SB 1317: Inmates: psychiatric medication: informed consent.
- Session Year: 2023-2024
- House: Senate
- Latest Version Date: 2024-09-20
Current Status:
Passed
(2024-09-20: Chaptered by Secretary of State. Chapter 326, Statutes of 2024.)
Introduced
In Committee
First Chamber
In Committee
Second Chamber
Enacted
What does this bill do?
The bill extends until January 1, 2030 protections for county jail inmates that generally bar giving psychiatric drugs without their consent and that require a judge or court-appointed hearing officer to authorize nonemergency involuntary medication, including for people awaiting arraignment, trial, or sentencing. It also requires counties that gave involuntary medication to inmates awaiting court between January 1, 2025 and July 1, 2028 to report details to the Legislature, requires involuntary treatment to meet the standard of care, and allows a county to use a signed declaration under penalty of perjury to show it tried to find a nonjail treatment bed.
The summary is provided by generative AI which can make mistakes. For original language, please view the details in the table below.
Existing law prohibits, except as specified, a person sentenced to imprisonment in a county jail from being administered any psychiatric medication without prior informed consent. Existing law authorizes a county department of mental health, or other designated county department, to administer to an inmate involuntary medication on a nonemergency basis only after the inmate is provided, among other things, a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer.
Existing law, until January 1, 2025, additionally protects all inmates in a county jail from being administered any psychiatric medication without prior informed consent, with certain exceptions, and imposes additional criteria that must be satisfied before a county department of mental health or other designated county department may administer involuntary medication, including a requirement that the jail first make a documented attempt to locate an available bed for the inmate in a community-based treatment facility, under certain conditions, in lieu of seeking involuntary administration of psychiatric medication. Until January 1, 2025, if an inmate is awaiting resolution of a criminal case, existing law requires that a hearing to administer involuntary medication on a nonemergency basis be held before, and that any requests for ex parte orders be submitted to, a judge in the superior court where the criminal case is pending. Existing law, also until January 1, 2025, sets limits on the amount of time such orders are valid and requires any court-ordered psychiatric medication to be administered in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if one is available.
This bill would extend these provisions until January 1, 2030. The bill would also require any county that, between January 1, 2025, and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, to prepare and submit a report to the Legislature, as specified. The bill would require any involuntary treatment to be consistent with the standard of care. The bill would also permit the county to demonstrate a documented attempt to locate an available bed by submitting a declaration under penalty of perjury.
By imposing new duties on counties and expanding the scope of the crime of perjury, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason.
With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law prohibits, except as specified, a person sentenced to imprisonment in a county jail from being administered any psychiatric medication without prior informed consent. Existing law authorizes a county department of mental health, or other designated county department, to administer to an inmate involuntary medication on a nonemergency basis only after the inmate is provided, among other things, a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer.
Existing law, until January 1, 2025, additionally protects all inmates in a county jail from being administered any psychiatric medication without prior informed consent, with certain exceptions, and imposes additional criteria that must be satisfied before a county department of mental health or other designated county department may administer involuntary medication, including a requirement that the jail first make a documented attempt to locate an available bed for the inmate in a community-based treatment facility, under certain conditions, in lieu of seeking involuntary administration of psychiatric medication. Until January 1, 2025, if an inmate is awaiting resolution of a criminal case, existing law requires that a hearing to administer involuntary medication on a nonemergency basis be held before, and that any requests for ex parte orders be submitted to, a judge in the superior court where the criminal case is pending. Existing law, also until January 1, 2025, sets limits on the amount of time such orders are valid and requires any court-ordered psychiatric medication to be administered in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if one is available.
This bill would extend these provisions until January 1, 2030. The bill would also require any county that, between January 1, 2025, and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, to prepare and submit a report to the Legislature, as specified. The bill would require any involuntary treatment to be consistent with the standard of care. The bill would also permit the county to demonstrate a documented attempt to locate an available bed by submitting a declaration under penalty of perjury.
By imposing new duties on counties and expanding the scope of the crime of perjury, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason.
With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law prohibits, except as specified, a person sentenced to imprisonment in a county jail from being administered any psychiatric medication without prior informed consent. Existing law authorizes a county department of mental health, or other designated county department, to administer to an inmate involuntary medication on a nonemergency basis only after the inmate is provided, among other things, a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer.
Existing law, until January 1, 2025, additionally protects all inmates in a county jail from being administered any psychiatric medication without prior informed consent, with certain exceptions, and imposes additional criteria that must be satisfied before a county department of mental health or other designated county department may administer involuntary medication, including a requirement that the jail first make a documented attempt to locate an available bed for the inmate in a community-based treatment facility, under certain conditions, in lieu of seeking involuntary administration of psychiatric medication. Until January 1, 2025, if an inmate is awaiting resolution of a criminal case, existing law requires that a hearing to administer involuntary medication on a nonemergency basis be held before, and that any requests for ex parte orders be submitted to, a judge in the superior court where the criminal case is pending. Existing law, also until January 1, 2025, sets limits on the amount of time such orders are valid and requires any court-ordered psychiatric medication to be administered in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if one is available.
This bill would extend these provisions until January 1, 2030. The bill would also require any county that, between January 1, 2025, and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, to prepare and submit a report to the Legislature, as specified. The bill would require any involuntary treatment to be consistent with the standard of care. The bill would also permit the county to demonstrate a documented attempt to locate an available bed by submitting a declaration under penalty of perjury.
By imposing new duties on counties and expanding the scope of the crime of perjury, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason.
With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law prohibits, except as specified, a person sentenced to imprisonment in a county jail from being administered any psychiatric medication without prior informed consent. Existing law authorizes a county department of mental health, or other designated county department, to administer to an inmate involuntary medication on a nonemergency basis only after the inmate is provided, among other things, a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer.
Existing law, until January 1, 2025, additionally protects all inmates in a county jail from being administered any psychiatric medication without prior informed consent, with certain exceptions, and imposes additional criteria that must be satisfied before a county department of mental health or other designated county department may administer involuntary medication, including a requirement that the jail first make a documented attempt to locate an available bed for the inmate in a community-based treatment facility, under certain conditions, in lieu of seeking involuntary administration of psychiatric medication. Until January 1, 2025, if an inmate is awaiting resolution of a criminal case, existing law requires that a hearing to administer involuntary medication on a nonemergency basis be held before, and that any requests for ex parte orders be submitted to, a judge in the superior court where the criminal case is pending. Existing law, also until January 1, 2025, sets limits on the amount of time such orders are valid and requires any court-ordered psychiatric medication to be administered in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if one is available.
This bill would extend these provisions until January 1, 2030. The bill would also require any county that, between January 1, 2025, and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, to prepare and submit a report to the Legislature, as specified. The bill would require any involuntary treatment to be consistent with the standard of care. The bill would also permit the county to demonstrate a documented attempt to locate an available bed by submitting a declaration under penalty of perjury.
By imposing new duties on counties, counties and expanding the scope of the crime of perjury, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason.
With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law prohibits, except as specified, a person sentenced to imprisonment in a county jail from being administered any psychiatric medication without prior informed consent. Existing law authorizes a county department of mental health, or other designated county department, to administer to an inmate involuntary medication on a nonemergency basis only after the inmate is provided, among other things, a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer.
Existing law, until January 1, 2025, additionally protects all inmates in a county jail from being administered any psychiatric medication without prior informed consent, with certain exceptions, and imposes additional criteria that must be satisfied before a county department of mental health or other designated county department may administer involuntary medication, including a requirement that the jail first make a documented attempt to locate an available bed for the inmate in a community-based treatment facility, under certain conditions, in lieu of seeking involuntary administration of psychiatric medication. Until January 1, 2025, if an inmate is awaiting resolution of a criminal case, existing law requires that a hearing to administer involuntary medication on a nonemergency basis be held before, and that any requests for ex parte orders be submitted to, a judge in the superior court where the criminal case is pending. Existing law, also until January 1, 2025, sets limits on the amount of time such orders are valid and requires any court-ordered psychiatric medication to be administered in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if one is available.
This bill would make the above changes permanent. extend these provisions until January 1, 2030. The bill would also require any county that, between January 1, 2025, and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, to prepare and submit a report to the Legislature, as specified.
By imposing new duties on counties, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law prohibits, except as specified, a person sentenced to imprisonment in a county jail from being administered any psychiatric medication without prior informed consent. Existing law authorizes a county department of mental health, or other designated county department, to administer to an inmate involuntary medication on a nonemergency basis only after the inmate is provided, among other things, a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer.
Existing law, until January 1, 2025, additionally protects all inmates in a county jail from being administered any psychiatric medication without prior informed consent, with certain exceptions, and imposes additional criteria that must be satisfied before a county department of mental health or other designated county department may administer involuntary medication, including a requirement that the jail first make a documented attempt to locate an available bed for the inmate in a community-based treatment facility, under certain conditions, in lieu of seeking involuntary administration of psychiatric medication. Until January 1, 2025, if an inmate is awaiting resolution of a criminal case, existing law requires that a hearing to administer involuntary medication on a nonemergency basis be held before, and that any requests for ex parte orders be submitted to, a judge in the superior court where the criminal case is pending. Existing law, also until January 1, 2025, sets limits on the amount of time such orders are valid and requires any court-ordered psychiatric medication to be administered in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if one is available.
This bill would make the above changes permanent.
(a)Except as provided in subdivision (b), an inmate confined in a county jail shall not be administered any psychiatric medication without their prior informed consent.
(b)If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d). Any such treatment shall be consistent with the standard of care.
(c)A county department of mental health, or other designated county department, may administer involuntary medication on a nonemergency basis only if all of the following conditions have been met:
(1)A psychiatrist or psychologist has determined that the inmate has a serious mental disorder.
(2)A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others.
(3)A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmates disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.
(4)The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication and refuses, or is unable to consent to, the administration of the medication.
(5)The jail has made a documented attempt to locate an available bed for the inmate in a noncarceral treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of noncarceral treatment beds and the inability of many facilities to accept transfers from correctional facilities. Submission of a declaration under penalty of perjury is sufficient for the county to demonstrate a documented attempt to locate an available bed.
(6)The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified in subdivision (c) of Section 5334 of the Welfare and Institutions Code.
(A)If the inmate is in custody awaiting trial, including an inmate whose criminal proceedings are suspended pursuant to Section 1370 or an inmate whose competence has been called into question and is undergoing evaluation pursuant to Section 1369, any hearing pursuant to this section shall be held before, and any requests for ex parte orders shall be submitted to, a judge in the superior court where the criminal case is pending.
(B)A superior court judge may consider whether involuntary medication would prejudice the inmates defense.
(7)(A)The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive expedited access to counsel.
(B)In the case of an inmate awaiting arraignment, the inmate is provided counsel within 48 hours of the filing of the notice of the hearing with the superior court, unless counsel has previously been appointed.
(C)The hearing shall be held not more than 30 days after the filing of the notice with the superior court, unless counsel for the inmate agrees to extend the date of the hearing.
(8)(A)The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive an expedited hearing.
(B)The written notice shall do all of the following:
(i)Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication.
(ii)Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential section of the inmates central file which contains materials unrelated to medical treatment.
(iii)Inform the inmate of their right to appeal the determination to the superior court or the court of appeal as specified in subdivisions (e) and (f) of Section 5334 of the Welfare and Institutions Code, and their right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health, or other designated county department, to continue treatment with involuntary medication after the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer has authorized treatment with involuntary medication.
(9)(A)In the hearing described in paragraph (6), the superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that, as a result of that illness, the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmates best medical interest.
(B)The superior court judge, court-appointed commissioner or referee, or a court-appointed hearing officer shall not make a finding pursuant to subparagraph (A) of this paragraph that there is no less intrusive alternative to involuntary medication and that the medication is in the inmates best medical interest, without information from the jail to indicate that neither of the conditions specified in paragraph (5) is present.
(C)If the court makes the findings in subparagraph (A), that administration shall occur in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if available.
(D)In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, or other designated county department, the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmates counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and, if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default.
(10)The historical course of the inmates mental disorder, as determined by available relevant information about the course of the inmates mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder.
(11)An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. This paragraph does not prevent a court from reviewing, modifying, or terminating an involuntary medication order for an inmate awaiting trial if there is a showing that the involuntary medication is interfering with the inmates due process rights in the criminal proceeding.
(d)(1)(A)This section does not prohibit a physician from taking appropriate action in an emergency. An emergency exists when both of the following criteria are met:
(i)There is a sudden and marked change in an inmates mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others.
(ii)It is impractical, due to the seriousness of the emergency, to first obtain informed consent.
(B)If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist.
(2)(A)If the clinicians of the county department of mental health, or other designated county department, identify a situation that jeopardizes the inmates health or well-being as the result of a serious mental illness, and necessitates the continuation of medication beyond the initial 72 hours pending the full mental health hearing, the county department may seek to continue the medication by giving notice to the inmate and their counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing, and filing an ex parte order within the initial 72-hour period. Treatment of the inmate in a facility pursuant to Section 4011.6 shall not be required in order to continue medication pursuant to this subdivision unless the treatment is otherwise medically necessary.
(B)The notice shall be served upon the inmate and counsel at the same time the inmate is given the written notice that the involuntary medication proceedings are being initiated and is appointed counsel as provided in subdivision (c).
(C)The order may be issued ex parte upon a showing that, in the absence of the medication, the emergency conditions are likely to recur. The request for an ex parte order shall be supported by an affidavit from the psychiatrist or psychologist showing specific facts.
(D)The inmate and the inmates appointed counsel shall have two business days to respond to the county departments ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the departments request. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer shall review the ex parte request and shall have three business days to determine the merits of the departments request for an ex parte order.
(E)If an order is issued, the psychiatrist may continue the administration of the medication until the hearing described in paragraph (6) of subdivision (c) is held.
(3)If the county elects to seek an ex parte order pursuant to this subdivision, the county department of mental health, or other designated county department, shall file with the superior court, and serve on the inmate and their counsel, the written notice described in paragraph (8) of subdivision (c) within 72 hours of commencing medication pursuant to this subdivision, unless either of the following occurs:
(A)The inmate gives informed consent to continue the medication.
(B)A psychiatrist determines that the psychiatric medication is not necessary and administration of the medication is discontinued.
(4)If medication is being administered pursuant to this subdivision, the hearing described in paragraph (6) of subdivision (c) shall commence within 21 days of the filing and service of the notice, unless counsel for the inmate agrees to a different period of time.
(5)With the exception of the timeline provisions specified in paragraphs (3) and (4) for providing notice and commencement of the hearing in emergency or interim situations, the inmate shall be entitled to and be given the same due process protections as specified in subdivision (c). The county department of mental health, or other designated county department, shall prove the same elements supporting the involuntary administration of psychiatric medication and the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall be required to make the same findings described in subdivision (c).
(e)(1)(A)An order by the court authorizing involuntary medication of an inmate shall be valid for no more than one year after the date of determination.
(B)Notwithstanding subparagraph (A), in the case of an inmate who is awaiting arraignment, trial, or sentencing, the determination that an inmate may receive involuntary medication shall be valid for no more than 180 days. The court shall review the order at intervals of not more than 60 days to determine whether the grounds for the order remain. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendants attorney. In determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendants attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order.
(2)Notwithstanding subparagraph (A) of paragraph (1), any determination of an inmates incapacity to refuse treatment with antipsychotic medication made pursuant to this section shall remain in effect only until one of the following occurs, whichever occurs first:
(A)The duration of the inmates confinement ends, unless, pursuant to Section 1370, the inmate is transferred to a State Department of State Hospitals facility, as defined in Section 4100 of the Welfare and Institutions Code. If the inmate is transferred to such a facility, the order shall remain valid for the period ordered by the court and the facility may administer antipsychotic medication as needed, including on an involuntary basis, if the treating psychiatrist determines that antipsychotic medication is medically necessary and appropriate.
(B)A court determines that the inmate no longer meets the criteria of subdivision (c) or (d), or by any other order of the court.
(3)An inmates period of confinement may not be extended in order to provide treatment to the inmate with antipsychotic medication pursuant to this section.
(f)This section does not prohibit the court, upon making a determination that an inmate awaiting arraignment, preliminary hearing, trial, sentencing, or a postconviction proceeding to revoke or modify supervision may receive involuntary medication pursuant to subdivision (c) or (d), and, upon ex parte request of the defendant or counsel, from suspending all proceedings in the criminal prosecution, until the court determines that the defendants medication will not interfere with their ability to meaningfully participate in the criminal proceedings.
(g)If a determination has been made to involuntarily medicate an inmate pursuant to subdivision (c) or (d), the medication shall be discontinued one year after the date of that determination, unless the inmate gives informed consent to the administration of the medication, or unless a new determination is made pursuant to the procedures set forth in subdivision (h).
(h)To renew an existing order allowing involuntary medication, the county department of mental health, or other designated county department, shall file with the superior court, and shall serve on the inmate and their counsel, a written notice indicating the departments intent to renew the existing involuntary medication order.
(1)The request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication.
(2)The inmate shall be entitled to, and shall be given, the same due process protections as specified in subdivision (c).
(3)(A)Except as provided in subparagraph (B), renewal orders shall be valid for one year from the date of the hearing.
(B)In the case of an inmate awaiting arraignment, trial, or sentencing, the renewal order shall be valid for no more than 180 days. The court shall review the order at intervals of not more than 60 days to determine whether the grounds for the order remain. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendants attorney. In determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendants attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order.
(4)(A)An order renewing an existing order shall be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding their need for the medication, such that it is unlikely that the inmate would be able to manage their own medication and treatment regimen. No new acts need be alleged or proven.
(B)The superior court judge, court-appointed commissioner or referee, or a court-appointed hearing officer shall also make a finding that treatment of the inmate in a correctional setting continues to be necessary if neither of the criteria in paragraph (5) of subdivision (c) is present.
(5)If the county department of mental health, or other designated county department, wishes to add a basis to an existing order, it shall give the inmate and the inmates counsel notice in advance of the hearing via a renewal notice or supplemental petition. Within the renewal notice or supplemental petition, as described in subdivision (h), the county department of mental health, or other designated county department, shall specify what additional basis is being alleged and what qualifying conduct within the past year supports that additional basis. The county department of mental health, or other designated county department, shall prove the additional basis and conduct by clear and convincing evidence at a hearing as specified in subdivision (c).
(6)The hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order.
(i)In the event of a conflict between the provisions of this section and the Administrative Procedure Act (Chapter 4.5 (commencing with Section 11400) of Part 1 of Division 3 of the Government Code), this section shall control.
(j)Each county that, between January 1, 2025 and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, shall, by no later than January 1, 2029, prepare and submit a written report to the Assembly Committee on Public Safety and the Senate Committee on Public Safety, summarizing all of the following information:
(1)The number of inmates who were administered involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2025, and July 1, 2028.
(2)The crime for which each of these inmates was arrested, if it is practically feasible to obtain that information.
(3)The total time each inmate was detained while awaiting arraignment, trial, or sentencing, if it is practically feasible to obtain that information.
(4)The duration of the administration of involuntary medication for each inmate.
(5)The number of times, if any, that each existing order for the administration of involuntary medication was renewed.
(6)The reason that administration of involuntary medication was terminated for each inmate.
(k)As used in this section, inmate means a person confined in the county jail, including, but not limited to, a person sentenced to imprisonment in a county jail, a person housed in a county jail during or awaiting trial proceedings, and a person who has been booked into a county jail and is awaiting arraignment.
(l)This section does not apply to a person housed in a county jail solely on the basis of an immigration hold, except as it applies to medication provided on an emergency or interim basis as provided in subdivision (d).
(m)This section shall remain in effect only until January 1, 2030, and as of that date is repealed, unless a later enacted statute, which is chaptered before that date, deletes or extends the date.
SEC. 2.Section 2603 of the Penal Code, as amended by Section 12 of Chapter 434 of the Statutes of 2021, is amended to read:2603.(a)Except as provided in subdivision (b), no person sentenced to imprisonment in a county jail shall be administered any psychiatric medication without prior informed consent.
(b)If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d).
(c)A county department of mental health, or other designated county department, may seek to initiate involuntary medication on a nonemergency basis only if all of the following conditions have been met:
(1)A psychiatrist or psychologist has determined that the inmate has a serious mental disorder.
(2)A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others.
(3)A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmates disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.
(4)The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication, and refuses, or is unable to consent to, the administration of the medication.
(5)The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified in subdivision (c) of Section 5334 of the Welfare and Institutions Code.
(6)The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive expedited access to counsel. The hearing shall be held not more than 30 days after the filing of the notice with the superior court, unless counsel for the inmate agrees to extend the date of the hearing.
(7)The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive an expedited hearing. The written notice shall do all of the following:
(A)Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication.
(B)Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential section of the inmates central file which contains materials unrelated to medical treatment.
(C)Inform the inmate of the right to appeal the determination to the superior court or the court of appeal as specified in subdivisions (e) and (f) of Section 5334 of the Welfare and Institutions Code, and of the right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health, or other designated county department, to continue treatment with involuntary medication after the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer has authorized treatment with involuntary medication.
(8)A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmates best medical interest. In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, or other designated county department, the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmates counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and, if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default.
(9)The historical course of the inmates mental disorder, as determined by available relevant information about the course of the inmates mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder.
(10)An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown.
(d)Nothing in this section is intended to prohibit a physician from taking appropriate action in an emergency. An emergency exists when there is a sudden and marked change in an inmates mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others, and it is impractical, due to the seriousness of the emergency, to first obtain informed consent. If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist. If the clinicians of the county department of mental health, or other designated county department, identify a situation that jeopardizes the inmates health or well-being as the result of a serious mental illness, and necessitates the continuation of medication beyond the initial 72 hours pending the full mental health hearing, the county department may seek to continue the medication by giving notice to the inmate and their counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing. Treatment of the inmate in a facility pursuant to Section 4011.6 shall not be required in order to continue medication pursuant to this subdivision unless the treatment is otherwise medically necessary. The notice shall be served upon the inmate and counsel at the same time the inmate is given the written notice that the involuntary medication proceedings are being initiated and is appointed counsel as provided in subdivision (c). The order may be issued ex parte upon a showing that, in the absence of the medication, the emergency conditions are likely to recur. The request for an ex parte order shall be supported by an affidavit from the psychiatrist or psychologist showing specific facts. The inmate and the inmates appointed counsel shall have two business days to respond to the county departments ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the departments request. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer shall review the ex parte request and shall have three business days to determine the merits of the departments request for an ex parte order. If an order is issued, the psychiatrist may continue the administration of the medication until the hearing described in paragraph (5) of subdivision (c) is held.
(1)If the county elects to seek an ex parte order pursuant to this subdivision, the county department of mental health, or other designated county department, shall file with the superior court, and serve on the inmate and their counsel, the written notice described in paragraph (7) of subdivision (c) within 72 hours of commencing medication pursuant to this subdivision, unless either of the following occurs:
(A)The inmate gives informed consent to continue the medication.
(B)A psychiatrist determines that the psychiatric medication is not necessary and administration of the medication is discontinued.
(2)If medication is being administered pursuant to this subdivision, the hearing described in paragraph (5) of subdivision (c) shall commence within 21 days of the filing and service of the notice, unless counsel for the inmate agrees to a different period of time.
(3)With the exception of the timeline provisions specified in paragraphs (1) and (2) for providing notice and commencement of the hearing in emergency or interim situations, the inmate shall be entitled to and be given the same due process protections as specified in subdivision (c). The county department of mental health, or other designated county department, shall prove the same elements supporting the involuntary administration of psychiatric medication, and the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall be required to make the same findings described in subdivision (c).
(e)The determination that an inmate may receive involuntary medication shall be valid for one year from the date of the determination, regardless of whether the inmate subsequently gives informed consent.
(f)If a determination has been made to involuntarily medicate an inmate pursuant to subdivision (c) or (d), the medication shall be discontinued one year after the date of that determination, unless the inmate gives informed consent to the administration of the medication, or unless a new determination is made pursuant to the procedures set forth in subdivision (g).
