Let’s Make Laura’s Law More User Friendly

by Judi Iranyi on April 9, 2009

Last legislative session state Senator Leland Yee sponsored Senate Bill 1606, which if it had passed, would have removed a number of costly and burdensome requirements in Laura’s Law, an assisted outpatient treatment (AOT) program passed by the California Legislature in 1999. SB 1606 probably languished in the legislature because of its rush to pass a budget. To date, San Francisco has not implemented Laura’s Law ostensibly because it is too expensive. I urge Senator Yee to resurrect this amendment to Laura’s Law.

For the uninitiated, an AOT program allows court-ordered, intensive outpatient treatment for people with severe mental illnesses who refuse medication because their illness impairs their ability to make rational decisions. Laura’s Law provides for a 180 day period of intensive treatment under the supervision of the court. While we as a society must safeguard the civil rights of the unfortunate, we also have an obligation to care for those who are unable to care for themselves. Laura’s Law provides safeguards to protect the civil rights of those being considered for the AOT program.

Currently AOT can only be used if a county’s board of supervisors enacts a resolution to implement and independently fund a discrete Laura’s Law program. SB 1606 would eliminate this requirement. Under SB 1606, an AOT program would be available statewide as a tool that can be, but would not required to be, used to efficiently treat the most problematic patients. SB 1606 would give the San Francisco Department of Public Health complete discretion over whether or not to initiate an AOT program but would be precluded from doing so if the services needed for a particular AOT treatment plan are not available within the San Francisco’s delivery system.

With the passage of SB 1606, counties would no longer have to set up new agencies with extremely high staff-to-patient ratios. Instead, counties would be given more flexibility to use existing mental health services, rather than establishing a brand new program. In addition, a county would no longer have to have various minimum levels of unconnected voluntary services before it could use the AOT program; would allow intensive AOT services without the need to make these services available to all consumers on a voluntary basis before implementing the AOT program for those who specifically need it; and it would provide a means to keep people released from hospitals stable in the community.

An amended Laura’s Law could be invoked by the Community Justice Center and provide a more flexible, alternative to the present system. With so many reductions in social services, a more user friendly Laura’s Law would provide a useful tool for the courts and health care providers. Hopefully, Senator Yee will reintroduce SB 1606.

Judi Iranyi, a licensed clinical social worker, is a social services advocate for the Homeless Advocacy Project and a former member of San Francisco’s Shelter Monitoring Committee.

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