BILL ANALYSIS �
AB 1569
Page 1
ASSEMBLY THIRD READING
AB 1569 (Allen)
As Amended April 16, 2012
Majority vote
HEALTH 15-3 JUDICIARY 10-0
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|Ayes:|Monning, Logue, Atkins, |Ayes:|Feuer, Wagner, Atkins, |
| |Eng, Garrick, Gordon, | |Dickinson, Gorell, Huber, |
| |Roger Hern�ndez, Torres, | |Jones, Monning, |
| |Mansoor, Mitchell, | |Wieckowski, Bonnie |
| |Nestande, Pan, V. Manuel | |Lowenthal |
| |P�rez, Silva, Williams | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Ammiano, Hayashi, Smyth | | |
| | | | |
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APPROPRIATIONS 16-0
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|Ayes:|Fuentes, Blumenfield, |
| |Bradford, Charles |
| |Calderon, Campos, Davis, |
| |Donnelly, Gatto, Hall, |
| |Hill, Lara, Mitchell, |
| |Nielsen, Norby, Solorio, |
| |Wagner |
| | |
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SUMMARY : Extends the sunset date in current law providing counties
with the option to implement court-ordered assisted outpatient
treatment (AOT) programs for mentally ill persons from January 1,
2013, to January 1, 2017, and requires a related evaluation report
to be submitted to the Legislature by July 1, 2015.
EXISTING LAW :
1)Establishes, pursuant to AB 1421 (Thomson), Chapter 1017, Statutes
of 2002, the AOT Demonstration Project Act of 2002 (Act) to permit
counties to provide AOT services for people with serious mental
illnesses when a court finds that a person's recent history of
hospitalizations or violent behavior, and noncompliance with
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voluntary treatment, indicates the person is likely to become
dangerous or gravely disabled without the court-ordered outpatient
treatment.
2)Sunsets the Act on January 1, 2013, and requires the Department of
Mental Health (DMH) to submit a report and evaluation to the
Legislature of all counties implementing an AOT program by July
31, 2011.
FISCAL EFFECT : According to the Assembly Appropriations Committee:
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. To date, only one
county has implemented an AOT program.
COMMENTS : The author states that scientific research demonstrates
that sustained AOT services can be highly successful for individuals
with the most severe and persistent mental illnesses. The author
points to numerous studies of New York's AOT law, also known as
Kendra's Law, that have found that, in the first five years of the
program, the estimated 3,900 individuals who received treatment
orders experienced increases in engagement of services and adherence
to prescribed medications, and reductions in hospitalizations,
homelessness, arrests, and, incarcerations. 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.
According to a December 2011 report that DMH submitted to the
Legislature, as required by AB 2357 (Karnette), Chapter 774,
Statutes of 2006, which extended the sunset date of AB 1421, from
2008 to 2013, the only fully implemented AOT program is in Nevada
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County where it has been operational since 2008. For fiscal years
(FY) 2008-09 and 2009-10, data show that the AOT program served a
total of four court-ordered individuals over two years. However,
DMH notes that recent data suggest an additional six individuals
were served by Nevada County through FY 2010-11. According to the
report, 75% of referrals to Nevada County's AOT program result in a
"voluntary" agreement by the individual to accept mental health
treatment assistance. Of the four individuals served by Nevada
County's program, the data show that the total hospitalization days
for all individuals in the 12 months prior to AOT were 239, compared
to 97 days during their participation in the program.
Supporters of this bill, including the California Psychiatric
Association, the California State Sheriffs' Association, and the
National Alliance for the Mentally Ill, state that AB 1421 needs to
be extended because it is a valuable early intervention alternative
to revolving door hospitalization and incarceration for a small
group of individuals who meet certain stringent criteria and
occupies a unique niche in counties' continuum of care that supports
recovery from severe and persistent mental illness. They note that,
in Nevada County, AOT saved $1.81 in hospitalization and
incarceration costs for every $1.00 invested and it has had a
positive fiscal impact on decreasing costs to other county systems,
such as emergency departments, ambulance, law enforcement, and the
courts.
Opponents of this bill, including Disability Rights California, the
American Civil Liberties Union of California, and other patient
advocacy groups, argue that AOT is unnecessary as there are good
alternatives to ensure access to needed mental health services; AOT
has not been widely implemented and does not work; and, the current
Lanterman-Petris Short Act law allows for involuntary mental health
treatment under statutorily defined criteria. They maintain that
forced treatment is inconsistent with mental health recovery
principles of self-determination and empowerment and state that
California should increase the availability of a full array of
voluntary mental health services for the mentally disabled and
expand programs that have demonstrated success in saving lives and
money.
Analysis Prepared by : Cassie Royce / HEALTH / (916) 319-2097
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