Inmates: mental health.

Senator Stern’s proposal would authorize emergency administration of antipsychotic medication to county jail inmates found incompetent to stand trial after misdemeanor charges, within a narrowly defined framework that requires an emergency condition, administration in the least restrictive manner, and ongoing judicial oversight. The core objective is to address urgent health needs in custody while preserving due process, with the provisions scheduled to sunset on January 1, 2030.

Under the measure, emergency administration may occur before a capacity hearing and may last up to 72 hours; if continued beyond that period, a psychiatrist may petition a superior court for authorization to treat. The court may issue an order for ongoing treatment if gravely disabled and lacking capacity to consent, based on findings that a mental disorder is treatable with antipsychotic medication, that there is no less intrusive alternative, and that the treatment is in the individual’s best medical interest. The process includes rights protections prior to involuntary medication—written notice of diagnosis and risks, counsel, timely access to records, presence at proceedings, and the opportunity to present evidence and cross-examine witnesses—and a court review no later than 60 days after an order is issued, with a psychiatrist’s affidavit filed at that review. The order can extend up to a maximum when specific triggers occur, such as a defined period after incompetency, referral to a program, court action, or release from custody. If a community-based bed is unavailable, medication may be administered by noncustody health care staff with monitoring at short intervals after administration.

The proposal also amends transfer and evaluation procedures to align the 72-hour treatment-and-evaluation framework with the Welfare and Institutions Code’s emergency-custody processes, requiring prompt notification to the local mental health director, counsel, and prosecutors, and clarifying reporting duties by facilities. Time spent in a treatment facility counts toward the individual’s sentence, and the option to convert to voluntary inpatient status is preserved. The measures contemplate concurrent consideration under related civil-commitment provisions and maintain habeas rights to challenge ongoing orders. A sunset provision remains in place, with no general reimbursement required for local agencies, though the bill acknowledges potential local costs associated with expanded oversight, reporting, and court proceedings, and notes that certain elements could create a state-mandated local program.

In the broader policy context, the authors describe the framework as a tightly regulated mechanism to address emergencies in custody within the existing competency and mental health treatment structures, linking competency determinations, court oversight, and civil-commitment standards. The provisions would expand perjury-related offenses and place new duties on jail staff, mental health authorities, and courts, with a finite evaluation window through 2030. Stakeholders potentially affected include inmates found incompetent, defense counsel, prosecutors, jail personnel, county mental health departments, and community-based treatment providers, all operating within a system that seeks to balance health needs with procedural protections and judicial review.