BILL ANALYSIS                                                                                                                                                                                                    






                        SENATE HEALTH AND HUMAN SERVICES
                               COMMITTEE ANALYSIS
                        Senator Deborah V. Ortiz, Chair


          BILL NO:       SB 1448                                      
          S
          AUTHOR:        Chesbro                                      
          B
          AMENDED:       As introduced
          HEARING DATE:  April 3, 2002                                
          1
          FISCAL:        Appropriations                               
          4
                                                                      
          4
          CONSULTANT:                                                 
          8
          McCarthy / ak
                                        

                                     SUBJECT
                                         
            Deceased residents of state hospitals and developmental  
                                    centers

                                     SUMMARY
                                         
          The purpose of this bill is to require the state to assist  
          persons with disabilities in efforts to locate and preserve  
          the gravesites of state hospital or developmental center  
          residents who died and were buried on state lands, or lands  
          designated by the state for burial of state hospital or  
          development center residents.

                                     ABSTRACT  

          Existing law:
          1.Provides for the state Department of Mental Health (DMH)  
            to have jurisdiction over state institutions for the  
            mentally disordered (i.e., state hospitals) and imposes  
            various functions and duties on DMH with respect to the  
            administration of those institutions.  The four state  
            hospitals over which DMH has jurisdiction include  
            Atascadero, Metropolitan, Napa, and Patton (another  
            hospital is expected to open in Coalinga in 2004).  
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          2.Provides for the state Department of Developmental  
            Services (DDS) to have jurisdiction over state  
            developmental centers for persons with developmental  
            disabilities, as defined, and imposes various functions  
            and duties on DDS with respect to the administration of  
            those centers.  The five developmental centers over which  
            DDS has jurisdiction include Agnews, Fairview, Lanterman,  
            Porterville, and Sonoma.  

          3.Provides for various types of cemeteries (including  
            public cemeteries, private cemeteries, and cemetery  
            authorities) and establishes record keeping requirements  
            for each type of cemetery.

          4.Provides that title to lands situated in or near any  
            city, and used by the inhabitants continuously as a  
            cemetery for five years, is vested in the inhabitants of  
            the city and the lands shall not be used except as a  
            public cemetery (H&S Code Section 8126).

          This bill:
          1.Requires DMH to conduct various inventories regarding  
            persons who have died while residing at a state hospital  
            or a state developmental center, including the location  
            of gravesites on existing state hospital and  
            developmental center lands or gravesites located on other  
            lands designated by the state for burial of state  
            hospital or developmental center residents.  The  
            inventories would also include the names and location of  
            the remains of persons whose remains were donated for  
            medical research.

          2.Requires DMH to conduct the required inventories in  
            coordination with a task force of specified organizations  
            representing persons with disabilities and with other  
            state departments including, but not limited to, the  
            departments of General Services, Developmental Services,  
            and the California State Library.  

          3.Requires DMH, in coordination with other state  
            departments and the task force, to assist and cooperate  
            with state or local organizations representing persons  
            with disabilities that conduct research regarding the  
            records of deaths and burials of persons at state  
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            hospitals or developmental centers, and to grant access  
            to state records as necessary to perform the inventories  
            described in the bill.

          4.Requires DMH to assist organizations that represent  
            persons with disabilities, and conduct research on deaths  
            and burials of persons with disabilities, to develop a  
            plan for the restoration of the gravesites and cemeteries  
            on state hospital and developmental center grounds (or  
            located on other lands designated by the state for burial  
            of state hospital or developmental center residents).   
            Further, requires DMH to develop a protocol for the  
            future interment of patients who die while residing in a  
            state hospital or developmental center and whose remains  
            are not claimed by a family member.

          5.Requires DMH to establish a task force, with specified  
            members, to provide direction in carrying out the  
            requirements of this bill.  Also, this bill requires DMH  
            to submit a progress report to the Legislature regarding  
            the implementation of the bill, no later than January 31,  
            2004.

                                  FISCAL IMPACT 

          Unknown at this time, however, it is the author's intent  
          that the costs be absorbable by DMH and DDS.  
          
                            BACKGROUND AND DISCUSSION
           
          Senate Select Committee on Developmental Disabilities and  
          Mental Health:  Hearing and Report
          On November 19, 2001, the Senate Select Committee on  
          Developmental Disabilities and Mental Health held a public  
          hearing at Napa State Hospital to examine the historic use  
          and current status of cemeteries at state mental hospitals  
          and development centers.  At the hearing, testimony was  
          received from advocates from Minnesota and Georgia  
          regarding efforts in those states, led by persons with  
          disabilities, to restore and preserve cemeteries at state  
          institutions for the disabled.  Testimony also was received  
          from a number of persons who are seeking information on the  
          location of the gravesite of a close relative or friend who  
          died while residing in a state hospital or developmental  
          center.  Testimony included the emotional distress  
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          experienced by former patients of these state institutions,  
          and by relatives and friends of deceased residents, due to  
          the apparent lack of respect and care that has been given  
          to the remains of persons who died prior to 1965 while in  
          the care of these institutions.

