BILL ANALYSIS �
SENATE COMMITTEE ON PUBLIC SAFETY
Senator Loni Hancock, Chair S
2011-2012 Regular Session B
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9
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SB 794 (Blakeslee)
As Introduced February 18, 2011
Hearing date: May 3, 2011
Penal Code
JM:mc
BATTERIES ON PEACE OFFICERS AND STAFF - "GASSING"
PATIENTS CONFINED IN STATE MENTAL HOSPITALS
HISTORY
Source: California Statewide Law Enforcement Association
Prior Legislation: AB 2246 (Blakeslee) - 2010, held in Assembly
Appropriations
Support: Service Employees International Union, Local 1000;
California Correctional Supervisors Organization;
California Association of Psychiatric Technicians;
American Federation of State, County and Municipal
Employees, AFL-CIO; California Psychological
Association
Opposition:Disability Rights California; Legal Services for
Prisoners with Children; California Nurses Association;
National Alliance on Mental Illness; California
Coalition for Women Prisoners
KEY ISSUES
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WHERE A PERSON CONFINED IN A STATE MENTAL HOSPITAL INTENTIONALLY
THROWS OR PLACES HUMAN EXCREMENT, BODILY FLUIDS OR BODILY
SUBSTANCES ON A PEACE OFFICER OR HOSPITAL EMPLOYEE, SHOULD THE
PERSON BE SUBJECT TO PROSECUTION FOR GASSING, AN ALTERNATE
FELONY-MISDEMEANOR WITH A PRISON TERM OF 2, 3, OR 4 YEARS?
(CONTINUED)
SHOULD A DEPARTMENT OF MENTAL HEALTH (DMH) HOSPITAL DIRECTOR BE
REQUIRED TO IMMEDIATELY INVESTIGATE ANY REPORTED GASSING, AND REFER
A DOCUMENTED MATTER TO THE DISTRICT ATTORNEY FOR PROSECUTION, AS
SPECIFIED?
SHOULD A DMH HOSPITAL DIRECTOR BE AUTHORIZED TO ORDER TESTING OF THE
PERPETRATOR FOR HEPATITIS AND TUBERCULOSIS?
SHOULD A DETAILED REPORT ABOUT IMPLEMENTATION OF THIS BILL,
INCLUDING SPECIFIED DATA, BE PRESENTED BY DMH TO THE LEGISLATURE BY
JANUARY 1, 2016?
PURPOSE
The purposes of this bill are to 1) provide that a person
confined in a state hospital who commits battery by "gassing"
upon a peace officer or hospital employee is guilty of an
alternate felony-misdemeanor, punishable by a jail term of up to
six months or a prison term of two, three, or fours years; 2)
define gassing as intentionally throwing or placing human
excrement, bodily fluids or bodily substances on another person
so as to contact the person's skin or membranes; 3) require a
DMH hospital director to immediately investigate any reported
gassing, and refer documented cases to the district attorney; 4)
authorize the director to order testing the perpetrator for
hepatitis and tuberculosis; and 5) require DMH to report to the
Legislature by January 1, 2016, on DMH gassing incidents and
implementation of the bill.
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Existing law states that every person confined in a state prison
or local detention facility who commits gassing of a peace
officer or employee of the prison or facility is guilty of
aggravated battery, punishable by imprisonment in a county jail
for up to six month or by imprisonment in the state prison for
two, three, or four years. (Pen. Code �� 243.9 and 4501.1.)
Existing law defines "gassing" as intentionally placing or
throwing, or causing to be placed or thrown, upon another person
any human excrement, bodily fluids or bodily substances or any
mixture containing such fluids or substances that result in
actual contact with the person's skin or membranes. (Pen. Code
�� 243.9, subd. (b); 4501.1, subd (b).)
Existing law provides that a person who was insane when he or
she committed a crime is not guilty by reason of insanity (NGI).
One is insane if he or she does not understand the nature of
the charged act, or does not understand the difference between
right and wrong. (Pen. Code �� 25, subd. (b) and 1026.)
Existing law provides that persons who, by reason of mental
disorders, are "dangerous to others or to themselves or who are
gravely disabled" may be involuntarily held for 72 hours, and
then held and treated for 14, 30, and 180 days following
judicial hearings at each step. (Welf. & Inst. Code � 5000 et
seq.)
