Tom McNichol, a contributing writer to California Lawyer, recently wrote an interesting article on the Coalinga State Hospital. The hospital is “the nation’s largest and most expensive hospital for housing and treating men who have been declared to be sexually violent predators–or SVPs…”

Each of the patients in Coalinga has served a full sentence in state prison for committing one or more serious sexual offenses, usually child molestation or rape. But instead of being released, they continue to be denied freedom under a twelve-year-old California law that lets the state at once declare offenders to be SVPs and commit them to a state psychiatric facility.
Initially, the limit of internment was set at two years, subject to renewal. But with the 2006 passage of Proposition 83, the so-called Jessica’s Law, the length of civil commitment for SVPs is now “indeterminate.” That makes Coalinga State Hospital a strange kind of “Hotel California”–you can check out any time you like, but odds are you can never leave.

Below is the full article, by Tom McNichol:
Pause for a moment in the sun-dappled area they call The Mall at Coalinga State Hospital, and it looks for all the world like Anytown, U.S.A. Against the south wall is the barber shop (“Back at 3:30” announces a sign in the window), and close by is the post office and the Union Square Cafe. Other destinations are known by names that make the facility sound more like a California theme park than a hospital: the Cali-stoga Dental Office, the Moss Landing Lending Library, the Candlestick Park Visitor’s Center. Everything is Disneyland spotless, down to the buffed tile floors.
But things aren’t all they appear to be at Coalinga State Hospital–not by a long shot. The compound’s theme-park veneer masks a much harsher reality: Coalinga is a long-term treatment facility for rapists and pedophiles. And most of the 762 patients currently in residence may never leave–except in a box.
Wrapped around the hospital, gleaming white-hot in the Central Valley sun, are twin 14-foot-tall razor-wire fences. Armed security guards patrol the hospital grounds, and an observation tower looms overhead. Visitors are subjected to security searches and must walk through a metal detector. And staff members carry “personal duress alarms”–handheld “panic” buttons to push in case of trouble. (The signals go off a couple times a day on average, officials say, but usually for nothing more serious than a scuffle.)
All the patients are dressed alike, in desert-brown khaki shirts and pants, the color of the burnished hills surrounding the hospital. Three times a day a doleful announcement sounds over the hospital’s loudspeakers–the same directive heard in practically every prison yard in America: Please return to your unit for the head count.
Welcome to the nation’s largest and most expensive hospital for housing and treating men who have been declared to be sexually violent predators–or SVPs, as they’re known in bureaucratic argot.
When Coalinga opened in August 2005 at a cost of $388 million, California hadn’t built a new psychiatric hospital since Dwight Eisenhower was president. Coalinga has been called everything from a state-of-the-art treatment center to a sex gulag.
Each of the patients in Coalinga has served a full sentence in state prison for committing one or more serious sexual offenses, usually child molestation or rape. But instead of being released, they continue to be denied freedom under a twelve-year-old California law that lets the state at once declare offenders to be SVPs and commit them to a state psychiatric facility. Initially, the limit of internment was set at two years, subject to renewal. But with the 2006 passage of Proposition 83, the so-called Jessica’s Law, the length of civil commitment for SVPs is now “indeterminate.” That makes Coalinga State Hospital a strange kind of “Hotel California”–you can check out any time you like, but odds are you can never leave.
In addition to the controversial nature of its mission, Coalinga has been dogged during its three-year history by chronic staffing shortages and patient unrest. At this writing, the hospital is on its fifth executive director, and 8 of the hospital’s 16 budgeted staff psychiatrist positions are unfilled. Well over half of the hospital’s staff positions were vacant as of July (670 out of 1,069), and as one manifestation of the understaffing, patients report that some bathrooms have not been cleaned in several months. Last fall patients protested these conditions by staging a “strike” for several days in which they refused to eat meals or participate in educational and treatment programs.
“They’ve spent a fortune to build this place, and it’s really quite fabulous,” says Michael St. Martin, a Coalinga detainee since December 2006, who previously served ten years in state prison for molesting two 13-year-old boys. “The problem is that no one wants to come here to work. So nothing here functions properly. It’s just one disaster after another. Everything is in total collapse.”