(g)To renew an existing order allowing involuntary medication, the county department of mental health, or other designated county department, shall file with the superior court, and shall serve on the inmate and their counsel, a written notice indicating the departments intent to renew the existing involuntary medication order.
(1)The request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication.
(2)The inmate shall be entitled to, and shall be given, the same due process protections as specified in subdivision (c).
(3)Renewal orders shall be valid for one year from the date of the hearing.
(4)An order renewing an existing order shall be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding their need for the medication, such that it is unlikely that the inmate would be able to manage their own medication and treatment regimen. No new acts need be alleged or proven.
(5)If the county department of mental health, or other designated county department, wishes to add a basis to an existing order, it shall give the inmate and the inmates counsel notice in advance of the hearing via a renewal notice or supplemental petition. Within the renewal notice or supplemental petition, as described in subdivision (g), the county department of mental health, or other designated county department, shall specify what additional basis is being alleged and what qualifying conduct within the past year supports that additional basis. The county department of mental health, or other designated county department, shall prove the additional basis and conduct by clear and convincing evidence at a hearing as specified in subdivision (c).
(6)The hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order.
(h)In the event of a conflict between the provisions of this section and the Administrative Procedure Act (Chapter 4.5 (commencing with Section 11400) of Part 1 of Division 3 of Title 2 of the Government Code), this section shall control.
(i)This section shall become operative on January 1, 2030.
SEC. 3.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution for certain costs that may be incurred by a local agency or school district because, in that regard, this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
However, if the Commission on State Mandates determines that this act contains other costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.
(a)Except as provided in subdivision (b), an inmate confined in a county jail shall not be administered any psychiatric medication without their prior informed consent.
(b)If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d). Any such treatment shall be consistent with the standard of care.
(c)A county department of mental health, or other designated county department, may administer involuntary medication on a nonemergency basis only if all of the following conditions have been met:
(1)A psychiatrist or psychologist has determined that the inmate has a serious mental disorder.
(2)A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others.
(3)A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmates disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.
(4)The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication and refuses, or is unable to consent to, the administration of the medication.
(5)The jail has made a documented attempt to locate an available bed for the inmate in a noncarceral treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of noncarceral treatment beds and the inability of many facilities to accept transfers from correctional facilities. Submission of a declaration under penalty of perjury is sufficient for the county to demonstrate a documented attempt to locate an available bed.
(6)The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified in subdivision (c) of Section 5334 of the Welfare and Institutions Code.
(A)If the inmate is in custody awaiting trial, including an inmate whose criminal proceedings are suspended pursuant to Section 1370 or an inmate whose competence has been called into question and is undergoing evaluation pursuant to Section 1369, any hearing pursuant to this section shall be held before, and any requests for ex parte orders shall be submitted to, a judge in the superior court where the criminal case is pending.
(B)A superior court judge may consider whether involuntary medication would prejudice the inmates defense.
(7)(A)The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive expedited access to counsel.
(B)In the case of an inmate awaiting arraignment, the inmate is provided counsel within 48 hours of the filing of the notice of the hearing with the superior court, unless counsel has previously been appointed.
(C)The hearing shall be held not more than 30 days after the filing of the notice with the superior court, unless counsel for the inmate agrees to extend the date of the hearing.
(8)(A)The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive an expedited hearing.
(B)The written notice shall do all of the following:
(i)Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication.
(ii)Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential section of the inmates central file which contains materials unrelated to medical treatment.
(iii)Inform the inmate of their right to appeal the determination to the superior court or the court of appeal as specified in subdivisions (e) and (f) of Section 5334 of the Welfare and Institutions Code, and their right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health, or other designated county department, to continue treatment with involuntary medication after the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer has authorized treatment with involuntary medication.
(9)(A)In the hearing described in paragraph (6), the superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that, as a result of that illness, the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmates best medical interest.
(B)The superior court judge, court-appointed commissioner or referee, or a court-appointed hearing officer shall not make a finding pursuant to subparagraph (A) of this paragraph that there is no less intrusive alternative to involuntary medication and that the medication is in the inmates best medical interest, without information from the jail to indicate that neither of the conditions specified in paragraph (5) is present.
(C)If the court makes the findings in subparagraph (A), that administration shall occur in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if available.
(D)In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, or other designated county department, the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmates counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and, if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default.
(10)The historical course of the inmates mental disorder, as determined by available relevant information about the course of the inmates mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder.
(11)An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. This paragraph does not prevent a court from reviewing, modifying, or terminating an involuntary medication order for an inmate awaiting trial if there is a showing that the involuntary medication is interfering with the inmates due process rights in the criminal proceeding.
(d)(1)(A)This section does not prohibit a physician from taking appropriate action in an emergency. An emergency exists when both of the following criteria are met:
(i)There is a sudden and marked change in an inmates mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others.
(ii)It is impractical, due to the seriousness of the emergency, to first obtain informed consent.
(B)If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist.
(2)(A)If the clinicians of the county department of mental health, or other designated county department, identify a situation that jeopardizes the inmates health or well-being as the result of a serious mental illness, and necessitates the continuation of medication beyond the initial 72 hours pending the full mental health hearing, the county department may seek to continue the medication by giving notice to the inmate and their counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing, and filing an ex parte order within the initial 72-hour period. Treatment of the inmate in a facility pursuant to Section 4011.6 shall not be required in order to continue medication pursuant to this subdivision unless the treatment is otherwise medically necessary.
(B)The notice shall be served upon the inmate and counsel at the same time the inmate is given the written notice that the involuntary medication proceedings are being initiated and is appointed counsel as provided in subdivision (c).
(C)The order may be issued ex parte upon a showing that, in the absence of the medication, the emergency conditions are likely to recur. The request for an ex parte order shall be supported by an affidavit from the psychiatrist or psychologist showing specific facts.
(D)The inmate and the inmates appointed counsel shall have two business days to respond to the county departments ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the departments request. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer shall review the ex parte request and shall have three business days to determine the merits of the departments request for an ex parte order.
(E)If an order is issued, the psychiatrist may continue the administration of the medication until the hearing described in paragraph (6) of subdivision (c) is held.
(3)If the county elects to seek an ex parte order pursuant to this subdivision, the county department of mental health, or other designated county department, shall file with the superior court, and serve on the inmate and their counsel, the written notice described in paragraph (8) of subdivision (c) within 72 hours of commencing medication pursuant to this subdivision, unless either of the following occurs:
(A)The inmate gives informed consent to continue the medication.
(B)A psychiatrist determines that the psychiatric medication is not necessary and administration of the medication is discontinued.
(4)If medication is being administered pursuant to this subdivision, the hearing described in paragraph (6) of subdivision (c) shall commence within 21 days of the filing and service of the notice, unless counsel for the inmate agrees to a different period of time.
(5)With the exception of the timeline provisions specified in paragraphs (3) and (4) for providing notice and commencement of the hearing in emergency or interim situations, the inmate shall be entitled to and be given the same due process protections as specified in subdivision (c). The county department of mental health, or other designated county department, shall prove the same elements supporting the involuntary administration of psychiatric medication and the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall be required to make the same findings described in subdivision (c).
(e)(1)(A)An order by the court authorizing involuntary medication of an inmate shall be valid for no more than one year after the date of determination.
(B)Notwithstanding subparagraph (A), in the case of an inmate who is awaiting arraignment, trial, or sentencing, the determination that an inmate may receive involuntary medication shall be valid for no more than 180 days. The court shall review the order at intervals of not more than 60 days to determine whether the grounds for the order remain. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendants attorney. In determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendants attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order.
(2)Notwithstanding subparagraph (A) of paragraph (1), any determination of an inmates incapacity to refuse treatment with antipsychotic medication made pursuant to this section shall remain in effect only until one of the following occurs, whichever occurs first:
(A)The duration of the inmates confinement ends, unless, pursuant to Section 1370, the inmate is transferred to a State Department of State Hospitals facility, as defined in Section 4100 of the Welfare and Institutions Code. If the inmate is transferred to such a facility, the order shall remain valid for the period ordered by the court and the facility may administer antipsychotic medication as needed, including on an involuntary basis, if the treating psychiatrist determines that antipsychotic medication is medically necessary and appropriate.
(B)A court determines that the inmate no longer meets the criteria of subdivision (c) or (d), or by any other order of the court.
(3)An inmates period of confinement may not be extended in order to provide treatment to the inmate with antipsychotic medication pursuant to this section.
(f)This section does not prohibit the court, upon making a determination that an inmate awaiting arraignment, preliminary hearing, trial, sentencing, or a postconviction proceeding to revoke or modify supervision may receive involuntary medication pursuant to subdivision (c) or (d), and, upon ex parte request of the defendant or counsel, from suspending all proceedings in the criminal prosecution, until the court determines that the defendants medication will not interfere with their ability to meaningfully participate in the criminal proceedings.
(g)If a determination has been made to involuntarily medicate an inmate pursuant to subdivision (c) or (d), the medication shall be discontinued one year after the date of that determination, unless the inmate gives informed consent to the administration of the medication, or unless a new determination is made pursuant to the procedures set forth in subdivision (h).
(h)To renew an existing order allowing involuntary medication, the county department of mental health, or other designated county department, shall file with the superior court, and shall serve on the inmate and their counsel, a written notice indicating the departments intent to renew the existing involuntary medication order.
(1)The request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication.
(2)The inmate shall be entitled to, and shall be given, the same due process protections as specified in subdivision (c).
(3)(A)Except as provided in subparagraph (B), renewal orders shall be valid for one year from the date of the hearing.
(B)In the case of an inmate awaiting arraignment, trial, or sentencing, the renewal order shall be valid for no more than 180 days. The court shall review the order at intervals of not more than 60 days to determine whether the grounds for the order remain. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendants attorney. In determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendants attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order.
(4)(A)An order renewing an existing order shall be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding their need for the medication, such that it is unlikely that the inmate would be able to manage their own medication and treatment regimen. No new acts need be alleged or proven.
(B)The superior court judge, court-appointed commissioner or referee, or a court-appointed hearing officer shall also make a finding that treatment of the inmate in a correctional setting continues to be necessary if neither of the criteria in paragraph (5) of subdivision (c) is present.
(5)If the county department of mental health, or other designated county department, wishes to add a basis to an existing order, it shall give the inmate and the inmates counsel notice in advance of the hearing via a renewal notice or supplemental petition. Within the renewal notice or supplemental petition, as described in subdivision (h), the county department of mental health, or other designated county department, shall specify what additional basis is being alleged and what qualifying conduct within the past year supports that additional basis. The county department of mental health, or other designated county department, shall prove the additional basis and conduct by clear and convincing evidence at a hearing as specified in subdivision (c).
(6)The hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order.
(i)In the event of a conflict between the provisions of this section and the Administrative Procedure Act (Chapter 4.5 (commencing with Section 11400) of Part 1 of Division 3 of the Government Code), this section shall control.
(j)Each county that, between January 1, 2025 and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, shall, by no later than January 1, 2029, prepare and submit a written report to the Assembly Committee on Public Safety and the Senate Committee on Public Safety, summarizing all of the following information:
(1)The number of inmates who were administered involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2025, and July 1, 2028.
(2)The crime for which each of these inmates was arrested, if it is practically feasible to obtain that information.
(3)The total time each inmate was detained while awaiting arraignment, trial, or sentencing, if it is practically feasible to obtain that information.
(4)The duration of the administration of involuntary medication for each inmate.
(5)The number of times, if any, that each existing order for the administration of involuntary medication was renewed.
(6)The reason that administration of involuntary medication was terminated for each inmate.
(k)As used in this section, inmate means a person confined in the county jail, including, but not limited to, a person sentenced to imprisonment in a county jail, a person housed in a county jail during or awaiting trial proceedings, and a person who has been booked into a county jail and is awaiting arraignment.
(l)This section does not apply to a person housed in a county jail solely on the basis of an immigration hold, except as it applies to medication provided on an emergency or interim basis as provided in subdivision (d).
(m)This section shall remain in effect only until January 1, 2030, and as of that date is repealed, unless a later enacted statute, which is chaptered before that date, deletes or extends the date.
SEC. 2.Section 2603 of the Penal Code, as amended by Section 12 of Chapter 434 of the Statutes of 2021, is amended to read:2603.(a)Except as provided in subdivision (b), no person sentenced to imprisonment in a county jail shall be administered any psychiatric medication without prior informed consent.
(b)If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d).
(c)A county department of mental health, or other designated county department, may seek to initiate involuntary medication on a nonemergency basis only if all of the following conditions have been met:
(1)A psychiatrist or psychologist has determined that the inmate has a serious mental disorder.
(2)A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others.
(3)A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmates disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.
(4)The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication, and refuses, or is unable to consent to, the administration of the medication.
(5)The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified in subdivision (c) of Section 5334 of the Welfare and Institutions Code.
(6)The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive expedited access to counsel. The hearing shall be held not more than 30 days after the filing of the notice with the superior court, unless counsel for the inmate agrees to extend the date of the hearing.
(7)The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive an expedited hearing. The written notice shall do all of the following:
(A)Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication.
(B)Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential section of the inmates central file which contains materials unrelated to medical treatment.
(C)Inform the inmate of the right to appeal the determination to the superior court or the court of appeal as specified in subdivisions (e) and (f) of Section 5334 of the Welfare and Institutions Code, and of the right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health, or other designated county department, to continue treatment with involuntary medication after the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer has authorized treatment with involuntary medication.
(8)A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmates best medical interest. In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, or other designated county department, the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmates counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and, if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default.
(9)The historical course of the inmates mental disorder, as determined by available relevant information about the course of the inmates mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder.
(10)An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown.
(d)Nothing in this section is intended to prohibit a physician from taking appropriate action in an emergency. An emergency exists when there is a sudden and marked change in an inmates mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others, and it is impractical, due to the seriousness of the emergency, to first obtain informed consent. If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist. If the clinicians of the county department of mental health, or other designated county department, identify a situation that jeopardizes the inmates health or well-being as the result of a serious mental illness, and necessitates the continuation of medication beyond the initial 72 hours pending the full mental health hearing, the county department may seek to continue the medication by giving notice to the inmate and their counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing. Treatment of the inmate in a facility pursuant to Section 4011.6 shall not be required in order to continue medication pursuant to this subdivision unless the treatment is otherwise medically necessary. The notice shall be served upon the inmate and counsel at the same time the inmate is given the written notice that the involuntary medication proceedings are being initiated and is appointed counsel as provided in subdivision (c). The order may be issued ex parte upon a showing that, in the absence of the medication, the emergency conditions are likely to recur. The request for an ex parte order shall be supported by an affidavit from the psychiatrist or psychologist showing specific facts. The inmate and the inmates appointed counsel shall have two business days to respond to the county departments ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the departments request. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer shall review the ex parte request and shall have three business days to determine the merits of the departments request for an ex parte order. If an order is issued, the psychiatrist may continue the administration of the medication until the hearing described in paragraph (5) of subdivision (c) is held.
(1)If the county elects to seek an ex parte order pursuant to this subdivision, the county department of mental health, or other designated county department, shall file with the superior court, and serve on the inmate and their counsel, the written notice described in paragraph (7) of subdivision (c) within 72 hours of commencing medication pursuant to this subdivision, unless either of the following occurs:
(A)The inmate gives informed consent to continue the medication.
(B)A psychiatrist determines that the psychiatric medication is not necessary and administration of the medication is discontinued.
(2)If medication is being administered pursuant to this subdivision, the hearing described in paragraph (5) of subdivision (c) shall commence within 21 days of the filing and service of the notice, unless counsel for the inmate agrees to a different period of time.
(3)With the exception of the timeline provisions specified in paragraphs (1) and (2) for providing notice and commencement of the hearing in emergency or interim situations, the inmate shall be entitled to and be given the same due process protections as specified in subdivision (c). The county department of mental health, or other designated county department, shall prove the same elements supporting the involuntary administration of psychiatric medication, and the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall be required to make the same findings described in subdivision (c).
(e)The determination that an inmate may receive involuntary medication shall be valid for one year from the date of the determination, regardless of whether the inmate subsequently gives informed consent.
(f)If a determination has been made to involuntarily medicate an inmate pursuant to subdivision (c) or (d), the medication shall be discontinued one year after the date of that determination, unless the inmate gives informed consent to the administration of the medication, or unless a new determination is made pursuant to the procedures set forth in subdivision (g).
(g)To renew an existing order allowing involuntary medication, the county department of mental health, or other designated county department, shall file with the superior court, and shall serve on the inmate and their counsel, a written notice indicating the departments intent to renew the existing involuntary medication order.
(1)The request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication.
(2)The inmate shall be entitled to, and shall be given, the same due process protections as specified in subdivision (c).
(3)Renewal orders shall be valid for one year from the date of the hearing.
(4)An order renewing an existing order shall be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding their need for the medication, such that it is unlikely that the inmate would be able to manage their own medication and treatment regimen. No new acts need be alleged or proven.
(5)If the county department of mental health, or other designated county department, wishes to add a basis to an existing order, it shall give the inmate and the inmates counsel notice in advance of the hearing via a renewal notice or supplemental petition. Within the renewal notice or supplemental petition, as described in subdivision (g), the county department of mental health, or other designated county department, shall specify what additional basis is being alleged and what qualifying conduct within the past year supports that additional basis. The county department of mental health, or other designated county department, shall prove the additional basis and conduct by clear and convincing evidence at a hearing as specified in subdivision (c).
(6)The hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order.
(h)In the event of a conflict between the provisions of this section and the Administrative Procedure Act (Chapter 4.5 (commencing with Section 11400) of Part 1 of Division 3 of Title 2 of the Government Code), this section shall control.
(i)This section shall become operative on January 1, 2030.
SEC. 3.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution for certain costs that may be incurred by a local agency or school district because, in that regard, this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
However, if the Commission on State Mandates determines that this act contains other costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.
(a)Except as provided in subdivision (b), an inmate confined in a county jail shall not be administered any psychiatric medication without their prior informed consent.
(b)If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d). Any such treatment shall be consistent with the standard of care.
(c)A county department of mental health, or other designated county department, may administer involuntary medication on a nonemergency basis only if all of the following conditions have been met:
(1)A psychiatrist or psychologist has determined that the inmate has a serious mental disorder.
(2)A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others.
(3)A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmates disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.
(4)The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication and refuses, or is unable to consent to, the administration of the medication.
(5)The jail has made a documented attempt to locate an available bed for the inmate in a noncarceral treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of noncarceral treatment beds and the inability of many facilities to accept transfers from correctional facilities. Submission of a declaration under penalty of perjury is sufficient for the county to demonstrate a documented attempt to locate an available bed.
(6)The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified in subdivision (c) of Section 5334 of the Welfare and Institutions Code.
(A)If the inmate is in custody awaiting trial, including an inmate whose criminal proceedings are suspended pursuant to Section 1370 or an inmate whose competence has been called into question and is undergoing evaluation pursuant to Section 1369, any hearing pursuant to this section shall be held before, and any requests for ex parte orders shall be submitted to, a judge in the superior court where the criminal case is pending.
(B)A superior court judge may consider whether involuntary medication would prejudice the inmates defense.
(7)(A)The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive expedited access to counsel.
(B)In the case of an inmate awaiting arraignment, the inmate is provided counsel within 48 hours of the filing of the notice of the hearing with the superior court, unless counsel has previously been appointed.
(C)The hearing shall be held not more than 30 days after the filing of the notice with the superior court, unless counsel for the inmate agrees to extend the date of the hearing.
(8)(A)The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive an expedited hearing.
(B)The written notice shall do all of the following:
(i)Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication.
(ii)Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential section of the inmates central file which contains materials unrelated to medical treatment.
(iii)Inform the inmate of their right to appeal the determination to the superior court or the court of appeal as specified in subdivisions (e) and (f) of Section 5334 of the Welfare and Institutions Code, and their right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health, or other designated county department, to continue treatment with involuntary medication after the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer has authorized treatment with involuntary medication.
(9)(A)In the hearing described in paragraph (6), the superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that, as a result of that illness, the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmates best medical interest.
(B)The superior court judge, court-appointed commissioner or referee, or a court-appointed hearing officer shall not make a finding pursuant to subparagraph (A) of this paragraph that there is no less intrusive alternative to involuntary medication and that the medication is in the inmates best medical interest, without information from the jail to indicate that neither of the conditions specified in paragraph (5) is present.
(C)If the court makes the findings in subparagraph (A), that administration shall occur in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if available.
(D)In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, or other designated county department, the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmates counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and, if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default.
(10)The historical course of the inmates mental disorder, as determined by available relevant information about the course of the inmates mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder.
(11)An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. This paragraph does not prevent a court from reviewing, modifying, or terminating an involuntary medication order for an inmate awaiting trial if there is a showing that the involuntary medication is interfering with the inmates due process rights in the criminal proceeding.
(d)(1)(A)This section does not prohibit a physician from taking appropriate action in an emergency. An emergency exists when both of the following criteria are met:
(i)There is a sudden and marked change in an inmates mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others.
(ii)It is impractical, due to the seriousness of the emergency, to first obtain informed consent.
(B)If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist.
(2)(A)If the clinicians of the county department of mental health, or other designated county department, identify a situation that jeopardizes the inmates health or well-being as the result of a serious mental illness, and necessitates the continuation of medication beyond the initial 72 hours pending the full mental health hearing, the county department may seek to continue the medication by giving notice to the inmate and their counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing, and filing an ex parte order within the initial 72-hour period. Treatment of the inmate in a facility pursuant to Section 4011.6 shall not be required in order to continue medication under pursuant to this subdivision unless the treatment is otherwise medically necessary.
(B)The notice shall be served upon the inmate and counsel at the same time the inmate is given the written notice that the involuntary medication proceedings are being initiated and is appointed counsel as provided in subdivision (c).
(C)The order may be issued ex parte upon a showing that, in the absence of the medication, the emergency conditions are likely to recur. The request for an ex parte order shall be supported by an affidavit from the psychiatrist or psychologist showing specific facts.
(D)The inmate and the inmates appointed counsel shall have two business days to respond to the county departments ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the departments request. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer shall review the ex parte request and shall have three business days to determine the merits of the departments request for an ex parte order.
(E)If an order is issued, the psychiatrist may continue the administration of the medication until the hearing described in paragraph (6) of subdivision (c) is held.
(3)If the county elects to seek an ex parte order pursuant to this subdivision, the county department of mental health, or other designated county department, shall file with the superior court, and serve on the inmate and their counsel, the written notice described in paragraph (8) of subdivision (c) within 72 hours of commencing medication pursuant to this subdivision, unless either of the following occurs:
(A)The inmate gives informed consent to continue the medication.
(B)A psychiatrist determines that the psychiatric medication is not necessary and administration of the medication is discontinued.
(4)If medication is being administered pursuant to this subdivision, the hearing described in paragraph (6) of subdivision (c) shall commence within 21 days of the filing and service of the notice, unless counsel for the inmate agrees to a different period of time.
(5)With the exception of the timeline provisions specified in paragraphs (3) and (4) for providing notice and commencement of the hearing in emergency or interim situations, the inmate shall be entitled to and be given the same due process protections as specified in subdivision (c). The county department of mental health, or other designated county department, shall prove the same elements supporting the involuntary administration of psychiatric medication and the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall be required to make the same findings described in subdivision (c).
(e)(1)(A)An order by the court authorizing involuntary medication of an inmate shall be valid for no more than one year after the date of determination.
(B)Notwithstanding subparagraph (A), in the case of an inmate who is awaiting arraignment, trial, or sentencing, the determination that an inmate may receive involuntary medication shall be valid for no more than 180 days. The court shall review the order at intervals of not more than 60 days to determine whether the grounds for the order remain. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendants attorney. In determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendants attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order.