Existing law provides that a prisoner found to be a mentally
disordered offender (MDO) can be required to receive mental
treatment as a condition of parole and may annually be civilly
confined after his or her parole expires. (Pen. Code � 2960 et
seq.)
Existing law provides that a person found to be sexually violent
predator (SVP) shall be committed to DMH for indefinite
treatment. An "SVP" has been convicted of a sexually violent
offense for which he or she received a determinate sentence and
has a mental disorder that makes him likely to engage in
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sexually violent criminal behavior. (Welf. & Inst. Code ��
6600-6608.)
Existing law provides that a person is incompetent to stand
trial (IST) 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. A person who is IST
is immune from trial or punishment. (Pen. Code � 1367.)
Existing law requires the court to order that an IST defendant
be placed in a state hospital, a public or private treatment
facility, or on outpatient status. (Pen. Code � 1370.)
Existing law provides that where a person held as NGI escapes,
he or she is guilty of an alternate misdemeanor-felony,
punishable by up to one year in the county jail, or one year and
one day in state prison. (Pen. Code �� 1026 and 1026.4.)
Existing law mandates where an IST defendant escapes from a
mental health facility, he or she is guilty of an alternate
misdemeanor-felony, punishable by up to one year in the county
jail, or one year and one day in state prison. (Pen. Code �
1370.5.)
This bill provides that every person confined to a state
hospital who commits gassing of any peace officer or employee of
a state hospital is guilty of aggravated battery and shall be
punished by imprisonment in a county jail or imprisonment in the
state prison for two, three, or four years.
This bill defines "gassing" as intentionally placing or
throwing, or causing to be placed or thrown, upon the person of
another, human excrement, bodily fluids or bodily substances, or
any mixture thereof, resulting in contact with the other
person's skin or membranes.
This bill requires the hospital director to use all available
means to immediately investigate gassing incidents. The
director may order the perpetrator to be immediately tested for
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hepatitis or tuberculosis, or both, and thereafter as necessary.
Test results shall be provided to the victim.
This bill mandates the hospital director to refer all documented
gassing incidents, as specified, to the district attorney for
prosecution.
This bill provides that DMH shall report to the Legislature, by
January 1, 2016, on gassing incidents at state hospitals. The
report shall include, but not be limited to, all of the
following:
The total number of gassing incidents at each hospital.
The disposition of each incident, including
administrative penalties, the number of incidents
prosecuted, and the results of prosecutions, including
penalties.
A profile of the individuals who commit gassings,
including the number of individuals who have one or more
prior serious or violent felony convictions.
Efforts to limit gassing, including training and use of
protective clothing and goggles.
The results and costs of the medical testing authorized
by this section.
This bill provides that it shall stay in effect until January 1,
2017, and as of that date is repealed, unless a later enacted
statute that is enacted before January 1, 2017, deletes or
extends that date.
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
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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
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 appear to aggravate the prison overcrowding
crisis described above.
COMMENTS
1. Need for This Bill
According to the author:
Protecting our community is about more than keeping
offenders off the streets. It's also about ensuring a
safe environment for the men and women who work on
behalf of our taxpayers in dangerous facilities like
Atascadero State Hospital. Last March, the Atascadero
Tribune ran an editorial by representatives of the
police officers at Atascadero State Hospital
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highlighting a troubling problem ("State hospital
police need equal legal protection," March 4). The
California Statewide Law Enforcement Association
revealed that although laws protect prison officers
from a malicious type of assault known as gassing,
these protections do not exist for workers at
Atascadero State Hospital who are responsible for the
same population of dangerous offenders.
Gassing is the using of human feces or bodily fluids
as weapons, exposing employees to communicable
diseases such as hepatitis. Many gassing offenders at
facilities like Atascadero have been in prisons where
gassings are on the rise.
According to a recent report produced by DMH, 21
percent of the population in the facility had
hepatitis C. Nationally, between 30 percent and 40
percent of prison inmates have hepatitis C and about
one in four are infected with tuberculosis. The risk
of contracting one of the dangerous diseases is a
threat to the men and women working in these
facilities and their family members. Under current
law, gassing of a correctional officer at the
California Men's Colony is a felony. If that same
offender is transferred 20 miles to Atascadero and
gasses a hospital police officer, nurse or psych
technician, the assault is considered a misdemeanor
and often goes unprosecuted. Common sense dictates
that all those who oversee the same dangerous
population should have the same protections. The
consequences for these vicious assaults should be
consistently applied, whether the attack occurs in a
prison or in a state hospital.