St. Martin has become something of an unofficial spokesperson for Coalinga patients. He’s a frequent contributor to a website called Voices of the Gulag ( and aggressively pursues members of the media who inquire about conditions at the hospital.
Patients at Coalinga effectively face “a lifetime commitment, because they have a vested interest to keep us in here,” St. Martin says. “Seventeen years ago when I was first sentenced [to state prison], I didn’t have a mental disorder because I did-n’t qualify for it. Six years ago, when I ended my prison sentence, suddenly I had a mental disorder. The only mental disorder we have is a political one.”
The reasons for Coalinga’s staffing shortage aren’t hard to fathom, of course. For one thing, a lingering social stigma attached to working with sex offenders discourages many would-be employees from applying. Then there’s the location of the hospital: exactly midway between San Francisco and Los Angeles and close to absolutely nothing. If housing sex offenders is the ultimate “not in my backyard” issue, then at least California solved that part of the problem: Coalinga isn’t in anyone’s backyard. From the hospital gates, Fresno is a punishing 75-mile drive over a sun-baked two-lane road. Summer temperatures in the area often top 100 degrees. The region is also home to “valley fever,” a nasty, flu-like malady that in California infects 35,000 people a year. Even for locals, the word around town is that you’re much better off applying for a job at Pleasant Valley State Prison, located adjacent to the hospital. At least the prison, so the thinking goes, houses a more socially acceptable criminal clientele, and pays higher wages to boot.
Compared to sex offenders, perhaps the only defendants who engender less sympathy these days are accused terrorists. And terrorists may be easier to represent in court than SVPs. “I get calls all the time from attorneys all over California,” says Todd Melnik, a telegenic former deputy district attorney for Los Angeles County who is one of only a handful of private defense attorneys in the state who specialize in SVP cases. “They say, ‘Oh, I’ve heard your name around the hospital. Can you give me any pointers about how to handle a case like this?’ I have to tell them that these cases are monsters. There’s an enormous amount of education you have to have before you can tackle these cases competently. I think a lot of these [less experienced] attorneys are committing malpractice, quite frankly.”
As with terrorists, the ever-harsher laws passed to protect us against sex offenders come despite little evidence that the threat they pose is growing. In fact, arrests for sex crimes are down across the country, falling from 70,237 in 1997 to 63,243 last year. This decline began in the early 1990s, well before many of the current get-tough measures were implemented.
At the same time, the reason often advanced for incarcerating sex offenders indefinitely turns out to be much less compelling than is often claimed. A Bureau of Justice study in 1994 found that only 3.5 percent of sex offenders let out of prison after completing their sentences were rearrested for another sex crime within the first three years. Even over a five- to six-year period, the recidivism rate among sex offenders averages only about 14 percent, according to a meta-analysis of 95 studies that Canadian researchers published in 2004. That’s still well below observed recidivism rates for burglars (74 percent), larcenists (75 percent), and car thieves (79 percent), although researchers caution that sex crimes are more likely than others to go undetected.
But over the past few decades the public’s awareness of violent crimes against children has been heightened–thanks, at least in part, to the rise of the Internet and cable TV news shows. In 1981 six-year-old Adam Walsh was abducted from a Sears store in Florida and later found murdered. Soon after, his father, John Walsh, became the avenging angel of TV’s America’s Most Wanted. The hunt was on.
In 1993 twelve-year-old Petaluma resident Polly Klass was abducted and murdered by Richard Allen Davis. Before long Americans couldn’t pour milk onto their breakfast cereal without confronting the face of a missing child, while the names of the victims and the laws they helped inspire began to blur into one another: Megan’s Law. Jessica’s Law. The Adam Walsh Child Protection and Safety Act. The Amber Alert. The Jacob Wetterling Crimes Against Children and Sexually Violent Offender Act.
The state of Washington broke new legal ground with this issue in 1990 when it enacted the nation’s first sexually violent predator law. The law allows for anyone who commits a sexually violent offense and who “suffers from a mental abnormality or personality disorder which makes the person likely to engage in predatory acts of sexual violence” to be incarcerated indefinitely. Like many similar laws that would follow,Washington’s SVP law was not part of the state’s criminal codes but rather came under its mental health statutes. The internment of a person deemed to be an SVP was thus a civil commitment, skirting standard criminal law protections, such as the right to remain silent.
