California Department of Mental Health

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WHAT HOSPITALS AND UNITS COMPRISE THE DIVISION OF LONG TERM CARE SERVICES (LTCS)?

LTCS consists of five state hospitals, two psychiatric programs, and four units: Forensic Services, Hospital Operations, Program Policy and Fiscal Support, and Sex Offender Commitment Program.

LTCS is responsible for the direct operation of five state hospitals: Atascadero (ASH), Metropolitan (MSH), Napa (NSH), Patton (PSH) and a new state hospital in the City of Coalinga (CSH) scheduled to open in March 2006. In addition, LTCS, through an interagency agreement with the California Department of Corrections (CDC), provides acute inpatient and intermediate/day-treatment mental health services at the Vacaville Psychiatric Program (VPP) at California Medical Facility (CMF) and at the new intermediate inpatient Psychiatric Program at Salinas Valley State Prison (SVSP) that opened in May 2003. MSH operates through an interagency agreement with the California Department of Youth Authority (CYA), the Correctional Treatment Center (CTC) at the Southern Youth Correctional Reception Center and Clinic (SYCRCC). All four active state hospitals are accredited by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), the national accrediting body, and fully licensed by the state Department of Health Services (DHS). The VPP and the Salinas Valley Psychiatric Program (SVPP) are licensed by DHS and adhere to the standards of JCAHO but will not be accredited.

The patients served are often classified on the basis of the legal class or type of commitment proceeding that resulted in their placement in a state hospital. There are two basic types of commitments to state hospitals: patients may be committed as a danger to self or others, or gravely disabled, under civil statutes commonly referred to as Lanterman-Petris-Short (LPS) commitments; or they may receive a Judicially Committed/Penal Code (JC/PC) commitment from the courts, Board of Prison Terms (BPT), or the CDC. JC/PC commitments include Not Guilty by Reason of Insanity (PC 1026), Incompetent to Stand Trial (PC 1370), Mentally Ill Inmates (PC 2684), and Mentally Disordered Offenders (PC 2960-72). The Sexually Violent Predators (Welfare & Institutions Code Section 6600), although a civil commitment, are committed via a judicial process.

There are currently almost 4,300 patients in the four state hospitals with over 80% being JC/PC patients. The future LPS population is very difficult to predict; however, we believe it will remain close to 700 patients for the foreseeable future. The JC/PC population is expected to continue growing.

  • Forensic Services supervises the California Forensic Conditional Release Program (CONREP) and performs evaluations of prison inmates who meet statutory criteria as mentally disordered offenders (MDO). CONREP is a community outpatient mental health program, designed especially for persons with mental disorders and special conditions of treatment ordered as a result of court or BPT action. Forensic Services has management oversight of contracts with various CONREP treatment providers throughout the state. The MDO population consists of inmates who are ordered into mental health treatment by the BPT as a condition of parole. Forensic Services also provides analysis and recommendations on statutorily determined policies and practices impacting population movement in and out of state hospitals.
  • Hospital Operations is responsible for a variety of administrative and operational functions that support the state hospitals including major and minor capital outlay and special repair programs. Related to this is the work they do to monitor the Department's Energy Management Program for the state hospitals, develop and provide the required reports and inventories of the Department's land assets, and coordinate leases at the state hospitals. Presently, Hospital Operations staff is in the process of the design and development of the new state hospital in the city of Coalinga. In addition, a variety of administrative functions fall under their charge including analysis of proposed legislation, development of budget change proposals, responses to inquires from patients, the public, other agencies, and the Legislature; the distribution, storage, and indexing of special orders--directives that establish the operational policies of LTCS and the state hospitals; collection and management of headquarters reportable special incident briefs and reports, consultation on professional discipline issues; management of the contract that provides for patients’ rights services at the state hospitals; and coordination of the Governing Body process.
  • Program Policy and Fiscal Support provides leadership and direction on licensing, certification and accreditation; contracts and interagency agreements relating to state hospital services; hospital fiscal operations, e.g., budget development and allocations, cost reporting, expenditure projections, revenue projection and collection, and state hospital rate setting; and special projects, e.g., Board of Control Claims, out-of-state travel, claims from counties pursuant to the provisions of Welfare and Institutions Code Section 4117, DMH Merit Award Employee Suggestion Program, Interstate Compact Coordination, Cooperative Agreement with Department of Rehabilitation, Arts in Mental Health Program and educational and vocational services. The unit is also responsible for conducting hearings and adjudicating county inpatient Medi-Cal review appeals.
  • Sex Offender Commitment Program (SOCP) Evaluation Unit (also known as the Sexually Violent Predator (SVP) Evaluation Unit) is responsible for record review, assessment, and clinical evaluation of CDC inmates referred after pre-screening as potential SVP’s. These inmates are about to be paroled or released from prison, but meet basic legal criteria for this commitment. This unit fully assesses each referral and performs clinical evaluations at prison sites. This unit contracts with 40 psychologists and psychiatrists who perform clinical evaluations and testify in court as to their findings.