(2)Notwithstanding subparagraph (A) of paragraph (1), any determination of an inmates incapacity to refuse treatment with antipsychotic medication made pursuant to this section shall remain in effect only until one of the following occurs, whichever occurs first:
(A)The duration of the inmates confinement ends, unless, pursuant to Section 1370, the inmate is transferred to a State Department of State Hospitals facility, as defined in Section 4100 of the Welfare and Institutions Code. If the inmate is transferred to such a facility, the order shall remain valid for the period ordered by the court and the facility may administer antipsychotic medication as needed, including on an involuntary basis, if the treating psychiatrist determines that antipsychotic medication is medically necessary and appropriate.
(B)A court determines that the inmate no longer meets the criteria of subdivision (c) or (d), or by any other order of the court.
(3)An inmates period of confinement may not be extended in order to provide treatment to the inmate with antipsychotic medication pursuant to this section.
(f)This section does not prohibit the court, upon making a determination that an inmate awaiting arraignment, preliminary hearing, trial, sentencing, or a postconviction proceeding to revoke or modify supervision may receive involuntary medication pursuant to subdivision (c) or (d), and, upon ex parte request of the defendant or counsel, from suspending all proceedings in the criminal prosecution, until the court determines that the defendants medication will not interfere with their ability to meaningfully participate in the criminal proceedings.
(g)If a determination has been made to involuntarily medicate an inmate pursuant to subdivision (c) or (d), the medication shall be discontinued one year after the date of that determination, unless the inmate gives informed consent to the administration of the medication, or unless a new determination is made pursuant to the procedures set forth in subdivision (h).
(h)To renew an existing order allowing involuntary medication, the county department of mental health, or other designated county department, shall file with the superior court, and shall serve on the inmate and their counsel, a written notice indicating the departments intent to renew the existing involuntary medication order.
(1)The request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication.
(2)The inmate shall be entitled to, and shall be given, the same due process protections as specified in subdivision (c).
(3)(A)Except as provided in subparagraph (B), renewal orders shall be valid for one year from the date of the hearing.
(B)In the case of an inmate awaiting arraignment, trial, or sentencing, the renewal order shall be valid for no more than 180 days. The court shall review the order at intervals of not more than 60 days to determine whether the grounds for the order remain. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendants attorney. In determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendants attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order.
(4)(A)An order renewing an existing order shall be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding their need for the medication, such that it is unlikely that the inmate would be able to manage their own medication and treatment regimen. No new acts need be alleged or proven.
(B)The superior court judge, court-appointed commissioner or referee, or a court-appointed hearing officer shall also make a finding that treatment of the inmate in a correctional setting continues to be necessary if neither of the criteria in paragraph (5) of subdivision (c) is present.
(5)If the county department of mental health, or other designated county department, wishes to add a basis to an existing order, it shall give the inmate and the inmates counsel notice in advance of the hearing via a renewal notice or supplemental petition. Within the renewal notice or supplemental petition, as described in subdivision (h), the county department of mental health, or other designated county department, shall specify what additional basis is being alleged and what qualifying conduct within the past year supports that additional basis. The county department of mental health, or other designated county department, shall prove the additional basis and conduct by clear and convincing evidence at a hearing as specified in subdivision (c).
(6)The hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order.
(i)In the event of a conflict between the provisions of this section and the Administrative Procedure Act (Chapter 4.5 (commencing with Section 11400) of Part 1 of Division 3 of the Government Code), this section shall control.
(j)Each county that, between January 1, 2025 and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, shall, by no later than January 1, 2029, prepare and submit a written report to the Assembly Committee on Public Safety and the Senate Committee on Public Safety, summarizing all of the following information:
(1)The number of inmates who were administered involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2025, and July 1, 2028.
(2)The crime for which each of these inmates was arrested, if it is practically feasible to obtain that information.
(3)The total time each inmate was detained while awaiting arraignment, trial, or sentencing, if it is practically feasible to obtain that information.
(4)The duration of the administration of involuntary medication for each inmate.
(5)The number of times, if any, that each existing order for the administration of involuntary medication was renewed.
(6)The reason that administration of involuntary medication was terminated for each inmate.
(k)As used in this section, inmate means a person confined in the county jail, including, but not limited to, a person sentenced to imprisonment in a county jail, a person housed in a county jail during or awaiting trial proceedings, and a person who has been booked into a county jail and is awaiting arraignment.
(l)This section does not apply to a person housed in a county jail solely on the basis of an immigration hold, except as it applies to medication provided on an emergency or interim basis as provided in subdivision (d).
(m)This section shall remain in effect only until January 1, 2030, and as of that date is repealed, unless a later enacted statute, which is chaptered before that date, deletes or extends the date.
SEC. 2.Section 2603 of the Penal Code, as amended by Section 12 of Chapter 434 of the Statutes of 2021, is amended to read:2603.(a)Except as provided in subdivision (b), no person sentenced to imprisonment in a county jail shall be administered any psychiatric medication without prior informed consent.
(b)If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d).
(c)A county department of mental health, or other designated county department, may seek to initiate involuntary medication on a nonemergency basis only if all of the following conditions have been met:
(1)A psychiatrist or psychologist has determined that the inmate has a serious mental disorder.
(2)A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others.
(3)A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmates disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.
(4)The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication, and refuses, or is unable to consent to, the administration of the medication.
(5)The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified in subdivision (c) of Section 5334 of the Welfare and Institutions Code.
(6)The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive expedited access to counsel. The hearing shall be held not more than 30 days after the filing of the notice with the superior court, unless counsel for the inmate agrees to extend the date of the hearing.
(7)The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive an expedited hearing. The written notice shall do all of the following:
(A)Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication.
(B)Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential section of the inmates central file which contains materials unrelated to medical treatment.
(C)Inform the inmate of the right to appeal the determination to the superior court or the court of appeal as specified in subdivisions (e) and (f) of Section 5334 of the Welfare and Institutions Code, and of the right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health, or other designated county department, to continue treatment with involuntary medication after the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer has authorized treatment with involuntary medication.
(8)A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmates best medical interest. In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, or other designated county department, the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmates counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and, if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default.
(9)The historical course of the inmates mental disorder, as determined by available relevant information about the course of the inmates mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder.
(10)An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown.
(d)Nothing in this section is intended to prohibit a physician from taking appropriate action in an emergency. An emergency exists when there is a sudden and marked change in an inmates mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others, and it is impractical, due to the seriousness of the emergency, to first obtain informed consent. If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist. If the clinicians of the county department of mental health, or other designated county department, identify a situation that jeopardizes the inmates health or well-being as the result of a serious mental illness, and necessitates the continuation of medication beyond the initial 72 hours pending the full mental health hearing, the county department may seek to continue the medication by giving notice to the inmate and their counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing. Treatment of the inmate in a facility pursuant to Section 4011.6 shall not be required in order to continue medication under pursuant to this subdivision unless the treatment is otherwise medically necessary. The notice shall be served upon the inmate and counsel at the same time the inmate is given the written notice that the involuntary medication proceedings are being initiated and is appointed counsel as provided in subdivision (c). The order may be issued ex parte upon a showing that, in the absence of the medication, the emergency conditions are likely to recur. The request for an ex parte order shall be supported by an affidavit from the psychiatrist or psychologist showing specific facts. The inmate and the inmates appointed counsel shall have two business days to respond to the county departments ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the departments request. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer shall review the ex parte request and shall have three business days to determine the merits of the departments request for an ex parte order. If an order is issued, the psychiatrist may continue the administration of the medication until the hearing described in paragraph (5) of subdivision (c) is held.
(1)If the county elects to seek an ex parte order pursuant to this subdivision, the county department of mental health, or other designated county department, shall file with the superior court, and serve on the inmate and their counsel, the written notice described in paragraph (7) of subdivision (c) within 72 hours of commencing medication pursuant to this subdivision, unless either of the following occurs:
(A)The inmate gives informed consent to continue the medication.
(B)A psychiatrist determines that the psychiatric medication is not necessary and administration of the medication is discontinued.
(2)If medication is being administered pursuant to this subdivision, the hearing described in paragraph (5) of subdivision (c) shall commence within 21 days of the filing and service of the notice, unless counsel for the inmate agrees to a different period of time.
(3)With the exception of the timeline provisions specified in paragraphs (1) and (2) for providing notice and commencement of the hearing in emergency or interim situations, the inmate shall be entitled to and be given the same due process protections as specified in subdivision (c). The county department of mental health, or other designated county department, shall prove the same elements supporting the involuntary administration of psychiatric medication, and the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall be required to make the same findings described in subdivision (c).
(e)The determination that an inmate may receive involuntary medication shall be valid for one year from the date of the determination, regardless of whether the inmate subsequently gives informed consent.
(f)If a determination has been made to involuntarily medicate an inmate pursuant to subdivision (c) or (d), the medication shall be discontinued one year after the date of that determination, unless the inmate gives informed consent to the administration of the medication, or unless a new determination is made pursuant to the procedures set forth in subdivision (g).
(g)To renew an existing order allowing involuntary medication, the county department of mental health, or other designated county department, shall file with the superior court, and shall serve on the inmate and their counsel, a written notice indicating the departments intent to renew the existing involuntary medication order.
(1)The request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication.
(2)The inmate shall be entitled to, and shall be given, the same due process protections as specified in subdivision (c).
(3)Renewal orders shall be valid for one year from the date of the hearing.
(4)An order renewing an existing order shall be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding their need for the medication, such that it is unlikely that the inmate would be able to manage their own medication and treatment regimen. No new acts need be alleged or proven.
(5)If the county department of mental health, or other designated county department, wishes to add a basis to an existing order, it shall give the inmate and the inmates counsel notice in advance of the hearing via a renewal notice or supplemental petition. Within the renewal notice or supplemental petition, as described in subdivision (g), the county department of mental health, or other designated county department, shall specify what additional basis is being alleged and what qualifying conduct within the past year supports that additional basis. The county department of mental health, or other designated county department, shall prove the additional basis and conduct by clear and convincing evidence at a hearing as specified in subdivision (c).
(6)The hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order.
(h)In the event of a conflict between the provisions of this section and the Administrative Procedure Act (Chapter 4.5 (commencing with Section 11400) of Part 1 of Division 3 of Title 2 of the Government Code), this section shall control.
(i)This section shall become operative on January 1, 2030.
SEC. 3.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution for certain costs that may be incurred by a local agency or school district because, in that regard, this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
However, if the Commission on State Mandates determines that this act contains other costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.
(a)Except as provided in subdivision (b), an inmate confined in a county jail shall not be administered any psychiatric medication without their prior informed consent.
(b)If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d). Any such treatment shall be consistent with the standard of care.
(c)A county department of mental health, or other designated county department, may administer involuntary medication on a nonemergency basis only if all of the following conditions have been met:
(1)A psychiatrist or psychologist has determined that the inmate has a serious mental disorder.
(2)A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others.
(3)A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmates disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.
(4)The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication and refuses, or is unable to consent to, the administration of the medication.
(5)The jail has made a documented attempt to locate an available bed for the inmate in a community-based noncarceral treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based noncarceral treatment beds and the inability of many facilities to accept transfers from correctional facilities. Submission of a declaration under penalty of perjury is sufficient for the county to demonstrate a documented attempt to locate an available bed.
(6)The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified in subdivision (c) of Section 5334 of the Welfare and Institutions Code.
(A)If the inmate is in custody awaiting trial, including an inmate whose criminal proceedings are suspended pursuant to Section 1370 or an inmate whose competence has been called into question and is undergoing evaluation pursuant to Section 1369, any hearing pursuant to this section shall be held before, and any requests for ex parte orders shall be submitted to, a judge in the superior court where the criminal case is pending.
(B)A superior court judge may consider whether involuntary medication would prejudice the inmates defense.
(7)(A)The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive expedited access to counsel.
(B)In the case of an inmate awaiting arraignment, the inmate is provided counsel within 48 hours of the filing of the notice of the hearing with the superior court, unless counsel has previously been appointed.
(C)The hearing shall be held not more than 30 days after the filing of the notice with the superior court, unless counsel for the inmate agrees to extend the date of the hearing.
(8)(A)The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive an expedited hearing.
(B)The written notice shall do all of the following:
(i)Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication.
(ii)Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential section of the inmates central file which contains materials unrelated to medical treatment.
(iii)Inform the inmate of their right to appeal the determination to the superior court or the court of appeal as specified in subdivisions (e) and (f) of Section 5334 of the Welfare and Institutions Code, and their right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health, or other designated county department, to continue treatment with involuntary medication after the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer has authorized treatment with involuntary medication.
(9)(A)In the hearing described in paragraph (6), the superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that, as a result of that illness, the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmates best medical interest.
(B)The superior court judge, court-appointed commissioner or referee, or a court-appointed hearing officer shall not make a finding pursuant to subparagraph (A) of this paragraph that there is no less intrusive alternative to involuntary medication and that the medication is in the inmates best medical interest, without information from the jail to indicate that neither of the conditions specified in paragraph (5) is present.
(C)If the court makes the findings in subparagraph (A), that administration shall occur in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if available.
(D)In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, or other designated county department, the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmates counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and, if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default.
(10)The historical course of the inmates mental disorder, as determined by available relevant information about the course of the inmates mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder.
(11)An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. This paragraph does not prevent a court from reviewing, modifying, or terminating an involuntary medication order for an inmate awaiting trial if there is a showing that the involuntary medication is interfering with the inmates due process rights in the criminal proceeding.
(d)(1)(A)This section does not prohibit a physician from taking appropriate action in an emergency. An emergency exists when both of the following criteria are met:
(i)There is a sudden and marked change in an inmates mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others.
(ii)It is impractical, due to the seriousness of the emergency, to first obtain informed consent.
(B)If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist.
(2)(A)If the clinicians of the county department of mental health, or other designated county department, identify a situation that jeopardizes the inmates health or well-being as the result of a serious mental illness, and necessitates the continuation of medication beyond the initial 72 hours pending the full mental health hearing, the county department may seek to continue the medication by giving notice to the inmate and their counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing, and filing an ex parte order within the initial 72-hour period. Treatment of the inmate in a facility pursuant to Section 4011.6 shall not be required in order to continue medication under this subdivision unless the treatment is otherwise medically necessary.
(B)The notice shall be served upon the inmate and counsel at the same time the inmate is given the written notice that the involuntary medication proceedings are being initiated and is appointed counsel as provided in subdivision (c).
(C)The order may be issued ex parte upon a showing that, in the absence of the medication, the emergency conditions are likely to recur. The request for an ex parte order shall be supported by an affidavit from the psychiatrist or psychologist showing specific facts.
(D)The inmate and the inmates appointed counsel shall have two business days to respond to the county departments ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the departments request. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer shall review the ex parte request and shall have three business days to determine the merits of the departments request for an ex parte order.
(E)If an order is issued, the psychiatrist may continue the administration of the medication until the hearing described in paragraph (6) of subdivision (c) is held.
(3)If the county elects to seek an ex parte order pursuant to this subdivision, the county department of mental health, or other designated county department, shall file with the superior court, and serve on the inmate and their counsel, the written notice described in paragraph (8) of subdivision (c) within 72 hours of commencing medication pursuant to this subdivision, unless either of the following occurs:
(A)The inmate gives informed consent to continue the medication.
(B)A psychiatrist determines that the psychiatric medication is not necessary and administration of the medication is discontinued.
(4)If medication is being administered pursuant to this subdivision, the hearing described in paragraph (6) of subdivision (c) shall commence within 21 days of the filing and service of the notice, unless counsel for the inmate agrees to a different period of time.
(5)With the exception of the timeline provisions specified in paragraphs (3) and (4) for providing notice and commencement of the hearing in emergency or interim situations, the inmate shall be entitled to and be given the same due process protections as specified in subdivision (c). The county department of mental health, or other designated county department, shall prove the same elements supporting the involuntary administration of psychiatric medication and the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall be required to make the same findings described in subdivision (c).
(e)(1)(A)An order by the court authorizing involuntary medication of an inmate shall be valid for no more than one year after the date of determination.
(B)Notwithstanding subparagraph (A), in the case of an inmate who is awaiting arraignment, trial, or sentencing, the determination that an inmate may receive involuntary medication shall be valid for no more than 180 days. The court shall review the order at intervals of not more than 60 days to determine whether the grounds for the order remain. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendants attorney. In determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendants attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order.
(2)Notwithstanding subparagraph (A) of paragraph (1), any determination of an inmates incapacity to refuse treatment with antipsychotic medication made pursuant to this section shall remain in effect only until one of the following occurs, whichever occurs first:
(A)The duration of the inmates confinement ends, unless, pursuant to Section 1370, the inmate is transferred to a State Department of State Hospitals facility, as defined in Section 4100 of the Welfare and Institutions Code. If the inmate is transferred to such a facility, the order shall remain valid for the period ordered by the court and the facility may administer antipsychotic medication as needed, including on an involuntary basis, if the treating psychiatrist determines that antipsychotic medication is medically necessary and appropriate.
(B)A court determines that the inmate no longer meets the criteria of subdivision (c) or (d), or by any other order of the court.
(3)An inmates period of confinement may not be extended in order to provide treatment to the inmate with antipsychotic medication pursuant to this section.
(f)This section does not prohibit the court, upon making a determination that an inmate awaiting arraignment, preliminary hearing, trial, sentencing, or a postconviction proceeding to revoke or modify supervision may receive involuntary medication pursuant to subdivision (c) or (d), and, upon ex parte request of the defendant or counsel, from suspending all proceedings in the criminal prosecution, until the court determines that the defendants medication will not interfere with their ability to meaningfully participate in the criminal proceedings.
(g)If a determination has been made to involuntarily medicate an inmate pursuant to subdivision (c) or (d), the medication shall be discontinued one year after the date of that determination, unless the inmate gives informed consent to the administration of the medication, or unless a new determination is made pursuant to the procedures set forth in subdivision (h).
(h)To renew an existing order allowing involuntary medication, the county department of mental health, or other designated county department, shall file with the superior court, and shall serve on the inmate and their counsel, a written notice indicating the departments intent to renew the existing involuntary medication order.
(1)The request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication.
(2)The inmate shall be entitled to, and shall be given, the same due process protections as specified in subdivision (c).
(3)(A)Except as provided in subparagraph (B), renewal orders shall be valid for one year from the date of the hearing.
(B)In the case of an inmate awaiting arraignment, trial, or sentencing, the renewal order shall be valid for no more than 180 days. The court shall review the order at intervals of not more than 60 days to determine whether the grounds for the order remain. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendants attorney. In determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendants attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order.
(4)(A)An order renewing an existing order shall be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding their need for the medication, such that it is unlikely that the inmate would be able to manage their own medication and treatment regimen. No new acts need be alleged or proven.
(B)The superior court judge, court-appointed commissioner or referee, or a court-appointed hearing officer shall also make a finding that treatment of the inmate in a correctional setting continues to be necessary if neither of the criteria in paragraph (5) of subdivision (c) is present.
(5)If the county department of mental health, or other designated county department, wishes to add a basis to an existing order, it shall give the inmate and the inmates counsel notice in advance of the hearing via a renewal notice or supplemental petition. Within the renewal notice or supplemental petition, as described in subdivision (h), the county department of mental health, or other designated county department, shall specify what additional basis is being alleged and what qualifying conduct within the past year supports that additional basis. The county department of mental health, or other designated county department, shall prove the additional basis and conduct by clear and convincing evidence at a hearing as specified in subdivision (c).
(6)The hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order.
(i)In the event of a conflict between the provisions of this section and the Administrative Procedure Act (Chapter 4.5 (commencing with Section 11400) of Part 1 of Division 3 of the Government Code), this section shall control.
(j)Each county that, between January 1, 2025 and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, shall, by no later than January 1, 2029, prepare and submit a written report to the Assembly Committee on Public Safety and the Senate Committee on Public Safety, summarizing all of the following information:
(1)The number of inmates who were administered involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2025, and July 1, 2028.
(2)The crime for which each of these inmates was arrested, if it is practically feasible to obtain that information.
(3)The total time each inmate was detained while awaiting arraignment, trial, or sentencing, if it is practically feasible to obtain that information.
(4)The duration of the administration of involuntary medication for each inmate.
(5)The number of times, if any, that each existing order for the administration of involuntary medication was renewed.
(6)The reason that administration of involuntary medication was terminated for each inmate.
(k)As used in this section, inmate means a person confined in the county jail, including, but not limited to, a person sentenced to imprisonment in a county jail, a person housed in a county jail during or awaiting trial proceedings, and a person who has been booked into a county jail and is awaiting arraignment.
(l)This section does not apply to a person housed in a county jail solely on the basis of an immigration hold, except as it applies to medication provided on an emergency or interim basis as provided in subdivision (d).
(m)This section shall remain in effect only until January 1, 2030, and as of that date is repealed, unless a later enacted statute, which is chaptered before that date, deletes or extends the date.
SEC. 2.Section 2603 of the Penal Code, as amended by Section 12 of Chapter 434 of the Statutes of 2021, is amended to read:2603.(a)Except as provided in subdivision (b), no person sentenced to imprisonment in a county jail shall be administered any psychiatric medication without prior informed consent.
(b)If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d).
(c)A county department of mental health, or other designated county department, may seek to initiate involuntary medication on a nonemergency basis only if all of the following conditions have been met:
(1)A psychiatrist or psychologist has determined that the inmate has a serious mental disorder.
(2)A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others.
(3)A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmates disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.
(4)The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication, and refuses, or is unable to consent to, the administration of the medication.
(5)The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified in subdivision (c) of Section 5334 of the Welfare and Institutions Code.
(6)The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive expedited access to counsel. The hearing shall be held not more than 30 days after the filing of the notice with the superior court, unless counsel for the inmate agrees to extend the date of the hearing.
(7)The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive an expedited hearing. The written notice shall do all of the following:
(A)Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication.
(B)Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential section of the inmates central file which contains materials unrelated to medical treatment.
(C)Inform the inmate of the right to appeal the determination to the superior court or the court of appeal as specified in subdivisions (e) and (f) of Section 5334 of the Welfare and Institutions Code, and of the right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health, or other designated county department, to continue treatment with involuntary medication after the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer has authorized treatment with involuntary medication.
(8)A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmates best medical interest. In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, or other designated county department, the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmates counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and, if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default.
(9)The historical course of the inmates mental disorder, as determined by available relevant information about the course of the inmates mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder.
(10)An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown.
(d)Nothing in this section is intended to prohibit a physician from taking appropriate action in an emergency. An emergency exists when there is a sudden and marked change in an inmates mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others, and it is impractical, due to the seriousness of the emergency, to first obtain informed consent. If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist. If the clinicians of the county department of mental health, or other designated county department, identify a situation that jeopardizes the inmates health or well-being as the result of a serious mental illness, and necessitates the continuation of medication beyond the initial 72 hours pending the full mental health hearing, the county department may seek to continue the medication by giving notice to the inmate and their counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing. Treatment of the inmate in a facility pursuant to Section 4011.6 shall not be required in order to continue medication under this subdivision unless the treatment is otherwise medically necessary. The notice shall be served upon the inmate and counsel at the same time the inmate is given the written notice that the involuntary medication proceedings are being initiated and is appointed counsel as provided in subdivision (c). The order may be issued ex parte upon a showing that, in the absence of the medication, the emergency conditions are likely to recur. The request for an ex parte order shall be supported by an affidavit from the psychiatrist or psychologist showing specific facts. The inmate and the inmates appointed counsel shall have two business days to respond to the county departments ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the departments request. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer shall review the ex parte request and shall have three business days to determine the merits of the departments request for an ex parte order. If an order is issued, the psychiatrist may continue the administration of the medication until the hearing described in paragraph (5) of subdivision (c) is held.
(1)If the county elects to seek an ex parte order pursuant to this subdivision, the county department of mental health, or other designated county department, shall file with the superior court, and serve on the inmate and their counsel, the written notice described in paragraph (7) of subdivision (c) within 72 hours of commencing medication pursuant to this subdivision, unless either of the following occurs:
(A)The inmate gives informed consent to continue the medication.
(B)A psychiatrist determines that the psychiatric medication is not necessary and administration of the medication is discontinued.
(2)If medication is being administered pursuant to this subdivision, the hearing described in paragraph (5) of subdivision (c) shall commence within 21 days of the filing and service of the notice, unless counsel for the inmate agrees to a different period of time.
