Cal. Code Regs. tit. 9 § 4210

Current through Register 2024 Notice Reg. No. 45, November 8, 2024
Section 4210 - Interim Involuntary Medication Hearing Procedures at State Hospitals
(a) The Department of State Hospitals may conduct administrative hearings on hospital grounds to determine the necessity to administer non-emergency interim involuntary antipsychotic medication to a patient committed under:
(1) Penal Code section 1026 et seq. (Not Guilty by Reason of Insanity);
(2) Penal Code sections 2962 et seq. and 2972 et seq. (Mentally Disordered Offender);
(3) Welfare and Institutions Code section 6316 (Stats. 1967, c. 1667; see also, Stats. 1981, c. 928, for additional legislative intent) et seq. (Mentally Disordered Sex Offender); and/or
(4) Welfare and Institutions Code section 6000 et seq. (Sexually Violent Predator).
(b) A state hospital psychiatrist shall determine that involuntary antipsychotic medication is medically and psychiatrically appropriate for a patient before initiating an administrative hearing.
(c) Prior to an administrative hearing for interim involuntary medication, the treating psychiatrist shall inform the patient of his/her diagnosis, explain why antipsychotic medication is necessary, and explain the anticipated benefits and possible side effects.
(d) After informing the patient pursuant to subsection (c) above, the treating psychiatrist shall ascertain either that the patient refuses to give informed consent; or is incompetent or lacks capacity to give informed consent to the medication; and/or poses a danger to others.
(e) The state hospital shall hold the administrative hearing pursuant to the applicable legal standard for each commitment category.
(f) The state hospital shall provide a patient with a written Notice of Involuntary Psychotropic Medication Hearing, form DSH-9164 (11-2015), hereby incorporated by reference, at least 24 hours prior to the hearing and notify the Office of Patients' Rights of the service of the Notice.
(g) A patient shall be given the opportunity to be represented by a disinterested lay adviser, Patients' Rights Advocate, or designee versed in the applicable psychological issues who shall explain the hearing procedures, the applicable legal standard for the involuntary administration of antipsychotic medication, and the hearing panel's decision.
(h) Each administrative hearing shall be conducted by a panel of two psychiatrists and one psychologist, or three psychiatrists, none of whom are providing treatment to the patient.
(i) A state hospital psychiatrist shall present evidence at the administrative hearing of the patient's treatment history, current medical and/or mental health condition, and of the information enumerated in subsections (b), (c) and (d) above.
(j) The patient shall be given the opportunity to present evidence and question witnesses at the administrative hearing. This may be done in person and/or via the patient's adviser, advocate, or designee.
(k) The administrative hearing panel's decision shall be by majority vote, in writing, include information about the participants at the hearing, and describe whether the legal standard has been met to administer non-emergency involuntary antipsychotic medication applicable to the patient.
(l) The administrative hearing panel shall give the patient their decision verbally immediately following the hearing. In addition, a completed Involuntary Psychotropic Medication Review Hearing form DSH-9165 (11-2015), hereby incorporated by reference, shall be given to the patient within 24 hours.
(m) The patient shall have three business days after receipt of the written decision to appeal to the state hospital's medical director or designee.
(n) The state hospital's medical director or designee shall have three business days after receipt of a patient's appeal to review and respond to the patient in writing of the decision.
(o) The hearing panel's decision to allow involuntary non-emergency antipsychotic medication may direct such treatment for up to 14 days, unless superseded by a court decision.
(p) After the initial 14-day treatment period, further treatment may be authorized only after a second administrative hearing is conducted pursuant to this section wherein the hearing panel may then direct treatment to continue for an additional 180 days, or when a court renders a decision.
(q) The state hospital shall request a court hearing as required by law, concurrent with or subsequent to the administrative hearing.
(r) Nothing in these regulations shall affect any existing legal rights of the individual patient to seek a judicial review of the hearing panel's determination for involuntary medication.
(s) Nothing in these regulations shall affect any existing legal authority of the state hospital to involuntarily medicate the individual patient in emergency situations.

Cal. Code Regs. Tit. 9, § 4210

1. New article 2 (section 4210) and section filed 8-9-2010; operative 8-9-2010 pursuant to Government Code section 11343.4 (Register 2010, No. 33).
2. Amendment of section heading, section and NOTE filed 9-29-2014 as an emergency; operative 9-29-2014 (Register 2014, No. 40). A Certificate of Compliance must be transmitted to OAL by 3-30-2015 or emergency language will be repealed by operation of law on the following day.
3. Amendment of section heading, section and NOTE refiled 3-9-2015 as an emergency; operative 3-30-2015 pursuant to Government Code section 11346.1(d) (Register 2015, No. 11). A Certificate of Compliance must be transmitted to OAL by 6-29-2015 or emergency language will be repealed by operation of law on the following day.
4. Amendment of section heading, section and NOTE refiled 6-15-2015 as an emergency; operative 6-29-2015 pursuant to Government Code section 11346.1(d) (Register 2015, No. 25). A Certificate of Compliance must be transmitted to OAL by 9-28-2015 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 6-15-2015 order, including further amendment of section, transmitted to OAL 9-28-2015 and filed 11-5-2015; amendments operative 11-5-2015 pursuant to Government Code section 11343.4(b)(3) (Register 2015, No. 45).

Note: Authority cited: Section 2972, Penal Code; and Sections 4005.1, 4027 and 4101, Welfare and Institutions Code. Reference: In Re Qawi (2004) 32 Cal.4th 1; In Re Calhoun (2004) 121 Cal.App.4th 1315; In Re Greenshields (2014) 227 Cal.App.4th 1284; Washington v. Harper (1990) 494 U.S. 210; Section 2972, Penal Code; and Section 6316.2 (Stats. 1977, c. 164; see also, Stats. 1981, c. 928, for additional legislative intent), Welfare and Institutions Code.

1. New article 2 (section 4210) and section filed 8-9-2010; operative 8-9-2010 pursuant to Government Code section 11343.4 (Register 2010, No. 33).
2. Amendment of section heading, section and Note filed 9-29-2014 as an emergency; operative 9/29/2014 (Register 2014, No. 40). A Certificate of Compliance must be transmitted to OAL by 3-30-2015 or emergency language will be repealed by operation of law on the following day.
3. Amendment of section heading, section and Note refiled 3-9-2015 as an emergency; operative 3-30-2015 pursuant to Government Code section 11346.1(d) (Register 2015, No. 11). A Certificate of Compliance must be transmitted to OAL by 6-29-2015 or emergency language will be repealed by operation of law on the following day.
4. Amendment of section heading, section and Note refiled 6-15-2015 as an emergency; operative 6-29-2015 pursuant to Government Code section 11346.1(d) (Register 2015, No. 25). A Certificate of Compliance must be transmitted to OAL by 9-28-2015 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 6-15-2015 order, including further amendment of section, transmitted to OAL 9-28-2015 and filed 11-5-2015; amendments operative 11/5/2015 pursuant to Government Code section 11343.4(b)(3) (Register 2015, No. 45).