Santa Clara County To Finally Vote On Court-Ordered Psychiatric Treatment

Campbell CA

24 May, 2021

3:58 PM

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By Madelyn Reese, San Jose Spotlight May 24, 2021 More than a year tabling a discussion on Laura's Law, county leaders Tuesday are expected to decide whether to enact the law that allows courts to order psychiatric treatment for individuals struggling with severe mental illness. The Santa Clara County Board of Supervisors will consider opting in to Laura's Law and administering its own assisted outpatient treatment (AOT) program. State officials passed the law 19 years ago, but new legislation requires counties to formally opt in or out by June 30. To date, only 21 of California's 58 counties have opted in to the program, according to the California Association of Local Behavioral Health Boards & Commissions. Laura's Law is named after Laura Wilcox, a 19-year-old woman killed in 2001 while working as a receptionist at the Nevada County Department of Behavioral Health. The man who killed Wilcox was a former patient of the county's outpatient mental health clinic, and had a habit of resisting treatment. The law, which allows a court to compel services to a mentally unstable person or a person who refuses treatment, only applies to a specific group of people who have formerly been hospitalized or incarcerated as a result of their mental illness. "Laura's Law aims to care for a targeted subset of people: individuals suffering from severe mental illness who have experienced repeated visits to jail cells and emergency rooms, yet continue to refuse treatment," San Jose Councilmember Matt Mahan said. "While the county offers a wide variety of mental health treatment options, these programs offer no value to those who refuse help." On Monday, Mahan will host a news conference with mental health and housing advocates from across the county to encourage supervisors to finally opt in to the program. Fellow Councilmember Raul Peralez recently wrote an op-ed supporting Laura's Law in Santa Clara County. Over the years, California counties have delayed deciding on whether to implement Laura's Law, with some citing a lack of funding for programming and others questioning if the law violates the civil liberties of the people it sets out to help. "The actions of one individual 17 years ago are now being used to potentially affect the civil liberties of possibly hundreds or thousands of people in Santa Clara County," wrote South Bay homeless advocate Robert Aguirre in an op-ed opposing the law. "Forty percent of all Americans suffer from some form of mental illness." The Santa Clara County Behavioral Health Services Department estimates that the cost to implement the program, after MediCal reimbursements, will be a bit more than $10 million per year. The department also estimates the need for about 18 full-time employees dedicated to the program. "The full cost of AOT is not anticipated to be fully expended in (the next fiscal year), but rather over time, as the program requires time to ramp up and hire staffing," county health officials wrote in a report to supervisors. "Additional funding for increased program slots, expansions, or other adjustments to address existing service needs may also be required depending on actual number of AOT clients that qualify for services." If Santa Clara County opts in to Laura's Law, health officials say the program could serve between 20 to 50 people annually, based on an analysis of surrounding counties with similar programs. Counties are prohibited from reducing existing voluntary mental health programs to enact Laura's Law, meaning implementation would expand, rather than shift, the county's current services. Elisa Koff-Ginsborg, executive director of the Behavioral Health Contractors Association of Santa Clara County, represents more than 30 contractors providing mental health services in the region. Koff-Ginsborg said some members support Laura's Law while others are strongly opposed. "For family members and friends, it's grueling pain to watch your loved ones suffer… while they're refusing to accept treatment," Koff-Ginsborg said. "We have a crisis and we need to make sure we're doing everything we can, and that goes beyond the limited potential of AOT." Those advocating for the program shouldn't see it as a panacea.. Santa Clara County already has many resources that neighboring counties didn't have before implementing AOT, she added, including a comprehensive program that offers a wide range of services from therapy to temporary housing and job support. "So the question I would ask is, what's preventing us from having more people engaged in those now?" Koff-Gonsborg said. "The mandatory aspect is only going to be a small portion, how are we going to engage everyone else? If AOT is passed and nothing else is changed, no one should be surprised that we don't get the results that we're looking for." Supervisors Otto Lee and Joe Simitian supported implementing the program at a county Health and Hospital Committee meeting in March. Simitian voted in favor of Laura's Law when he was a state assemblyman in 2002. In a March 24 letter to supervisors, the Santa Clara County National Alliance on Mental Illness (NAMI) urged county leaders to finally implement Laura's Law. "(AOT) is the only option for families having a loved one living with mental illness; these families are often desperate to get treatment for family members but are generally barred from helping, even to warn of potentially volatile behavior," the NAMI Board of Directors wrote. Those compelled to get help under Laura's Law must meet specific requirements that include recent hospitalizations within the last 36 months, demonstrated violent behavior towards themselves or others, repeatedly refused treatment, or is in a "substantially deteriorating" state. Concerned family members and caregivers can also request that an individual be referred to an assisted outpatient treatment program. County supervisors put off a decision on Laura's Law in 2019, asking administrators to first detail other mental health services offered by the county. Meanwhile, San Jose leaders sent a letter to supervisors urging them to adopt the law. The Santa Clara County Board of Supervisors meets on Tuesdays beginning at 9:30 a.m. Watch or view the agenda here. To participate in the meeting, learn how to do so with this guide. Contact Madelyn Reese at [email protected] or follow @MadelynGReese on Twitter. San José Spotlight is the city's first nonprofit news organization dedicated to independent political and business reporting. Please support our public service journalism by clicking here.