(3)With the exception of the timeline provisions specified in paragraphs (1) and (2) for providing notice and commencement of the hearing in emergency or interim situations, the inmate shall be entitled to and be given the same due process protections as specified in subdivision (c). The county department of mental health, or other designated county department, shall prove the same elements supporting the involuntary administration of psychiatric medication, and the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall be required to make the same findings described in subdivision (c).
(e)The determination that an inmate may receive involuntary medication shall be valid for one year from the date of the determination, regardless of whether the inmate subsequently gives informed consent.
(f)If a determination has been made to involuntarily medicate an inmate pursuant to subdivision (c) or (d), the medication shall be discontinued one year after the date of that determination, unless the inmate gives informed consent to the administration of the medication, or unless a new determination is made pursuant to the procedures set forth in subdivision (g).
(g)To renew an existing order allowing involuntary medication, the county department of mental health, or other designated county department, shall file with the superior court, and shall serve on the inmate and their counsel, a written notice indicating the departments intent to renew the existing involuntary medication order.
(1)The request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication.
(2)The inmate shall be entitled to, and shall be given, the same due process protections as specified in subdivision (c).
(3)Renewal orders shall be valid for one year from the date of the hearing.
(4)An order renewing an existing order shall be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding their need for the medication, such that it is unlikely that the inmate would be able to manage their own medication and treatment regimen. No new acts need be alleged or proven.
(5)If the county department of mental health, or other designated county department, wishes to add a basis to an existing order, it shall give the inmate and the inmates counsel notice in advance of the hearing via a renewal notice or supplemental petition. Within the renewal notice or supplemental petition, as described in subdivision (g), the county department of mental health, or other designated county department, shall specify what additional basis is being alleged and what qualifying conduct within the past year supports that additional basis. The county department of mental health, or other designated county department, shall prove the additional basis and conduct by clear and convincing evidence at a hearing as specified in subdivision (c).
(6)The hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order.
(h)In the event of a conflict between the provisions of this section and the Administrative Procedure Act (Chapter 4.5 (commencing with Section 11400) of Part 1 of Division 3 of Title 2 of the Government Code), this section shall control.
(i)This section shall become operative on January 1, 2030.
SEC. 3.If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.SEC. 3.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution for certain costs that may be incurred by a local agency or school district because, in that regard, this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
However, if the Commission on State Mandates determines that this act contains other costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.
(a)Except as provided in subdivision (b), an inmate confined in a county jail shall not be administered any psychiatric medication without their prior informed consent.
(b)If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d).
(c)A county department of mental health, or other designated county department, may administer involuntary medication on a nonemergency basis only if all of the following conditions have been met:
(1)A psychiatrist or psychologist has determined that the inmate has a serious mental disorder.
(2)A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others.
(3)A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmates disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.
(4)The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication and refuses, or is unable to consent to, the administration of the medication.
(5)The jail has made a documented attempt to locate an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based beds and the inability of many facilities to accept transfers from correctional facilities.
(6)The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified in subdivision (c) of Section 5334 of the Welfare and Institutions Code.
(A)If the inmate is in custody awaiting trial, including an inmate whose criminal proceedings are suspended pursuant to Section 1370 or an inmate whose competence has been called into question and is undergoing evaluation pursuant to Section 1369, any hearing pursuant to this section shall be held before, and any requests for ex parte orders shall be submitted to, a judge in the superior court where the criminal case is pending.
(B)A superior court judge may consider whether involuntary medication would prejudice the inmates defense.
(7)(A)The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive expedited access to counsel.
(B)In the case of an inmate awaiting arraignment, the inmate is provided counsel within 48 hours of the filing of the notice of the hearing with the superior court, unless counsel has previously been appointed.
(C)The hearing shall be held not more than 30 days after the filing of the notice with the superior court, unless counsel for the inmate agrees to extend the date of the hearing.
(8)(A)The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive an expedited hearing.
(B)The written notice shall do all of the following:
(i)Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication.
(ii)Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential section of the inmates central file which contains materials unrelated to medical treatment.
(iii)Inform the inmate of their right to appeal the determination to the superior court or the court of appeal as specified in subdivisions (e) and (f) of Section 5334 of the Welfare and Institutions Code, and their right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health, or other designated county department, to continue treatment with involuntary medication after the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer has authorized treatment with involuntary medication.
(9)(A)In the hearing described in paragraph (6), the superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that, as a result of that illness, the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmates best medical interest.
(B)The superior court judge, court-appointed commissioner or referee, or a court-appointed hearing officer shall not make a finding pursuant to subparagraph (A) of this paragraph that there is no less intrusive alternative to involuntary medication and that the medication is in the inmates best medical interest, without information from the jail to indicate that neither of the conditions specified in paragraph (5) is present.
(C)If the court makes the findings in subparagraph (A), that administration shall occur in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if available.
(D)In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, or other designated county department, the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmates counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and, if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default.
(10)The historical course of the inmates mental disorder, as determined by available relevant information about the course of the inmates mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder.
(11)An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. This paragraph does not prevent a court from reviewing, modifying, or terminating an involuntary medication order for an inmate awaiting trial if there is a showing that the involuntary medication is interfering with the inmates due process rights in the criminal proceeding.
(d)(1)(A)This section does not prohibit a physician from taking appropriate action in an emergency. An emergency exists when both of the following criteria are met:
(i)There is a sudden and marked change in an inmates mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others.
(ii)It is impractical, due to the seriousness of the emergency, to first obtain informed consent.
(B)If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist.
(2)(A)If the clinicians of the county department of mental health, or other designated county department, identify a situation that jeopardizes the inmates health or well-being as the result of a serious mental illness, and necessitates the continuation of medication beyond the initial 72 hours pending the full mental health hearing, the county department may seek to continue the medication by giving notice to the inmate and their counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing, and filing an ex parte order within the initial 72-hour period. Treatment of the inmate in a facility pursuant to Section 4011.6 shall not be required in order to continue medication under this subdivision unless the treatment is otherwise medically necessary.
(B)The notice shall be served upon the inmate and counsel at the same time the inmate is given the written notice that the involuntary medication proceedings are being initiated and is appointed counsel as provided in subdivision (c).
(C)The order may be issued ex parte upon a showing that, in the absence of the medication, the emergency conditions are likely to recur. The request for an ex parte order shall be supported by an affidavit from the psychiatrist or psychologist showing specific facts.
(D)The inmate and the inmates appointed counsel shall have two business days to respond to the county departments ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the departments request. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer shall review the ex parte request and shall have three business days to determine the merits of the departments request for an ex parte order.
(E)If an order is issued, the psychiatrist may continue the administration of the medication until the hearing described in paragraph (6) of subdivision (c) is held.
(3)If the county elects to seek an ex parte order pursuant to this subdivision, the county department of mental health, or other designated county department, shall file with the superior court, and serve on the inmate and their counsel, the written notice described in paragraph (8) of subdivision (c) within 72 hours of commencing medication pursuant to this subdivision, unless either of the following occurs:
(A)The inmate gives informed consent to continue the medication.
(B)A psychiatrist determines that the psychiatric medication is not necessary and administration of the medication is discontinued.
(4)If medication is being administered pursuant to this subdivision, the hearing described in paragraph (6) of subdivision (c) shall commence within 21 days of the filing and service of the notice, unless counsel for the inmate agrees to a different period of time.
(5)With the exception of the timeline provisions specified in paragraphs (3) and (4) for providing notice and commencement of the hearing in emergency or interim situations, the inmate shall be entitled to and be given the same due process protections as specified in subdivision (c). The county department of mental health, or other designated county department, shall prove the same elements supporting the involuntary administration of psychiatric medication and the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall be required to make the same findings described in subdivision (c).
(e)(1)(A)An order by the court authorizing involuntary medication of an inmate shall be valid for no more than one year after the date of determination.
(B)Notwithstanding subparagraph (A), in the case of an inmate who is awaiting arraignment, trial, or sentencing, the determination that an inmate may receive involuntary medication shall be valid for no more than 180 days. The court shall review the order at intervals of not more than 60 days to determine whether the grounds for the order remain. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendants attorney. In determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendants attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order.
(2)Notwithstanding subparagraph (A) of paragraph (1), any determination of an inmates incapacity to refuse treatment with antipsychotic medication made pursuant to this section shall remain in effect only until one of the following occurs, whichever occurs first:
(A)The duration of the inmates confinement ends, unless, pursuant to Section 1370, the inmate is transferred to a State Department of State Hospitals facility, as defined in Section 4100 of the Welfare and Institutions Code. If the inmate is transferred to such a facility, the order shall remain valid for the period ordered by the court and the facility may administer antipsychotic medication as needed, including on an involuntary basis, if the treating psychiatrist determines that antipsychotic medication is medically necessary and appropriate.
(B)A court determines that the inmate no longer meets the criteria of subdivision (c) or (d), or by any other order of the court.
(3)An inmates period of confinement may not be extended in order to provide treatment to the inmate with antipsychotic medication pursuant to this section.
(f)This section does not prohibit the court, upon making a determination that an inmate awaiting arraignment, preliminary hearing, trial, sentencing, or a postconviction proceeding to revoke or modify supervision may receive involuntary medication pursuant to subdivision (c) or (d), and, upon ex parte request of the defendant or counsel, from suspending all proceedings in the criminal prosecution, until the court determines that the defendants medication will not interfere with their ability to meaningfully participate in the criminal proceedings.
(g)If a determination has been made to involuntarily medicate an inmate pursuant to subdivision (c) or (d), the medication shall be discontinued one year after the date of that determination, unless the inmate gives informed consent to the administration of the medication, or unless a new determination is made pursuant to the procedures set forth in subdivision (h).
(h)To renew an existing order allowing involuntary medication, the county department of mental health, or other designated county department, shall file with the superior court, and shall serve on the inmate and their counsel, a written notice indicating the departments intent to renew the existing involuntary medication order.
(1)The request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication.
(2)The inmate shall be entitled to, and shall be given, the same due process protections as specified in subdivision (c).
(3)(A)Except as provided in subparagraph (B), renewal orders shall be valid for one year from the date of the hearing.
(B)In the case of an inmate awaiting arraignment, trial, or sentencing, the renewal order shall be valid for no more than 180 days. The court shall review the order at intervals of not more than 60 days to determine whether the grounds for the order remain. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendants attorney. In determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendants attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order.
(4)(A)An order renewing an existing order shall be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding their need for the medication, such that it is unlikely that the inmate would be able to manage their own medication and treatment regimen. No new acts need be alleged or proven.
(B)The superior court judge, court-appointed commissioner or referee, or a court-appointed hearing officer shall also make a finding that treatment of the inmate in a correctional setting continues to be necessary if neither of the criteria in paragraph (5) of subdivision (c) is present.
(5)If the county department of mental health, or other designated county department, wishes to add a basis to an existing order, it shall give the inmate and the inmates counsel notice in advance of the hearing via a renewal notice or supplemental petition. Within the renewal notice or supplemental petition, as described in subdivision (h), the county department of mental health, or other designated county department, shall specify what additional basis is being alleged and what qualifying conduct within the past year supports that additional basis. The county department of mental health, or other designated county department, shall prove the additional basis and conduct by clear and convincing evidence at a hearing as specified in subdivision (c).
(6)The hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order.
(i)In the event of a conflict between the provisions of this section and the Administrative Procedure Act (Chapter 4.5 (commencing with Section 11400) of Part 1 of Division 3 of the Government Code), this section shall control.
(j)Each county that, between January 1, 2025 and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, shall, by no later than January 1, 2029, prepare and submit a written report to the Assembly Committee on Public Safety and the Senate Committee on Public Safety, summarizing all of the following information:
(1)The number of inmates who were administered involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2025, and July 1, 2028.
(2)The crime for which each of these inmates was arrested, if it is practically feasible to obtain that information.
(3)The total time each inmate was detained while awaiting arraignment, trial, or sentencing, if it is practically feasible to obtain that information.
(4)The duration of the administration of involuntary medication for each inmate.
(5)The number of times, if any, that each existing order for the administration of involuntary medication was renewed.
(6)The reason that administration of involuntary medication was terminated for each inmate.
(j)(k)As used in this section, inmate means a person confined in the county jail, including, but not limited to, a person sentenced to imprisonment in a county jail, a person housed in a county jail during or awaiting trial proceedings, and a person who has been booked into a county jail and is awaiting arraignment.
(k)(l)This section does not apply to a person housed in a county jail solely on the basis of an immigration hold, except as it applies to medication provided on an emergency or interim basis as provided in subdivision (d).
(m)This section shall remain in effect only until January 1, 2030, and as of that date is repealed, unless a later enacted statute, which is chaptered before that date, deletes or extends the date.
SEC. 2.Section 2603 of the Penal Code, as amended by Section 12 of Chapter 434 of the Statutes of 2021, is amended to read:2603.(a)Except as provided in subdivision (b), no person sentenced to imprisonment in a county jail shall be administered any psychiatric medication without prior informed consent.
(b)If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d).
(c)A county department of mental health, or other designated county department, may seek to initiate involuntary medication on a nonemergency basis only if all of the following conditions have been met:
(1)A psychiatrist or psychologist has determined that the inmate has a serious mental disorder.
(2)A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others.
(3)A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmates disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.
(4)The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication, and refuses, or is unable to consent to, the administration of the medication.
(5)The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified in subdivision (c) of Section 5334 of the Welfare and Institutions Code.
(6)The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive expedited access to counsel. The hearing shall be held not more than 30 days after the filing of the notice with the superior court, unless counsel for the inmate agrees to extend the date of the hearing.
(7)The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive an expedited hearing. The written notice shall do all of the following:
(A)Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication.
(B)Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential section of the inmates central file which contains materials unrelated to medical treatment.
(C)Inform the inmate of the right to appeal the determination to the superior court or the court of appeal as specified in subdivisions (e) and (f) of Section 5334 of the Welfare and Institutions Code, and of the right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health, or other designated county department, to continue treatment with involuntary medication after the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer has authorized treatment with involuntary medication.
(8)A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmates best medical interest. In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, or other designated county department, the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmates counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and, if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default.
(9)The historical course of the inmates mental disorder, as determined by available relevant information about the course of the inmates mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder.
(10)An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown.
(d)Nothing in this section is intended to prohibit a physician from taking appropriate action in an emergency. An emergency exists when there is a sudden and marked change in an inmates mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others, and it is impractical, due to the seriousness of the emergency, to first obtain informed consent. If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist. If the clinicians of the county department of mental health, or other designated county department, identify a situation that jeopardizes the inmates health or well-being as the result of a serious mental illness, and necessitates the continuation of medication beyond the initial 72 hours pending the full mental health hearing, the county department may seek to continue the medication by giving notice to the inmate and their counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing. Treatment of the inmate in a facility pursuant to Section 4011.6 shall not be required in order to continue medication under this subdivision unless the treatment is otherwise medically necessary. The notice shall be served upon the inmate and counsel at the same time the inmate is given the written notice that the involuntary medication proceedings are being initiated and is appointed counsel as provided in subdivision (c). The order may be issued ex parte upon a showing that, in the absence of the medication, the emergency conditions are likely to recur. The request for an ex parte order shall be supported by an affidavit from the psychiatrist or psychologist showing specific facts. The inmate and the inmates appointed counsel shall have two business days to respond to the county departments ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the departments request. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer shall review the ex parte request and shall have three business days to determine the merits of the departments request for an ex parte order. If an order is issued, the psychiatrist may continue the administration of the medication until the hearing described in paragraph (5) of subdivision (c) is held.
(1)If the county elects to seek an ex parte order pursuant to this subdivision, the county department of mental health, or other designated county department, shall file with the superior court, and serve on the inmate and their counsel, the written notice described in paragraph (7) of subdivision (c) within 72 hours of commencing medication pursuant to this subdivision, unless either of the following occurs:
(A)The inmate gives informed consent to continue the medication.
(B)A psychiatrist determines that the psychiatric medication is not necessary and administration of the medication is discontinued.
(2)If medication is being administered pursuant to this subdivision, the hearing described in paragraph (5) of subdivision (c) shall commence within 21 days of the filing and service of the notice, unless counsel for the inmate agrees to a different period of time.
(3)With the exception of the timeline provisions specified in paragraphs (1) and (2) for providing notice and commencement of the hearing in emergency or interim situations, the inmate shall be entitled to and be given the same due process protections as specified in subdivision (c). The county department of mental health, or other designated county department, shall prove the same elements supporting the involuntary administration of psychiatric medication, and the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall be required to make the same findings described in subdivision (c).
(e)The determination that an inmate may receive involuntary medication shall be valid for one year from the date of the determination, regardless of whether the inmate subsequently gives informed consent.
(f)If a determination has been made to involuntarily medicate an inmate pursuant to subdivision (c) or (d), the medication shall be discontinued one year after the date of that determination, unless the inmate gives informed consent to the administration of the medication, or unless a new determination is made pursuant to the procedures set forth in subdivision (g).
(g)To renew an existing order allowing involuntary medication, the county department of mental health, or other designated county department, shall file with the superior court, and shall serve on the inmate and their counsel, a written notice indicating the departments intent to renew the existing involuntary medication order.
(1)The request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication.
(2)The inmate shall be entitled to, and shall be given, the same due process protections as specified in subdivision (c).
(3)Renewal orders shall be valid for one year from the date of the hearing.
(4)An order renewing an existing order shall be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding their need for the medication, such that it is unlikely that the inmate would be able to manage their own medication and treatment regimen. No new acts need be alleged or proven.
(5)If the county department of mental health, or other designated county department, wishes to add a basis to an existing order, it shall give the inmate and the inmates counsel notice in advance of the hearing via a renewal notice or supplemental petition. Within the renewal notice or supplemental petition, as described in subdivision (g), the county department of mental health, or other designated county department, shall specify what additional basis is being alleged and what qualifying conduct within the past year supports that additional basis. The county department of mental health, or other designated county department, shall prove the additional basis and conduct by clear and convincing evidence at a hearing as specified in subdivision (c).
(6)The hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order.
(h)In the event of a conflict between the provisions of this section and the Administrative Procedure Act (Chapter 4.5 (commencing with Section 11400) of Part 1 of Division 3 of Title 2 of the Government Code), this section shall control.
(i)This section shall become effective operative on January 1, 2025. 2030.
SEC. 2.Section 2603 of the Penal Code, as amended by Section 12 of Chapter 434 of the Statutes of 2021, is repealed.SEC. 3.If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.
REVISIONS: HeadingLine 4.(a)Except as provided in subdivision (b), an inmate confined in a county jail shall not be administered any psychiatric medication without their prior informed consent.
(b)If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d).
(c)A county department of mental health, or other designated county department, may administer involuntary medication on a nonemergency basis only if all of the following conditions have been met:
(1)A psychiatrist or psychologist has determined that the inmate has a serious mental disorder.
(2)A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others.
(3)A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmates disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.
(4)The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication and refuses, or is unable to consent to, the administration of the medication.
(5)The jail has made a documented attempt to locate an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based beds and the inability of many facilities to accept transfers from correctional facilities.
(6)The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified in subdivision (c) of Section 5334 of the Welfare and Institutions Code.
(A)If the inmate is in custody awaiting trial, including an inmate whose criminal proceedings are suspended pursuant to Section 1370 or an inmate whose competence has been called into question and is undergoing evaluation pursuant to Section 1369, any hearing pursuant to this section shall be held before, and any requests for ex parte orders shall be submitted to, a judge in the superior court where the criminal case is pending.
(B)A superior court judge may consider whether involuntary medication would prejudice the inmates defense.
(7)(A)The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive expedited access to counsel.
(B)In the case of an inmate awaiting arraignment, the inmate is provided counsel within 48 hours of the filing of the notice of the hearing with the superior court, unless counsel has previously been appointed.
(C)The hearing shall be held not more than 30 days after the filing of the notice with the superior court, unless counsel for the inmate agrees to extend the date of the hearing.
(8)(A)The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive an expedited hearing.
(B)The written notice shall do all of the following:
(i)Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication.
(ii)Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential section of the inmates central file which contains materials unrelated to medical treatment.
(iii)Inform the inmate of their right to appeal the determination to the superior court or the court of appeal as specified in subdivisions (e) and (f) of Section 5334 of the Welfare and Institutions Code, and their right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health, or other designated county department, to continue treatment with involuntary medication after the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer has authorized treatment with involuntary medication.
(9)(A)In the hearing described in paragraph (6), the superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that that, as a result of that illness illness, the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmates best medical interest.
(B)The superior court judge, court-appointed commissioner or referee, or a court-appointed hearing officer shall not make a finding pursuant to subparagraph (A) of this paragraph that there is no less intrusive alternative to involuntary medication and that the medication is in the inmates best medical interest, without information from the jail to indicate that neither of the conditions specified in paragraph (5) is present.
(C)If the court makes the findings in subparagraph (A), that administration shall occur in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if available.
(D)In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, or other designated county department, the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmates counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and, if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default.
(10)The historical course of the inmates mental disorder, as determined by available relevant information about the course of the inmates mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder.
(11)An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. This paragraph does not prevent a court from reviewing, modifying, or terminating an involuntary medication order for an inmate awaiting trial, trial if there is a showing that the involuntary medication is interfering with the inmates due process rights in the criminal proceeding.
(d)(1)(A)This section does not prohibit a physician from taking appropriate action in an emergency. An emergency exists when both of the following criteria are met:
(i)There is a sudden and marked change in an inmates mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others.
(ii)It is impractical, due to the seriousness of the emergency, to first obtain informed consent.
(B)If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist.
(2)(A)If the clinicians of the county department of mental health, or other designated county department, identify a situation that jeopardizes the inmates health or well-being as the result of a serious mental illness, and necessitates the continuation of medication beyond the initial 72 hours pending the full mental health hearing, the county department may seek to continue the medication by giving notice to the inmate and their counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing, and filing an ex parte order within the initial 72-hour period. Treatment of the inmate in a facility pursuant to Section 4011.6 shall not be required in order to continue medication under this subdivision unless the treatment is otherwise medically necessary.
(B)The notice shall be served upon the inmate and counsel at the same time the inmate is given the written notice that the involuntary medication proceedings are being initiated and is appointed counsel as provided in subdivision (c).
(C)The order may be issued ex parte upon a showing that, in the absence of the medication, the emergency conditions are likely to recur. The request for an ex parte order shall be supported by an affidavit from the psychiatrist or psychologist showing specific facts.
(D)The inmate and the inmates appointed counsel shall have two business days to respond to the county departments ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the departments request. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer shall review the ex parte request and shall have three business days to determine the merits of the departments request for an ex parte order.
(E)If an order is issued, the psychiatrist may continue the administration of the medication until the hearing described in paragraph (6) of subdivision (c) is held.
(3)If the county elects to seek an ex parte order pursuant to this subdivision, the county department of mental health, or other designated county department, shall file with the superior court, and serve on the inmate and their counsel, the written notice described in paragraph (8) of subdivision (c) within 72 hours of commencing medication pursuant to this subdivision, unless either of the following occurs:
(A)The inmate gives informed consent to continue the medication.
(B)A psychiatrist determines that the psychiatric medication is not necessary and administration of the medication is discontinued.
(4)If medication is being administered pursuant to this subdivision, the hearing described in paragraph (6) of subdivision (c) shall commence within 21 days of the filing and service of the notice, unless counsel for the inmate agrees to a different period of time.
(5)With the exception of the timeline provisions specified in paragraphs (3) and (4) for providing notice and commencement of the hearing in emergency or interim situations, the inmate shall be entitled to and be given the same due process protections as specified in subdivision (c). The county department of mental health, or other designated county department, shall prove the same elements supporting the involuntary administration of psychiatric medication and the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall be required to make the same findings described in subdivision (c).
(e)(1)(A)An order by the court authorizing involuntary medication of an inmate shall be valid for no more than one year after the date of determination.
