SB820 - Inmates: mental health.

Senate Bill No. 820 CHAPTER 330 An act to amend Section 4011.6 of, and to add and repeal Section 2603.5 of, the Penal Code, relating to county jail inmates. [ Approved by Governor October 03, 2025. Filed with Secretary of State October 03, 2025. ] LEGISLATIVE COUNSEL'S DIGEST SB 820, Stern. Inmates: mental health. Existing law prohibits a person from being tried or adjudged to punishment while that person is mentally incompetent. Existing law establishes a process by which a defendant’s mental competency is evaluated. Existing law, in the case of a misdemeanor charge in which the defendant is found incompetent, requires the court to hold a hearing to determine if the defendant is eligible for diversion. Existing law requires, if the defendant is not eligible for diversion, the court to hold a hearing to determine whether the defendant will be referred to outpatient treatment, conservatorship, or the CARE program, or if the defendant’s treatment plan will be modified. Existing law requires the court to dismiss the case if a defendant does not qualify for the above-described services. Existing law prohibits, except as specified, a person confined 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 involuntarily administer psychiatric medication to an inmate 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 also provides for the involuntary administration of psychiatric medication to an inmate in an emergency situation. Existing law limits the duration during which an inmate can be involuntarily administered psychiatric medication on an emergency basis and requires that, except as specified, the inmate be provided the same due process protections they would be entitled to when psychiatric medication is involuntarily administered on a nonemergency basis. Existing law specifies that an emergency exists for these purposes 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. This bill would, if an individual has been found incompetent to stand trial after having been charged with a misdemeanor, additionally authorize the administration of antipsychotic medication to the individual without their prior informed consent on an emergency basis when treatment is necessary to address the emergency condition and the medication is administered in the least restrictive manner, as specified. The bill would specify that a determination made pursuant to these provisions is valid for up to 72 hours if the medication is necessary to address the emergency condition, except as provided. The bill would require the court, prior to issuing an involuntary medication order after hearing, to find by clear and convincing evidence that, among other things, a psychiatrist or psychologist has determined that the individual has a serious mental health disorder that can be treated with antipsychotic medication, and there is no less intrusive alternative to the involuntary administration of antipsychotic medication, and involuntary administration of the medication is in the individual’s best interest. The bill would require the court to review that order at least every 60 days and would require the psychiatrist to file an affidavit at that review, as specified. By expanding the crime of perjury, the bill would create a state-mandated local program. The bill would also enumerate certain rights for individuals, prior to the administration of involuntary medication pursuant to these provisions. The bill would make these provisions inoperative and would repeal them on January 1, 2030, subject to a later enacted statute. Existing law provides that if a person in charge of a county jail, city jail, or juvenile detention facility, or a judge, as specified, believes that a person in custody may have a mental health disorder, that person or judge may cause the prisoner to be taken to a facility for 72 hours of treatment and evaluation. The bill would prohibit certain factors, including the person’s temporary access to food, clothing, and shelter, while transferred to a 72-hour facility for treatment and evaluation, from being a basis to conclude that the person is able to provide for their basic personal needs. 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 no reimbursement is required by this act for a specified reason. Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES Bill Text The people of the State of California do enact as follows: SECTION 1. Section 2603.5 is added to the Penal Code, to read: 2603.5. (a) Notwithstanding Section 2603, if an individual has been found incompetent to stand trial after having been charged with a misdemeanor offense, as described in Section 1370.01, and is confined in the county jail, antipsychotic medication may be administered without their prior informed consent only in the following circumstances: (1) An emergency, as defined by either subdivision (m) of Section 5008 of the Welfare and Institutions Code or subdivision (d) of Section 2603 of the Penal Code. (A) In the case of an emergency, antipsychotic medication may, despite the individual’s objection, be administered before a capacity hearing if the medication is necessary to address the emergency condition and is administered in the least restrictive manner, only for the duration of the emergency, and in no case for more than 72 hours, except as provided by subparagraph (B). (B) If a psychiatrist determines that continued administration of antipsychotic medication is necessary beyond the initial 72 hours and the individual does not consent to take the medication voluntarily, the psychiatrist may petition the superior court in the county where the individual is confined to order continued treatment with antipsychotic medication. The petition and a written notice, as described in paragraph (1) of subdivision (b), shall be filed within the initial 72-hour period that the antipsychotic medication is administered and served on the individual and their counsel. (2) (A) Upon a court’s determination that the individual is gravely disabled, as defined in subparagraph (A) of paragraph (1) of subdivision (h) of Section 5008 of the Welfare and Institutions Code, and that the individual does not have the capacity to consent to or refuse treatment with antipsychotic medication. The fact that an individual has temporary access to food, clothing, shelter, personal safety, and necessary medical care while incarcerated is not a basis to conclude that the individual is able to provide for their basic personal needs for food, clothing, shelter, personal safety, or necessary medical care, which shall be evaluated based upon the individual’s ability to provide for those needs while not incarcerated. The court shall consider opinions in the reports prepared pursuant to subdivision (b) of Section 1369, as applicable to the issue of whether the individual lacks the capacity to make decisions regarding the