William King v. County of Los Angeles, et al

Filing

FILED OPINION (WILLIAM A. FLETCHER, SANDRA S. IKUTA and SARAH EVANS BARKER) In light of King s death during the pendency of this appeal, we instruct the clerk of this court to hold the mandate for ninety days, pending a motion for substitution of a personal representative under Federal Rule of Appellate Procedure 43(a)(1). If no motion for substitution is filed within ninety days, this appeal is subject to dismissal as moot. REVERSED IN PART; AFFIRMED IN PART; REMANDED. Judge: WAF Authoring. FILED AND ENTERED JUDGMENT. [10793917]

CA Dept of State Hospitals - Coalinga

Case: 14-55320, 03/12/2018, ID: 10793917, DktEntry: 60-2, Page 1 of 4

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coalinga

Department of State Hospitals - Coalinga
History | Patient Population | Hospital Staff | Treatment and Programs | Community

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HISTORY
The Department of State Hospitals-Coalinga is California’s newest state mental health hospital
located at the edge of the Coastal Mountain Range on the western side of Fresno County.
Coalinga is halfway between Los Angeles and San Francisco and sixty miles southwest of
Fresno.
DSH-Coalinga opened in 2005 and began treating forensically committed patients, mostly of
which are sexually violent predators. It is a self-contained psychiatric hospital constructed with a
security perimeter. California Department of Corrections and Rehabilitation (CDCR) provides
perimeter security as well as transportation of patients to outside medical services and court
proceedings.
The hospital does not accept voluntary admissions.

PATIENT POPULATION
The hospital operates approximately 1,286 beds. The commitment categories of patients
http://www.dsh.ca.gov/coalinga/[3/7/2018 12:38:50 PM]

CA Dept of State Hospitals - Coalinga

Case: 14-55320, 03/12/2018, ID: 10793917, DktEntry: 60-2, Page 2 of 4

treated at DSH-Coalinga are described below:

Lanterman-Petris-Short (LPS) Act
These patients are treated under a conservatorship agreement. Conservatorships are for
severely disabled individuals who represent a danger to themselves or others due to mental
illness. They have not been charged with a crime, but are instead referred by local community
mental health programs through involuntary civil commitment procedures pursuant to the LPS
Act. Those whose psychiatric conditions require a higher level of care and cannot be treated in
locked facilities or board-and-care homes are sent to a state hospital for treatment. LPS
patients leave state hospitals when their county of residence places them in a different facility,
or home with their families, or they have successfully petitioned the court to remove the
conservatorship.
Mentally Disordered Offenders (Penal Code Section 2962/2972)
Parolees who committed one of a specified list of crimes and who were treated for a severe
mental disorder connected to their original crime can be committed to a state hospital as a
condition of parole for a period not to exceed the length of their parole term. If the person still
requires treatment at the end of their parole term, they can be civilly committed under PC2972 if
it is determined that they are a substantial danger to themselves or others. These commitments
last for one year and may be renewed annually by the court.

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Patients judged by the court to
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Mentally Ill Prisoners transferred from CDCR (PC 2684)

sentence of their most serious offense. Their treatment goal is to control violent behaviors and
develop socially responsible behavior and independent living skills, while treating their mental
illness.
Sexually Violent Predators (Welfare and Institutions Code 6602 & 6604)
Individuals who are convicted of a legislatively defined set of sex offenses who complete their
prison sentences are evaluated by DSH or independent evaluators. Those that meet Sexually
Violent Predator (SVP) criteria receive a probable cause hearing and are placed in a state
hospital pending full commitment (WIC 6602). A trial confirming SVP status can result in
commitment to a state hospital for an indeterminate period (WIC 6604). SVPs can petition
annually for release, be recommended for outpatient status by DSH practitioners, or be
determined to no longer meet SVP criteria.
The patient population breakdown for DSH-Coalinga as of 11/7/2016 is listed below. The data
below includes patients who are not in the facility because of a court appearance or who are at
a general acute care hospital to receive other medical treatment.
Patient Commitments

http://www.dsh.ca.gov/coalinga/[3/7/2018 12:38:50 PM]