(B)Notwithstanding subparagraph (A), in the case of an inmate who is awaiting arraignment, trial, or sentencing, the determination that an inmate may receive involuntary medication shall be valid for no more than 180 days. The court shall review the order at intervals of not more than 60 days to determine whether the grounds for the order remain. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendants attorney. In determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendants attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order.
(2)Notwithstanding subparagraph (A) of paragraph (1), any determination of an inmates incapacity to refuse treatment with antipsychotic medication made pursuant to this section shall remain in effect only until one of the following occurs, whichever occurs first:
(A)The duration of the inmates confinement ends, unless, pursuant to Section 1370, the inmate is transferred to a State Department of State Hospitals facility, as defined in Section 4100 of the Welfare and Institutions Code. If the inmate is transferred to such a facility, the order shall remain valid for the period ordered by the court and the facility may administer antipsychotic medication as needed, including on an involuntary basis, if the treating psychiatrist determines that antipsychotic medication is medically necessary and appropriate.
(B)A court determines that the inmate no longer meets the criteria of subdivision (c) or (d), or by any other order of the court.
(3)An inmates period of confinement may not be extended in order to provide treatment to the inmate with antipsychotic medication pursuant to this section.
(f)This section does not prohibit the court, upon making a determination that an inmate awaiting arraignment, preliminary hearing, trial, sentencing, or a postconviction proceeding to revoke or modify supervision may receive involuntary medication pursuant to subdivision (c) or (d), and, upon ex parte request of the defendant or counsel, from suspending all proceedings in the criminal prosecution, until the court determines that the defendants medication will not interfere with their ability to meaningfully participate in the criminal proceedings.
(g)If a determination has been made to involuntarily medicate an inmate pursuant to subdivision (c) or (d), the medication shall be discontinued one year after the date of that determination, unless the inmate gives informed consent to the administration of the medication, or unless a new determination is made pursuant to the procedures set forth in subdivision (h).
(h)To renew an existing order allowing involuntary medication, the county department of mental health, or other designated county department, shall file with the superior court, and shall serve on the inmate and their counsel, a written notice indicating the departments intent to renew the existing involuntary medication order.
(1)The request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication.
(2)The inmate shall be entitled to, and shall be given, the same due process protections as specified in subdivision (c).
(3)(A)Except as provided in subparagraph (B), renewal orders shall be valid for one year from the date of the hearing.
(B)In the case of an inmate awaiting arraignment, trial, or sentencing, the renewal order shall be valid for no more than 180 days. The court shall review the order at intervals of not more than 60 days to determine whether the grounds for the order remain. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendants attorney. In determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendants attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order.
(4)(A)An order renewing an existing order shall be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding their need for the medication, such that it is unlikely that the inmate would be able to manage their own medication and treatment regimen. No new acts need be alleged or proven.
(B)The superior court judge, court-appointed commissioner or referee, or a court-appointed hearing officer shall also make a finding that treatment of the inmate in a correctional setting continues to be necessary if neither of the criteria in paragraph (5) of subdivision (c) is present.
(5)If the county department of mental health, or other designated county department, wishes to add a basis to an existing order, it shall give the inmate and the inmates counsel notice in advance of the hearing via a renewal notice or supplemental petition. Within the renewal notice or supplemental petition, as described in subdivision (h), the county department of mental health, or other designated county department, shall specify what additional basis is being alleged and what qualifying conduct within the past year supports that additional basis. The county department of mental health, or other designated county department, shall prove the additional basis and conduct by clear and convincing evidence at a hearing as specified in subdivision (c).
(6)The hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order.
(i)In the event of a conflict between the provisions of this section and the Administrative Procedure Act (Chapter 4.5 (commencing with Section 11400) of Part 1 of Division 3 of the Government Code), this section shall control.
(j)As used in this section, inmate means a person confined in the county jail, including, but not limited to, a person sentenced to imprisonment in a county jail, a person housed in a county jail during or awaiting trial proceedings, and a person who has been booked into a county jail and is awaiting arraignment.
(k)This section does not apply to a person housed in a county jail solely on the basis of an immigration hold, except as it applies to medication provided on an emergency or interim basis as provided in subdivision (d).
(l)Each county that administers involuntary medication to an inmate awaiting arraignment, trial, or sentencing, shall file, by January 1, 2021, a written report with the Assembly Committees on Judiciary and Public Safety and the Senate Committee on Public Safety summarizing the following: the number of inmates who received involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2018, and July 1, 2020; the crime for which those inmates were arrested; the total time those inmates were detained while awaiting arraignment, trial, or sentencing; the duration of the administration of involuntary medication; the number of times, if any, that an existing order for the administration of involuntary medication was renewed; and the reason for termination of the administration of involuntary medication.(m)This section shall remain in effect only until January 1, 2025, and as of that date is repealed, unless a later enacted statute, which is chaptered before that date, deletes or extends the date.SEC. 2.Section 2603 of the Penal Code, as amended by Section 12 of Chapter 434 of the Statutes of 2021, is repealed.2603.(a)Except as provided in subdivision (b), no person sentenced to imprisonment in a county jail shall be administered any psychiatric medication without prior informed consent.(b)If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d).(c)A county department of mental health, or other designated county department, may seek to initiate involuntary medication on a nonemergency basis only if all of the following conditions have been met:(1)A psychiatrist or psychologist has determined that the inmate has a serious mental disorder.(2)A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others.(3)A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmates disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient.(4)The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication, and refuses, or is unable to consent to, the administration of the medication.(5)The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified in subdivision (c) of Section 5334 of the Welfare and Institutions Code.(6)The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive expedited access to counsel. The hearing shall be held not more than 30 days after the filing of the notice with the superior court, unless counsel for the inmate agrees to extend the date of the hearing.(7)The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency or interim medication is being administered pursuant to subdivision (d), in which case the inmate would receive an expedited hearing. The written notice shall do all of the following:(A)Set forth the diagnosis, the factual basis for the diagnosis, the basis upon which psychiatric medication is recommended, the expected benefits of the medication, any potential side effects and risks to the inmate from the medication, and any alternatives to treatment with the medication.(B)Advise the inmate of the right to be present at the hearing, the right to be represented by counsel at all stages of the proceedings, the right to present evidence, and the right to cross-examine witnesses. Counsel for the inmate shall have access to all medical records and files of the inmate, but shall not have access to the confidential section of the inmates central file which contains materials unrelated to medical treatment.(C)Inform the inmate of the right to appeal the determination to the superior court or the court of appeal as specified in subdivisions (e) and (f) of Section 5334 of the Welfare and Institutions Code, and of the right to file a petition for writ of habeas corpus with respect to any decision of the county department of mental health, or other designated county department, to continue treatment with involuntary medication after the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer has authorized treatment with involuntary medication.(8)A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmates best medical interest. In the event of any statutory notice issues with either initial or renewal filings by the county department of mental health, or other designated county department, the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall hear arguments as to why the case should be heard, and shall consider factors such as the ability of the inmates counsel to adequately prepare the case and to confer with the inmate, the continuity of care, and, if applicable, the need for protection of the inmate or institutional staff that would be compromised by a procedural default.(9)The historical course of the inmates mental disorder, as determined by available relevant information about the course of the inmates mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder.(10)An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown.(d)Nothing in this section is intended to prohibit a physician from taking appropriate action in an emergency. An emergency exists when there is a sudden and marked change in an inmates mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others, and it is impractical, due to the seriousness of the emergency, to first obtain informed consent. If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency continues to exist. If the clinicians of the county department of mental health, or other designated county department, identify a situation that jeopardizes the inmates health or well-being as the result of a serious mental illness, and necessitates the continuation of medication beyond the initial 72 hours pending the full mental health hearing, the county department may seek to continue the medication by giving notice to the inmate and their counsel of its intention to seek an ex parte order to allow the continuance of medication pending the full hearing. Treatment of the inmate in a facility pursuant to Section 4011.6 shall not be required in order to continue medication under this subdivision unless the treatment is otherwise medically necessary. The notice shall be served upon the inmate and counsel at the same time the inmate is given the written notice that the involuntary medication proceedings are being initiated and is appointed counsel as provided in subdivision (c). The order may be issued ex parte upon a showing that, in the absence of the medication, the emergency conditions are likely to recur. The request for an ex parte order shall be supported by an affidavit from the psychiatrist or psychologist showing specific facts. The inmate and the inmates appointed counsel shall have two business days to respond to the county departments ex parte request to continue interim medication, and may present facts supported by an affidavit in opposition to the departments request. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer shall review the ex parte request and shall have three business days to determine the merits of the departments request for an ex parte order. If an order is issued, the psychiatrist may continue the administration of the medication until the hearing described in paragraph (5) of subdivision (c) is held.(1)If the county elects to seek an ex parte order pursuant to this subdivision, the county department of mental health, or other designated county department, shall file with the superior court, and serve on the inmate and their counsel, the written notice described in paragraph (7) of subdivision (c) within 72 hours of commencing medication pursuant to this subdivision, unless either of the following occurs:(A)The inmate gives informed consent to continue the medication.(B)A psychiatrist determines that the psychiatric medication is not necessary and administration of the medication is discontinued.(2)If medication is being administered pursuant to this subdivision, the hearing described in paragraph (5) of subdivision (c) shall commence within 21 days of the filing and service of the notice, unless counsel for the inmate agrees to a different period of time.(3)With the exception of the timeline provisions specified in paragraphs (1) and (2) for providing notice and commencement of the hearing in emergency or interim situations, the inmate shall be entitled to and be given the same due process protections as specified in subdivision (c). The county department of mental health, or other designated county department, shall prove the same elements supporting the involuntary administration of psychiatric medication, and the superior court judge, court-appointed commissioner or referee, or court-appointed hearing officer shall be required to make the same findings described in subdivision (c).(e)The determination that an inmate may receive involuntary medication shall be valid for one year from the date of the determination, regardless of whether the inmate subsequently gives informed consent.(f)If a determination has been made to involuntarily medicate an inmate pursuant to subdivision (c) or (d), the medication shall be discontinued one year after the date of that determination, unless the inmate gives informed consent to the administration of the medication, or unless a new determination is made pursuant to the procedures set forth in subdivision (g).(g)To renew an existing order allowing involuntary medication, the county department of mental health, or other designated county department, shall file with the superior court, and shall serve on the inmate and their counsel, a written notice indicating the departments intent to renew the existing involuntary medication order.(1)The request to renew the order shall be filed and served no later than 21 days prior to the expiration of the current order authorizing involuntary medication.(2)The inmate shall be entitled to, and shall be given, the same due process protections as specified in subdivision (c).(3)Renewal orders shall be valid for one year from the date of the hearing.(4)An order renewing an existing order shall be granted based on clear and convincing evidence that the inmate has a serious mental disorder that requires treatment with psychiatric medication, and that, but for the medication, the inmate would revert to the behavior that was the basis for the prior order authorizing involuntary medication, coupled with evidence that the inmate lacks insight regarding their need for the medication, such that it is unlikely that the inmate would be able to manage their own medication and treatment regimen. No new acts need be alleged or proven.(5)If the county department of mental health, or other designated county department, wishes to add a basis to an existing order, it shall give the inmate and the inmates counsel notice in advance of the hearing via a renewal notice or supplemental petition. Within the renewal notice or supplemental petition, as described in subdivision (g), the county department of mental health, or other designated county department, shall specify what additional basis is being alleged and what qualifying conduct within the past year supports that additional basis. The county department of mental health, or other designated county department, shall prove the additional basis and conduct by clear and convincing evidence at a hearing as specified in subdivision (c).(6)The hearing on any petition to renew an order for involuntary medication shall be conducted prior to the expiration of the current order.(h)In the event of a conflict between the provisions of this section and the Administrative Procedure Act (Chapter 4.5 (commencing with Section 11400) of Part 1 of Division 3 of Title 2 of the Government Code), this section shall control.(i)This section shall become effective on January 1, 2025.|
Date
|
Status
|
|---|---|
| Sep 20, 2024 | Chaptered by Secretary of State. Chapter 326, Statutes of 2024. |
| Sep 20, 2024 | Approved by the Governor. |
| Sep 4, 2024 | Enrolled and presented to the Governor at 4 p.m. |
| Aug 28, 2024 | Assembly amendments concurred in. (Ayes 39. Noes 0. Page 5615.) Ordered to engrossing and enrolling. |
| Aug 27, 2024 | Ordered to special consent calendar. |
| Aug 26, 2024 | In Senate. Concurrence in Assembly amendments pending. |
| Aug 26, 2024 | Read third time. Passed. (Ayes 76. Noes 0. Page 6512.) Ordered to the Senate. |
| Aug 22, 2024 | Read third time and amended. |
| Aug 22, 2024 | Ordered to third reading. |
| Aug 19, 2024 | Read third time and amended. |
| Aug 19, 2024 | Ordered to third reading. |
| Aug 15, 2024 | Ordered to third reading. |
| Aug 15, 2024 | From consent calendar on motion of Assembly Member McCarty. |
| Aug 8, 2024 | Read second time. Ordered to consent calendar. |
| Aug 7, 2024 | From committee: Do pass. Ordered to consent calendar. (Ayes 14. Noes 0.) (August 7). |
| Jun 18, 2024 | From committee: Do pass and re-refer to Com. on APPR. (Ayes 7. Noes 0.) (June 18). Re-referred to Com. on APPR. |
| Jun 18, 2024 | Coauthors revised. |
| May 28, 2024 | Referred to Com. on PUB. S. |
| May 21, 2024 | In Assembly. Read first time. Held at Desk. |
| May 20, 2024 | Read third time. Passed. (Ayes 39. Noes 0. Page 4021.) Ordered to the Assembly. |
| May 14, 2024 | Read second time. Ordered to third reading. |
| May 13, 2024 | From committee: Be ordered to second reading pursuant to Senate Rule 28.8. |
| May 3, 2024 | Set for hearing May 13. |
| Apr 24, 2024 | Re-referred to Com. on APPR. pursuant to Joint Rule 10.5. |
| Apr 23, 2024 | Read second time and amended. Ordered to third reading. |
| Apr 22, 2024 | From committee: Do pass as amended. (Ayes 5. Noes 0. Page 3637.) (April 16). |
| Apr 3, 2024 | Set for hearing April 16. |
| Feb 29, 2024 | Referred to Com. on PUB S. |
| Feb 20, 2024 | From printer. May be acted upon on or after March 18. |
| Feb 16, 2024 | Introduced. Read first time. To Com. on RLS. for assignment. To print. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Aug 28, 2024 | Special Consent SB1317 Wahab et al. | Senate Floor |
Passed |
|
| Aug 26, 2024 | SB 1317 Wahab Senate Third Reading By McCarty | Assembly Floor |
Passed |
|
| Aug 7, 2024 | Do pass. To Consent Calendar. | Assembly Standing Committee on Appropriations |
Passed |
|
| Jun 18, 2024 | Do pass and be re-referred to the Committee on [Appropriations] | Assembly Standing Committee on Public Safety |
Passed |
|
| May 20, 2024 | Senate 3rd Reading SB1317 Wahab et al. | Senate Floor |
Passed |
|
| Apr 16, 2024 | Do pass as amended | Senate Standing Committee on Public Safety |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| Alameda County Families Advocating for The Seriously Mentally Ill | ** Support | |
| California Public Defenders Association | * Against | Jun 18, 2024 |
| California State Association of Psychiatrists | ** Support | |
| California State Sheriffs' Association | ** Support | |
| County Of Los Angeles | * Support | Jun 18, 2024 |
| County of Los Angeles Board of Supervisors | ** Support | |
| County of Santa Clara | ** Support | |
| Family Advocates for Individuals with Serious Mental Illness in Sacramento County | * Support | Jun 18, 2024 |
| Los Angeles County Professional Peace Officers Association | ** Support | |
| Los Angeles County Sheriff Robert Luna | * Support | Jun 18, 2024 |
| Los Angeles County Sheriff'S Department | ** Support | |
| Psychiatric Physicians Alliance of California | ** Support | |
| Riverside Sheriff's Office | * Support | Jun 18, 2024 |
| San Bernardino County Sheriff Department | * Support | Jun 18, 2024 |
| Steinberg Institute | ** Support |
SENATE RULES COMMITTEE Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | SB 1317 |
UNFINISHED BUSINESS
Bill No: SB 1317
Author: Wahab (D), et al.
Amended: 8/22/24
Vote: 21
SENATE PUBLIC SAFETY COMMITTEE: 5-0, 4/16/24
AYES: Wahab, Seyarto, Bradford, Skinner, Wiener
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
SENATE FLOOR: 39-0, 5/20/24
AYES: Allen, Alvarado-Gil, Archuleta, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dahle, Dodd, Durazo, Eggman, Glazer, Gonzalez, Grove, Hurtado, Jones, Laird, Limón, McGuire, Menjivar, Newman, Nguyen, Niello, Ochoa Bogh, Padilla, Portantino, Roth, Rubio, Seyarto, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk
NO VOTE RECORDED: Min
ASSEMBLY FLOOR: 76-0, 8/26/24 - See last page for vote
SUBJECT: Inmates: psychiatric medication: informed consent
SOURCE: County of Santa Clara
DIGEST:
This bill extends the sunset date until January 1, 2030 on the provision of law authorizing involuntary medication of county jail inmates who are awaiting arraignment, trial or sentencing.
Assembly Amendments specify that treatment of the inmate shall be consistent with the standard of care and provide that submission of a declaration under penalty of perjury is sufficient for the county to demonstrate a documented attempt to locate an alternative bed.
ANALYSIS:
Existing law:
- Authorizes, until January 1, 2025, the administration of psychotropic medication on an involuntary basis to county jail inmates who are awaiting arraignment, trial, or sentencing if a psychiatrist determines that the inmate should be treated with psychiatric medication and specified procedures are followed. (Pen. Code, § 2603, subd. (b).)
- Authorizes, until January 1, 2025, the administration of medication without a defendant’s consent on a nonemergency basis only if all of the following conditions have been met:
- A psychiatrist or psychologist has determined that the inmate has a serious mental disorder;
- A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others;
- A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmate’s disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient;
- The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication and refuses, or is unable to consent to, the administration of the medication;
- The jail has made a documented attempt to locate an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based beds and the inability of many facilities to accept transfers from correctional facilities;
- The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified;
- The inmate is provided counsel at least 21 days prior to the hearing, unless emergency medication is being administered, in which case the inmate would receive expedited access to counsel;
- The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency medication is being administered, in which case the inmate would receive an expedited hearing;
- In the hearing described in paragraph (6), the superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness, the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmate’s best medical interest;
- The historical course of the inmate’s mental disorder, as determined by available relevant information about the course of the inmate’s mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder; and,
- An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. This paragraph does not prevent a court from reviewing, modifying, or terminating an involuntary medication order for an inmate awaiting trial if there is a showing that the involuntary medication is interfering with the inmate’s due process rights in the criminal proceeding. (Pen. Code, § 2603, subd. (c).)
- Provides, until January 1, 2025, that an order by the court authorizing involuntary medication of an inmate awaiting arraignment, trial or sentencing shall be valid for no more than 180 days and the court shall review the order at intervals of not more than 60 days to determine whether the ground for the order remains. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendant’s attorney. (Pen Code, § 2603, subd. (e)(1)(B).)
- States, until January 1, 2025, that in determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendant’s attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order. (Ibid.)
- States, until January 1, 2025, that in the case of an inmate awaiting arraignment, trial, or sentencing, the renewal order shall be valid for no more than 180 days and follows the same requirements in the initial order authorizing involuntary medication. (Pen Code, § 2603, subd. (h)(3)(B).)
- Required each county that administers involuntary medication to an inmate awaiting arraignment, trial, or sentencing to file, by January 1, 2021, a written report to the Senate Committee on Public Safety and the Assembly Committees on Public Safety and Judiciary summarizing the following:
- The number of inmates who received involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2018 and July 1, 2020;
- The crime for which those inmates were arrested;
- The total time those inmates were detained while awaiting arraignment, trial, or sentencing;
- The duration of the administration of involuntary medication;
- The reason for termination of administration of involuntary medication;
- The number of times, if any, that an existing order for the administration of involuntary medication was renewed; and,
- The reason for termination of the administration of involuntary medication. (Pen. Code, §2603, subd. (l).)
- Sunsets the provisions of law authorizing involuntary medication of inmates detained in county jail while awaiting arraignment, trial or sentencing on January 1, 2025.
This bill:
- Extends the operational date on the provisions of law authorizing involuntary medication of inmates detained in county jail while awaiting arraignment, trial or sentencing until January 1, 2030.
- Provides that any such treatment shall be consistent with the standard of care.
- Revises the requirement that the jail must have made a documented attempt to located an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication by providing that submission of a declaration under penalty of perjury is sufficient for the county to demonstrate a documented attempt to locate an alternative bed.
- Requires each county that, between January 1, 2025 and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, by no later than January 1, 2029, prepare and submit a written report to the Assembly Committee on Public Safety and the Senate Committee on Public Safety, summarizing all of the following information:
- The number of inmates who were administered involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2025 and July 1, 2028;
- The crime for which each of these inmates was arrested, if it is practically feasible to obtain that information;
- The total time each inmate was detained while awaiting arraignment, trial, or sentencing, if it is practically feasible to obtain that information;
- The duration of the administration of involuntary medication for each inmate;
- The number of times, if any, that each existing order for the administration of involuntary medication was renewed; and,
- The reason that administration of involuntary medication was terminated for each inmate.
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: Yes
According to the Assembly Committee on Appropriations: Likely nonreimbursable costs to counties that choose to seek and implement involuntary medication orders, and to counties that must report to the Legislature about involuntary medication of county jail inmates awaiting arraignment, trial, or sentencing.
SUPPORT: (Verified 8/26/24)
County of Santa Clara (source)
Alameda County Families Advocating for the Seriously Mentally Ill
California State Association of Psychiatrists (CSAP)
California State Sheriffs' Association
County of Los Angeles Board of Supervisors
County of Santa Clara (source)
Los Angeles County Professional Peace Officers Association
Los Angeles County Sheriff's Department
Psychiatric Physicians Alliance of California (PPAC)
Steinberg Institute
OPPOSITION: (Verified 8/26/24)
None received
ASSEMBLY FLOOR: 76-0, 8/26/24
AYES: Addis, Aguiar-Curry, Alanis, Alvarez, Arambula, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Chen, Connolly, Megan Dahle, Davies, Dixon, Essayli, Flora, Mike Fong, Friedman, Gabriel, Gallagher, Garcia, Gipson, Grayson, Haney, Hart, Holden, Hoover, Irwin, Jackson, Jones-Sawyer, Kalra, Lackey, Lee, Low, Lowenthal, Maienschein, Mathis, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Pacheco, Papan, Jim Patterson, Joe Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Rendon, Reyes, Luz Rivas, Rodriguez, Blanca Rubio, Sanchez, Santiago, Schiavo, Soria, Ta, Ting, Valencia, Villapudua, Waldron, Wallis, Ward, Weber, Wicks, Wilson, Wood, Zbur, Robert Rivas
NO VOTE RECORDED: Bonta, Cervantes, Ortega
Prepared by: Stella Choe / PUB. S. /
8/26/24 21:34:26
**** END ****
SENATE THIRD READING
STR Bill Id:SB 1317
Author:(Wahab)
As Amended Ver:August 22, 2024
Majority vote
SUMMARY
Extends the sunset date until January 1, 2030 on the provision of law authorizing involuntary medication of county jail inmates who are awaiting arraignment, trial, or sentencing.
Major Provisions
- Extends the sunset date from January 1, 2025 to January 1, 2030 to authorize involuntary medication of county jail inmates, as specified.
- Requires each county that administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing to, by no later than January 1, 2029, prepare and submit a written report about any instances of involuntary medication between January 1, 2025 and July 1, 2028, to the Assembly Committee on Public Safety and the Senate Committee on Public Safety, summarizing all of the following information:
- The number of inmates who were administered involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2025 and July 1, 2028;
- The crime for which each of these inmates was arrested, if it is practically feasible to obtain that information;
- The total time each inmate was detained while awaiting arraignment, trial, or sentencing, if it is practically feasible to obtain that information;
- The duration of the administration of involuntary medication for each inmate;
- The number of times, if any, that each existing order for the administration of involuntary medication was renewed; and,
- The reason that administration of involuntary medication was terminated for each inmate.
