Agenda

Return

D.4

To:	Board of Supervisors
From:	FAMILY & HUMAN SERVICES COMMITTEE
Date:	October 17, 2017

Contra

Costa

County

Subject:

Assisted Outpatient Treatment (Laura's Law) Annual Implementation Update Report

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 10/17/2017

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Diane Burgis, District III Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:

Enid Mendoza, (925) 335-1039

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: October 17, 2017
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

ACCEPT the annual report from the Health Services Department on the implementation of Laura's Law - Assisted Outpatient Treatment (AOT) program during the period July 1, 2016 through June 30, 2017.

FISCAL IMPACT:

This is an informational report and has no immediate fiscal impact.

BACKGROUND:

The Assisted Outpatient Treatment Demonstration Project Act (AB 1421), known as Laura’s Law, was signed into California law in 2002 and is authorized until January 1, 2017. Laura’s Law is named after a 19 year old woman working at a Nevada County mental health clinic. She was one of three individuals who died after a shooting by a psychotic individual who had not engaged in treatment.

BACKGROUND: (CONT'D)

AB 1421 allows court-ordered intensive outpatient treatment called Assisted Outpatient Treatment (AOT) for a clearly defined set of individuals that must meet specific criteria. AB 1421 also specifies which individuals may request the County Mental Health Director to file a petition with the superior court for a hearing to determine if the person should be court ordered to receive the services specified under the law. The County Mental Health Director or his licensed designee is required to perform a clinical investigation, and if the request is confirmed, to file a petition to the Court for AOT.

If the court finds that the individual meets the statutory criteria, the recipient will be provided intensive community treatment services and supervision by a multidisciplinary team of mental health professionals with staff-to-client rations of not more that 1 to 10. Treatment is to be client-directed and employ psychosocial rehabilitation and recovery principles. The law specifies various rights of the person who is subject of a Laura’s Law petition as well as due process hearing rights.

If a person refuses treatment under AOT, treatment cannot be forced. The Court orders meeting with the treatment team to gain cooperation and can authorize a 72 hour hospitalization to gain cooperation. A Laura’s Law petition does not allow for involuntary medication.

AB 1421 requires that a county Board of Supervisors adopt Laura’s Law by resolution to authorize the legislation within that county. AB 1421 also requires the Board of Supervisors to make a finding that no voluntary mental health program serving adults or children would be reduced as a result of implementation.

At its June 3, 2013 meeting, the Legislation Committee requested that this matter be referred to the Family and Human Services Committee (F&HS) for consideration of whether to develop a program in the Behavioral Health Division of the Health Services Department that would implement assisted outpatient treatment options here in Contra Costa County.

On July 9, 2013, the Board of Supervisors referred the matter to F&HS for consideration. F&HS received reports on the implementation of Laura's Law on October 16, 2013 and March 10, 2014. On February 3, 2015 the Contra Costa Board of Supervisors adopted resolution No. 2015/9 to direct the implementation of an Assisted Outpatient Treatment program for a three year period and directed the Health Services Department to develop a program design with stakeholder participation, and comply with MHSA statutory requirements for a community program planning process. The Board further authorized the Health Services Director to execute a contract with Resource Development Associates, Inc. to provide consultation and technical assistance with regard to the evaluation of the County’s AOT Program for persons with serious mental illness who demonstrate resistance to voluntarily participating in behavioral health treatment for the period from November 16, 2015 through June 30, 2019.

In February 2016, Laura's Law was implemented and the Department provided F&HS with a 6-month implementation report on September 12, 2016 and a data report on the 6-month implementation on December 12, 2016. Both reports were accepted by the Board on September 27, 2016 and December 20, 2016, respectively. On May 22, 2017 the Family and Human Services Committee received and approved a report on the AOT Program implementation for the period February through December 2016. The report was later approved by the Board of Supervisors at their July 11, 2017 meeting.

On September 25, 2017 the Family and Human Services Committee received and discussed the AOT Program reports (attached) for fiscal year 2016-17 as provided by the Health Service Department and Resource Development Associates. Contra Costa Behavioral Health Services was directed to coordinate with the Health, Housing and Homeless Services Division and develop a plan to maximize enrollment in treatment of persons who are eligible for the AOT Program and are homeless or at risk of being homeless. This plan is also attached and accompanies the evaluation reports.

CONSEQUENCE OF NEGATIVE ACTION:

The Board will not receive the report as approved by the Family and Human Services Committee.

CLERK'S ADDENDUM

Speakers: Douglas Dunn, Lauren Rettagliata, Linda Dunn, Sharon Madison. Written commentary attached.