administration of antipsychotic medication, and shall proceed as follows: (i) The court shall conduct 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, to determine whether any of the following is true: (I) Based upon the opinion of the psychiatrist or licensed psychologist offered to the court pursuant to subdivision (b) of Section 1369, the individual lacks the capacity to make decisions regarding antipsychotic medication, the individual’s mental disorder requires medical treatment with antipsychotic medication, and, if the individual’s mental disorder is not treated with antipsychotic medication, it is probable that serious harm to the physical or mental health of the individual will result. Probability of serious harm to the physical or mental health of the individual requires evidence that the individual is presently suffering adverse effects to their physical or mental health, or the individual has previously suffered these effects as a result of a mental disorder and their condition is substantially deteriorating. The fact that an individual has a diagnosis of a mental disorder does not alone establish probability of serious harm to the physical or mental health of the individual. (II) Based upon the opinion of the psychiatrist or licensed psychologist offered to the court pursuant to subdivision (b) of Section 1369, the individual is a danger to others, in that the individual has inflicted, attempted to inflict, or made a serious threat of inflicting substantial physical harm on another while in custody, or the individual had inflicted, attempted to inflict, or made a serious threat of inflicting substantial physical harm on another that resulted in the individual being taken into custody, and the individual presents, as a result of mental disorder or mental defect, a danger of inflicting substantial physical harm to others. (ii) (I) If the court finds the conditions described in subclause (I) or (II) of clause (i) to be true, and has considered the conditions in subdivision (c), and if, pursuant to the opinion offered to the court pursuant to subdivision (b) of Section 1369, a psychiatrist has opined that treatment with antipsychotic medication may be appropriate for the individual, the court may issue an order authorizing the administration of antipsychotic medication as needed, including on an involuntary basis, to be administered under the direction and supervision of a licensed psychiatrist. (II) If the court finds the conditions described in subclause (I) or (II) of clause (i) to be true, and has considered the conditions in subdivision (c), and if, pursuant to the opinion offered to the court pursuant to subdivision (b) of Section 1369, a licensed psychologist has opined that treatment with antipsychotic medication may be appropriate for the individual, the court may issue an order authorizing treatment by a licensed psychiatrist on an involuntary basis. That treatment may include the administration of antipsychotic medication, as needed, to be administered under the direction and supervision of a licensed psychiatrist. (B) A hearing pursuant to this section may occur at the same time as the competency hearing held pursuant to Section 1369. (b) Before an order authorizing the administration of involuntary medication is issued pursuant to this section, the person shall have the following rights: (1) To receive written notice of the diagnosis, the factual basis for the diagnosis, the expected benefits of the medication, any potential side effects and risks of the medication, and any alternatives to treatment with the medication. (2) To be represented by counsel at all stages of the proceedings. (3) To receive timely access to their medical records and files. (4) To be present at all stages of the proceedings. (5) To present evidence and cross-examine witnesses. (c) After hearing, involuntary medication may be administered if the court finds by clear and convincing evidence that all of the following conditions are met: (1) A psychiatrist or psychologist has determined that the individual has a mental disorder that can be treated with antipsychotic medication. (2) A psychiatrist or psychologist has determined that, as a result of that mental disorder, the individual is gravely disabled and lacks the capacity to consent to, or refuse treatment with, antipsychotic medications. (3) That serious harm to the physical or mental health of the individual is likely to result absent treatment with antipsychotic medication. (4) A psychiatrist has prescribed one or more antipsychotic medications for the treatment of the individual’s disorder, has considered the risk, 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 individual. (5) The individual has been advised of the expected benefits of any potential side effects and risks to the individual, any alternatives to treatment with antipsychotic medication, and refuses, or is unable to consent to, the administration of the medication. (6) The jail has made a documented attempt to locate an available bed for the individual in a community-based treatment facility in lieu of seeking to administer involuntary medication. If a community-based alternative is not available, medication shall only be administered by noncustody, health care staff and individuals will be monitored at least every 15 minutes for at least one hour after administration of medication. (7) There is no less intrusive alternative to the involuntary administration of antipsychotic medication, and involuntary administration of the medication is in the individual’s best medical interest. (d) The individual’s confinement shall not be extended to provide treatment to the individual with antipsychotic medication pursuant to this section. An order pursuant to this section shall be valid until the first of the following events occurs: (1) Ninety days from the date the individual is found incompetent to stand trial pursuant to Section 1370.01. (2) Ninety days after the date when the individual is referred to a program described in paragraph (4) of subdivision (b) of Section 1370.01. (3) Upon order of any court with jurisdiction over the individual, including pursuant to a program described in paragraph (4) of subdivision (b) of Section 1370.01. (4) The individual is released from custody in the county jail. (e) The court shall review the order no more than 60 days after an order is issued pursuant to this section to determine whether the grounds for the order remain. At the 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 individual who is the subject of the order and the individual’s attorney. In determining whether the criteria for involuntary medication still exists, the court shall consider the affidavit of the psychiatrist or psychiatrists and any supplemental information provided by the individual’s at [Text truncated for display. Full text available on Congress.gov.]