5-08-140 Felony/Misdemeanor Incompetent to Stand Trial (FIST/MIST) Program- Approved by CSS on 07/29/2025

                                                                         Los Angeles County Sheriff’s Department

PURPOSE OF ORDER:

The purpose of this order is to establish procedures regarding the Felony/Misdemeanor Incompetent to Stand Trial (FIST/MIST) program at the Century Regional Detention Facility (CRDF).

SCOPE OF ORDER: 

This order shall apply to all personnel who are assigned to and/or working in any capacity at the CRDF.

ORDER:

Inmates who have been adjudicated incompetent to stand trial and are unable to provide informed consent to prescribed medication, may have a court order authorizing the administration of involuntary medication pursuant to Penal Code sections 1370.01, 2603, or other legal authority.

Inmates who have been ordered subject to a conservatorship by the court may have an order authorizing the conservator, which may be a named person or the Public Guardian, to give consent for medical treatment on behalf of the inmate-conservatee.

The CRDF Court Refusal Team/Mental Health Sweep Team (CRT/MH Sweep Team) will consist of two (2) deputies and one (1) sergeant.  The booking sergeant shall be assigned the collateral duty to oversee the team, Monday through Friday. 

NOTE:  In the absence of the booking sergeant, any supervisor, with the minimum rank of sergeant, may oversee the daily operations of the CRT/MH Sweep Team.

The CRT/MH Sweep Team shall provide security for Correctional Health Services (CHS) medical personnel assigned to Long Acting Injections (LAI).  CHS personnel assigned to LAI are responsible for obtaining a list of all inmates with a valid court order authorizing the administration of involuntary medication.  This list may be generated daily or dependent upon the availability of an LAI nurse.

 Prior to administration of any involuntary medication, the booking sergeant shall:

• Verify the inmate’s name and booking number
• Confirm the inmate’s housing location
• Gather any pertinent information (prior uses of force, Inmate Reports Tracking System (IRTS), and movement history).

Each identified inmate shall be offered the opportunity to voluntarily receive their medication prior to any involuntary administration. 

Should an inmate elect to receive their medication voluntarily or without incident, the booking sergeant, or their designee, shall log the incident in the Jail Compliance Team folder located in the SharedFiles, and pull an electronic Line Operations Tracking System (e-LOTS) number.

Should an inmate refuse to voluntarily receive their medication, the CRT/MH Sweep Team, in collaboration with the LAI nurse, shall attempt to explain the nature of the court order, the ramifications of the refusal, and allow the inmate to explain why they are refusing the medication.  The CRT/MH Sweep Team shall document each refusal and include the inmate’s statements, condition of their cell, use-of-force history, IRTS entries, and any other pertinent information.

Upon a third refusal by the inmate, the booking sergeant, or their designee, shall video record the inmate’s refusal and save it in the following location:

• SharedFiles /Jail Compliance Team/Court Ordered Medical Injections/Mist or Fist/Corresponding year/Inmates last name and booking number

Subsequently, the CRT/MH Sweep Team shall request the assistance of CHS mental health personnel in attempt to gain the inmate’s voluntary compliance.  If the inmate still refuses, the booking sergeant shall:

• Review the court order to confirm it is valid prior to initiating the procedure for the involuntary administration of psychotropic medications
• Assemble team members who will participate in the administration of the medication and conduct a briefing.
• Determine the time, method, manner, specific location and terms for the involuntary administration of the prescribed medication.  The briefing will include consideration of where the inmate is to be placed, a designated route to the secure location inside the module, any specific medical concerns, and the intended site(s) of the body for the administration of the medication.  For additional information, refer to Custody Division Manual (CDM) section, 7-02/000.00 "Planned Use of Force for Inmates with Special Needs." 
• Participate directly in the planning and supervision of the administration of the medication. 
• Assign a team member to video record both the approach and administration of the medication. 
• Direct all actions of the team members throughout the involuntary medication administration. 
• Ensure that, if force becomes necessary, custody personnel shall only use that level of force which is objectively reasonable for the involuntary administration of psychotropic medication(s).  For additional information, refer to CDM sections 7-01/040.00, "Planned Use of Force,"  7-06/010.00, "Video Recording Procedures," and 7-01/010.00, "Force Prevention Principles."
• Ensure the following documentation is saved in the SharedFiles/Jail Compliance folder after involuntarily medication is administered to the inmate:
• • Court order authorizing the administration of involuntary medication
  • e-LOTS and reference number
  • Captain’s memorandum
  • All video recordings of refusal
  • All team members’ information (custody and CHS personnel) including names, employee numbers, and their roles (e.g., camera, door, secured arms, legs, etc.)

NOTE:  The safety of the inmate and personnel shall always be considered before any operation occurs.  If medication administration is not deemed safe at the time of a planned involuntary administration, the operation shall be postponed.  The operation may resume when deemed safe to do so by the booking sergeant and the LAI nurse.

NOTE:  If CHS personnel advise custody of an arising medical issue, custody personnel shall notify the booking sergeant and ensure the inmate receives the appropriate medical attention.  For additional information, refer to CDM section 5-03/060.00, “Response to Inmate Medical Emergencies.”

If force is used, all involved personnel shall report and document the use of force in accordance with CDM section 7-06/000.00, “Use of Force Reporting Procedures.”

When force is used, in addition to completing the "Supervisor's Use of Force Report" (SH-R-438S), the sergeant overseeing the involuntary medication administration shall submit a memorandum to the facility unit commander.  The memorandum shall include a copy of the court order, e-LOTS and reference number associated with the use of force, a synopsis of the force used by Department personnel, names of participating medical and mental health members, a copy of the video recording, and any medical attention the inmate received as a result of the involuntary administration.  The memo shall be submitted prior to the end of the shift during which the incident occurred.