- Allow an inmate in a county jail to be involuntarily administered psychiatric medication on a nonemergency basis consistent with the standard of care, and requires the county to submit a declaration under penalty of perjury to the Superior Court demonstrating a documented attempt to locate an available noncustodial bed.
- Makes technical non-substantive changes.
COMMENTS
According to the Author
"Spending time in a county jail is hard on anyone's mental health. But those with truly severe mental health challenges who won't voluntarily accept treatment are at a major risk of deterioration, victimization, or harming themselves or others. They often languish in horrid conditions in their cells, refusing to eat, bathe, or care for themselves. These troubling circumstances reflect the unfortunate reality that has led county jails to serve as de facto mental health institutions. It is a reality that we cannot ignore. To let a person who is gravely disabled or a danger to self or others exist in such conditions is inhumane. In such cases, involuntary medication is a form of harm reduction.
The process to seek a judicial order to administer involuntary medication in county jail settings (Penal Code section 2603) has already been in statute for 12 years. Specifically tailored for county jail settings, it safeguards the rights of those in custody who are in need of psychiatric medication and reduces delays in the delivery of vital treatment. Further, this statutory procedure to authorize involuntary medication – sought only for those individuals whose condition is truly dire and deteriorating – is critical to counties' ability to address the most acute mental health treatment needs of those in local custody. The objective of such an order is to stabilize the individual so that they can participate in their self-care and treatment and move to a less restrictive setting. Without action by this Legislature, the statute will expire on January 1, 2025. SB 1317 extends that sunset date to January 1, 2030, allowing counties to continue using this authority in rare but necessary cases, under appropriate judicial oversight, along with a robust reporting requirements."
Arguments in Support
According to Psychiatric Physicians Alliance of California: With the marked reduction in psychiatric hospital beds in California communities in the last 5 decades, county jails have become the de facto default destination to house untreated, often homeless, mentally ill persons. In a jail setting, many of these inmates who are admitted – often very sick with a mental disorder – become even more delusional, disorganized, and disruptive in confinement. Mentally ill individuals tend to spend much longer in the pretrial process than their peers without mental illness when charged with the same crimes. Many weeks, and more likely months, may pass before adjudication. Many of these inmates refuse to accept medication, in fact are so sick they are not able to recognize they are ill and need help.
Under these circumstances psychotic individuals, for instance, who are delusional and experiencing hallucinations cannot follow correction officer orders, may bang their heads against walls, scream for hours at all hours, or smear feces around their cells. These individuals obtain a significant benefit from medication, but until AB 720 (Eggman, 2017) was these individuals languished for lack of medication unless they accepted them voluntarily. Case law, most recently United States v. Loughner, in the 9th Circuit Court of Appeal (2012), has determined that the same standards for involuntary medication of convicted inmates who are dangerous or gravely disabled because of a mental disorder apply to pretrial detainees who are dangerous or gravely disabled because of a mental disorder. The proposal in AB 1317 guarantees that a vital tool will be continued in a statute which lies squarely within the clearly defined Loughner legal parameters.
Arguments in Opposition
According to the California Public Defenders Association: We share with the author and the sponsor the goal of alleviating our severely mentally ill clients' suffering in the jail. While appreciating the author's willingness to engage with us, we remain concerned because there is no mandatory requirement that any administration and treatment with powerful psychotropic involuntary medication be done utilizing the medical standard of care and that there is no enforcement of the provision that involuntary medication in the jail be a last resort, not a first option. During our discussions with the author for the last three months, we have significantly narrowed our proposed amendments to the following:
(b) If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d). Any such treatment shall be consistent with the standard of care.
(5) The jail has made a documented attempt to locate an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based treatment beds and the inability of many facilities to accept transfers from correctional facilities. It is sufficient for the sheriff or their designee to show due diligence of the attempt to locate an available bed by submitting a declaration under penalty of perjury.
Santa Clara County, the sponsor of SB 1317, has numerous policies and safeguards in place including their own acute mental health facility for jailed individuals. Unfortunately, other counties are not as well-resourced and do not have access to the same level of mental health care for incarcerated individuals. Involuntary Psychiatric Medication: Psychiatric medications can cause significant liver and other organ damage, including increasing the risk of diabetes. When an individual knowingly consents to the use of such medication, they are presented with the risks and benefits. Such is not the case for individuals who are involuntarily medicated.
The Department of State Hospitals facilities routinely monitor individuals with blood tests and other lab tests. Santa Clara County's practice appears to be consistent with the Department of State Hospitals. According to the Santa Clara County Jail Reform website, Santa Clara County responded to recommendations for needed reforms stating that they do the following:
Medications for medical and behavioral health are monitored using lab testing as appropriate to determine levels as per the recommendation of the manufacturer and medical decision making. Voluntary versus involuntary medication use is reviewed on a case by cases basis and is dependent on review by a physician or psychiatrist. https://jailreforms.sccgov.org/summarized-recommendations/inmatehealthcare-hlc#3925188384-4062458531
Community Based or Other Treatment Beds
Again, Santa Clara County has their own treatment facility in the jail. In other counties, such as Contra Costa, the sheriff or county counsel either does not make a robust attempt to find a treatment facility before attempting involuntary medication in the jail or in counties such as Alameda, they transfer the individual to an acute non-carceral county facility. CPDA and our members want the same protections that Santa Clara County affords to its incarcerated severely mentally ill individuals to be extended to all Californians who are incarcerated and subject to involuntary medication orders.
FISCAL COMMENTS
According to the Assembly Appropriations Committee, "Likely nonreimbursable costs to counties that choose to seek and implement involuntary medication orders, and to counties that must report to the Legislature about involuntary medication of county jail inmates awaiting arraignment, trial, or sentencing."
VOTES
SENATE FLOOR: 39-0-1
YES: Allen, Alvarado-Gil, Archuleta, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dahle, Dodd, Durazo, Eggman, Glazer, Gonzalez, Grove, Hurtado, Jones, Laird, Limón, McGuire, Menjivar, Newman, Nguyen, Niello, Ochoa Bogh, Padilla, Portantino, Roth, Rubio, Seyarto, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk
ABS, ABST OR NV: Min
ASM PUBLIC SAFETY: 7-0-1
YES: McCarty, Alanis, Lackey, Stephanie Nguyen, Reyes, Ting, Zbur
ABS, ABST OR NV: Wilson
ASM APPROPRIATIONS: 14-0-1
YES: Wicks, Sanchez, Arambula, Bryan, Calderon, Wendy Carrillo, Dixon, Mike Fong, Grayson, Haney, Hart, Jim Patterson, Pellerin, Ta
ABS, ABST OR NV: Villapudua
UPDATED
VERSION: August 22, 2024
CONSULTANT: Gregory Pagan / PUB. S. / (916) 319-3744, Kimberly Horiuchi / PUB. S. / (916) 319-3744 FN: 0004281
SENATE THIRD READING
STR Bill Id:SB 1317
Author:(Wahab)
As Amended Ver:August 19, 2024
Majority vote
SUMMARY
Extends the sunset date until January 1, 2030 on the provision of law authorizing involuntary medication of county jail inmates who are awaiting arraignment, trial, or sentencing.
Major Provisions
- Extends the sunset date from January 1, 2025 to January 1, 2030 to authorize involuntary medication of county jail inmates, as specified.
- Requires each county that administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing to, by no later than January 1, 2029, prepare and submit a written report about any instances of involuntary medication between January 1, 2025 and July 1, 2028, to the Assembly Committee on Public Safety and the Senate Committee on Public Safety, summarizing all of the following information:
- The number of inmates who were administered involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2025 and July 1, 2028;
- The crime for which each of these inmates was arrested, if it is practically feasible to obtain that information;
- The total time each inmate was detained while awaiting arraignment, trial, or sentencing, if it is practically feasible to obtain that information;
- The duration of the administration of involuntary medication for each inmate;
- The number of times, if any, that each existing order for the administration of involuntary medication was renewed; and,
- The reason that administration of involuntary medication was terminated for each inmate.
- Allow an inmate in a county jail to be involuntarily administered psychiatric medication on a nonemergency basis consistent with the standard of care, and requires the county to submit a declaration under penalty of perjury to the Superior Court demonstrating a documented attempt to locate an available noncustodial bed.
COMMENTS
According to the Author
"Spending time in a county jail is hard on anyone's mental health. But those with truly severe mental health challenges who won't voluntarily accept treatment are at a major risk of deterioration, victimization, or harming themselves or others. They often languish in horrid conditions in their cells, refusing to eat, bathe, or care for themselves. These troubling circumstances reflect the unfortunate reality that has led county jails to serve as de facto mental health institutions. It is a reality that we cannot ignore. To let a person who is gravely disabled or a danger to self or others exist in such conditions is inhumane. In such cases, involuntary medication is a form of harm reduction.
The process to seek a judicial order to administer involuntary medication in county jail settings (Penal Code section 2603) has already been in statute for 12 years. Specifically tailored for county jail settings, it safeguards the rights of those in custody who are in need of psychiatric medication and reduces delays in the delivery of vital treatment. Further, this statutory procedure to authorize involuntary medication – sought only for those individuals whose condition is truly dire and deteriorating – is critical to counties' ability to address the most acute mental health treatment needs of those in local custody. The objective of such an order is to stabilize the individual so that they can participate in their self-care and treatment and move to a less restrictive setting. Without action by this Legislature, the statute will expire on January 1, 2025. SB 1317 extends that sunset date to January 1, 2030, allowing counties to continue using this authority in rare but necessary cases, under appropriate judicial oversight, along with a robust reporting requirements."
Arguments in Support
According to Psychiatric Physicians Alliance of California: With the marked reduction in psychiatric hospital beds in California communities in the last 5 decades, county jails have become the de facto default destination to house untreated, often homeless, mentally ill persons. In a jail setting, many of these inmates who are admitted – often very sick with a mental disorder – become even more delusional, disorganized, and disruptive in confinement. Mentally ill individuals tend to spend much longer in the pretrial process than their peers without mental illness when charged with the same crimes. Many weeks, and more likely months, may pass before adjudication. Many of these inmates refuse to accept medication, in fact are so sick they are not able to recognize they are ill and need help.
Under these circumstances psychotic individuals, for instance, who are delusional and experiencing hallucinations cannot follow correction officer orders, may bang their heads against walls, scream for hours at all hours, or smear feces around their cells. These individuals obtain a significant benefit from medication, but until AB 720 (Eggman, 2017) was these individuals languished for lack of medication unless they accepted them voluntarily. Case law, most recently United States v. Loughner, in the 9th Circuit Court of Appeal (2012), has determined that the same standards for involuntary medication of convicted inmates who are dangerous or gravely disabled because of a mental disorder apply to pretrial detainees who are dangerous or gravely disabled because of a mental disorder. The proposal in AB 1317 guarantees that a vital tool will be continued in a statute which lies squarely within the clearly defined Loughner legal parameters.
Arguments in Opposition
According to the California Public Defenders Association: We share with the author and the sponsor the goal of alleviating our severely mentally ill clients' suffering in the jail. While appreciating the author's willingness to engage with us, we remain concerned because there is no mandatory requirement that any administration and treatment with powerful psychotropic involuntary medication be done utilizing the medical standard of care and that there is no enforcement of the provision that involuntary medication in the jail be a last resort, not a first option. During our discussions with the author for the last three months, we have significantly narrowed our proposed amendments to the following:
(b) If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d). Any such treatment shall be consistent with the standard of care.
(5) The jail has made a documented attempt to locate an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based treatment beds and the inability of many facilities to accept transfers from correctional facilities. It is sufficient for the sheriff or their designee to show due diligence of the attempt to locate an available bed by submitting a declaration under penalty of perjury.
Santa Clara County, the sponsor of SB 1317, has numerous policies and safeguards in place including their own acute mental health facility for jailed individuals. Unfortunately, other counties are not as well-resourced and do not have access to the same level of mental health care for incarcerated individuals. Involuntary Psychiatric Medication: Psychiatric medications can cause significant liver and other organ damage, including increasing the risk of diabetes. When an individual knowingly consents to the use of such medication, they are presented with the risks and benefits. Such is not the case for individuals who are involuntarily medicated.
The Department of State Hospitals facilities routinely monitor individuals with blood tests and other lab tests. Santa Clara County's practice appears to be consistent with the Department of State Hospitals. According to the Santa Clara County Jail Reform website, Santa Clara County responded to recommendations for needed reforms stating that they do the following:
Medications for medical and behavioral health are monitored using lab testing as appropriate to determine levels as per the recommendation of the manufacturer and medical decision making. Voluntary versus involuntary medication use is reviewed on a case by cases basis and is dependent on review by a physician or psychiatrist. https://jailreforms.sccgov.org/summarized-recommendations/inmatehealthcare-hlc#3925188384-4062458531
Community Based or Other Treatment Beds
Again, Santa Clara County has their own treatment facility in the jail. In other counties, such as Contra Costa, the sheriff or county counsel either does not make a robust attempt to find a treatment facility before attempting involuntary medication in the jail or in counties such as Alameda, they transfer the individual to an acute non-carceral county facility. CPDA and our members want the same protections that Santa Clara County affords to its incarcerated severely mentally ill individuals to be extended to all Californians who are incarcerated and subject to involuntary medication orders.
FISCAL COMMENTS
According to the Assembly Appropriations Committee, "Likely nonreimbursable costs to counties that choose to seek and implement involuntary medication orders, and to counties that must report to the Legislature about involuntary medication of county jail inmates awaiting arraignment, trial, or sentencing."
VOTES
SENATE FLOOR: 39-0-1
YES: Allen, Alvarado-Gil, Archuleta, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dahle, Dodd, Durazo, Eggman, Glazer, Gonzalez, Grove, Hurtado, Jones, Laird, Limón, McGuire, Menjivar, Newman, Nguyen, Niello, Ochoa Bogh, Padilla, Portantino, Roth, Rubio, Seyarto, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk
ABS, ABST OR NV: Min
ASM PUBLIC SAFETY: 7-0-1
YES: McCarty, Alanis, Lackey, Stephanie Nguyen, Reyes, Ting, Zbur
ABS, ABST OR NV: Wilson
ASM APPROPRIATIONS: 14-0-1
YES: Wicks, Sanchez, Arambula, Bryan, Calderon, Wendy Carrillo, Dixon, Mike Fong, Grayson, Haney, Hart, Jim Patterson, Pellerin, Ta
ABS, ABST OR NV: Villapudua
UPDATED
VERSION: August 19, 2024
CONSULTANT: Kimberly Horiuchi / PUB. S. / (916) 319-3744 FN: 0003888
SENATE THIRD READING
STR Bill Id:SB 1317
Author:(Wahab)
As Amended Ver:April 23, 2024
Majority vote
SUMMARY
Extends the sunset date until January 1, 2030 on the provision of law authorizing involuntary medication of county jail inmates who are awaiting arraignment, trial, or sentencing.
Major Provisions
- Extends the sunset date from January 1, 2025 to January 1, 2030 to authorize involuntary medication of county jail inmates, as specified.
- Requires each county that administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing to, by no later than January 1, 2029, prepare and submit a written report about any instances of involuntary medication between January 1, 2025 and July 1, 2028, to the Assembly Committee on Public Safety and the Senate Committee on Public Safety, summarizing all of the following information:
- The number of inmates who were administered involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2025 and July 1, 2028;
- The crime for which each of these inmates was arrested, if it is practically feasible to obtain that information;
- The total time each inmate was detained while awaiting arraignment, trial, or sentencing, if it is practically feasible to obtain that information;
- The duration of the administration of involuntary medication for each inmate;
- The number of times, if any, that each existing order for the administration of involuntary medication was renewed; and,
- The reason that administration of involuntary medication was terminated for each inmate.
COMMENTS
According to the Author
"Spending time in a county jail is hard on anyone's mental health. But those with truly severe mental health challenges who won't voluntarily accept treatment are at a major risk of deterioration, victimization, or harming themselves or others. They often languish in horrid conditions in their cells, refusing to eat, bathe, or care for themselves. These troubling circumstances reflect the unfortunate reality that has led county jails to serve as de facto mental health institutions. It is a reality that we cannot ignore. To let a person who is gravely disabled or a danger to self or others exist in such conditions is inhumane. In such cases, involuntary medication is a form of harm reduction.
The process to seek a judicial order to administer involuntary medication in county jail settings (Penal Code section 2603) has already been in statute for 12 years. Specifically tailored for county jail settings, it safeguards the rights of those in custody who are in need of psychiatric medication and reduces delays in the delivery of vital treatment. Further, this statutory procedure to authorize involuntary medication – sought only for those individuals whose condition is truly dire and deteriorating – is critical to counties' ability to address the most acute mental health treatment needs of those in local custody. The objective of such an order is to stabilize the individual so that they can participate in their self-care and treatment and move to a less restrictive setting. Without action by this Legislature, the statute will expire on January 1, 2025. SB 1317 extends that sunset date to January 1, 2030, allowing counties to continue using this authority in rare but necessary cases, under appropriate judicial oversight, along with a robust reporting requirements."
Arguments in Support
According to Psychiatric Physicians Alliance of California: With the marked reduction in psychiatric hospital beds in California communities in the last 5 decades, county jails have become the de facto default destination to house untreated, often homeless, mentally ill persons. In a jail setting, many of these inmates who are admitted – often very sick with a mental disorder – become even more delusional, disorganized, and disruptive in confinement. Mentally ill individuals tend to spend much longer in the pretrial process than their peers without mental illness when charged with the same crimes. Many weeks, and more likely months, may pass before adjudication. Many of these inmates refuse to accept medication, in fact are so sick they are not able to recognize they are ill and need help.
Under these circumstances psychotic individuals, for instance, who are delusional and experiencing hallucinations cannot follow correction officer orders, may bang their heads against walls, scream for hours at all hours, or smear feces around their cells. These individuals obtain a significant benefit from medication, but until AB 720 (Eggman, 2017) was these individuals languished for lack of medication unless they accepted them voluntarily. Case law, most recently United States v. Loughner, in the 9th Circuit Court of Appeal (2012), has determined that the same standards for involuntary medication of convicted inmates who are dangerous or gravely disabled because of a mental disorder apply to pretrial detainees who are dangerous or gravely disabled because of a mental disorder. The proposal in AB 1317 guarantees that a vital tool will be continued in a statute which lies squarely within the clearly defined Loughner legal parameters.
Arguments in Opposition
According to the California Public Defenders Association: We share with the author and the sponsor the goal of alleviating our severely mentally ill clients' suffering in the jail. While appreciating the author's willingness to engage with us, we remain concerned because there is no mandatory requirement that any administration and treatment with powerful psychotropic involuntary medication be done utilizing the medical standard of care and that there is no enforcement of the provision that involuntary medication in the jail be a last resort, not a first option. During our discussions with the author for the last three months, we have significantly narrowed our proposed amendments to the following:
(b) If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d). Any such treatment shall be consistent with the standard of care.
(5) The jail has made a documented attempt to locate an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based treatment beds and the inability of many facilities to accept transfers from correctional facilities. It is sufficient for the sheriff or their designee to show due diligence of the attempt to locate an available bed by submitting a declaration under penalty of perjury.
Santa Clara County, the sponsor of SB 1317, has numerous policies and safeguards in place including their own acute mental health facility for jailed individuals. Unfortunately, other counties are not as well-resourced and do not have access to the same level of mental health care for incarcerated individuals. Involuntary Psychiatric Medication: Psychiatric medications can cause significant liver and other organ damage, including increasing the risk of diabetes. When an individual knowingly consents to the use of such medication, they are presented with the risks and benefits. Such is not the case for individuals who are involuntarily medicated.
The Department of State Hospitals facilities routinely monitor individuals with blood tests and other lab tests. Santa Clara County's practice appears to be consistent with the Department of State Hospitals. According to the Santa Clara County Jail Reform website, Santa Clara County responded to recommendations for needed reforms stating that they do the following:
Medications for medical and behavioral health are monitored using lab testing as appropriate to determine levels as per the recommendation of the manufacturer and medical decision making. Voluntary versus involuntary medication use is reviewed on a case by cases basis and is dependent on review by a physician or psychiatrist. https://jailreforms.sccgov.org/summarized-recommendations/inmatehealthcare-hlc#3925188384-4062458531
Community Based or Other Treatment Beds
Again, Santa Clara County has their own treatment facility in the jail. In other counties, such as Contra Costa, the sheriff or county counsel either does not make a robust attempt to find a treatment facility before attempting involuntary medication in the jail or in counties such as Alameda, they transfer the individual to an acute non-carceral county facility. CPDA and our members want the same protections that Santa Clara County affords to its incarcerated severely mentally ill individuals to be extended to all Californians who are incarcerated and subject to involuntary medication orders.
FISCAL COMMENTS
According to the Assembly Appropriations Committee, "Likely nonreimbursable costs to counties that choose to seek and implement involuntary medication orders, and to counties that must report to the Legislature about involuntary medication of county jail inmates awaiting arraignment, trial, or sentencing."
VOTES
SENATE FLOOR: 39-0-1
YES: Allen, Alvarado-Gil, Archuleta, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dahle, Dodd, Durazo, Eggman, Glazer, Gonzalez, Grove, Hurtado, Jones, Laird, Limón, McGuire, Menjivar, Newman, Nguyen, Niello, Ochoa Bogh, Padilla, Portantino, Roth, Rubio, Seyarto, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk
ABS, ABST OR NV: Min
ASM PUBLIC SAFETY: 7-0-1
YES: McCarty, Alanis, Lackey, Stephanie Nguyen, Reyes, Ting, Zbur
ABS, ABST OR NV: Wilson
ASM APPROPRIATIONS: 14-0-1
YES: Wicks, Sanchez, Arambula, Bryan, Calderon, Wendy Carrillo, Dixon, Mike Fong, Grayson, Haney, Hart, Jim Patterson, Pellerin, Ta
ABS, ABST OR NV: Villapudua
UPDATED
VERSION: April 23, 2024
CONSULTANT: Kimberly Horiuchi / PUB. S. / (916) 319-3744 FN: 0003902
Date of Hearing: August 7, 2024
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Buffy Wicks, Chair
SBPCA Bill Id:SB 1317
Author:(Wahab) – As Amended Ver:April 23, 2024
Policy Committee: | Public Safety | Vote: | 7 - 0 |
|
| ||
|
|
Urgency: No State Mandated Local Program: Yes Reimbursable: No
SUMMARY:
This bill extends, until January 1, 2030, the sunset date on the statute that authorizes involuntary medication of a county jail inmate.
Specifically, this bill:
- Extends the sunset date, from January 1, 2025, to January 1, 2030, on the statute that authorizes involuntary medication of county jail inmates.
- Requires each county that administers involuntary medication to a county jail inmate who is awaiting arraignment, trial, or sentencing to prepare and submit a written report to the Assembly Committee on Public Safety and the Senate Committee on Public Safety.
FISCAL EFFECT:
Likely nonreimbursable costs to counties that choose to seek and implement involuntary medication orders, and to counties that must report to the Legislature about involuntary medication of county jail inmates awaiting arraignment, trial, or sentencing.
COMMENTS:
This bill is sponsored by the County of Santa Clara. Existing law permits a county to administer psychotropic medication on an involuntary basis to a county jail inmate if a psychiatrist determines that the inmate should be treated with psychiatric medication, the court issues an order authorizing the administration of involuntary medication, and specified procedures are followed. The statute that authorizes administration of involuntary medication for a county jail inmate will sunset on January 1, 2025. According to the bill’s author:
Spending time in a county jail is hard on anyone’s mental health. But those with truly severe mental health challenges who won’t voluntarily accept treatment are at a major risk of deterioration, victimization, or harming themselves or others. They often languish in horrid conditions in their cells, refusing to eat, bathe, or care for themselves. These troubling circumstances reflect the unfortunate reality that has led county jails to serve as de facto mental health institutions. It is a reality that we cannot ignore. To let a person who is gravely disabled or a danger to self or others exist in such conditions is inhumane. In such cases, involuntary medication is a form of harm reduction.
