Tuesday, February 11, 2020 | 2:13 PM
The Legislative Analyst's Office has just published the following
report:
The 2020-21 Budget: Analysis of the Department of State Hospitals
Budget
In this report, we evaluate the Governor's proposed $2.3 billion
budget for the Department of State Hospitals (DSH). We provide an
analysis of three key new policy proposals in the DSH budget, the most
significant of which is the proposal for $24.6 million General Fund
(totaling $364.2 million over six years) to implement a two-pronged pilot
program to address concerns with the rising amount of incompetent to
stand trial (IST) referrals to state hospitals. While we find that the
intent behind the proposal for a pilot program has merit, we raise
various concerns about its efficacy and governance. Specifically, we find
the component of the pilot that would provide progress payments to
counties for community-based restoration treatment may be premature given
that a similar pilot in Los Angeles County is continuing and has yet to
be fully evaluated. The component of the pilot that would provide
incentive payments to counties to invest in strategies to reduce the
overall number of felony IST designations and referrals to DSH adds
another funding entity for community mental health, potentially
complicating program coordination and oversight of the community mental
health system. We offer recommendations to improve the structure of the
pilot program should the Legislature approve the proposal, including
clarifying in statute the target population of the pilot program to
better focus funding on achieving the intended outcomes.
In addition, in our report, we assess the Governor's proposal to augment
staffing levels and apply a new staffing model for treatment team and
primary care staff at state hospitals. This proposal also adds new
positions at state hospitals, for example, to address issues related to
implementing trauma-informed care at the hospitals. We recommend
requiring the administration to report back on some concerns we raise
before its approval, and recommend approval of two of the requested
position types on a pilot basis to determine their effectiveness.
Finally, we assess the Governor's proposal to update the staffing models
for protective services at state hospitals, and to implement new staffing
levels beginning with Napa State Hospital in 2020-21. We recommend
requiring the administration to report back on the cost of implementing
the new staffing levels at all five state hospitals and to provide a time
schedule for doing so.
This report is available using the following link:
https://lao.ca.gov/Publications/Report/4154?utm_source=laowww&utm_medium=email&utm_campaign=4154