Psych technicians, doctors and nurses, mental health
experts and police officers at state mental hospitals
work with some of the state's most dangerous and
disturbed offenders. These workers do not benefit
from the high security of a prison setting. There are
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no locked cells or armed guards to protect these men
and women who work on the front lines of the state's
forensic hospitals. SB 794 simply extends to state
hospital employees the same protections against
gassing currently afforded those working in our state
prisons.
2. Persons to Whom this Bill Applies - Those Confined to State
Hospitals
This bill defines a new felony of the gassing of a peace officer
or hospital employee by persons "confined" in a state hospital.
The bill does not define the term "confined in" a state
hospital. Most people confined in state hospitals have been
judicially committed in a civil matter. However, most of the
patients committed in civil proceedings are forensic patients.
Forensic patients come from the criminal justice system. Only a
small minority of DMH patients, 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
-----------------------------------------------------------------
|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.) |
|--------------------------------+--------------------------------|
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|Forensic commitments |5087 (91.5% of state hospital |
| |pop.) |
|--------------------------------+--------------------------------|
|Forensic commitments and |5853 (92.3% of total DMH |
|treated inmates |patients) |
| | |
-----------------------------------------------------------------
While all of these patients were involuntarily committed for
mental health treatment, there are substantial differences among
them. The following is a short description of the major
classes of patients in DMH facilities:
LPS Patients - Welfare & Institutions Code � 5150 et seq - True
Civil Commitment, not from Jail, Prison or a Criminal Case
Dangerous to self or others, or gravely disabled due to
a mental disorder.
Gravely disabled person cannot provide his or her own
food, clothing or shelter.
Detentions are incremental. Initial involuntarily
evaluation for 72 hours. (Welf. & Inst. Code, � 5150)
72-hour evaluation may lead to civil commitments lasting 14
days, 30 days, and 180 days and to establishment of annual
conservatorship. 180-day commitment if imminently
dangerous to others.
Gravely disabled person - conservatorship for up to one
year.
Criminal Defendant Incompetent to Stand Trial (IST) - Penal
Code � 1368 et seq
Counsel or court expresses doubt as to defendant's
mental competence.
IST means defendant cannot understand proceedings or
assist in presenting a defense.
IST defendant committed to DMH, local facility, or
outpatient treatment.
Criminal proceedings reinstated after competence
restored.
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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.
Inmate 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 have psychiatric disorders that are treatable
with psychotropic medication. Hospitalized MDO patients -
those subject to this bill - could well be floridly
psychotic.
Sexually Violent Predators - Welfare & Institutions Code � 6600
et seq
An SVP has been convicted of a sexually violent offense
and has a mental disorder that makes him<1> likely to
engage in sexually violent behavior.
Indefinite commitment to DMH for treatment.
Annual review by DMH to determine if SVP meets
commitment criteria.
Only a small percentage of SVPs have obtained release.
SVPs are not likely to suffer from traditional mental
illnesses or be incompetent.
Not Guilty by Reason of Insanity (NGI) - Penal Code � 1026 et
seq
NGI standard: Defendant either was 1) incapable of
--------------------------
<1> Virtually all persons found to be SVPs have been men.
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knowing or understanding the nature and quality of his or
her act, or 2) incapable of distinguishing right from
wrong.
Defendant has the burden to prove insanity.
Defendant found NGI committed to DMH, community facility
or outpatient treatment.
NGI patient released upon expiration of maximum term of
commitment; or
Release 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.
3.State Prison Inmates Transferred to DMH Hospitals for
Psychiatric Treatment are Considered to be Confined in Prison
and likely Covered by Existing Gassing Statute
Treatment of Prison Inmates in DMH Hospitals
CDCR can recommend that a mentally ill prisoner be transferred
to DMH if recovery can be expedited by treatment at a DMH
hospital. DMH must determine if the inmate would benefit from
treatment. DMH shall keep the inmate until the inmate will not
benefit from further treatment. (Pen. Code � 2684.)
Prison Inmates Treated at DMH are Still Considered to be
Confined in Prison
The California Supreme Court has recently held that prison
inmates transferred to DMH for treatment (under Pen. Code �
2684) shall be considered confined in state prison. (People v.