This bill extends the sunset date on the statute authorizing involuntary medication of jail inmates to January 1, 2030. The bill also requires each county that administers involuntary medication to a county jail inmate who is awaiting arraignment, trial, or sentencing to report specified information to the Legislature before January 1, 2029, including the number of such inmates who were administered involuntary medication, the offense for which they were incarcerated, the duration of their incarceration, and the duration of their involuntary medication.
Analysis Prepared by: Annika Carlson / APPR. / (916) 319-2081
Date of Hearing: June 18, 2024
Counsel: Kimberly Horiuchi
ASSEMBLY COMMITTEE ON PUBLIC SAFETY
Kevin McCarty, Chair
SBPCA Bill Id:SB 1317
Author:(Wahab) – As Amended Ver:April 23, 2024
SUMMARY: Extends the sunset date until January 1, 2030 on the provision of law authorizing involuntary medication of county jail inmates who are awaiting arraignment, trial, or sentencing. Specifically, this bill:
- Extends the sunset date from January 1, 2025 to January 1, 2030 to authorize involuntary medication of county jail inmates, as specified.
- Requires each county that administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing to, by no later than January 1, 2029, prepare and submit a written report about any instances of involuntary medication between January 1, 2025 and July 1, 2028, to the Assembly Committee on Public Safety and the Senate Committee on Public Safety, summarizing all of the following information:
- The number of inmates who were administered involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2025 and July 1, 2028;
- The crime for which each of these inmates was arrested, if it is practically feasible to obtain that information;
- The total time each inmate was detained while awaiting arraignment, trial, or sentencing, if it is practically feasible to obtain that information;
- The duration of the administration of involuntary medication for each inmate;
- The number of times, if any, that each existing order for the administration of involuntary medication was renewed; and,
- The reason that administration of involuntary medication was terminated for each inmate.
EXISTING LAW:
- Authorizes, until January 1, 2025, the administration of psychotropic medication on an involuntary basis to county jail inmates who are awaiting arraignment, trial, or sentencing if a psychiatrist determines that the inmate should be treated with psychiatric medication and specified procedures are followed. (Pen. Code, § 2603, subd. (b).)
- Authorizes, until January 1, 2025, the administration of medication without a defendant’s consent on a nonemergency basis only if all of the following conditions have been met:
- A psychiatrist or psychologist determines that the inmate has a serious mental disorder;
- A psychiatrist or psychologist determines, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others;
- A psychiatrist prescribes one or more psychiatric medications for the treatment of the inmate’s disorder, considers the risks, benefits, and treatment alternatives to involuntary medication, and determines that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient;
- Advises the inmate of the risks and benefits of, and treatment alternatives to, the psychiatric medication and refuses, or is unable to consent to, the administration of the medication;
- The jail documents an attempt to locate an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication. The jail transfers that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based beds and the inability of many facilities to accept transfers from correctional facilities;
- Provides the inmate a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified;
- Provides inmate counsel at least 21 days prior to the hearing, unless emergency medication is being administered, in which case the inmate would receive expedited access to counsel;
- Provides the inmate and counsel with written notice of the hearing at least 21 days prior to the hearing, unless emergency medication is being administered, in which case the inmate would receive an expedited hearing;
- In the hearing described in paragraph (f), the superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness, the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmate’s best medical interest;
- The historical course of the inmate’s mental disorder, as determined by available relevant information about the course of the inmate’s mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder; and,
- An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. This paragraph does not prevent a court from reviewing, modifying, or terminating an involuntary medication order for an inmate awaiting trial if there is a showing that the involuntary medication is interfering with the inmate’s due process rights in the criminal proceeding. (Pen. Code, § 2603, subd. (c)(1-8).)
- Provides, until January 1, 2025, that an order by the court authorizing involuntary medication of an inmate awaiting arraignment, trial or sentencing shall be valid for no more than 180 days and the court shall review the order at intervals of not more than 60 days to determine whether the ground for the order remains. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendant’s attorney. (Pen Code, § 2603, subd. (e)(1)(B).)
- States, until January 1, 2025, that in determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendant’s attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order. (Ibid.)
- States, until January 1, 2025, that in the case of an inmate awaiting arraignment, trial, or sentencing, the renewal order shall be valid for no more than 180 days and follows the same requirements in the initial order authorizing involuntary medication. (Pen Code, § 2603, subd. (h)(3)(B).)
- Required each county that administers involuntary medication to an inmate awaiting arraignment, trial, or sentencing to file, by January 1, 2021, a written report to the Senate Committee on Public Safety and the Assembly Committees on Public Safety and Judiciary summarizing the following:
- The number of inmates who received involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2018 and July 1, 2020;
- The crime for which those inmates were arrested;
- The total time those inmates were detained while awaiting arraignment, trial, or sentencing;
- The duration of the administration of involuntary medication;
- The reason for termination of administration of involuntary medication;
- The number of times, if any, that an existing order for the administration of involuntary medication was renewed; and,
- The reason for termination of the administration of involuntary medication. (Pen. Code, §2603, subd. (l).)
- Sunsets the provisions of law authorizing involuntary medication of inmates detained in county jail while awaiting arraignment, trial or sentencing on January 1, 2025.
FISCAL EFFECT: Unknown.
COMMENTS:
- Author's Statement: According to the author, "Spending time in a county jail is hard on anyone’s mental health. But those with truly severe mental health challenges who won’t voluntarily accept treatment are at a major risk of deterioration, victimization, or harming themselves or others. They often languish in horrid conditions in their cells, refusing to eat, bathe, or care for themselves. These troubling circumstances reflect the unfortunate reality that has led county jails to serve as de facto mental health institutions. It is a reality that we cannot ignore. To let a person who is gravely disabled or a danger to self or others exist in such conditions is inhumane. In such cases, involuntary medication is a form of harm reduction.
The process to seek a judicial order to administer involuntary medication in county jail settings (Penal Code section 2603) has already been in statute for 12 years. Specifically tailored for county jail settings, it safeguards the rights of those in custody who are in need of psychiatric medication and reduces delays in the delivery of vital treatment. Further, this statutory procedure to authorize involuntary medication – sought only for those individuals whose condition is truly dire and deteriorating – is critical to counties’ ability to address the most acute mental health treatment needs of those in local custody. The objective of such an order is to stabilize the individual so that they can participate in their self-care and treatment and move to a less restrictive setting. Without action by this Legislature, the statute will expire on January 1, 2025. SB 1317 extends that sunset date to January 1, 2030, allowing counties to continue using this authority in rare but necessary cases, under appropriate judicial oversight, along with a robust reporting requirements.”
- Involuntary Medication: The Lanterman-Petris Short (“LPS”) Act authorizes an involuntary detention for varying lengths of time for the purpose of evaluation and treatment, provided certain requirements are met, such as that an individual is taken to a county-designated facility. Typically, one first interacts with the LPS Act through a “5150” hold initiated by a peace officer or other person authorized by a county, who must determine and document that the individual meets the standard for a 5150 hold. A county-designated facility is authorized to then involuntarily detain an individual for up to 72 hours for evaluation and treatment if they are determined to be, as a result of a mental health disorder, a danger to self or others, or gravely disabled.
The professional person in charge of the county-designated facility is required to assess an individual to determine the appropriateness of the involuntary detention prior to admitting the individual. Subject to various conditions, a person who is found to be a danger to self or others, or gravely disabled, can be subsequently involuntarily detained for an initial up-to 14 days for intensive treatment, an additional 14 days (or up to an additional 30 days in counties that have opted to provide this additional up-to 30 day intensive treatment episode), and ultimately a conservatorship, which is typically for up to a year and may be extended as appropriate.
Throughout this process, existing law requires specified entities to notify family members or others identified by the detained individual of various hearings, where it is determined whether a person will be further detained or released, unless the detained person requests that this information is not provided. Additionally, a person cannot be found to be gravely disabled if they can survive safely without involuntary detention with the help of responsible family, friends, or others who indicate they are both willing and able to help. A person can also be released prior to the end of intensive treatment if they are found to no longer meet the criteria or are prepared to accept treatment voluntarily.
“Involuntary medication” means the administration of any psychiatric medication or drug to a patient by the use of force, discipline, or restraint, including administration upon a patient who lacks capacity to accept or refuse medication. Involuntary psychiatric medications may be utilized after less restrictive non-pharmaceutical alternatives have been deemed unavailable or clinically inappropriate, or in a medical emergency. If psychiatric medication is administered during an emergency, the medication shall only be that which is required to treat the emergency condition and shall be administered for only so long as the emergency exists. (Cal. Code of Regs., tit. 15 § 3999.345, subd. (a)(6).)
- Riese hearings: The Department of Health Care Services (DHCS’s) website includes the handbook “Rights for Individuals in Mental Health Facilities,” which states that a capacity hearing, also called a Riese hearing,[1] may be held to determine whether an individual can refuse treatment with medications. The capacity hearing is conducted by a hearing officer at the facility where the individual is receiving treatment or by a judge.
The hearing officer will determine whether the individual has the capacity to consent to or refuse medication as a form of treatment. An individual’s representative helps them prepare for the hearing and will answer questions or discuss concerns that they may have about the hearing process. If an individual disagrees with the capacity hearing decision, they may appeal the decision to a superior court or to a court of appeal. Their patients’ rights advocate or attorney can assist them with filing an appeal.
The first of these hearings typically occur during the initial 72 hour hold. When a patient’s condition necessitates an additional hold beyond the initial 72 hour and 14 day periods, a certification review hearing is held to determine that the patient still meets the criteria to be held at the beginning of each proposed hold. In addition to a certification review hearing, a new Riese hearing may be held to determine the patient’s incapacity to refuse treatment prior to each new hold. The hearings impacted by this bill are those for an additional 14 day hold, initial up-to 30 day hold, and additional up-to 30 day hold.
Under current law, Riese hearings are required to be heard within 24 hours of the filing of the petition whenever possible. Twenty-four hour delays are permitted if parties need additional time to prepare or to accommodate county policies regarding the scheduling of hearings. However, current law states that hearings cannot be held beyond 72 hours of the filing of the petition.
- Constitutional Issues: In Washington v. Harper, (1990) 494 U.S. 210, the U.S. Supreme Court held that a mentally-ill prisoner who was a danger to themselves or others may be involuntarily medicated. Furthermore, the Court held in Riggins v. Nevada, (1992) 504 U.S. 127 that forced medication to render a defendant competent to stand trial for murder was constitutionally permissible under certain circumstances.
Read together, the Court “indicate(s) that the Constitution permits the Government to involuntarily to administer antipsychotic drugs to a mentally ill defendant facing serious criminal charges in order to render that defendant competent to stand trial, but only if the treatment is medically appropriate, is substantially unlikely to have side effects that may undermine the fairness of the trial, and, talking account of less intrusive alternatives, is necessary significantly to the further important governmental trial-related interests.” (Emphasis added.) (Sell v. United States (2003) 539 U.S. 166, 179.)
In Sell, the Court goes on to state the limited circumstances when the U.S. Constitution permits the government to administer drugs to a pretrial detainee against the mentally ill criminal detainee's will when seeking to render him competent for trial. Under those circumstances, all of the following conditions must apply:
- A court must find that important governmental interests are at stake. While bringing to trial a person accused of a serious crime is an important government interest, and timely prosecution satisfies the literal aspect of this element, that alone does not satisfy the purpose as there may be special circumstances that lessen its importance in a particular case. Consequently, this analysis must be done on a case-by-case basis. (Id. at 180; Carter v. Superior Court (2006) 141 Cal.App.4th 992, 1002.)
- A "court must conclude that involuntary medication will significantly further those concomitant state interests. It must find that administration of the drugs is substantially likely to render the defendant competent to stand trial." (Sell, supra, 539 U.S. at 181.)
- A court must find that the administration of the drugs is "substantially unlikely" to have side effects that interfere significantly with the person's ability to assist his or her counsel in conducting a defense. (Id., citing Riggins v. Nevada (1992) 504 U.S. 127, 142-145.)
- A court must find that involuntary medication is necessary to further those interests and that alternative, less intrusive treatments are unlikely to achieve substantially the same results. (Id.)
- A court must find that administering the medication is medically appropriate, that is to say, in the inmate's best medical interest in light of his or her condition. (Id.)
- A court must find that important governmental interests are at stake. While bringing to trial a person accused of a serious crime is an important government interest, and timely prosecution satisfies the literal aspect of this element, that alone does not satisfy the purpose as there may be special circumstances that lessen its importance in a particular case. Consequently, this analysis must be done on a case-by-case basis. (Id. at 180; Carter v. Superior Court (2006) 141 Cal.App.4th 992, 1002.)
The 9th Circuit Court of Appeal held that the U.S. Supreme Court standard articulated in Harper, supra, also applies to pretrial detainees who are a danger to self or others. (United States v. Loughner, (2012) (9th Cir.) 672 F.3d 731, 750.) The court in Loughner stated, “. . . , we now hold that when the government seeks to medicate a detainee—whether pretrial or post-conviction—on the grounds that he is a danger to himself or others, the government must satisfy the standard set forth in Harper…‘[T]he Due Process Clause permits the State to treat a prison inmate who has a serious mental illness with antipsychotic drugs against his will, if the inmate is dangerous to himself or others and the treatment is in the inmate' s medical interest.’” (Loughner at 752, citing Harper, supra at 227.)
The author may wish to consider whether specification should be included in the bill about ensuring a fidelity to the medical standard of care so inmates are not physically harmed by the medication, and that people are not just warehoused in the county jail because there is no “community based” treatment.
- Argument in Support: According to Psychiatric Physicians Alliance of California: With the marked reduction in psychiatric hospital beds in California communities in the last 5 decades, county jails have become the de facto default destination to house untreated, often homeless, mentally ill persons. In a jail setting, many of these inmates who are admitted – often very sick with a mental disorder – become even more delusional, disorganized, and disruptive in confinement. Mentally ill individuals tend to spend much longer in the pretrial process than their peers without mental illness when charged with the same crimes. Many weeks, and more likely months, may pass before adjudication. Many of these inmates refuse to accept medication, in fact are so sick they are not able to recognize they are ill and need help.
Under these circumstances psychotic individuals, for instance, who are delusional and experiencing hallucinations cannot follow correction officer orders, may bang their heads against walls, scream for hours at all hours, or smear feces around their cells. These individuals obtain a significant benefit from medication, but until AB 720 (Eggman, 2017) was these individuals languished for lack of medication unless they accepted them voluntarily. Case law, most recently United States v. Loughner, in the 9th Circuit Court of Appeal (2012), has determined that the same standards for involuntary medication of convicted inmates who are dangerous or gravely disabled because of a mental disorder apply to pretrial detainees who are dangerous or gravely disabled because of a mental disorder. The proposal in AB 1317 guarantees that a vital tool will be continued in a statute which lies squarely within the clearly defined Loughner legal parameters.
- Argument in Opposition: According to the California Public Defenders Association: We share with the author and the sponsor the goal of alleviating our severely mentally ill clients’ suffering in the jail. While appreciating the author’s willingness to engage with us, we remain concerned because there is no mandatory requirement that any administration and treatment with powerful psychotropic involuntary medication be done utilizing the medical standard of care and that there is no enforcement of the provision that involuntary medication in the jail be a last resort, not a first option. During our discussions with the author for the last three months, we have significantly narrowed our proposed amendments to the following:
(b) If a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication. Treatment may be given on either a nonemergency basis as provided in subdivision (c), or on an emergency or interim basis as provided in subdivision (d). Any such treatment shall be consistent with the standard of care.
(5) The jail has made a documented attempt to locate an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based treatment beds and the inability of many facilities to accept transfers from correctional facilities. It is sufficient for the sheriff or their designee to show due diligence of the attempt to locate an available bed by submitting a declaration under penalty of perjury.
Santa Clara County, the sponsor of SB 1317, has numerous policies and safeguards in place including their own acute mental health facility for jailed individuals. Unfortunately, other counties are not as well-resourced and do not have access to the same level of mental health care for incarcerated individuals. Involuntary Psychiatric Medication: Psychiatric medications can cause significant liver and other organ damage, including increasing the risk of diabetes. When an individual knowingly consents to the use of such medication, they are presented with the risks and benefits. Such is not the case for individuals who are involuntarily medicated.
The Department of State Hospitals facilities routinely monitor individuals with blood tests and other lab tests. Santa Clara County’s practice appears to be consistent with the Department of State Hospitals. According to the Santa Clara County Jail Reform website, Santa Clara County responded to recommendations for needed reforms stating that they do the following:
Medications for medical and behavioral health are monitored using lab testing as appropriate to determine levels as per the recommendation of the manufacturer and medical decision making. Voluntary versus involuntary medication use is reviewed on a case by cases basis and is dependent on review by a physician or psychiatrist. https://jailreforms.sccgov.org/summarized-recommendations/inmatehealthcare-hlc#3925188384-4062458531
Community Based or Other Treatment Beds
Again, Santa Clara County has their own treatment facility in the jail. In other counties, such as Contra Costa, the sheriff or county counsel either does not make a robust attempt to find a treatment facility before attempting involuntary medication in the jail or in counties such as Alameda, they transfer the individual to an acute non-carceral county facility. CPDA and our members want the same protections that Santa Clara County affords to its incarcerated severely mentally ill individuals to be extended to all Californians who are incarcerated and subject to involuntary medication orders.
- Related Legislation:
- AB 2547 (Ta) requires a court to conduct a hearing on a defendant’s eligibility for mental health diversion when they are declared incompetent to stand trial (IST) and charged with a misdemeanor. AB 2547 failed passage in this committee.
- AB 2692 (Papan), specifies that the diversion period for an IST defendant commences when the defendant is admitted to receive treatment, as specified. AB 2692 is pending in the Senate Committee on Public Safety.
- SB 1323 (Menjivar), would require the court, upon a finding a defendant charged with a felony IST, to determine if it is in the interests of justice to restore the defendant to competence, and if the restoration of the defendant’s mental competence is not in the interests of justice, to hold a hearing to consider granting mental health diversion or other programs to the defendant, as specified, and, if none of those solutions are appropriate, to dismiss the charges against the defendant. SB 1323 is pending in this committee.
- SB 1400 (Stern), removes, for misdemeanor IST proceedings, the option for the court to dismiss the case and would instead require the court to hold a hearing to determine if the defendant is eligible for diversion. SB 1400 is pending in this committee.
- AB 2547 (Ta) requires a court to conduct a hearing on a defendant’s eligibility for mental health diversion when they are declared incompetent to stand trial (IST) and charged with a misdemeanor. AB 2547 failed passage in this committee.
- Prior Legislation:
- AB 720 (Eggman), Chapter 347, Statutes of 2017, applies the existing framework for involuntary medication of a person in county jail after being sentenced on a criminal conviction, to all inmates in county jail
- AB 1907 (Lowenthal), Chapter 814, Statutes of 2012, created the involuntary medication statute for inmates.
- AB 1114 (Lowenthal), Chapter 665, Statutes of 2011, changed the procedures for involuntary medication of inmates in CDCR.
- AB 2380 (Dymally), of the 2005-06 Legislative Session, would have clarified that “treatment” for medically disordered offenders paroled to other facilities for treatment includes involuntary medication. AB 2380 failed passage in Public Safety Committee.
- AB 720 (Eggman), Chapter 347, Statutes of 2017, applies the existing framework for involuntary medication of a person in county jail after being sentenced on a criminal conviction, to all inmates in county jail
REGISTERED SUPPORT / OPPOSITION:
Support
Alameda County Families Advocating for The Seriously Mentally Ill
County of Los Angeles Board of Supervisors
County of Santa Clara
Los Angeles County Professional Peace Officers Association
Psychiatric Physicians Alliance of California (PPAC)
Steinberg Institute
Opposition
California Public Defenders Association
Analysis Prepared by: Kimberly Horiuchi / PUB. S. / (916) 319-3744
Riese hearings get their name from Riese v. St. Mary's Hospital & Medical Center (1987) 209 Cal.App.3d 1303, 1320. In Riese, the Court held “absent a judicial determination of incompetence, antipsychotic drugs cannot be administered to involuntarily committed mental patients in nonemergency situations without their informed consent.” Accordingly, administering psychotropic medication requires a significant amount of due process to ensure a person’s basic human dignity are protected. ↑
SENATE RULES COMMITTEE Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | SB 1317 |
THIRD READING
Bill No: SB 1317
Author: Wahab (D), et al.
Amended: 4/23/24
Vote: 21
SENATE PUBLIC SAFETY COMMITTEE: 5-0, 4/16/24
AYES: Wahab, Seyarto, Bradford, Skinner, Wiener
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
SUBJECT: Inmates: psychiatric medication: informed consent
SOURCE: County of Santa Clara
DIGEST:
This bill extends the sunset date until January 1, 2030 on the provision of law authorizing involuntary medication of county jail inmates who are awaiting arraignment, trial or sentencing.
ANALYSIS:
Existing law:
- Authorizes, until January 1, 2025, the administration of psychotropic medication on an involuntary basis to county jail inmates who are awaiting arraignment, trial, or sentencing if a psychiatrist determines that the inmate should be treated with psychiatric medication and specified procedures are followed. (Pen. Code, § 2603, subd. (b).)
- Authorizes, until January 1, 2025, the administration of medication without a defendant’s consent on a nonemergency basis only if all of the following conditions have been met:
- A psychiatrist or psychologist determines that the inmate has a serious mental disorder;
- A psychiatrist or psychologist determines, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others;
- A psychiatrist prescribes one or more psychiatric medications for the treatment of the inmate’s disorder, considers the risks, benefits, and treatment alternatives to involuntary medication, and determines that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient;
- Advises the inmate of the risks and benefits of, and treatment alternatives to, the psychiatric medication and refuses, or is unable to consent to, the administration of the medication;
- The jail documents an attempt to locate an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication. The jail transfers that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based beds and the inability of many facilities to accept transfers from correctional facilities;
- Provides the inmate a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified;
- Provides inmate counsel at least 21 days prior to the hearing, unless emergency medication is being administered, in which case the inmate would receive expedited access to counsel;
- Provides the inmate and counsel with written notice of the hearing at least 21 days prior to the hearing, unless emergency medication is being administered, in which case the inmate would receive an expedited hearing;
- In the hearing described in paragraph (6), the superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness, the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmate’s best medical interest;
- The historical course of the inmate’s mental disorder, as determined by available relevant information about the course of the inmate’s mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder; and,
- An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. This paragraph does not prevent a court from reviewing, modifying, or terminating an involuntary medication order for an inmate awaiting trial if there is a showing that the involuntary medication is interfering with the inmate’s due process rights in the criminal proceeding. (Pen. Code, § 2603, subd. (c).)
- Provides, until January 1, 2025, that an order by the court authorizing involuntary medication of an inmate awaiting arraignment, trial or sentencing shall be valid for no more than 180 days and the court shall review the order at intervals of not more than 60 days to determine whether the ground for the order remains. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendant’s attorney. (Pen Code, § 2603, subd. (e)(1)(B).)
- States, until January 1, 2025, that in determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendant’s attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order. (Ibid.)
- States, until January 1, 2025, that in the case of an inmate awaiting arraignment, trial, or sentencing, the renewal order shall be valid for no more than 180 days and follows the same requirements in the initial order authorizing involuntary medication. (Pen Code, § 2603, subd. (h)(3)(B).)
- Required each county that administers involuntary medication to an inmate awaiting arraignment, trial, or sentencing to file, by January 1, 2021, a written report to the Senate Committee on Public Safety and the Assembly Committees on Public Safety and Judiciary summarizing the following:
- The number of inmates who received involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2018 and July 1, 2020;
- The crime for which those inmates were arrested;
- The total time those inmates were detained while awaiting arraignment, trial, or sentencing;
- The duration of the administration of involuntary medication;
- The reason for termination of administration of involuntary medication;
- The number of times, if any, that an existing order for the administration of involuntary medication was renewed; and,
- The reason for termination of the administration of involuntary medication. (Pen. Code, §2603, subd. (l).)
