CA- State pays millions for contract psychologists to comply with Jessica's Law

Civil Commitment evaluations only!

8-9-2008 California:

In 2007, contractors earned $24 million because state employees couldn't handle the increased caseload. The voter-approved initiative requires all sex offenders to undergo mental health evaluations.

A 2006 law intended to crack down on sex offenders has proved a bonanza for a small group of private psychologists and psychiatrists, 14 of whom billed California taxpayers last year for a half a million dollars or more each, a Times investigation found.

Among the 79 contractors hired by the state to evaluate sex offenders, the top earner was Robert Owen, a Central Coast psychologist who pulled in more than $1.5 million in 2007, according to state records reviewed by The Times.

That's equivalent to working 100 hours per week for 52 weeks at nearly $300 per hour -- top-scale in the private sector.

The No. 2 earner, psychologist Dawn Starr, billed the state $1.1 million in 2007, including $17,500 for a single day in April.

"It's been a boatload of money, to put it colloquially," psychologist Shoba Sreenivasan said during court testimony in November. Working only part time, she billed the state nearly $900,000 last year and at least $290,000 this year.


A civil servant doing the same work earns $101,000 to $110,000 annually.

Passed overwhelmingly by voter initiative in 2006, Jessica's Law mandated evaluations for thousands more sex offenders than in the past to determine whether their conditions warrant hospitalization after criminal sentences have been served. All told, evaluators hired by the state earned more than $24 million in 2007.

It's unclear, however, what benefit the investment has yielded. There's been a nearly ninefold increase in evaluations and a threefold increase in recommendations for hospital commitment. But the actual number of commitments has remained essentially the same -- 41 in the 18 months before the law was passed, 42 in the 18 months afterward.

As the state confronts a budget shortfall of $15.2 billion, legislation to fund contractors to evaluate offenders through 2010 is expected to be voted on in the Assembly as soon as this week. Costs from Jessica's Law are expected to rise to several hundred million dollars annually over the next eight years, with further increases thereafter, according to projections by California's legislative analyst.

State officials defend their approach, saying they have moved aggressively to implement the voters' mandate.

"The public needs to appreciate how seriously we took the 70% vote for Jessica's Law, and public safety," said Stephen Mayberg, director of the California Department of Mental Health, which manages the program. "Was it like a crisis? Yes. . . . Anybody who was willing to take on evaluations at any time and in any place could literally work around the clock."

Mayberg said the backlog of imminent parolees has diminished, so the cases now can be distributed more evenly among contractors. But fees will remain high and the overall costs about the same, even if million-dollar payments disappear.

He described the work of his department and its contractors thus far as "heroic."

Jessica's Law required evaluations for convicts nearing parole for a single sex offense -- even if committed as a juvenile -- in any of 35 categories. Before that law passed, at least two offenses were required in any of nine categories.

To induce contractors to work more and to attract new ones, the Department of Mental Health roughly doubled its compensation to $3,500 for an initial evaluation and $200 per hour for legal testimony and travel.

In 2005, state evaluators -- almost all contractors -- reported on 244 individuals. In 2007, the first full year after passage of Jessica's Law, they evaluated 2,201.

"They were shoving these things down our throats," said psychologist Thomas MacSpeiden, an evaluator who earned more than $400,000 last year. "They were just saying, 'take them, take them, take them!' "

MacSpeiden said he and others maintained high standards despite the need to shoehorn prisoner assessments around their day jobs. He called the pool of evaluators -- highly experienced medical doctors or Ph.D.s who receive special training from the state -- "the creme de la creme."

Even if it prevents only a few additional sex crimes, the broader net cast by Jessica's Law is necessary, said James Cahan, a Santa Clara County deputy district attorney who cochairs the sexually violent predator committee of the California District Attorneys Assn.

"I've seen 5-year-olds curled up on the witness stand," he said. "Anyone who does this work knows that it's worth the money."

Prosecutors use the expert evaluations to argue that offenders should be confined indefinitely, in most cases to Coalinga State Hospital, for treatment as sexually violent predators. An inmate can be so designated if a jury affirms such a diagnosis by two psychologists or psychiatrists.

But some defense attorneys have aggressively questioned state evaluators, suggesting that their judgments were swayed by high fees. New research also shows far lower rates of recidivism by sex offenders than previously thought, an issue often raised to juries.

System ill prepared

In 2005, John Couey, a sex offender who had completed parole, raped and murdered 9-year-old Jessica Lunsford, the law's namesake. He buried the girl alive in a shallow grave.

Jessica's Law was intended to keep such criminals from reoffending. But the mental health system was ill prepared for soaring workloads.


Evaluations often require review of thousands of pages of medical, legal and prison files and interviews with inmates, Mayberg said. Reports are usually 20 to 30 pages and require an average of 20 hours to finish, he said.

Dr. Michael First, editor of the American Psychiatric Assn. Diagnostic and Statistical Manual, the standard reference for mental disorders, said most reports require at least 30 hours.

"It's often hard to get into a person's head," he said. "I don't think there is any way to do shortcuts and do a decent report. You have people's lives and liberty at stake."

Yet on a single day, Nov. 13, 2007, No. 2-earner Starr billed for five evaluations.On April 23, 2007, she billed more than 17 hours for a range of court-related work and still found time to complete an evaluation, according to her invoices, which were reviewed by The Times.

Starr declined to comment. Owen, the top earner, did not return calls for comment.

Dr. Mohan Nair, a psychiatrist with offices in Beverly Hills and Los Alamitos, earned nearly $1 million last year under the state program. He also saw private patients, provided forensic testimony and evaluation for other government agencies, directed a diagnostic lab and supervised residents at two medical centers.

Nair completed up to 20 sex-offender evaluations a month in 2007. Including time billed for legal matters, they comprised just 20% to 30% of his professional practice, he said.

Even at 100 hours per week, he would have had no more than six hours to complete each of five evaluations.

Jessica's Law made fast work possible, Nair said, by requiring evaluations of offenders with "thin files."

"The less data you have, the less criminal history, history of offenses," he said, "it's going to take less time."

Mayberg, director of the Department of Mental Health, said some high earners increased their volume by interviewing up to three inmates in a single prison visit and hiring assistants to organize documents and fill in boilerplate portions of reports.

The vast cost of the evaluations and the system's reliance on contractors have prompted concerns by the American Federation of State, County and Municipal Employees, which represents state psychologists.

"There is going to have to be some kind of adjustment in what the contractors are making if [the state] is going to recruit" staff psychologists, Judi Herman, who chairs the union's psychologist committee, said in an interview.

The State Personnel Board recently took up the issue, ruling that the use of contractors violated state law by failing to make an adequate effort to fill evaluator jobs with regular employees. The board ordered mental health officials to replace the contractors with civil servants. Despite an increase in pay to up to $110,000 annually, Mayberg said, just four jobs out of 80 have been filled.

Since then, the department and the union helped to craft a bill to permit the use of contract evaluators until January 2011.

The legislation, sponsored by Jessica's Law co-author Sen. George Runner (R- Lancaster), would require that state officials report to the Legislature twice a year on hiring efforts and on the costs and effects of the program.

The data could help determine whether the evaluation process is operating as voters intended. One high-earning evaluator is among those voicing doubts.

Nair said that since Jessica's Law, the proportion of inmates he recommends for commitment has plummeted. That shift convinced him that the law's criteria are overly broad. Asked whether Jessica's Law is a good law, Nair paused.

"I have to wonder," he said. "There may be a better allocation of resources." ..News Source.. by By Charles Piller and Lee Romney