BILL ANALYSIS �
AB 1569
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Date of Hearing: April 25, 2012
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 1569 (Allen) - As Amended: April 16, 2012
Policy Committee: Health Vote:15-3
Judiciary Vote: 10-0
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill extends the sunset date of the Assisted Outpatient
Treatment (AOT) Demonstration Project Act of 2002 (Laura's Law)
from January 1, 2013 to January 1, 2017 and requires the
Department of Mental Health to submit an evaluation report by
July 1, 2015.
FISCAL EFFECT
1)Based on experience to date, likely minor state trial court
costs.
2)Minor, absorbable one-time costs to DMH to collect data from
counties and prepare an evaluation report.
3)To the extent the involuntary AOT program is implemented more
widely throughout the state, and is successful in helping
treated individuals avoid hospitalizations or interaction with
the criminal justice system, there could be minor avoided
costs in local law enforcement or health care programs.
However, given that there is no dedicated funding for the
program, and that implementing the program requires a finding
by a county board of supervisors that no voluntary programs
will be affected as a result of implementation, it appears
unlikely that the program will be widely implemented. To date
only one county has implemented an AOT program.
COMMENTS
1)Rationale . AB 1569 would extend the sunset date of Laura's
AB 1569
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Law, which authorizes counties to implement involuntary
assisted outpatient treatment services to severely mentally
disabled individuals who have chronically refused mental
health treatment. The author notes that, while only Nevada
County has opted to implement an AOT program in California,
this bill is needed to ensure that counties continue to have
another tool available for providing the legal and clinical
treatment structure necessary to give severely mentally ill
individuals who chronically refuse voluntary treatment the
support they need to achieve stability and meaningful recovery
in their communities.
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 man suffering from serious delusional paranoia.
Specifically, 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 petition
requesting the court-ordered treatment must be made to the
county mental health department by an adult living with the
mentally disabled individual, the parent, spouse, sibling,
adult child of that person, mental health workers, or law
enforcement personnel.
Current law establishes other mechanisms for administering
involuntary treatment; however, generally, individuals must be
found gravely disabled or a threat to themselves or others.
The intent of Laura's Law is to provide prevent deterioration
among a small number of individuals who meet narrow
eligibility criteria, in order to prevent the individuals from
becoming gravely disabled or threatening.
3)Evaluation . At this point, it is unclear whether the
demonstration project has been effective, because the number
of individuals treated through court order was small (4) and
because the implementation of the program does not offer a
true experimental design. Based on the individual cases in
Nevada County who were treated under court order, the program
appears to have been successful in reducing hospitalization
and interaction with the criminal justice system. A review of
a similar law in New York through which nearly 4,000
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individuals received court-ordered AOT found increased
participation in case management and other services, increased
adherence to prescribed medication, improved community and
social functioning, and reduced incidence of harmful
behaviors.
4)Opposition . Opponents of this bill, including some patient
advocacy groups, argue that this bill forces treatment on
individuals who may not need or want it. The opposition
further argues that increased emphasis should be placed on
enhancing voluntary services, which have a long track record
of effectiveness, rather than preserving or expanding options
for involuntary treatment.
5)Previous Legislation . AB 2357 (Karnette), Chapter 1017,
Statutes of 2002 extended the sunset of Laura's Law from 2008
to 2013 and required DMH to produce an evaluation report.
AB 1421 (Thomson), established the Laura's Kaw demonstration
program, including the program structure, eligibility
criteria, and rights of individuals to appeal decisions.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081