          Also, a number of persons testified regarding the lack of  
          appropriate interment procedures, record keeping and  
          cemetery maintenance that has occurred on or near state  
          hospital and developmental center grounds.  Testimony and  
          pictures showed that some cemeteries have been allowed to  
          deteriorate or are "just fields" without markers.  In  
          addition, testimony was received from persons who have  
          conducted historical research indicating that in two  
          locations, burial sites were transferred (by a local  
          governmental entity or a state institution) to other owners  
          (e.g., an American Legion Post), and eventually used for  
          other purposes.  According to this testimony in at least  
          one case, the transfer was made without proper historical  
          accounting for -- and without proper removal and reburial  
          of -- the remains of all the state institution residents  
          buried at the site.
           
          Subsequent to the hearing, the Select Committee published a  
          report, "  Historic Use and Current Status of Cemeteries at  
          California State Hospital and Developmental Centers"  . 
          The report contained data submitted by witnesses at the  
          hearing regarding the status of the cemeteries at both  
          state hospitals and state developmental centers, including  
          the following:  

           California has provided services to persons with  
            disabilities in state hospitals and developmental centers  
            since the mid-1880's.  
           Between the mid-1880's and 1965, over 16,000 patients,  
            and perhaps substantially more, have died and were  
            interred at a state hospital or developmental center.
           Since the 1960's, cemeteries at both state hospitals and  
            state developmental centers have fallen into disrepair  
            and are in need of restoration.  
           Many of the existing gravesites are unmarked, and in some  
            cases, the cemeteries are untended.  At Sonoma  
            Developmental Center, 1,418 are buried in unmarked  
            graves.
           Historical information about the patients who died while  
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            residing at a state hospital or developmental center is  
            incomplete.  For example, at Patton state hospital,  
            approximately 2,022 persons are buried in unmarked  
            graves.  In other cases, to protect confidentiality  
            numbers were used to mark graves, instead of names, and  
            the markers are missing. 
           Efforts are underway at a few of the state institutions  
            to recreate historical records, repair some of the  
            deteriorated grave markers, etc., but there is no overall  
            state plan to restore and preserve the cemeteries.
           Currently, when patients die while residing in one of  
            these institutions, and no family member claims the  
            remains, the local county inters the body in the local  
            cemetery for indigent persons.  Sometimes, these graves  
            are unmarked.

          SB 1448 incorporates a number of the recommendations made  
          by witnesses at the November hearing, as summarized in the  
          subsequent report of the Select Committee. 

          Author's stated purpose
          The author's intent in introducing SB 1448 is to require an  
          inventory of existing records and materials to create the  
          most complete record possible of persons who have died  
          while in residency at a state hospital or developmental  
          center and the location of all existing gravesites on and  
          off state grounds.  The bill is also intended to require  
          development of a plan to restore and preserve the  
          gravesites, and enable persons with disabilities to provide  
          leadership and direction in developing and carrying out the  
          plan. 

          Arguments in support
          The California Network of Mental Health Clients, co-sponsor  
          of SB 1448, states that restoration of state hospital and  
          developmental center graveyards is a priority because, "How  
          we are treated in death is indicative of the way we were  
          valued in life".  The Network further states that, between  
          the mid-1880's and 1960, thousands of persons were buried  
          on state hospital or developmental centers lands in, "?for  
          the most part, unmarked, mass gravesites, where numbered  
          markers have long ago disappeared?The intent of SB 1448 is  
          to support persons with disabilities in their efforts to  
          restore dignity?" to these persons.

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          According to Protection and Advocacy, Inc. (PAI), Peer  
          Self/Advocacy Units, also a co-sponsor of SB 1448, "For  
          many years, persons who died while residing in state  
          hospitals and developmental centers, frequently were buried  
          in group graves and/or in unmarked and untended  
          gravesites?PAI believes that in restoring these gravesites,  
          we will also begin to restore a sense of dignity and self  
          worth to people who have resided in state institutions,  
          which can only help in the ongoing fight against stigma and  
          discrimination."  Also, writing in support of the bill,  
          Project Return:  The Next Step states that "?when we  
          dishonor deceased institutionalized persons by inadequately  
          remembering them in death, we are also making a statement:   
          people with severe mental illness don't count, they are not  
          worth remembering?By restoring honor to the dead, we bring  
          honor to the living?"

                                    POSITIONS  

          Support:       California Network of Mental Health Clients  
          (co-sponsor)
                         Capital People First (co-sponsor)
                         Protection and Advocacy, Inc., Peer/Self  
          Advocacy Units
                           (co-sponsor)
                         Alameda County Network of Mental Health  
          Clients
                         Association of Regional Center Agencies

















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                         California Council of Community Mental  
                    Health Agencies
                         California Memorial Project
                         California Mental Health Directors  
          Association (CMHDA)
                         Mental Health Association in California
                         Project Return:  The Next Step
                         Two individuals

          Oppose:   None received






























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