BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 59|
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THIRD READING
Bill No: AB 59
Author: Waldron (R), et al.
Amended: 3/28/16 in Senate
Vote: 21
SENATE HEALTH COMMITTEE: 6-0, 6/8/16
AYES: Hernandez, Nguyen, Mitchell, Nielsen, Pan, Roth
NO VOTE RECORDED: Hall, Monning, Wolk
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
ASSEMBLY FLOOR: 77-0, 1/27/16 - See last page for vote
SUBJECT: Mental health services: assisted outpatient
treatment
SOURCE: Author
DIGEST: This bill extends the repeal date of the Assisted
Outpatient Treatment (AOT) Demonstration Project Act of 2002, or
"Laura's Law," by five years, to January 1, 2022, and deletes
and recasts in existing law the Department of Health Care
Service's (DHCS) reporting requirement, as specified, regarding
the AOT services a county provides.
ANALYSIS:
Existing law:
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1)Allows a county boards of supervisors, by resolution, to authorize
Laura's Law, whereby a county behavioral health director can
petition for a court to order a person over the age of 18 with a
mental illness to receive AOT if the court finds the individual
meets specified criteria, including: a clinical determination that
the person is unlikely to survive safely in the community without
supervision; the person has a history of noncompliance with
treatment for his or her mental illness; and the person's
condition is substantially deteriorating and participation in AOT
would be the least restrictive placement necessary to ensure the
person's recovery.
2)Requires counties that implement Laura's Law to make a finding
that no voluntary mental health program serving adults, and no
children's mental health program, may be reduced as a result of
the implementation.
3)Requires a county that provides court-ordered AOT services to also
offer the same services on a voluntary basis.
4)Requires DHCS to submit a report and evaluation of all
counties implementing any component of Laura's Law to the
Governor and the Legislature by July 1, 2015.
5)Sunsets Laura's Law on January 1, 2017, unless a later enacted
statute extends or repeals that date.
This bill extends the sunset of Laura's Law by five years, to
January 1, 2022, and deletes and recasts in existing law DHCS's
reporting requirement to the Governor and Legislature, on or
before May 1 of each year, regarding the AOT services the county
provides pursuant to Laura's Law.
Comments
1)Author's statement. According to the author, currently,
Laura's Law is set to sunset on January 1, 2017. Without AB
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59, Laura's Law will expire and leave those who are mentally
ill without the necessary treatment they need. AOT is a
program that helps assist family members to initiate
outpatient treatment for severe mentally ill adults who are
incapable of seeking help on their own and have a history of
incarceration, hospitalization, or have threatened to hurt
themselves or others. AOT is an evidence-based, well-studied
modality of treatment that has been effective in helping and
stabilizing mentally ill individuals. The program has
increased stable housing, medication adherence, and social
skills building. AB 59 will ensure Laura's Law is available to
the families of those who are mentally ill in order to provide
proper care and support.
2)Laura's Law. Enacted pursuant to AB 1421 (Thompson, Chapter
1017, Statutes of 2002), Laura's Law established a new
court-ordered AOT demonstration program aimed at individuals
with mental illness who meet specified criteria but who do not
meet the criteria (danger to self or others, or gravely
disabled) for involuntary commitment to an inpatient facility.
The law is named in memory of Laura Wilcox, a 19-year-old
college student who was killed by a severely mentally ill man
who was not adhering to prescribed mental health treatment.
AOT provides counties with the option to implement intensive
programs for individuals who have difficulty maintaining their
mental health stability in the community and have frequent
hospitalizations and contact with law enforcement related to
untreated or undertreated mental illness.
Laura's Law requires a county's board of supervisors to
authorize implementation by resolution and to make a finding
that access to voluntary mental health programs serving adults
and children would not be reduced as a result of
implementation. Implementation of Laura's Law is at the
discretion of each county. The law did not provide for any
state or local funding for the program's implementation. This
lack of funding has been perceived as one of the barriers to
its implementation. According to the former Department of
Mental Health in 2011, no county implemented a court-ordered
Laura's Law program until Nevada County implemented it in
2008. Since implementation, Nevada County has found that
Laura's Law has resulted in: 46% reduction in
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hospitalizations, 65% reduction in incarcerations, 61%
reduction in homelessness, 44% reduction in emergency
contacts, and $1.81-$2.52 in savings for every dollar spent as
a result of reducing incarceration, arrest, and
hospitalization.
