BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de Le�n, Chair


          AB 2625 (Achadjian) - Defendants: competence.
          
          Amended: April 24, 2014         Policy Vote: Public Safety 6-0
          Urgency: No                     Mandate: Yes
          Hearing Date: June 23, 2014                             
          Consultant: Jolie Onodera       
          
          This bill does not meet the criteria for referral to the  
          Suspense File.


          Bill Summary: AB 2625 would specify procedures relative to  
          returning to court a defendant committed to a state hospital or  
          other facility for treatment as incompetent to stand trial (IST)  
          who has not recovered competency, as specified.

          Fiscal Impact: 
              No significant near-term state costs (General Fund) to the  
              Department of State Hospitals (DSH) to the extent IST  
              patients who cannot be restored to competency are replaced  
              with IST patients from the wait list and require comparable  
              treatment, custody, and housing costs. 
              Future cost-savings (General Fund) to DSH once the IST wait  
              list is removed by ensuring that IST defendants who cannot  
              be restored to competency are returned to counties in a  
              timely manner, allowing DSH resources to be used more  
              efficiently.
              Potential ongoing cost savings to the courts (General  
              Fund*) due to fewer IST status conferences and court orders  
              issued under the more efficient process.
              Potential minor state-reimbursable costs for medical  
              directors of local facilities to promptly notify defense  
              counsel, the district attorney, and county sheriff. These  
              costs would likely be more than offset by cost savings  
              through reduced lengths of stay of IST patients in county  
              facilities. 
              Potential non-reimbursable local costs for increased  
              conservatorship proceedings upon order of the court. 
          *Trial Court Trust Fund

          Background: Existing law provides that a person cannot be tried  
          or adjudged to punishment while he or she is mentally  








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          incompetent, meaning he or she has a mental disorder or  
          developmental disability that renders him or her unable to  
          understand the nature of the criminal proceedings or is unable  
          to assist counsel in his or her defense. 

          Existing law provides that if the defendant is determined IST,  
          the matter is suspended until the person becomes mentally  
          competent. In the meantime, the court is required to order that  
          the IST defendant be delivered by the sheriff to a state  
          hospital for the care and treatment, or to any other available  
          public or private treatment facility, including a local county  
          jail treatment facility, approved by the community program  
          director that will promote the defendant's speedy restoration to  
          mental competence, or placed on outpatient status. 

          Within 90 days of commitment, the medical director of the state  
          hospital or other treatment facility to which the defendant is  
          confined is required to make a written report to the court and  
          the community program director for the county or region of  
          commitment, concerning the defendant's progress toward recovery  
          of mental competence. If the defendant has not recovered mental  
          competence, but the report discloses a substantial likelihood  
          that the defendant will regain mental competence in the  
          foreseeable future, the defendant is required to remain in the  
          state hospital or other treatment facility or on outpatient  
          status.
           
          Under existing law, if the report indicates that there is no  
          substantial likelihood that the defendant will regain mental  
          competence in the foreseeable future, the committing court is  
          required to order the defendant to be returned to the court for  
          conservatorship proceedings, and the court must transmit a copy  
          of its order to the community program director or a designee.  
          Under existing law, an IST defendant may be committed to a  
          treatment facility for three years or the period equal to the  
          maximum term of imprisonment for the most serious underlying  
          offense charged, whichever is shorter.

          This bill establishes a process and timelines in order to ensure  
          an IST patient for whom it has been determined there is a  
          substantial likelihood that he or she will not regain competency  
          within the foreseeable future is returned in a timely manner to  
          the county of commitment.









          AB 2625 (Achadjian)
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          Proposed Law: This bill would specify procedures relative to  
          returning to court a defendant committed to a state hospital or  
          other facility for treatment as IST who has not recovered  
          competency. Specifically, this bill:
           Requires the committing court to order an IST defendant  
            returned to court from the treating facility within 10 days of  
            the court's receipt of a report concluding that the IST  
            defendant will not regain competence within the foreseeable  
            future.
           Requires the medical director of the state hospital or other  
            facility, if the medical director's report regarding the  
            defendant's progress toward competency indicates it is  
            unlikely the defendant will regain competence in the  
            foreseeable future, to notify defense counsel and the  
            prosecutor of the finding and inform the committing county's  
            sheriff that transportation will be needed for the patient's  
            return to court. 
           Directs the court to institute conservatorship proceedings  
            upon the IST defendant's return to court.
           Requires that an IST defendant committed to a state hospital  
            to regain mental competency, but who has not recovered  
            competency, be returned to the committing court no later than  
            90 days before the expiration of the defendant's term of  
            commitment.

          Staff Comments: This bill establishes procedures and timelines  
          for the courts and medical directors of facilities that treat  
          IST defendants to follow when a progress report concerning an  
          IST defendant concludes that there is a substantial likelihood  
          that he or she will not regain competence within the foreseeable  
          future. 

          The DSH has indicated that as of March 2014, DSH housed 35 IST  
          patients who were determined unlikely to be restored to  
          competency or have been in a state hospital longer than the  
          maximum term of commitment. Returning these IST patients to the  
          committing county would result in an overall reduction in the  
          cost of competency restoration per patient at DSH. However,  
          these beds would likely be backfilled by defendants in county  
          jails currently on the IST waitlist (about 350 defendants). As a  
          result, the provisions of this bill are not estimated to result  
          in reduced costs in the near-term, but rather a continuation of  
          existing costs. However, over time the increased efficiencies  
          created by this bill could potentially result in cost savings by  








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          ensuring defendants who cannot be restored to competency are  
          returned to counties in a timely manner, allowing DSH resources  
          to be used in a more efficient manner.

          The Judicial Council has concurred that the current IST backlog  
          results in patients often spending prolonged periods of time  
          without proper treatment and evaluation services while placed in  
          local jails awaiting placement. These circumstances require  
          courts to set multiple status conferences and issue orders to  
          show cause. By more efficiently returning IST patients to their  
          county of commitment, the provisions of this bill will reduce  
          the number of status conferences called and assist in securing  
          more timely placements for IST patients.

          This bill could result in potential minor state-reimbursable  
          costs for medical directors of local facilities to promptly  
          notify defense counsel, the district attorney, and county  
          sheriff. These costs would likely be more than offset by cost  
          savings through reduced lengths of stay of IST patients in  
          county facilities.

          Staff notes the 2014 Budget Act includes $27.8 million (General  
          Fund) to the DSH for 105 additional IST beds to help reduce the  
          number of defendants waiting to be transferred to a state  
          hospital and $3.9 million (General Fund) for expansion of the  
          Restoration of Competency Program to add up to 55 IST beds at  
          local facilities.