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FAMILY AND HUMAN SERVICES COMMITTEE

Meeting Date:	09/25/2017
Subject: Assisted Outpatient Treatment (Laura's Law) Annual Implementation Update Report
Submitted For:	FAMILY & HUMAN SERVICES COMMITTEE
Department:	County Administrator
Referral No.:	107
Referral Name:	Laura's Law
Presenter:	Warren Hayes, MHSA Program Manager	Contact:	Enid Mendoza, (925) 335-1039

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 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, and on February 3, 2015 the Board accepted the recommendations to implement Laura's Law. 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 implementation for the period February through December 2016. The report was later approved by the Board of Supervisors at their July 11, 2017 meeting. The department reported that they would be prepared to provide a full fiscal year report to F&HS and the Board after the July 1, 2016 through June 30, 2017 data was available.

Referral Update:

In partnership with Resource Development Associates (RDA), the Health Services Department Behavioral Health Division has provided the attached reports, which include the AOT Program Evaluation Summary, the Contra Costa County Assisted Outpatient Treatment (AOT) Evaluation for fiscal year 2016/17, and the Contra Costa County Assisted Outpatient Treatment (AOT) Evaluation MHS' ACTiOn Team 2017 Fidelity Assessment.

Recommendation(s)/Next Step(s):

CONSIDER accepting the Assisted Outpatient Treatment evaluation reports for fiscal year 2016-17 as provided by the Health Services Department and Resource Development Associates and forwarding the attached reports to the Board of Supervisors for their information.

Fiscal Impact (if any):

There is no fiscal impact; the report is informational.

Attachments
AOT FY 16-17 Evaluation Summary Report
AOT FY 16-17 Evaluation Report
AOT Evaluation Fidelity Assessment Summary
AOT Evaluation Presentation Slides