Watson (2007) 42 Cal.4th 822.) It is likely that the courts
would hold that such persons would not be considered to also be
confined in a state hospital. As such, prison inmates
transferred to DMH for treatment may not be covered by this
bill, although the outcome of litigation on the issue cannot be
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predicted. However, it appears that the existing gassing
statute applicable to prison inmates would apply to an inmate
who was transferred to DMH for treatment.<2>
Batteries Committed by Prison Inmates, Including Those
Temporarily Outside Prison Walls
The defendant in Watson had been transferred to DMH for
psychiatric treatment. While being treated by DMH at
Atascadero, Watson punched a nurse. Watson was convicted under
Penal Code Section 4501.5 of battery by a prison inmate on a
non-inmate. Watson argued that because he was being treated in
a DMH hospital he was not a prison inmate. The court rejected
that argument and found that Watson was confined in a state
prison because at the time of the assault he was only
temporarily outside the walls of the prison for a particular
purpose. (Ibid.)
Any person "confined" in a state prison who commits gassing of a
peace officer is guilty of an alternate felony-misdemeanor.
(Pen. Code � 4501.1.) The gassing statute is in a chapter that
includes other battery crimes committed by prison inmates.
Gassing by Prison Inmates Being Treated at DMH Hospitals can
Likely be Prosecuted as Felonies Under Existing Law
It thus appears that any prison inmate who is being treated at a
DMH hospital pursuant to the transfer provisions in Section 2684
is still considered to be confined in a prison. Therefore, such
a person is subject to prosecution for gassing under existing
law.
IS A PRISON INMATE WHO HAS BEEN TRANSFERRED TO DMH FOR
PSYCHIATRIC TREATMENT STILL CONSIDERED TO BE CONFINED IN STATE
PRISON AND SUBJECT TO PROSECUTION UNDER SPECIAL BATTERY LAWS,
INCLUDING THE GASSING STATUTE, APPLICABLE TO PRISON INMATES?
---------------------------
<2> The existing prison gassings statute only covers gassings of
peace officers. This bill covers gassings of peace officers and
all hospital employees.
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4.Procedures for Crimes Charged Under This Bill Could be
Problematic and Complicated
This bill defines a new crime of gassing of DMH police or DMH
staff by any person committed to a state hospital. As noted
previously, a great proportion of the patients in state
hospitals are forensic patients - patients committed to the
state hospital from the criminal justice system. If charged
under the crime defined by this bill, these patients likely
would be involved in a complex combination of treatment,
prosecution and punishment. The purposes and procedures
involved in these matters could operate at cross-purposes and
results.
A good example of the complexity that could arise under this
bill concerns persons who are incompetent to stand trial (IST).
A person who is IST is unable to understand the criminal process
or assist counsel. A defendant who is IST cannot be tried until
competency is restored. While one need not be psychotic or
gravely disabled to be IST, many IST defendants are seriously
mentally ill. This is likely to be especially true for IST
defendants committed to the state hospital, as the court can
also commit an IST defendant to outpatient treatment, a
community facility. Those committed to DMH likely have serious
mental illnesses.
An IST patient charged with gassing would be taken to court for
arraignment on the gassing charges, while the prior charges are
stayed because of his or her incompetence. It would appear
likely that the person would be found to be incompetent on the
gassing charges as well. New experts could be required to
assess competency as to the gassing charges. In addition,
interrupting IST patients' treatment for the new criminal
proceedings could cause many of them to decompensate, making a
return to competence much more difficult and interfering with
any broader progress in treating the patient's mental illness.
Similar issues would arise with MDO patients, who are treated
while on parole. (Following parole, a new commitment hearing
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must be held annually.) As such, an MDO in DHM could be subject
to revocation of parole for a gassing incident and returned to
prison. It is unknown whether such circumstances have arisen.
However, it is likely that the person still would be in need of
treatment. Problems could arise where the person's DMH
treatment is interrupted for prosecution under this bill or by a
revocation of parole under existing law.
WOULD MANY, IF NOT MOST, PERSONS BEING TREATED AT A STATE
HOSPITAL AS INCOMPETENT TO STAND TRIAL ON EARLIER CRIMINAL
CHARGES ALSO BE FOUND TO BE INCOMPETENT ON THE GASSING CRIME
PROPOSED BY THIS BILL?
