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. (a) Except as provided in subdivision (b), no person
sentenced to imprisonment or housed in a state prison shall be
administered any psychiatric medication without his or her 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) The Department of Corrections and Rehabilitation may seek to
initiate involuntary medication on a nonemergency basis only if all
of the following conditions have been met:
(1) A psychiatrist has determined that the inmate has a serious
mental disorder.
(2) A psychiatrist 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 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.
(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 an administrative law
judge.
(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 Office of
Administrative Hearings, 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 inmate's central file which
contains materials unrelated to medical treatment.
(C) Inform the inmate of his or her right to contest the finding
of an administrative law judge authorizing treatment with involuntary
medication by filing a petition for writ of administrative mandamus
pursuant to Section 1094.5 of the Code of Civil Procedure, and his or
her right to file a petition for writ of habeas corpus with respect
to any decision of the Department of Corrections and Rehabilitation
to continue treatment with involuntary medication after the
administrative law judge has authorized treatment with involuntary
medication.
(8) An administrative law judge 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.
Failure of the department to provide timely or adequate notice
pursuant to this section shall be excused only upon a showing of good
cause and the absence of prejudice to the inmate. In making this
determination, the administrative law judge may consider factors,
including, but not limited to, the ability of the inmate's 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 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.
(10) An inmate is entitled to file one motion for reconsideration
following a determination that he or she may receive involuntary
medication, and may seek a hearing to present new evidence, upon good
cause shown.
(d) This section does not prohibit a physician from taking
appropriate action in an emergency. An emergency exists when 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. 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 Department of
Corrections and Rehabilitation's clinicians identify a situation that
jeopardizes the inmate's 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 department shall give notice to the inmate and his or
her counsel of the department's intention to seek an ex parte order
to allow the continuance of medication pending the full hearing. 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 showing
specific facts. The inmate and the inmate's appointed counsel shall
have two business days to respond to the department's ex parte
request to continue interim medication, and may present facts
supported by an affidavit in opposition to the department's request.
An administrative law judge shall review the ex parte request and
shall have three business days to determine the merits of the
department's 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) The Department of Corrections and Rehabilitation shall file
with the Office of Administrative Hearings, and serve on the inmate
and his or her 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 an 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 pursuant to the conditions specified in this subdivision, the
inmate shall be entitled to and be given the same due process
protections as specified in subdivision (c). The department shall
prove the same elements supporting the involuntary administration of
psychiatric medication and the administrative law judge 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
his or her 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 his or her 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 department shall file with the Office of Administrative Hearings,
and shall serve on the inmate and his or her counsel, a written
notice indicating the department's 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 his or her need for the medication, such that it is
unlikely that the inmate would be able to manage his or her own
medication and treatment regimen. No new acts need be alleged or
proven.
(5) If the department wishes to add a basis to an existing order,
the department shall give the inmate and the inmate's counsel notice
in advance of the hearing via a renewal notice or supplemental
petition. Within the renewal notice or supplemental petition, the
department shall specify what additional basis is being alleged and
what qualifying conduct within the past year supports that additional
basis. The 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) Pursuant to Section 5058, the Department of Corrections and
Rehabilitation shall adopt regulations to fully implement this
section.
(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.