California followed suit six years later with its own SVP statute, Welfare and Institutions Code section 6600. For persons judged to be sexually violent predators, it established a new category of civil commitment after incarceration. The commitment process works like this: If two state evaluators agree that a soon-to-be-released sex offender meets the SVP criteria, the case is referred to a district attorney for filing a commitment petition. The commitment proceedings are then held in the superior court of the county from which the inmate was last sent to prison. The individual has a right to trial by jury, or can choose to have his case heard before a sole judge. But unlike a criminal trial, there is no right against self-incrimination here. The defendant can be forced to take the stand and cross-examined vigorously. Hearsay evidence can be, and often is, used to prove prior sexual acts. And the accused is not entitled to a jury instruction on the presumption of innocence. All of this makes the prosecution’s job much easier than in a regular criminal proceeding.
If the court or a unanimous jury determines beyond a reasonable doubt that the person fits the criteria for being a sexually violent predator, he is committed to the care of the State Department of Mental Health. Next stop: Coalinga.
Short of escape, there are two ways of getting out alive. In one scenario, which is rare, the treatment facility finds that the committed person is no longer a threat to society and subsequently authorizes him to petition the court for release. In the second scenario, the committed person can petition for release without the consent of the facility. But in that situation, it’s the petitioner who bears the burden of proving he’s no longer a threat. Since 1996, 130 offenders have been unconditionally released from California’s sex-offender programs, while another 13 have been released with conditions attached (continued monitoring and treatment, for example).
Prosecutors insist that the SVPs who end up in Coalinga are unquestionably the worst of the worst. “Some of these folks are batshit crazy,” says Stephen Taylor, deputy district attorney and primary prosecutor of the SVP unit for San Joaquin County. “I know these guys, they need to be in the hospital. They’re just not ready for the sidewalk. You’ve got about 100,000 registered sex offenders in California, and these [Coalinga patients] are considered so radioactive that even a jury puts them in a state hospital. There’s a good reason why the [patients] in Coalinga are in there.”
Taylor has been prosecuting SVP cases for ten years and is convinced that civil internment is necessary, even if it turns out to be, in effect, a life sentence. “We’re not looking for just the average sex offender, we’re looking for the hunter types, the predators,” he continues. “We’re looking for a very particular thing, because we’re going to put someone in the nuthouse, possibly forever.”
From his office in Woodland Hills, defense attorney Todd Melnik begs to differ. “I’d say about 20 to 25 percent of the guys who are in there actually need to be there,” he says. “But the rest are in there because this legislation has gone amok. This is legislators trying to be tough on sexual offenders because they are the easiest pickings possible.”
Another lawyer with reservations about how SVPs are handled is David Lehr, a criminal defense attorney who, interestingly enough, used to prosecute SVP cases while working in the Ventura County district attorney’s office. “These laws are supposed to lock up the worst of the worst, but sometimes,” he says, “people get sucked into the system who don’t belong there. At the same time, there are guys in there who need to stay in there forever.”
Michael Feer, a psychiatric social worker, was on staff at Coalinga for about ten months. “I met some very sick guys when I was there-—serial child molesters who you wouldn’t want on the streets,” he remembers. “In fact, two of them said to me, ‘Never, ever let me out. If I’m released, I know what I would do, and I don’t want to do it.’ On the other hand, I also met guys who I didn’t feel met the criteria for being there. Of the 60 patients I personally treated, I didn’t consider 15 or 20 of them to be sexually violent predators.
“The system,” he adds, “is not perfect.”
Indeed, from the outset many lawyers questioned whether the SVP laws, as written, ran afoul of the Double Jeopardy Clause of the Fifth Amendment.
Enter the U.S. Supreme Court. In 1997 the high court, by a 5–4 vote, upheld the constitutionality of a three-year-old civil-commitment program in Kansas (Kansas v. Hendricks, 521 U.S. 346 (1997)). The defendant in that case claimed that a certification of mental illness alone was too arbitrary to sustain a civil-commitment order. The Court, however, held that the state’s SVP law met due process standards by requiring considerable evidence of past violent sexual behavior and a present mental inclination to repeat such offenses. The Court further ruled that the Kansas law did not violate the Fifth Amendment because it authorized civil rather than criminal commitments.
