|
Back to Calendar
Return
|
| |
4.
|
| FAMILY AND HUMAN SERVICES COMMITTEE |
|
|
|
| Information |
| Referral History: |
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.
AB 1421 allows court-ordered intensive outpatient treatment called Assisted Outpatient Treatment (AOT) for a clearly defined set of individuals. In order to be eligible for AOT an individual must meet the following criteria:
• Must be 18 years or older
• Must be suffering from a SMI (W&I 5600.3)
• Unable to survive safely in community without supervision
• History of lack of compliance with treatment, evidenced by either:
– Hospitalized/incarcerated 2 or more times in last 36 months in forensic or MH unit of State or local correction facility due to mental illness
– Demonstrated violent behavior towards self or others in the last 48 months
• Offered and refused treatment on a voluntary basis
• Condition must be deteriorating
• Assisted Outpatient Treatment (AOT) is considered the least restrictive treatment
• AOT is needed to prevent relapse or further deterioration
• Will benefit from AOT
AB 1421 specifies that any of the following -- an adult with whom the person resides; a parent, spouse, sibling or child of person (18 or older); the director/designee of the mental health treatment facility or residential facility where the person is/was receiving treatment; a licensed mental health treatment provider; or a law enforcement officer (including probation/parole) – 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. A lack of funding and ongoing controversy over forcing individuals with mental illness into treatment has led most counties to decide against enacting. Nevada County was the first to adopt Laura's Law. In addition to Nevada and Contra Costa, El Dorado, Kern, Los Angeles, Mendocino, Orange, Placer, San Diego, San Francisco, San Mateo, Santa Barbara, Shasta, and Yolo counties have implemented a Laura's Law pilot program.
At its June 3, 2013 meeting, the Legislation Committee requested that this matter be referred to Family and Human Services Committee (FHS) 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 FHS for consideration.
On January 6, 2015 and January 5, 2016, the Board of Supervisors accepted the staff recommendation to carry forward FHS Referral #107 Laura's Law to the 2016 FHS Committee.
|
| Referral Update: |
On March 10, 2014, FHS accepted the report and recommendations from the Health Services Department to pilot an Assisted Outpatient Treatment Program.
On October 7, 2014, the Board of Supervisors considered the report from the Health Services Assisted Outpatient Treatment (AOT) Workgroup. The Board expressed its intention to implement an involuntary assisted outpatient treatment program, and instructed the County Administrator’s Office and Health Services Department to provide additional information at a later Board meeting to ensure no voluntary programs would be reduced as a result of implementing Laura’s Law.
On February 3, 2015, the Board of Supervisors adopted the recommendations of the Health Services Department for a program to be developed with stakeholder participation. Additionally, the Board directed staff to return to the Board for final approval of the program once funding for the program implementation had been built into the budget.
On December 15, 2015, the Health Services Department provided the Board of Supervisors with an update on the progress of the Assisted Outpatient Treatment Program. The Board approved the department's recommendation to continue with the program's implementation using $2.25 million per year of Mental Health Services Act funding, which would not impact the County's General Fund or reduce the existing voluntary mental health program services. The Board asked that the department return with an update after six months of the full implementation.
|
| Recommendation(s)/Next Step(s): |
ACCEPT the report from the Health Services Department on the implementation of the County's Assisted Outpatient Treatment Program, as authorized by the Board of Supervisors and AB 1421 (Laura's Law), and forward the report to the Board of Supervisor for approval.
|
| Fiscal Impact (if any): |
Mental Health Services Act funding to support the program is contained within the Health Services Department budget. There is no impact to the County General Fund.
|
|
|
|