WOULD INTERRUPTING AN "IST" PATIENT'S TREATMENT IN ORDER TO
COMMENCE CRIMINAL PROCEEDINS ON GASSING CHARGES CREATE A
SUBSTANTIAL RISK THAT THE PATIENT WOULD DECOMPENSATE AND BECOME
MORE MENTALLY ILL, INCREASING THE TIME NECESSARY TO RESTORE THE
PATIENT TO COMPETENCE AND EXACERBATING THE PERSON'S UNDERLYING
MENTAL ILLNESS?
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 |
|--------------------------------+--------------------------------|
|1995 |45-7 |
---------------------------
<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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|--------------------------------+--------------------------------|
|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 rates 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. This raises the question
of whether or not a new gassing crime applicable to DMH patients
would significantly reduce such incidents.
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Gassing Incidents in State Hospitals (DMH Statistics provided by
author.)
As to gassing in particular, the author has provided the
following DMH statistics:
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|2005-2010 |56 gassings - DMH hospitals |
| |combined |
| | |
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A Los Angeles Times article provided by the author's office
noted that in 1999, a year after the prison gassing law went
into effect, gassing incidents were rapidly increasing.
(Inmates Use "Gassing" to Strike Back at the System, Mark Arax,
L.A. Times, June 1, 1999.) The article noted that a substantial
number of the inmates who engaged in gassing were mentally ill
or had serious mental health issues from being kept in solitary
confinement in places like the Secured Housing Unit (SHU) in
Pelican Bay State Prison. This raises a serious concern as to
whether or not an available felony for gassings committed by DMH
patients would deter such conduct. Members may wish to
consider whether DMH patients would be more likely to be
deterred from gassing by a new criminal penalty than prison
inmates.
6.Institutional Safety Measures and Plans are Essential in DMH
Facilities
Arguably, the main problem in DMH facilities is a lack of
institutional safety procedures and policies. In recent decades
the percentage of forensic patients in DMH facilities has grown
to well over 90% of the population. These patients often have a
serious history of violence and may have particularly severe
mental illnesses. It appears that hospital facilities and
procedures have not adjusted adequately to the change in patient
population.
Budget Committee staff has informed Committee staff that the
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Governor's May Revise Budget may include additional money for
critically needed security in DMH facilities. DMH officials
have begun a program to increase security in DMH facilities.
In particular, administrators at Napa State Hospital have issued
a plan for increased security at the hospital in response to the
murder of a staff member by a patient in October, 2010. The
plan includes prohibition on individual staff members escorting
patients, restricted areas of hospital grounds, elimination of
areas for persons to hide, lighting upgrades, individual alarms,
violence reduction seminars and a detailed plan for enhanced
security through hospital police procedures.
WILL A PLAN FOR INCREASED INSTITUTIONAL SECURITY AT NAPA STATE
HOSPITAL REDUCE VIOLENCE?
7.CRIPA (Constitutional Rights of Institutionalized Persons Act)
U.S. Department of Justice (DOJ) Consent Decree and Monitoring
of all DMH Hospitals except Coalinga
The Budget Committee has drafted 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
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November 2011 to fully comply with the �plan].
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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
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.]
8.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
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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 he could not
be seen. Because Gross was outside, her personal alarm would
not have worked.
SHOULD SUBSTANTIAL EFFORTS BE MADE TO MAKE DMH FACILITIES
SECURE?
WOULD INCREASING SECURITY BE MORE EFFECTIVE IN REDUCING VIOLENCE
IN STATE HOSPITALS THAN INCREASED CRIMINAL PENALTIES?
9. Security Screenings of Patients - Review of Commitment Status
SB 60 (Evans) - expected to be heard on May 3, 2011 - requires
security screening of all patients admitted to state hospitals.
SB 60 also requires housing and treatment of patients that will
ensure the safety of patients and staff.
SHOULD STATE HOSPITAL PATIENTS BE EVALUATED FOR RISK OF
VIOLENCE?
Further, if, as staff members claim, a significant number of
forensic patients are faking mental illness, commitment status
should be carefully reviewed and monitored. Committee members
may wish to inquire if there is a process for questioning and
evaluating the legitimacy of a patient's mental illness.
IS THERE A PROCESS FOR STAFF TO EXPRESS AND THE HOSPITAL TO
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<4>
http://www.npr.org/2011/04/08/134961895/violence-surges-at-hospit
al-for-mentally-ill-criminals.
SB 794 (Blakeslee)
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RESOLVE DOUBTS ABOUT THE LEGITIMACY OF A PATIENT'S MENTAL
ILLNESS?
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