Five years later, in another key decision also from Kansas, the U.S. Supreme Court asserted that to make an SVP finding the state need not demonstrate that a person is unable to control his behavior—only that “there must be proof of serious difficulty in controlling behavior.” (Kansas v. Crane, 534 U.S. 407 (2002).)
In 1999 the California Supreme Court gave similar sanction to this state’s SVP laws. (See Hubbart v. Superior Court, 19 Cal. 4th 1138.) Two years later it further ruled that a suspected SVP’s prior offenses need not have been predatory, only that likely future sexual offenses would be predatory (People v. Torres, 25 Cal. 4th 680 (2001)). And in 2002 a lower court in the state defined the “likelihood of a future sexual offense” to mean a substantial danger based on a serious and well-founded risk—greater than mere chance, but not necessarily above 50 percent (People v. Superior Court (Ghilotti), 27 Cal 4th 888 (2002)).
Emboldened by these court rulings, 18 other states have passed SVP laws as well, including Arizona, Massachusetts, Missouri, New Hampshire, New York, and Virginia. California’s SVP law has been amended several times, most recently by “Jessica’s Law” (Proposition 83), which was approved overwhelmingly by state voters in 2006. That law expands the definition of a sexual offense eligible for use as the basis for commitment (multiple victims are no longer required); lengthens prison sentences for sex offenders; and, most notably, allows for the civil commitment of SVPs for an “indeterminate” period of time.
Even if Coalinga doesn’t have the staff needed for its current population, the facility still has room for another 740 patients. But luckily for the hospital, although the state’s SVP evaluations have ballooned from 50 to 750 a month since the passage of Jessica’s Law, the number of actual commitments per year has barely increased. This, perhaps, is a reflection of the research showing that sex offenders do not re-offend nearly as often as once thought.
Defending SVPs can be a thankless job, confides Sacramento attorney Michael Aye, perhaps the most experienced SVP defense lawyer in the state. “I’ve had other attorneys wish me luck on a trial, until they found out what kind of case I was doing. Then they say, ‘Well, you know … I hope you lose, but it’s sure good to see you again.’ ”
Aye comes from a family of attorneys. His grandfather was a lawyer, and for many years his father was chief deputy in the Solano County public defender’s office. Aye himself has had a defense practice in Sacramento for 28 years, and his brick-walled office in Old Sacramento may well be the messiest in the state, at least among attorneys who still have a license. So many papers cover his work surface that it’s impossible to see the desktop. Still more documents are spread on the floor, which may or may not have a rug.
Aye started taking SVP cases a few months after California’s SVP law took effect in January 1996. Since then he’s become a nationally recognized expert on the complex legal and medical issues surrounding civil internment of people judged to be SVPs, and he has trained public defenders to handle SVP cases in several California counties. “I got into this because California’s SVP law really pissed me off, quite frankly,” Aye says in a clipped, streetwise tone less befitting a defense attorney than someone a defense attorney might represent. “The notion that someone can get locked up for a crime they hadn’t committed yet I found offensive, and I still do.”
So what does Aye tell his Coalinga clients when they ask about their chances of ever getting out? “I usually tell them ‘Not good,’ Aye says flatly. “Then I ask them, ‘How old are you?’ ”
Age, as it turns out, is one of the few factors that can work in an SVP patient’s favor. An increasing body of evidence suggests that few sex offenders re-offend after the age of 50, and even fewer after age 60. Still, Aye says he’s won only a handful of releases in SVP cases since he began working on them.
For Aye, the ideal SVP client is a 60-year-old rapist. Child molesters are always more problematic; key factors include the age of both the victim and the perpetrator at the time of the offense, the degree of force used in the attack, whether the victim was known to the attacker, and whether the attacker has ever had a stable relationship. But if the SVP determination goes to a jury, the most important element of all is the way the defendant tells his story.
“How the person presents is a big factor,” says Aye. “If he presents as very needy, as a narcissistic or borderline type, or every other word out of his mouth is ‘Yeah, but,’ or if there’s a lot of victim blaming, those are all real problems. If he can’t straighten out that kind of presentation, the first thing that’s going to happen is the DA will put him on the stand at trial. And then they’re toast.”