SB 585 (Steinberg and Correa, Chapter 288, Statutes of 2013),
clarified that Mental Health Services Act (MHSA) funds could
be used for AOT services if the county has implemented it.
According to DHCS, 15 counties have approved and/or
implemented Laura's Law: Alameda, Contra Costa, El Dorado,
Kern, Los Angeles, Mendocino, Nevada, Orange, Placer, San
Diego, San Francisco, San Luis Obispo, San Mateo, Ventura, and
Yolo.
Prior Legislation
AB 1193 (Eggman, 2015) would have, among other things, required
a county that has not held a specified public hearing by January
1, 2017, to hold a hearing by January 1, 2018, and would have
required the county board of supervisors to consider both
whether mental health programs may be reduced as a result of
participation in Laura's Law and options for providing services
other than court-ordered outpatient treatment. AB 1193 was held
on suspense in the Assembly Appropriations Committee.
SB 585 (Steinberg and Correa, Chapter 288, Statutes of 2013) See
Comments.
AB 1265 (Conway, 2014) would have permitted an initial court
order for AOT services to be extended for up to 12 months
(rather than the current six months), and required that each
person discharged from a hospital be considered for AOT in the
counties that have implemented Laura's Law. AB 1265 failed
passage in the Assembly Judiciary Committee.
AB 2266 (Waldron, 2014) was similar to AB 1265. AB 2266 failed
passage in the Assembly Judiciary Committee.
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SB 664 (Yee, 2013) would have removed the requirement that each
county board of supervisors pass a resolution prior to
implementing Laura's Law, and acknowledged that counties could
cap the number of people under the program. SB 664 failed
passage in the Senate Appropriations Committee without being
heard.
AB 1367 (Mansoor, 2013) would have clarified that MHSA funds
could be used to support Laura's Law and provided outreach to
school children who may be a threat to themselves or others. AB
1367 failed passage in the Assembly Health Committee without
being heard.
AB 1569 (Allen, Chapter 441, Statutes of 2012) extends the
sunset date of Laura's Law from January 1, 2013, until January
1, 2017, and requires DHCS to submit a report and evaluation of
all counties implementing any component of the law to the
Governor and the Legislature by July 1, 2015.
AB 2134 (Chesbro, 2012) would have required a county that elects
to provide AOT services to develop best practices for the
purposes of responding to a mental health crisis, and would have
required these best practices to include the utilization of
crisis intervention teams, mobile crisis teams, or psychiatric
emergency response teams, with an emphasis on peer support. AB
2134 failed passage in the Senate Health Committee.
AB 2357 (Karnette and Yee, Chapter 774, Statutes of 2006)
extended the Laura's Law sunset date to January 1, 2013, and
required the former Department of Mental Health to submit a
progress report to the Governor and Legislature in 2011.
AB 1421 (Thompson, Chapter 1017, Statutes of 2002) See Comments.
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FISCAL EFFECT: Appropriation: Yes Fiscal
Com.:YesLocal: No
SUPPORT: (Verified6/28/16)
California Chapter of the American College of Emergency
Physicians
California State Association of Counties
NAMI Contra Costa
San Diego Regional Chamber of Commerce
Tenet Healthcare
Urban Counties of California
One individual
OPPOSITION: (Verified6/28/16)
Disability Rights California
ARGUMENTS IN SUPPORT: Supporters of this bill argue that
extending Laura's Law allows local governments to assess the
needs of their communities on an ongoing basis, and that it is
an important part of the mental health continuum of care,
focusing on prevention, saving lives, and improving the quality
of life for individuals and communities. Supporters state that
counties that have implemented Laura's Law have also seen a
significant decrease in homelessness, as well as reduced
spending on emergency room and jail costs.
ARGUMENTS IN OPPOSITION: Disability Rights California (DRC)
argues that it has concerns about AOT programs and believes that
voluntary services are more effective and should be expanded.
DRC states that the sunset provision is important to protect the
rights of people with mental health disabilities in California.
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ASSEMBLY FLOOR: 77-0, 1/27/16
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,
Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang,
Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle,
Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina
Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez,
Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Irwin,
Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low,
Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin,
Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Quirk,
Rendon, Rodriguez, Salas, Santiago, Steinorth, Mark Stone,
Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood,
Atkins
NO VOTE RECORDED: Holden, Ridley-Thomas
Prepared by:Reyes Diaz / HEALTH / (916) 651-4111
6/29/16 15:45:48
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