State hospitals seek $3.4 billion as department reports faster care for ‘incompetent to stand trial’ patients and positive results from enhanced treatment pilot

Stephanie Clendenin, director of the California Department of State Hospitals, told the Senate Budget Subcommittee No. 3 at a May hearing that the department’s 2025–26 Governor’s budget proposes a total budget of $3,400,000,000 and 38 new positions to maintain operations, deliver services and pursue capital outlay improvements.

Clendenin summarized the department’s system — five state hospitals, about 6,000 inpatient beds across acute, intermediate, skilled nursing and residential recovery levels, plus conditional‑release and community programs run with counties and private providers — and said the majority of commitments are forensic commitments from criminal courts or Board of Parole hearings. “The Department of State Hospitals manages the California State Hospital System and a continuum of treatment programs in communities and jails throughout the state,” she said.

Why it matters: The department treats the state’s most clinically complex patients, including those found incompetent to stand trial or not guilty by reason of insanity; changes to bed use, referrals and program activation timelines affect county partners, corrections, courts and patient outcomes statewide.

Caseload and IST updates

Brent Hauser, chief deputy director of operations, and other DSH executives described caseload changes and several program adjustments that appear in the budget request.

- DSH expects a patient census of about 8,527 by the end of 2025–26 — roughly 204 more patients than the current‑year projection. - A Metropolitan secure‑bed capacity project produced a one‑time savings of $4,400,000 while adding roughly 234 forensic beds across five units; three…