The Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services convened on May 1, 2025, to discuss critical updates regarding the Enhanced Treatment Program (ETP) within the California State Hospital System. The meeting featured presentations from Stephanie Clindenin, Director of the Department of State Hospitals, and Dr. Kate Warburton, the Statewide Medical Director.

The ETP was established under Assembly Bill 1340 to provide specialized treatment for patients at high risk of severe physical violence who cannot be accommodated in standard treatment settings. Clindenin outlined that the ETP model includes enhanced staffing and increased security measures to ensure the safety of both patients and staff. The first ETP pilot, a 13-bed unit at DSH Atascadero, began operations in September 2021, with a second 10-bed unit at DSH Patton expected to open in the spring or summer of this year.

A key agenda item was the proposed trailer bill language to extend the authorization period for ETP units until January 1, 2030. This extension aims to provide adequate time for the department to implement the new unit at DSH Patton and to conduct a comprehensive analysis of outcomes across all ETP sites.

Dr. Warburton reported on the demand for ETP beds, noting that since the program's activation, there have been 69 referrals for 63 unique patients, with 30 patients receiving treatment. The data indicated a significant reduction in aggressive incidents following admission to the ETP, with aggression towards staff decreasing by 71% and towards other patients by 94%. Additionally, serious injuries to staff decreased by 68%, and incidents of serious injuries among patients were eliminated.

However, the ETP has also faced challenges, particularly with self-injurious behaviors among some patients, which have increased in the ETP setting. In response, the referral process has been adjusted to enhance screening for these behaviors, leading to a reduction in the use of restraints.

The meeting concluded with a commitment to further develop staff skills in managing patients at risk for self-injurious behaviors, utilizing the specialized environment of the ETP to improve patient outcomes. The discussions underscored the ongoing efforts to enhance treatment and safety within California's state hospital system.