BILL ANALYSIS Ó AB 1193 Page 1 Date of Hearing: May 13, 2015 ASSEMBLY COMMITTEE ON APPROPRIATIONS Jimmy Gomez, Chair AB 1193 (Eggman) - As Amended April 30, 2015 ----------------------------------------------------------------- |Policy |Health |Vote:|16 - 0 | |Committee: | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | |Judiciary | |10 - 0 | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | ----------------------------------------------------------------- Urgency: No State Mandated Local Program: YesReimbursable: Yes SUMMARY: This bill addresses local implementation of Assisted Outpatient Treatment (AOT, or Laura's Law). Specifically, this bill: AB 1193 Page 2 1)Allows specified judges to file a petition to obtain an order authorizing assisted outpatient treatment. 2)Requires any county that has not held a public hearing by January 1, 2017, to determine whether to implement AOT, to hold that hearing by January 1, 2018. Specifies what factors shall be considered at the hearing. 3)Removes the current requirement that a county 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" of AOT. 4)Extends the sunset date on statutes authorizing AOT to January 1, 2022 (from 2017). FISCAL EFFECT: 1)State-reimbursable mandate local costs associated with the requirement to hold public hearings in the range of $2 million GF. 2)Potential additional state-reimbursable mandate local costs, possibly in the range of hundreds of thousands of dollars annually, if authorizing a judge to request a petition compels a greater number of AOT investigations and reports. 3)In addition, counties could incur significant unknown costs associated with implementation of AOT if they choose to do so, but these costs are not state- reimbursable as it remains at the county's discretion. COMMENTS: AB 1193 Page 3 1)Purpose. The author believes this bill will ensure counties consider the preferences of their residents with respect to implementation of AOT. The author states the current process of opting in makes AOT implementation too difficult for counties to participate, evidenced by the fact that only a fraction of the counties have implemented AOT. The author contends mplementing AOT statewide will ensure that those at highest risks for hospitalization can obtain the necessary treatment services to keep them in the community, and notes this bill allows counties to retain control by opting out if they choose not to participate. 2)Background. Enacted in 2002, Laura's Law was named for Laura Wilcox, a 19-year-old college student in Nevada County who was killed by a severely mentally ill man who was not adhering to prescribed mental health treatment. Laura's Law permits counties to provide court-ordered outpatient treatment services for people with serious mental illness. To implement the order, a court must find that a person's recent history of hospitalizations or violent behavior, coupled with noncompliance with voluntary treatment, indicates the person is likely to become dangerous or gravely disabled without treatment. The intent of Laura's Law is to prevent a small number of individuals who meet narrow eligibility criteria from becoming gravely disabled or threatening. A county board of supervisors must pass a resolution in order to implement Laura's Law. To date, about nine counties have implemented Laura's Law in some form; counties have generally configured the implementation to align with local priorities. 3)Support. This bill is sponsored by the California Psychiatric Association and supported by physician groups, hospitals, and Nick and Amanda Wilcox, parents of the young woman for whom Laura's Law is named. They cite success of implemented AOT programs, and desire to increase the reach of this important option for outpatient treatment. AB 1193 Page 4 4)Opposition. Disability Rights California opposes this bill because it removes a key protection, namely, the prohibition on reducing voluntary mental health services when implementing AOT programs. Counties and their behavioral health agencies oppose this bill unless amended to remove all provisions, except the sunset extension. Counties cite increased county workload and reduction in county authority to decide whether to address the option to implement AOT, among other concerns. 5)Related Legislation. a) AB 59 (Waldron) removes the sunset on Laura's Law so that the program is indefinitely extended, eliminates the requirement that the board of supervisors in a county must find voluntary mental health programs will not be reduced as a result of implementation of AOT, and allows the professional staff of the facility where a person has been detained for involuntarily inpatient treatment to recommend a petition for AOT for that person. b) AB 193 (Maienschein) Allows probate courts to recommend a referral for an LPS conservatorship to the county officer providing conservatorship investigations. 1)Prior Legislation. AB 1193 Page 5 a) AB 2266 (Waldron, 2014) increased the maximum period of imposed outpatient treatment under the AOT Demonstration Project from six months to one year. AB 2266 failed in the Assembly Judiciary Committee. b) AB 1265 (Conway, 2013) increased the maximum period of imposed outpatient treatment under the AOT Demonstration Project from six months to one year. AB 1265 also failed in the Assembly Judiciary Committee. Analysis Prepared by:Lisa Murawski / APPR. / (916) 319-2081