BILL ANALYSIS                                                                                                                                                                                                    

                                                                    AB 1193

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          Date of Hearing:  May 13, 2015


                                 Jimmy Gomez, Chair

          1193 (Eggman) - As Amended April 30, 2015

          |Policy       |Health                         |Vote:|16 - 0       |
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          |             |Judiciary                      |     |10 - 0       |
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          Urgency:  No  State Mandated Local Program:  YesReimbursable:   


          This bill addresses local implementation of Assisted Outpatient  
          Treatment (AOT, or Laura's Law).  Specifically, this bill:


                                                                    AB 1193

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          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  

          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.  


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          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.  


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          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.  


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             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)