A new state department would be formed to manage California's violence-plagued mental hospitals under a proposal in the governor's Monday budget revision.
The push to create a Department of State Hospitals — and eventually do away with the Department of Mental Health, which now oversees the facilities — comes as lawmakers and employee unions press for changes to address increasing patient assaults on fellow patients and staff.
The budget document, known as the May revise, also includes $9.5 million for security teams at three of the facilities and an alarm system at Napa State Hospital, where a psychiatric technician was strangled in October.
The move to create a new department is in some ways symbolic: If a sweeping plan to shift the management of community mental health dollars to county control takes place as expected over the next two years, the current Department of Mental Health would have little but the hospitals left to oversee.
Health and Human Services Secretary Diana Dooley said a new department would allow her to immediately seek a director experienced with psychiatric hospitals that house patients who have been accused or convicted of crimes. Former Department of Mental Health Director Stephen Mayberg, who retired in December after 18 years on the job, had a community mental health background.
"We want to begin immediately to look for the leadership," Dooley said. "Nobody is on tap."
The state mental hospitals used to mainly house clients too ill to live at home who were committed through the civil courts. But a focus on less restrictive settings has reduced that population dramatically. Now, more than 90% of the hospitals' patients are funneled through the criminal justice system. Many have committed violent crimes.
Dooley, an appointee of Gov. Jerry Brown, has taken a strong interest in the hospitals, where safety concerns heated up after the October slaying. She lifted a hiring freeze last month — leading to 50 hires so far. The May budget revision calls for 78 additional jobs in the coming fiscal year for teams of hospital police officers and psychiatric technicians to patrol the grounds at Napa, Norwalk's Metropolitan State Hospital and San Bernardino's Patton State Hospital.
The Napa alarm system will be installed "as soon as possible," Dooley said. Patients there have been on virtual lockdown for eight months and can leave their units only if escorted by two staff members.
The creation of a new department would require approval through either a legislative or executive process, and Dooley said she has not yet decided which to pursue.
"This is a long overdue change with two good outcomes," said state Senate President Pro Tem Darrell Steinberg (D-Sacramento), a leader in mental healthcare policy, referring to both the new department for hospitals and the proposed shift of funding of community services to county control.
"Community mental health services will get much more focus and attention when viewed as part of overall health. In addition, a department squarely focused on the complex challenges for our state hospitals will hopefully improve patient and employee safety," he said.
The California Mental Health Directors Assn. has also pressed for the moves, said Patricia Ryan, the group's executive director. But Ryan and other mental health advocates warn that the state must maintain a role in guiding community mental health policy.