Like Aye, Todd Melnik in Southern California has as much SVP work as he can handle. But the two have very different practices. Aye has 20 active cases right now, many of them assigned to him by the county of Sacramento, which pays him about $80 an hour. Melnik, by contrast, says he works on about three SVP cases a year. He takes no assignments, and charges from $150,000 to $180,000 per case—-plus expenses for having top psychological experts on sex offenders testify, which may run $40,000 per expert witness. Melnik says he spends from six to eight weeks preparing for an SVP trial, putting in 40 to 60 hours each week. A trial, if it comes to that, lasts an additional four to six weeks. “The last SVP case I lost was in 1999,” Melnik says.
Perhaps the most controversial aspect of the sex-offender-commitment process used at Coalinga is the five-stage treatment program, which was devised soon after California’s SVP law took effect. Treatment is often the center of legal and moral justifications for indefinitely committing someone who’s served his full prison sentence. But roughly 70 percent of Coalinga’s patients refuse to participate in the phased program, and so far only eleven SVPs have successfully completed it. One reason for the low level of participation is that under the law, what SVPs say in treatment can be held against them.
Says Melnik: “One of the things these people have to do in treatment is write down fantasies, from the past or what they think about now. And that becomes a permanent record. The DA will bring out those fantasies in trial, and they’ll have a doctor who testifies, ‘Look, he’s still having fantasies, he still meets the criteria, he’s still dangerous.’ And I’ve heard of some cases where guys have to make up fantasies, even if they don’t have them, to make it through to the next phase of treatment. So it’s a catch-22.”
As the five-phase treatment program was originally envisioned, it would take only about two years to complete. But many patients have been in treatment much longer, with no end in sight.
Take Steven Burkhart, a 44-year-old Coalinga patient. He’s now in his eighth year of treatment, which began at Atascadero State Hospital—-the institution that held most of the state’s SVPs before Coalinga opened its doors—-after he’d served ten years in state prison for two counts of having sex with a minor. He’s still in Phase 2 of the treatment, in part, he says, because there’s so little opportunity to make progress. Treatment at Coalinga is conducted twice a week for one hour and 50 minutes, and most treatment groups have ten to twelve patients in them.
“To be honest, I’ve lost my motivation to push my treatment any further,” says Burkhart. “The attitude of the staff at the hospital is that the people in here have done the most despicable act you can do-—molesting a child or raping an adult—-so they can do anything they want to do, and the public won’t care.”
There is also controversy over the quality of the science behind some of the treatment that Coalinga patients are getting. One treatment regimen, called covert sensitization/sexual arousal modification, uses a device that monitors changes in blood flow to the penis in response to visual or audio stimuli. Therapists then study the results in an effort to determine how much progress a particular patient is making. (Subjects are taught to pair deviant sexual fantasies with adverse thoughts, which in turn is supposed to diminish inappropriate urges.) However, there is no shortage of skepticism about this approach. Dr. Richard Krueger, the medical director of the New York State Psychiatric Institute’s Sexual Behavior Clinic, states flatly, “There’s no scientific evidence that any of these [state-run] treatment programs for SVPs work.”
Despite all the problems that Coalinga faces, there is talk of building another similar hospital before too long. But in a state grappling with deficits, money is a major stumbling block, and it certainly doesn’t help that Gov. Arnold Schwarzenegger has already asked lawmakers for $7 billion in new spending just to bring health care in California’s state prisons up to snuff.
A much cheaper alternative to residential facilities such as Coalinga would be providing SVPs with outpatient treatment—perhaps an unlikely option in the current political environment. Nevertheless, Texas, of all places, allows for the reintegration of SVPs into the community. It also requires SVPs to actively participate in intensive outpatient sex-offender treatment and supervision. So far, outpatient SVPs in Texas are about twice as likely to participate in treatment as are SVPs at inpatient facilities like Coalinga.
“You look at what Texas is doing, and the reality is that these guys do better with treatment on the outside; they don’t re-offend at a high rate at all,” says Aye. “What we have here at Coalinga is basically a fraud. It’s a fraud on the people of California, that this is somehow protecting them. This is simply a way to continue to punish sex offenders. That’s all it is.”
Aye sighs. “Some days I count my reward by how often I can piss off the DA.”