BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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                                 THIRD READING


          Bill No:  SB 60
          Author:   Evans (D), et al
          Amended:  5/31/11
          Vote:     21

           
           SENATE PUBLIC SAFETY COMMITTEE  :  7-0, 5/3/11
          AYES:  Hancock, Anderson, Calderon, Harman, Liu, Price, 
            Steinberg

           SENATE APPROPRIATIONS COMMITTEE  :  9-0, 5/26/11
          AYES:  Kehoe, Walters, Alquist, Emmerson, Lieu, Pavley, 
            Price, Runner, Steinberg


           SUBJECT  :    Mental health:  state hospitals

           SOURCE  :     The American Federation of State, County and 
          Municipal 
                      Employees


           DIGEST  :    This bill requires upon being admitted to a 
          state hospital, the Department of Mental Health pursuant to 
          the Penal Code, be evaluated for security and violence 
          risks, as specified.

           ANALYSIS  :    Existing law provides that prior to admission 
          of a patient committed as "Not Guilty by Reason of 
          Insanity" or "Criminal Defendant Incompetent to Stand 
          Trial" to Napa or Metropolitan State Hospital, Department 
          of Mental Health (DMH) shall evaluate each patient for 
          risk.  Any high-risk patient shall be treated in DMH's most 
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          secure facilities. (Welfare & Institutions Code Section 
          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.  
          (Welfare & Institutions Code Section 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          is under observation pursuant to the (now repealed) 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.  (Welfare & Institutions Code Section 7301.)

          Existing law provides that DMH patients transferred to a 
          CDCR facility are not subject to prosecution under statutes 
          covering assaults by prison inmates (Penal Code Sections 
          4500-4502) and escapes by prison inmates (Penal Code 
          Sections 4530 and 4531 ). (Welfare & Institutions Code 
          Section 7301.) 
           
          This bill provides that upon the time a patient is admitted 
          to any state mental hospital pursuant to any provision of 
          the Penal Code, DMH shall evaluate each patient committed 
          pursuant to any section of the Penal Code to determine the 
          security and violence risk that patient presents to other 
          patients and staff and the risks to the patient's safety 
          and security that he/she faces upon admission to the state 
          hospital.  

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

           Major Provisions                2011-12     2012-13    
           2013-14   Fund  


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          DMH conduct new                         likely in the 
          hundreds of                             General
          Or augment existingthousands of dollars
          assessments

           SUPPORT  :   (Verified  5/31/11) (unable to reverify)

          California Association of Psychiatric Technicians
          California Statewide Law Enforcement Association
          Peace Officers Research Association in California
          The Board of Vocational Nursing and Psychiatric Technicians

           OPPOSITION  :    (Verified  5/31/11) (unable to reverify)

          Disability Rights California (unless amended)
          California Nurses Association

           ARGUMENTS IN SUPPORT  :    According to the author's office, 
          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 percent 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 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.

          This bill 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, 

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          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 this bill to end this being the 
          situation.

           ARGUMENTS IN OPPOSITION  :    Disability Rights California 
          opposes this bill for the following reasons:  (1) this bill 
          would prohibit a person who was transferred because he or 
          she, while housed in the stat hospital, committed an act 
          that resulted in the death, rape, or life threatening 
          injury of another patient or a staff member of the state 
          hospital, from being returned to the state hospital until a 
          court has determined in a hearing that the person does not 
          represent a substantial risk of harm to himself, herself, 
          or others; (2) this bill would also require a risk 
          evaluation prior to the commitment to any state hospital, 
          of a patient who is being committed pursuant to any 
          provision of the Penal Code.  The bill would require a 
          patient determined to be a high-security or violence risk 
          to be placed in a treatment unit within a state hospital, 
          correctional facility, state prison psychiatric facility, 
          or other secure facility with sufficient enhanced security 
          and treatment options to ensure the security of the 
          patient, the other patients, and the staff, and to 
          appropriately provide treatment to address the underlying 
          causes of the risk, consistent with generally accepted 
          professional standards; (3) the use of the term "security" 
          under section 7228 can have multiple meanings.  In order to 
          prevent situations where an individual is inappropriately 
          placed in a high-security unit (i.e., an individual whose 
          behavior makes him a target of physical aggression by other 
          individuals is placed in a high-security unit for his own 
          security) the term "security" should be removed.  Under 
          7228(c), the proposed language does not allow for timely 
          review of individuals placed in a high-security unit for 
          transfer back to a regular unit; and (4) the due process 
          procedures outlined in the Department of Mental Health's 

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          Special Order 608 should be incorporated into section 7301. 
           For proposed section 7301(b), a determination as to 
          whether an individual is ready for transfer from DCR back 
          to DMH should remain with treating professionals unless the 
          individual would like a court to review the appropriateness 
          of the placement with DCR.  The standard for returning to a 
          state hospital should be whether an individual can safely 
          be treated at a state hospital rather than the proposed 
          language of substantial risk of harm to self or others.  
           

          RJG:do  5/31/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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