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State Hospitals budget request includes new positions, capital upgrades; DSH reports sharp drop in competency‑restoration waitlist
Summary
The Department of State Hospitals outlined a proposed FY 2025‑26 budget that adds positions and capital funds, and reported that wait times for individuals found incompetent to stand trial (IST) have fallen substantially after statewide interventions and court benchmarks.
State Hospital Director Stephanie Clendenin testified to Assembly Budget Subcommittee No. 1 on Health about the Department of State Hospitals' (DSH) fiscal 2025‑26 budget proposal and operational priorities.
Clendenin said the governor's proposed budget for DSH in 2025‑26 is roughly $3.4 billion and would include 38 new positions and capital outlay funding for facility improvements. She highlighted several budget change proposals (BCPs) and items, including funding for patient‑driven operating costs, "Coleman" referrals from the Department of Corrections and Rehabilitation and expanded position authority to manage intake workload, and BCPs to support reevaluation services for incompetent‑to‑stand‑trial (IST) defendants.
On capital projects Clendenin cited a proposed electrical infrastructure upgrade at Napa with preliminary plan funding to replace transformers, switchgear and to install a generator, which DSH said is necessary to meet facility electrical demand.
Clendenin and Chief Deputy Director Brent Hauser presented data and work on the IST population. Clendenin summarized an IST backlog and court‑ordered benchmark history: a 2015 ACLU lawsuit led the court to set a 28‑day benchmark for initiating substantive treatment for ISTs, and the department experienced significant pandemic‑era increases in wait times.
DSH reported that after investments and statewide solutions the IST wait list has fallen from a high of 1,953 individuals in January 2022 to 281 as of February 2025, and that the average time to initiate treatment in February 2025 was five days. Clendenin said, "since November 2024, 100 percent of all ISTs who did not have extenuating circumstances beyond the SH's control receive services within the final court compliance benchmark of 28 days."
Hauser described workforce challenges and recruitment strategies, noting facility locations, care complexity and national shortages as drivers of staffing difficulty. DSH described a multifaceted workforce approach emphasizing marketing and outreach, streamlined hiring, training and development (including expanded residency and fellowship programs with university partners), and working with CalHR on compensation improvements.
Members questioned DSH about projections if referrals increase and about the long‑term sustainability of workforce strategies; DSH said the enactment of SB 1323 (which prioritizes community treatment options for ISTs) had reduced referrals and that they would continue to monitor trends.
The hearing included public comment from Diana Luna of the County Behavioral Health Directors Association urging review of the county IST growth cap methodology in light of initiatives that may increase IST determinations.