Population

Percentage of
Total at Facility

CA Dept of State Hospitals - Coalinga

Case: 14-55320, 03/12/2018, ID: 10793917, DktEntry: 60-2, Page 3 of 4

Lanterman Petris Short

1

0%

Mentally Disordered Offender

294

23%

Mentally Ill CDCR Prisoner

50

4%

Not Guilty by Reason of Insanity

2

0%

941

73%

Sexually Violent Predator

For additional categories and sub-categories of patients that may be found at each facility,
please visit our Legal Commitments webpage.

HOSPITAL STAFF
DSH-Coalinga has approximately 2,285 employees, with approximately 190 different job
classifications, providing around the clock care; including psychologists, psychiatrists, social
workers, rehabilitation therapists, registered nurses, psychiatric technicians, and other medical
and clinical staff. In addition to administrative and support staff; including information
technology, hospital police, plant operations, kitchen staff, custodial staff, warehouse workers,
groundskeepers and spiritual leaders.

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TREATMENT AND PROGRAMSos A 20
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The fundamental goal of the DSH-Coalinga Sex Offenders Treatment Program is for the
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individual to acquire pro-social skills andarchiv recurrence of sexual offending. The
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program combines components 532 Self-Regulation/Better Life models with the principles of
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Risk-Need-Responsivity (RNR). This combined approach strengthens the individual’s selfNo.
regulation skills to prepare him for a life free of sexual offending.

The three principals of the RNR model are explained here in more detail.
The risk principle involves matching the intensity of treatment to the individual’s risk level of
reoffending, with high-risk offenders receiving more intensive and extensive treatment than lowrisk offenders. Offense risk is determined by the combination of static and dynamic risk factors.
The need principle focuses on assessing dynamic risk factors and targeting them in treatment.
Dynamic Risk Factors are defined as enduring but changeable features of an offender; are
amenable to interventions, and when successfully addressed, result in a decrease in recidivism
risk.
The responsivity principle states that services should be delivered in a manner that is engaging
and consistent with the learning style of the individual. Examples include fostering strengths;
establishing meaningful relationships; and attending to relevant characteristics such as age,
cognitive skills, cultural factors, and emotional regulation issues. It also states that the primary
treatment components should use social learning and cognitive-behavioral approaches.
Empirical studies indicate that adhering to RNR principles can maximize treatment effects and
reduce recidivism.

http://www.dsh.ca.gov/coalinga/[3/7/2018 12:38:50 PM]

CA Dept of State Hospitals - Coalinga

Case: 14-55320, 03/12/2018, ID: 10793917, DktEntry: 60-2, Page 4 of 4

The Self-Regulation/Better Life model also provides some educational opportunities, vocational
services, and recreational activities. Individuals with intellectual disabilities or severe psychiatric
disorders participate in programs adapted for their treatment needs.

COMMUNITY
About one-third of the staff at DSH-Coalinga lives in Coalinga. The rest reside within a 70 mile
radius. In the fiscal year 2013-14, DSH-Coalinga contracted with and purchased from
approximately 200 companies in the local and surrounding communities for goods and services,
spending over $15.1 million.
The hospital is a partner with both West Hills College-Coalinga and Fresno City College.
Through its psychiatric technician education program, West Hills College has provided the
hospital with hundreds of graduates over the course of many years. Similarly, about 400
registered nurses from Fresno City College have completed clinical rotation in our hospital.
DSH-Coalinga is currently forming a new partnership with two California universities to create
clinical rotations for medical students.
In July 2014, a solar installation at DSH-Coalinga began supplying power to the hospital. Since
then the facility has lowered the kilowatt hours purchased from the electric company by an
average of 18 percent during the summer months.
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