BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                    THIRD READING


          Bill No:  AB 2186
          Author:   Lowenthal (D), et al.
          Amended:  8/20/14 in Senate
          Vote:     21


           SENATE PUBLIC SAFETY COMMITTEE  :  6-0, 6/10/14
          AYES:  Hancock, Anderson, De Le�n, Knight, Liu, Steinberg
          NO VOTE RECORDED:  Mitchell

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  74-0, 5/8/14 - See last page for vote


           SUBJECT  :    Defendants:  competency

           SOURCE  :     Department of State Hospitals


           DIGEST  :    This bill allows the representative of any facility  
          where a defendant found incompetent to stand trial (IST) is  
          committed, and specified others, to petition for an order to  
          involuntarily medicate the defendant, and, upon issuance of that  
          order; authorizes the involuntary administration of  
          antipsychotic medication to the defendant when and as prescribed  
          by the defendant's treating psychiatrist at any facility housing  
          him/her for purposes of recovering mental competency; and makes  
          other related changes, as specified.

           Senate Floor Amendments  of 8/20/14 add double-jointing language  
          with SB 1412 (Nielsen) and AB 2625 (Achadjian).

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           ANALYSIS  :    

          Existing law:

          1.States that a person cannot be tried or adjudged to punishment  
            while he/she is mentally IST.

          2.Provides that a defendant is incompetent to stand trial where  
            he/she has a mental disorder or developmental disability that  
            renders him/her unable to understand the nature of the  
            criminal proceedings or assist counsel in his/her defense.

          3.States that if the court has a doubt as to whether or not a  
            defendant is IST, the court shall state that doubt on the  
            record and shall seek defense counsel's opinion as to the  
            defendant's competence.

          4.States that if the defendant is found IST, the matter shall be  
            suspended until the person becomes mentally competent.

          5.States that prior to committing an IST defendant for  
            treatment, the court shall determine whether the defendant  
            consents to the administration of antipsychotic medications.

          6.Provides that if the administrative law judge upholds the  
            certification by the treating psychiatrist for involuntary  
            medication of the defendant for 21 days, the psychiatrist  
            shall file with the court a copy of the certification and a  
            petition for an order authorizing involuntary medications:

             A.   The court shall provide notice to the prosecutor and  
               counsel for the defendant of the pending hearing.

             B.   The court shall hold the hearing within 18 days of the  
               issuance of the certification and determine if a formal  
               order for involuntary medication should be made.

             C.   The court shall issue its decision within three calendar  
               days, but no later than the expiration of the 21-day  
               certification period.

          This bill:

          1.Requires the court, when determining if grounds exist for  

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            ordering involuntary administration of antipsychotic  
            medication to an IST defendant, to consider the reports  
            prepared by the psychiatrist or psychologist who examined the  
            defendant for mental competency purposes, per se, if those  
            reports are applicable to the involuntary medication issue.

          2.Provides that an order for involuntary medication shall remain  
            valid at any facility housing the defendant for purposes of  
            return to competency and resumption of criminal proceedings,  
            if the medication is prescribed by the defendant's treating  
            psychiatrist.

          3.Provides that if an administrative law judge upholds the  
            21-day certification by the treating psychiatrist that  
            antipsychotic medication has become medically necessary and  
            appropriate while the defendant is being treated, the court  
            may extend the certification and continue the hearing for no  
            more than 14 days, upon a showing of good cause or the  
            stipulation of the parties.

          4.Allows the district attorney, county counsel, or  
            representative of any facility where a defendant found IST is  
            committed to petition the court for an order, reviewable as  
            specified, to administer involuntary medication pursuant to  
            specified criteria.

          5.Requires the court to review the order to administer  
            involuntary medication at the time of the review of the  
            initial competency report by the medical director of the  
            treatment facility and at review of the six-month progress  
            reports.

          6.Allows the district attorney, county counsel, or  
            representative of any facility where a defendant found IST is  
            committed, within 60 days before the expiration of the  
            one-year involuntary medication order, to petition the  
            committing court for a renewal of the order, subject to the  
            specified conditions and requirements.

             A.   The petition shall include the basis for involuntary  
               medication, as specified, and requires notice of the  
               petition to be provided to the defendant, the defendant's  
               attorney, and the district attorney.


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             B.   The court shall hear and determine if the defendant  
               continues to meet the required criteria for involuntary  
               medication and that the hearing be conducted before the  
               expiration of the current order.

             1.   Contains double-jointing language with SB 1412 (Nielsen)  
               and AB 2625 (Achadjian).

           Comments
           
          According to the author's office:

          Under existing law, when a defendant's competency to stand trial  
          is in doubt, he or she is evaluated by a court-appointed mental  
          health expert and a hearing is held on the issue.  If the  
          defendant is found IST, he/she is typically transferred to a  
          state hospital for treatment to restore competency.

          IST defendants are usually held in the county jail pending the  
          transfer to a state hospital.  While the Department of State  
          Hospitals (DSH) has increased treatment capacity, the demand is  
          greater than the supply of beds, with a waiting list of between  
          300 to 350 defendants.  The wait for admission can vary from a  
          couple of weeks to six months.  To address the shortage of  
          treatment beds, DSH has initiated projects for treatment of  
          mentally-ill offenders and IST defendants in county jails,  
          streamlined programs and better aligned reporting requirements.

          One barrier to lasting competency is the disconnect between a  
          state hospital and county jail systems.  Currently, an order for  
          involuntary medication is only valid at a DSH facility and  
          becomes invalid upon return of the defendant to county jail  
          following the restoration of competency.  The defendant may not  
          receive any medication unless local authorities seek a new order  
          from the superior court.  Court congestion can delay new  
          treatment orders or extension of existing orders.  Any gap in  
          medication can result in the defendant decompensating to the  
          point of incompetency once again, necessitating DSH  
          recommitment.  Delays in treatment put the defendant's mental  
          health at risk and result in unnecessary costs to the state for  
          additional DSH treatment.

          In addition, reporting requirements for the defendant's progress  
          and involuntary treatment orders often result in overlapping  

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          reporting timelines.  Existing law currently requires a report  
          and review of the involuntary treatment orders six months after  
          the order was first issued.  Progress reports for a defendant's  
          competency restoration are also on a six-month timeline.   
          However, because the two timetables for the two different  
          reports are not synched, reports can be made within days or  
          weeks of each other when they could be aligned.  This bill  
          aligns the reports, providing the court with a complete  
          analysis.

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

           SUPPORT  :   (Verified  8/21/14)

          Department of State Hospitals (source)
          California Association of Psychiatric Technicians
          Los Angeles County Sheriff's Department


           ASSEMBLY FLOOR  :  74-0, 5/8/14
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,  
            Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian  
            Calderon, Campos, Chau, Ch�vez, Chesbro, Conway, Cooley,  
            Dababneh, Dahle, Daly, Dickinson, Fong, Fox, Frazier, Beth  
            Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gray, Grove,  
            Hagman, Hall, Harkey, Roger Hern�ndez, Holden, Jones,  
            Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein,  
            Medina, Melendez, Mullin, Muratsuchi, Nazarian, Nestande,  
            Olsen, Pan, Patterson, Perea, Quirk, Quirk-Silva, Rendon,  
            Ridley-Thomas, Rodriguez, Salas, Skinner, Stone, Ting, Wagner,  
            Waldron, Weber, Wieckowski, Wilk, Williams, Yamada, John A.  
            P�rez
          NO VOTE RECORDED:  Donnelly, Eggman, Gorell, Mansoor, V. Manuel  
            P�rez, Vacancy


          JG:e  8/21/14   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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