- Sunsets the provisions of law authorizing involuntary medication of inmates detained in county jail while awaiting arraignment, trial or sentencing on January 1, 2025.
This bill:
- Extends the operational date on the provisions of law authorizing involuntary medication of inmates detained in county jail while awaiting arraignment, trial or sentencing until January 1, 2030.
- Requires each county that, between January 1, 2025 and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, by no later than January 1, 2029, prepare and submit a written report to the Assembly Committee on Public Safety and the Senate Committee on Public Safety, summarizing all of the following information:
- The number of inmates who were administered involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2025 and July 1, 2028;
- The crime for which each of these inmates was arrested, if it is practically feasible to obtain that information;
- The total time each inmate was detained while awaiting arraignment, trial, or sentencing, if it is practically feasible to obtain that information;
- The duration of the administration of involuntary medication for each inmate;
- The number of times, if any, that each existing order for the administration of involuntary medication was renewed; and,
- The reason that administration of involuntary medication was terminated for each inmate.
Comments
According to the author of this bill:
Spending time in a county jail is hard on anyone’s mental health. But those with truly severe mental health challenges who won’t voluntarily accept treatment are at a major risk of deterioration, victimization, or harming themselves or others. They often languish in horrid conditions in their cells, refusing to eat, bathe, or care for themselves. These troubling circumstances reflect the unfortunate reality that have led county jails to serve as de facto mental health institutions. It is a reality that we cannot ignore. To let a person who is gravely disabled or a danger to self or others exist in such conditions is inhumane. In such cases, involuntary medication is a form of harm reduction. The process to seek a judicial order to administer involuntary medication in county jail settings (Penal Code section 2603) has already been in statute for 12 years. Specifically tailored for county jail settings, it safeguards the rights of those in custody who are in need of psychiatric medication and reduces delays in the delivery of vital treatment. Further, this statutory procedure to authorize involuntary medication – sought only for those individuals whose condition is truly dire and deteriorating – is critical to counties’ ability to address the most acute mental health treatment needs of those in local custody. Without action by this Legislature, the statute will expire on January 1, 2025.
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: Yes
SUPPORT: (Verified 5/14/24)
County of Santa Clara (source)
California State Association of Psychiatrists
California State Sheriffs’ Association
Los Angeles County Sheriff’s Department
Steinberg Institute
OPPOSITION: (Verified 5/14/24)
None received
ARGUMENTS IN SUPPORT: According to the Steinberg Institute:
Existing law authorizes psychiatrists in county jails to obtain an involuntary psychiatric medication order for persons in custody who are a danger to themselves, a danger to others, or suffering from grave disability. To ensure due process, state law also sets forth the procedures and timelines for providing notice, legal counsel, and judicial review of such orders. Current law is set to sunset at the end of this year.
This law has been critical in enabling counties’ to address the needs of those in county jails with the most severe mental health treatment needs. Involuntary administration of medication is a drastic measure of last resort sought by Custody Health psychiatrists only for those individuals whose condition is truly dire and deteriorating.
Prepared by: Stella Choe / PUB. S. /
5/14/24 15:06:54
**** END ****
SENATE RULES COMMITTEE Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | SB 1317 |
THIRD READING
Bill No: SB 1317
Author: Wahab (D), et al.
Introduced: 2/16/24
Vote: 21
SENATE PUBLIC SAFETY COMMITTEE: 5-0, 4/16/24
AYES: Wahab, Seyarto, Bradford, Skinner, Wiener
SUBJECT: Inmates: psychiatric medication: informed consent
SOURCE: Santa Clara County
DIGEST:
This bill extends the sunset date until January 1, 2030 on the provision of law authorizing involuntary medication of county jail inmates who are awaiting arraignment, trial or sentencing.
ANALYSIS:
Existing law:
- Authorizes, until January 1, 2025, the administration of psychotropic medication on an involuntary basis to county jail inmates who are awaiting arraignment, trial, or sentencing if a psychiatrist determines that the inmate should be treated with psychiatric medication and specified procedures are followed. (Pen. Code, § 2603, subd. (b).)
- Authorizes, until January 1, 2025, the administration of medication without a defendant’s consent on a nonemergency basis only if all of the following conditions have been met:
- A psychiatrist or psychologist has determined that the inmate has a serious mental disorder;
- A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others;
- A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmate’s disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient;
- The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication and refuses, or is unable to consent to, the administration of the medication;
- The jail has made a documented attempt to locate an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based beds and the inability of many facilities to accept transfers from correctional facilities;
- The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified;
- The inmate is provided counsel at least 21 days prior to the hearing, unless emergency medication is being administered, in which case the inmate would receive expedited access to counsel;
- The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency medication is being administered, in which case the inmate would receive an expedited hearing;
- In the hearing described in paragraph 6), the superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness, the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmate’s best medical interest;
- The historical course of the inmate’s mental disorder, as determined by available relevant information about the course of the inmate’s mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder; and,
- An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. This paragraph does not prevent a court from reviewing, modifying, or terminating an involuntary medication order for an inmate awaiting trial if there is a showing that the involuntary medication is interfering with the inmate’s due process rights in the criminal proceeding. (Pen. Code, § 2603, subd. (c).)
- Provides, until January 1, 2025, that an order by the court authorizing involuntary medication of an inmate awaiting arraignment, trial or sentencing shall be valid for no more than 180 days and the court shall review the order at intervals of not more than 60 days to determine whether the ground for the order remains. At each review, the psychiatrist shall file an affidavit with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendant’s attorney. (Pen Code, § 2603, subd. (e)(1)(B).)
- States, until January 1, 2025, that in determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendant’s attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order. (Ibid.)
- States, until January 1, 2025, that in the case of an inmate awaiting arraignment, trial, or sentencing, the renewal order shall be valid for no more than 180 days and follows the same requirements in the initial order authorizing involuntary medication. (Pen Code, § 2603, subd. (h)(3)(B).)
- Required each county that administers involuntary medication to an inmate awaiting arraignment, trial, or sentencing to file, by January 1, 2021, a written report to the Senate Committee on Public Safety and the Assembly Committees on Public Safety and Judiciary summarizing the following:
- The number of inmates who received involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2018 and July 1, 2020;
- The crime for which those inmates were arrested;
- The total time those inmates were detained while awaiting arraignment, trial, or sentencing;
- The duration of the administration of involuntary medication;
- The reason for termination of administration of involuntary medication;
- The number of times, if any, that an existing order for the administration of involuntary medication was renewed; and,
- The reason for termination of the administration of involuntary medication. (Pen. Code, §2603, subd. (l).)
- Sunsets the provisions of law authorizing involuntary medication of inmates detained in county jail while awaiting arraignment, trial or sentencing on January 1, 2025.
This bill:
- Extends the operational date on the provisions of law authorizing involuntary medication of inmates detained in county jail while awaiting arraignment, trial or sentencing until January 1, 2030.
- Requires each county that, between January 1, 2025 and July 1, 2028, administers involuntary medication to any inmate awaiting arraignment, trial, or sentencing, by no later than January 1, 2029, prepare and submit a written report to the Assembly Public Safety Committee and the Senate Public Safety Committee, summarizing all of the following information:
- The number of inmates who were administered involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2025 and July 1, 2028;
- The crime for which each of these inmates was arrested, if it is practically feasible to obtain that information;
- The total time each inmate was detained while awaiting arraignment, trial, or sentencing, if it is practically feasible to obtain that information;
- The duration of the administration of involuntary medication for each inmate;
- The number of times, if any, that each existing order for the administration of involuntary medication was renewed; and,
- The reason that administration of involuntary medication was terminated for each inmate.
Comments
According to the author of this bill:
Spending time in a county jail is hard on anyone’s mental health. But those with truly severe mental health challenges who won’t voluntarily accept treatment are at a major risk of deterioration, victimization, or harming themselves or others. They often languish in horrid conditions in their cells, refusing to eat, bathe, or care for themselves. These troubling circumstances reflect the unfortunate reality that have led county jails to serve as de facto mental health institutions. It is a reality that we cannot ignore. To let a person who is gravely disabled or a danger to self or others exist in such conditions is inhumane. In such cases, involuntary medication is a form of harm reduction. The process to seek a judicial order to administer involuntary medication in county jail settings (Penal Code section 2603) has already been in statute for 12 years. Specifically tailored for county jail settings, it safeguards the rights of those in custody who are in need of psychiatric medication and reduces delays in the delivery of vital treatment. Further, this statutory procedure to authorize involuntary medication – sought only for those individuals whose condition is truly dire and deteriorating – is critical to counties’ ability to address the most acute mental health treatment needs of those in local custody. Without action by this Legislature, the statute will expire on January 1, 2025.
FISCAL EFFECT: Appropriation: No Fiscal Com.: No Local: No
SUPPORT: (Verified 4/22/24)
Santa Clara County (source)
California State Association of Psychiatrists
California State Sheriffs’ Association
Los Angeles County Sheriff’s Department
Steinberg Institute
OPPOSITION: (Verified 4/22/24)
None received
ARGUMENTS IN SUPPORT: According to the Steinberg Institute:
Existing law authorizes psychiatrists in county jails to obtain an involuntary psychiatric medication order for persons in custody who are a danger to themselves, a danger to others, or suffering from grave disability. To ensure due process, state law also sets forth the procedures and timelines for providing notice, legal counsel, and judicial review of such orders. Current law is set to sunset at the end of this year.
This law has been critical in enabling counties’ to address the needs of those in county jails with the most severe mental health treatment needs. Involuntary administration of medication is a drastic measure of last resort sought by Custody Health psychiatrists only for those individuals whose condition is truly dire and deteriorating.
Prepared by: Stella Choe / PUB. S. /
4/23/24 10:01:34
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SENATE COMMITTEE ON PUBLIC SAFETY
Senator Aisha Wahab, Chair
2023 - 2024 Regular
Bill No: SB 1317 Hearing Date: April 16, 2024
Author: | Wahab | ||
Version: | February 16, 2024 | ||
Urgency: | No | Fiscal: | No |
Consultant: | SC | ||
Subject: Inmates: psychiatric medication: informed consent
HISTORY
Source: Santa Clara County
Prior Legislation: SB 827 (Committee on Public Safety), Ch. 434, Stats. 2021
AB 720 (Eggman), Ch. 347, Stats. 2017
AB 1907 (Lowenthal), Ch. 814, Stats. 2012
Support: California State Association of Psychiatrists; California State Sheriffs’ Association; Los Angeles County Sheriffs’ Department; Steinberg Institute
Opposition: None known
PURPOSE
The purpose of this bill is to remove the sunset on the provision of law authorizing involuntary medication of county jail inmates who are awaiting arraignment, trial or sentencing.
Existing law, until January 1, 2025, authorizes the administration of psychotropic medication on an involuntary basis to county jail inmates who are awaiting arraignment, trial, or sentencing if a psychiatrist determines that the inmate should be treated with psychiatric medication and specified procedures are followed. (Pen. Code, § 2603, subd. (b).)
Existing law, until January 1, 2025, authorizes the administration of medication without a defendant’s consent on a nonemergency basis only if all of the following conditions have been met:
- A psychiatrist or psychologist has determined that the inmate has a serious mental disorder;
- A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others;
- A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmate’s disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient;
- The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication and refuses, or is unable to consent to, the administration of the medication;
- The jail has made a documented attempt to locate an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based beds and the inability of many facilities to accept transfers from correctional facilities;
- The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified;
- The inmate is provided counsel at least 21 days prior to the hearing, unless emergency medication is being administered, in which case the inmate would receive expedited access to counsel;
- The inmate and counsel are provided with written notice of the hearing at least 21 days prior to the hearing, unless emergency medication is being administered, in which case the inmate would receive an expedited hearing;
- In the hearing described in paragraph (6), the superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder, that as a result of that illness, the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmate’s best medical interest;
- The historical course of the inmate’s mental disorder, as determined by available relevant information about the course of the inmate’s mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder; and,
- An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. This paragraph does not prevent a court from reviewing, modifying, or terminating an involuntary medication order for an inmate awaiting trial if there is a showing that the involuntary medication is interfering with the inmate’s due process rights in the criminal proceeding. (Pen. Code, § 2603, subd. (c).)
Existing law, until January 1, 2025, provides that an order by the court authorizing involuntary medication of an inmate awaiting arraignment, trial or sentencing shall be valid for no more than 180 days and the court shall review the order at intervals of not more than 60 days to determine whether the ground for the order remains. At each review, the psychiatrist shall file an affidavit
with the court that ordered the involuntary medication affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. A copy of the affidavit shall be provided to the defendant and the defendant’s attorney. (Pen Code, § 2603, subd. (e)(1)(B).)
Existing law, until January 1, 2025, states that in determining whether the criteria for involuntary medication still exist, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendant’s attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order. (Ibid.)
Existing law, until January 1, 2025, states that in the case of an inmate awaiting arraignment, trial, or sentencing, the renewal order shall be valid for no more than 180 days and follows the same requirements in the initial order authorizing involuntary medication. (Pen Code, § 2603, subd. (h)(3)(B).)
Existing law, until January 1, 2025, required each county that administers involuntary medication to an inmate awaiting arraignment, trial, or sentencing to file, by January 1, 2021, a written report to the Senate Committee on Public Safety and the Assembly Committees on Public Safety and Judiciary summarizing the following:
- The number of inmates who received involuntary medication while awaiting arraignment, trial, or sentencing between January 1, 2018 and July 1, 2020;
- The crime for which those inmates were arrested;
- The total time those inmates were detained while awaiting arraignment, trial, or sentencing;
- The duration of the administration of involuntary medication;
- The reason for termination of administration of involuntary medication;
- The number of times, if any, that an existing order for the administration of involuntary medication was renewed; and,
- The reason for termination of the administration of involuntary medication. (Pen. Code, §2603, subd. (l).
Existing law sunsets the provisions authorizing involuntary medication of inmates detained in county jail while awaiting arraignment, trial or sentencing on January 1, 2025.
This bill removes the sunset date and deletes the lapsed reporting requirement.
COMMENTS
- Need for This Bill
According to the author of this bill:
Spending time in a county jail is hard on anyone’s mental health. But those with truly severe mental health challenges who won’t voluntarily accept treatment are at a major risk of deterioration, victimization, or harming themselves or others. They often languish in horrid conditions in their cells, refusing to eat, bathe, or care for themselves. These troubling circumstances reflect the unfortunate reality that have led county jails to serve as de facto mental health institutions. It is a reality that we cannot ignore. To let a person who is gravely disabled or a danger to self or others exist in such conditions is inhumane. In such cases, involuntary medication is a form of harm reduction. The process to seek a judicial order to administer involuntary medication in county jail settings (Penal Code section 2603) has already been in statute for 12 years. Specifically tailored for county jail settings, it safeguards the rights of those in custody who are in need of psychiatric medication and reduces delays in the delivery of vital treatment. Further, this statutory procedure to authorize involuntary medication – sought only for those individuals whose condition is truly dire and deteriorating – is critical to counties’ ability to address the most acute mental health treatment needs of those in local custody. Without action by this Legislature, the statute will expire on January 1, 2025.
- Relevant Case Law
In Washington v. Harper, (1990) 494 U.S. 210, the U.S. Supreme Court held that a mentally-ill prisoner who is a danger to themselves or others can be involuntarily medicated. Furthermore, the Court held in Riggins v. Nevada, (1992) 504 U.S. 127, that forced medication in order to render a defendant competent to stand trial for murder was constitutionally permissible under certain circumstances. Read together, the Court has stated that these two cases "indicate that the Constitution permits the Government to involuntarily administer antipsychotic drugs to a mentally ill defendant facing serious criminal charges in order to render that defendant competent to stand trial, but only if the treatment is medically appropriate, is substantially unlikely to have side effects that may undermine the fairness of the trial, and, taking account of less intrusive alternatives, is significantly necessary to the further important governmental trial-related interests." (Sell v. United States (2003) 539 U.S. 166, 179.)
In Sell, the Court goes on to further specify the limited circumstances when the U.S. Constitution permits the government to administer drugs to a pretrial detainee against the mentally ill criminal detainee's will when seeking to render them competent for trial.
The 9th Circuit Court of Appeal, in United States v. Loughner, (2012) (9th Cir.) 672 F.3d 731, considered the following issue: what substantive due process standard must the government satisfy to medicate involuntarily a pretrial detainee on the ground that they are dangerous? The court differentiated between Harper and Sell, stating that the standard that applies depends on the purpose of the involuntary medication:
If the government seeks to medicate involuntarily a pretrial detainee on trial competency grounds, that is a matter of trial administration and the heightened standard announced in Sell applies. See Sell, 539 U.S. at 183. When dangerousness is a basis for the involuntary medication, however . . . , the concerns are the orderly administration of the prison and the inmate’s medical interests. See Harper, 494 U.S. at 222-25; citations omitted.
The Loughner court stated, “. . . , we now hold that when the government seeks to medicate a detainee—whether pretrial or post-conviction—on the grounds that he is a danger to himself or others, the government must satisfy the standard set forth in Harper. ‘[T]he Due Process Clause permits the State to treat a prison inmate who has a serious mental illness with antipsychotic drugs against their will, if the inmate is dangerous to themselves or others and the treatment is in the inmate's medical interest." (Loughner, supra, 672 F.3d at 752 (citing Harper, supra at 227.)
- Involuntary Medication of County Jail Inmates
County jails house inmates that have already been through the criminal process and have been sentenced, and they also house individuals who are detained in jail while they face criminal charges. In 2012, the Legislature enacted law providing procedures for involuntary medication which specifically applied to the portion of the county jail population that have been sentenced to imprisonment in the county jail. (AB 1907 (Lowenthal), chapter 814, statutes of 2012.) In 2017, The Legislature extended the involuntary medication procedure to inmates confined in county jail but not yet sentenced, including, but not limited to, a person housed in a county jail during or awaiting trial proceedings, a person who has been booked into a county jail and is awaiting arraignment, transfer, or release. (AB 720 (Eggman), chapter 347, statutes of 2017.)
Generally, an inmate confined in a county jail shall not be administered any psychiatric medication without their prior informed consent. (Pen. Code, § 2603, subd. (a).) However, if a psychiatrist determines that an inmate should be treated with psychiatric medication, but the inmate does not consent, the inmate may be involuntarily treated with the medication, either on an emergency basis or nonemergency basis as specified in the law. (Pen. Code, § 2603, subd. (b).) Emergency medication requires a showing that there is a sudden and marked change in an inmate’s mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others and it is impractical, due to the seriousness of the emergency, to first obtain informed consent. (Pen. Code, § 2603, subd. (d).) The initial authorization period for medication in an emergency is 72 hours. (Ibid.)
For nonemergency involuntary medication of a county jail inmate, if a psychiatrist determines that an inmate should be treated with psychiatric medication, involuntary psychiatric medication may be administered if the following conditions are met:
- A psychiatrist or psychologist has determined that the inmate has a serious mental disorder;
- A psychiatrist or psychologist has determined that, as a result of that mental disorder, the inmate is gravely disabled and does not have the capacity to refuse treatment with psychiatric medications, or is a danger to self or others;
- A psychiatrist has prescribed one or more psychiatric medications for the treatment of the inmate’s disorder, has considered the risks, benefits, and treatment alternatives to involuntary medication, and has determined that the treatment alternatives to involuntary medication are unlikely to meet the needs of the patient;
- The inmate has been advised of the risks and benefits of, and treatment alternatives to, the psychiatric medication and refuses, or is unable to consent to, the administration of the medication;
- The jail has made a documented attempt to locate an available bed for the inmate in a community-based treatment facility in lieu of seeking to administer involuntary medication. The jail shall transfer that inmate to such a facility only if the facility can provide care for the mental health needs, and the physical health needs, if any, of the inmate and upon the agreement of the facility. In enacting the act that added this paragraph, it is the intent of the Legislature to recognize the lack of community-based beds and the inability of many facilities to accept transfers from correctional facilities;
- The inmate is provided a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer, as specified;
- The inmate is provided counsel at least 21 days prior to the hearing, unless emergency or interim medication is being administered, in which case the inmate is to receive expedited access to counsel. If the inmate is awaiting arraignment, the inmate shall be provided counsel within 48 hours of the filing of the notice of the hearing with the superior court, unless counsel has previously been appointed, and the hearing shall be held no more than 30 days after the filing of the notice with the superior court, unless the date is extended;
- The inmate and counsel are provided with written notice, containing specified information; of the hearing at least 21 days prior to the hearing, unless it is an emergency basis, in which the inmate shall get an expedited hearing;
- At the hearing, the judge, court-appointed commissioner or referee, or a court-appointed hearing officer determines by clear and convincing evidence that the inmate has a mental illness or disorder and due to the illness the inmate is gravely disabled and lacks the capacity to consent to or refuse treatment with psychiatric medications or is a danger to self or others if not medicated, that there is no less intrusive alternative to involuntary medication, and that the medication is in the inmate’s best medical interest, as specified;
- The historical course of the inmate’s mental disorder, as determined by available relevant information about the course of the inmate’s mental disorder, shall be considered when it has direct bearing on the determination of whether the inmate is a danger to self or others, or is gravely disabled and incompetent to refuse medication as the result of a mental disorder; and,
- An inmate is entitled to file one motion for reconsideration following a determination that they may receive involuntary medication, and may seek a hearing to present new evidence, upon good cause shown. A court is not prevented from reviewing, modifying, or terminating an involuntary medication order for an inmate awaiting trial, trial if there is a showing that the involuntary medication is interfering with the inmate’s due process rights in the criminal proceeding. (Pen. Code, § 2603, subd. (c)(1)-(11).)
The law provides that in the case of an inmate awaiting arraignment, trial or sentencing, the involuntary medication order shall be valid for no more than 180 days. The court is required to review the order at intervals of not more than 60 days to determine whether grounds for the order remain. At each review, the psychiatrist is required to file an affidavit with the court affirming that the person who is the subject of the order continues to meet the criteria for involuntary medication. In making its decision, the court is required to consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the defendant’s attorney. The court may also require the testimony from the psychiatrist, if necessary. The court, at each review, may continue the order authorizing involuntary medication, vacate the order, or make any other appropriate order. (Pen. Code, § 2603, subd. (e)(1).)
When the provisions authorizing involuntary medication of pretrial inmates was first enacted, the Legislature put in a sunset date of January 1, 2022 and required each county that administers medication to this population to submit a written report containing specified information to the Legislature no later than January 1, 2021. In 2021, the Legislature extended the sunset date until January 1, 2025. However, the reporting requirement was not extended. To date, the committee has not received data from the counties that administers involuntary medication to the county jail pretrial population. It is unclear which counties are currently using the involuntary medication procedure for pretrial inmates and when they started using this procedure. At least one county has indicated that they started using the procedure after the reporting deadline had lapsed. The committee has also been informed that some counties cannot easily access information regarding the crime for which the inmate was arrested and the total time the inmate was detained while awaiting arraignment, trial, or sentencing.
- Amendments to be Adopted in Committee
The author intends to amend this bill to renew the reporting requirement with additional language to clarify that for information about the crime for which the inmate was arrested and the total time the inmate was detained pretrial, the counties shall include in their report if practically feasible. The amendments would also add in a sunset date of 5 years on the operation of its provisions to allow the Legislature to review the data reported by counties.
- Argument in Support
According to the Steinberg Institute:
Existing law authorizes psychiatrists in county jails to obtain an involuntary psychiatric medication order for persons in custody who are a danger to themselves, a danger to others, or suffering from grave disability. To ensure due process, state law also sets forth the procedures and timelines for providing notice, legal counsel, and judicial review of such orders. Current law is set to sunset at the end of this year.
This law has been critical in enabling counties’ to address the needs of those in county jails with the most severe mental health treatment needs. Involuntary administration of medication is a drastic measure of last resort sought by Custody Health psychiatrists only for those individuals whose condition is truly dire and deteriorating.
-- END –
Bill Author
Bill Co-Author(s):
