with staff about
safety issues. Such a patient should likely be placed in
protective housing.
DRC thus argues that the term "security" should be stricken from
the bill. The issue raised by the undefined or vague use of the
term could be cured by more fully explaining the reasons for
evaluation of each patient. The bill also could be amended to
provide that the evaluation should consider both the risk the
patient presents to the security of other patients and the staff
and the security risks other patients could pose to the patient.
SHOULD THE BILL BE AMENDED TO PROVIDE THAT EVALUATION OF THE
PATIENT'S SECURITY RISK SHALL INCLUDE THE RISK THE PATIENT
PRESENTS TO OTHER PATIENTS AND STAFF, AND THE RISKS THAT THE
PATIENT MAY FACE?
Procedures for determining whether or not a DMH Patient should
be transferred to CDCR for Security and when such a Patient
should be returned to DMH.
DRC argues that a procedure that was memorialized as DMH Special
Order 608 should apply to transfers of patients to CDCR for
secure housing and treatment and for returns of such patients to
DMH. Special Order 608 was released in 2002 and provides a
process for transfer of patients pursuant to Welfare and
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Institutions Code Section 7301, one of the two sections amended
by this bill.
DMH Special Order 608 provides the following as to transfers of
patients to CDCR for security reasons:
Basis for Transfer Determination
Executive Director determines that a patient meets the
criteria for transfer to a CDCR facility.
Treatment staff shall prepare a transfer and referral
recommendation that consists of the following:
o Facts and evidence supporting transfer.
o Analysis of facts that reveals the reasoning
of the treatment team.
o Treatment staff's conclusions from facts and
analysis
o Staff statement concerning treatment
(psychiatric and medical) needed by patient at CDCR;
specific issues to be addressed at CDCR; proposed
conditions or criteria for return of the patient to
DMH from CDCR; security and custody issues affecting
placement at CDCR.
Executive Director shall forward recommendation to
Deputy Director of Long-Term Care. The deputy shall review
the case with the director. If the deputy concurs with the
transfer recommendation, the deputy will send a transfer
request to CDCR.
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Patient Due Process Hearing:
Patient facing transfer may request a hearing at which
the following apply.
Written notice of hearing at least 72 hours prior to the
hearing.
Explanation of the reasons for the transfer, including
specific behaviors. Copy of notice shall be provided to
hospital patient advocate.
Patient may request assistance of a specific staff
member, including the patient advocate. Hearing officer
may deny request for assistance from a particular staff
member.
Patient may present information, statements or arguments
to challenge the transfer. This material may be presented
orally or in writing.
Patient shall be notified of decision within three
business days.
Hearing officer shall be the Medical Director or a
designee. The designee can be a clinical manager,
psychiatrist or psychologist who is not involved in the
patient's treatment.
SHOULD THIS BILL SET OUT CRITERIA AND PROCEDURES, INCLUDING A
HEARING PROCESS, FOR TRANSFER OF A DMH PATIENT TO A CDCR
FACILITY?
10. Existing Statutory Prohibition on Admission of High-Risk
Patients to Napa and Metropolitan State Hospitals
Welfare and Institutions Code Section 7230 provides that
high-risk patients shall be treated at the hospital at
Atascadero or Patton, a correctional facility, or other secure
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facility. Further, that section states that high-risk patients
shall not be treated at Napa or Metropolitan. Metropolitan and
Napa shall only treat low-to-moderate risk patients. (Welf. &
Inst. Code � 7230.)
The level of violence at Napa State Hospital, including the
October 2010 murder of a staff member and serious beatings of
staff members, may indicate that security evaluations have been
inadequate or that high-risk patients have been admitted to
Napa. If the hospital at Napa is not designed or prepared to
house and treat high-risk patients, this creates a particularly
dangerous situation.
HAVE HIGH-RISK PATIENTS BEEN ADMITTED TO NAPA AND METROPOLITAN
STATE HOSPITALS, IN APPARENT VIOLATION OF WELFARE AND
INSTITUTIONS CODE SECTION 7230?
SHOULD EVALUATIONS OF PATIENTS ADMITTED TO NAPA AND METROPOLITAN
BE MORE THOROUGH?
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