BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                    THIRD READING


          Bill No:  AB 2190
          Author:   Maienschein (R)
          Amended:  5/23/14 in Assembly
          Vote:     21

           
           SENATE HEALTH COMMITTEE  : 8-0, 6/18/14
          AYES: Hernandez, Morrell, Beall, DeSaulnier, Evans, Monning,  
            Nielsen, Wolk
          NO VOTE RECORDED: De Le�n

           SENATE PUBLIC SAFETY COMMITTEE  : 7-0, 6/24/14
          AYES: Hancock, Anderson, De Le�n, Knight, Liu, Mitchell,  
            Steinberg

           SENATE APPROPRIATIONS COMMITTEE  :  5-0, 8/14/14
          AYES:  De Le�n, Hill, Lara, Padilla, Steinberg
          NO VOTE RECORDED:  Walters, Gaines

           ASSEMBLY FLOOR  : 78-0, 5/28/14 - See last page for vote


           SUBJECT  :    Criminal defendants:  gravely disabled persons

           SOURCE  :     Judicial Council of California


           DIGEST  :    This bill allows a court to place a person found to  
          be incompetent to stand trial (IST) or not guilty by reason of  
          insanity (NGI) on outpatient status within a mental health  
          treatment facility, as specified.  Requires a conservatorship  
          investigator to submit a copy of his/her report, upon prior  
          written request of the defendant or the defendant's attorney, to  
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          specified entities in a criminal case.

           ANALYSIS  :    Existing law:

          1.Prohibits any person charged with and found IST on a charge or  
            conviction or found NGI of specified felonies from being  
            released on outpatient status unless the person has been  
            confined in a state hospital or other treatment facility for  
            180 days or more.

          2.Allows any person subject to the provision above to be placed  
            on outpatient status if specified conditions are satisfied.

          3.Authorizes a court to grant outpatient status, prior to actual  
            confinement in a state hospital or other treatment facility,  
            to any person charged with and found IST on the charge or  
            conviction of any misdemeanor or any non-specified felony or  
            found NGI of any misdemeanor. Allows any person subject to  
            this provision to be placed on outpatient status if specified  
            conditions are satisfied.

          4.Permits any person alleged, as a result of mental disorder, to  
            be a danger to him- or herself or others; or, to be gravely  
            disabled to be given an evaluation of his condition under a  
            superior court order, as specified. Requires that the  
            evaluation be carried out with the utmost consideration for  
            the privacy and dignity of the person for whom a court-ordered  
            evaluation is requested.  

          5.Permits a conservator of the person, of the estate, or of the  
            person and the estate to be appointed for any person who is  
            gravely disabled as a result of mental disorder or impairment  
            by chronic alcoholism.  

          6.Requires the officer providing conservatorship investigation  
            to investigate all available alternatives to conservatorship  
            and to recommend conservatorship to the court only if no  
            suitable alternatives are available and to set forth all  
            alternatives available if he or she recommends against  
            conservatorship. Requires the officer, prior to the hearing,  
            to render to the court a comprehensive written report that  
            contains all relevant aspects of the person's medical;  
            psychological; financial; family; vocational; and, social  
            condition; information obtained from the person's family  

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            members, close friends, social worker, or principal therapist;  
            and all available information concerning the person's real and  
            personal property. Requires the facilities providing intensive  
            treatment or comprehensive evaluation to disclose any records  
            or information that may facilitate the investigation.  

          7.Requires a copy of the officer's report to be transmitted to  
            the individual who originally recommended conservatorship, to  
            the person or agency, if any, recommended to serve as  
            conservator, and to the person recommended for  
            conservatorship. Allows the court that is determining  
            conservatorship to receive the report in evidence and to read  
            and consider its contents in rendering its judgment.  

          This bill:

          1.Allows outpatient status to a person, who under existing law  
            is required to be confined in a state hospital or other  
            treatment facility for 180 days or more for the commission of  
            specified felonies, if the court finds a suitable placement,  
            including an outpatient placement program, that would provide  
            the person with more appropriate mental health treatment and  
            the court finds that the placement would not pose a danger to  
            the health or safety of others, including the victim and his  
            or her family.

          2.Requires the officer providing a conservatorship  
            investigation, when a court with jurisdiction over a person in  
            a criminal case orders an evaluation of the person's mental  
            condition, as specified, to serve a copy of the report to the  
            defendant or his or her attorney. Requires, upon prior written  
            request of the defendant or his or her attorney, the officer  
            providing the conservatorship investigation to submit a copy  
            of the report to the court hearing the criminal case, the  
            district attorney, and the county probation department.  
            Requires the conservatorship investigation report, and the  
            information contained in it, to be kept confidential and not  
            further disclosed to anyone without the prior written consent  
            of the defendant.

          3.Requires the court to place all copies of the report in a  
            sealed file after disposition of the criminal case. Permits  
            the defendant and defendant's attorney to retain their copies.  
            Permits, if the defendant is placed on probation status, the  

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            probation department to retain a copy for the purpose of  
            supervision until probation is terminated, at which time the  
            department is required to return its copy to the court for  
            placement in the sealed file.

          4.Makes findings and declarations relative to a conservatee's  
            confidentiality rights. Makes other technical, clarifying  
            changes.

