State Hospital Safety Bill Moves Ahead in Sacramento

SACRAMENTO -- The Assembly Committee on Public Safety voted unanimously today to approve AB 366, a bill by (D – Santa Rosa) to address safety issues at state hospitals. 

Allen, a former psychiatric registered nurse who chairs the Assembly Select Committee on State Hospital Safety, is one of several lawmakers pushing for changes to enhance safety and security at the hospitals. 

In his testimony before the committee, Allen said “the recent tragic last October at and the of another employee just six week later at the same facility, have highlighted the inherent and increasing danger for both patients and staff at our state hospitals and psychiatric facilities.”

A joint study by the University of California, Davis and Napa State Hospital revealed that in 2010 there were over 8,300 aggressive incidents at the five state hospitals and over 5,100 injuries to patients and staff including one staff death which translates into 23 assaults and 14 injuries per day.

“From a workers’ compensation perspective, this translates into nearly 800 staff injuries and over 20,000 missed work days at Napa State Hospital alone over the last two years,” Allen said. “And while we cannot attribute all of the injuries to workplace assaults, data does show that as the number of assaults has increased so has the number of workers’ comp claims.”

The increase in those claims has led to an increase in overtime costs for the California Department of Mental Health, which must ensure that federal and state required staff ratios are met. In fact, since the 2003-04 fiscal year, DMH has spent over $311 million in overtime compensation, and overtime has increased from approximately $41 million to $101 million annually. 

“But the need for this bill is not simply about the money,” Allen testified. “This is about creating a safer environment for patients and staff, one that they both expect and deserve. To do that we must make changes to the security infrastructure of the various facilities and provide the necessary tools for effective medical treatment.” 

AB 366 makes state hospitals safer for patients and staff by improving the current involuntary medication process to eliminate significant gaps in necessary treatment for patients deemed incompetent to stand trial (IST) and committed to state hospitals who have demonstrated that they are a danger to themselves or others. 

AB 366 requires a judge to determine if a defendant lacks the capacity to make decisions regarding antipsychotic medication in an initial trial where the defendant is deemed incompetent to stand trial and consented to the administration of antipsychotic drugs. This requirement will eliminate unnecessary and redundant court hearings and ensure that patients who lack the capacity to make decisions about their medications won’t experience gaps in treatment.

AB 366 also creates a process to provide temporary involuntary medication if the defendant withdraws their consent to be medicated after admittance to the hospital until a court decides whether the defendant should be medicated. The bill also requires the courts to make decide on the order for involuntary medication within 21 days.

“The problem with existing law is that when defendants withdraw their consent to be medicated, a new court order for medication may take weeks and sometimes months,” Allen said. “For most patients, the lack of medication causes further deterioration of their mental disease making it harder to restore the defendant to competency, sometimes to the point where they may never be restored to competency.  Additionally, patients who are not only a danger to themselves, but a danger to others, compromise the recovery of other patients and create a very dangerous environment putting the lives of all patients and staff at risk. 

“By providing a temporary process for involuntary medication, one that uphold due a patient’s due process, patients in need of medication will no longer go untreated and patients will be restored to competency so that they can stand trial,” Allen said.

Among those testifying in support of AB 366 were Dr. Patricia Tyler, and Dr. Richard Frishman, psychiatrists at Napa State Hospital.

AB 366 is co-authored by Assemblymember Katcho Achadjian (R – San Luis Obispo) and Senator Sam Blakeslee (R – San Luis Obispo).

Allen represents California’s 7th Assembly District, comprised of Napa County as well as portions of Solano and Sonoma Counties.