           Background
           
          In an April 2011 report, "Recommendations for Changing the  
          Paradigm for Persons with Mental Illness in the Criminal Justice  
          System," the Task Force for Criminal Justice Collaboration on  
          Mental Health Issues stated that courts, in collaboration with  
          state hospitals and local mental health treatment facilities,  
          should create and employ methods that prevent prolonged delays  
          in case processing and ensure timely access to restoration  
          programs for defendants found incompetent to stand trial.  The  
          Task Force recommended that state hospitals and mental health  
          outpatient programs be adequately funded to ensure effective and  
          timely restoration of competency; increase community placement  
          options through the Forensic Conditional Release Program and  
          other community-based programs for IST defendants charged with  
          nonviolent offenses; and modify existing law to provide courts  
          hearing competency matters more alternative procedural and  
          disposition tools, including the jurisdiction to conditionally  
          release a defendant found IST to the community, where  
          appropriate, rather than in a custodial or hospital setting, to  
          receive mental health treatment with supervision until  
          competency is restored.  The Task Force also recognized that  
          some criminal defendants with mental illness may be conserved or  
          may be involved in conservatorship proceedings at the same time  
          that their criminal case is being processed. Because these cases  
          are currently heard by different judicial officers on different  
          calendars, judicial officers hearing either the civil or  
          criminal case often do not have all applicable information,  
          which can result in conflicting orders and other complications  
          for the defendant.  

           Comments
           
           Confidentiality of mental health records.   According to the  
          Disability Rights California Internet Web site, all information  

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          about mental health services that one receives, whether received  
          voluntarily or involuntarily, is confidential and cannot be  
          released without authorization. However, there are situations  
          when records can be released without authorization. In some  
          cases, limited information must be released to law enforcement  
          when a person is an involuntary patient or under a Penal Code  
          commitment in a facility and being moved, is under criminal  
          investigation, or escapes from a state hospital. Information  
          about a person's mental health care can also be released if one  
          is an involuntary patient and gravely disabled and the person  
          disappears from a facility or is transferred between state  
          hospitals. Generally, in order for mental health records to be  
          shared, a form must be signed by the person (or a person's  
          conservator) each time the information is shared, and it must  
          contain specific information to be shared, the name of the  
          agency or individual with whom information is shared, the name  
          of the agency or person authorized to release the information  
          and the purpose, and a valid expiration date. Statements must  
          also be provided informing a person about his or her right to  
          revoke authorization to share information, as well as a person's  
          right to a copy of the authorization. A person has the right to  
          receive copies of the form, which must be placed in the person's  
          medical record.
          
           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  Yes

          According to the Senate Appropriations Committee:
           
           Unknown potential increase in court costs from additional  
            hearings to determine appropriate placements (General Fund).   
            Some individuals who have been found IST or NGI and who have  
            been placed in a state hospital may request an additional  
            hearing to determine whether they can be placed in an  
            outpatient placement before 180 days have elapsed.  For  
            example, if 5% of the applicable individuals currently in a  
            state hospital were to receive an additional half-day court  
            hearing, annual costs would be about $275,000 per year.

           Potential annual costs in the low millions from community  
            placements paid for by the state (General Fund).  Under  
            current law, the state pays for community placements of  
            patients who are moved from a state hospital under the  
            Forensic Conditional Release Program.  If 50% of the patients  

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            in a state hospital who request a hearing for community  
            placement are successful, annual state costs to pay for their  
            community placement would be about $2 million.

           No savings are likely in the near-term.  There is a long  
            waiting list for placement in a state hospital for individuals  
            who are incompetent to stand trial or not guilty by reason of  
            insanity (typically, these individuals are being held in  
            county jails or other facilities at the local level).   
            Therefore, any individuals who are released from a state  
            hospital will immediately be replaced by another individual  
            from the waiting list.  In the 2014-15 Budget Act, the  
            Department of State Hospitals received about $35 million to  
            expand the capacity to house incompetent to stand trial  
            patients.  In the long-run, there could be savings to the  
            state if there is no longer a waiting list for admission to  
            state hospitals.

           SUPPORT  :   (Verified  8/15/14)

          Judicial Council of California (source) 
          Californians for Safety and Justice
          Legal Services for Prisoners with Children
          National Association of Social Workers, California Chapter


           ARGUMENTS IN SUPPORT  :    The sponsor and supporters argue that  
          this bill permits courts to make placements that are most  
          appropriate for individual defendants, which can result in cost  
          savings while still protecting the public. They further argue  
          that providing care to people in the criminal justice system  
          with a serious mental illness is essential to stopping the cycle  
          of crime and that access to appropriate care should be a  
          priority.
          

           ASSEMBLY FLOOR  :  78-0, 05/28/14
          AYES: Achadjian, Alejo, Allen, Ammiano, Bigelow, Bloom,  
            Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian  
            Calderon, Campos, Chau, Ch�vez, Chesbro, Conway, Cooley,  
            Dababneh, Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox,  
            Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell,  
            Gray, Grove, Hagman, Hall, Harkey, Roger Hern�ndez, Holden,  
            Jones, Jones-Sawyer, Levine, Linder, Logue, Lowenthal,  

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            Maienschein, Mansoor, Medina, Melendez, Mullin, Muratsuchi,  
            Nazarian, Nestande, Olsen, Pan, Patterson, Perea, John A.  
            P�rez, V. Manuel P�rez, Quirk, Quirk-Silva, Rendon,  
            Ridley-Thomas, Rodriguez, Salas, Skinner, Stone, Ting, Wagner,  
            Waldron, Weber, Wieckowski, Wilk, Williams, Yamada, Atkins
          NO VOTE RECORDED: Frazier, Vacancy


          JL:nl  8/16/14   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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