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Santa Barbara County Supervisors Support Laura’s Law Mental-Health Pilot Program

The Santa Barbara County Board of Supervisors supported a Laura’s Law pilot program Tuesday, setting up the program to be adopted and funded during the June budget hearings.

The board voted 4-1, with Second District Supervisor Janet Wolf dissenting, to support a three-year pilot with an implementation plan ready by November.

AB 1421, known as Laura’s Law, was passed in 2002, and allows court-ordered assisted outpatient treatment for people with serious mental illness who are resistant to voluntarily participating in services, said Alice Gleghorn, director of the county's Department of Behavioral Wellness.

Families have been asking the board to implement the program since at least 2004, according to Third District Supervisor Doreen Farr.

“I think 12 years is a long enough time to wait,” Farr said.

She made the motion to pursue the pilot program, and said the results from counties that have already implemented the program are encouraging.

“The time is now, let’s move forward, let’s find out whether it works in Santa Barbara County,” Farr said.  

Wolf voted against the pilot because she feels the program hasn’t proven effective, and it doesn’t make sense from a policy perspective.

“I feel in my heart of hearts it’s setting up false expectations for family members,” she said.

Fourth District Supervisor Peter Adam voted for the pilot program, but said he has “grave doubts that this is going to solve the problems the families want solved.”

If the Board of Supervisors funds and authorizes the adoption of Laura’s Law, the full range of services has to be available for all individuals who meet program criteria and those who would use the services voluntarily, Gleghorn said.

Since 2002, 16 California counties have adopted Laura’s Law, and seven have implemented programs — all but two of them very recently.

There isn’t much data to evaluate the effectiveness of the program, Gleghorn said.

Early numbers show that Los Angeles and Nevada counties both reported a substantial decrease in incarcerations and hospitalizations after implementing an assisted outpatient treatment program, according to the county.

Laura’s Law does not force patients to take medication, does not include the use of restraints and does not include locked placement in institutions, she said.

Medications and treatment can be ordered by a civil court judge, but the law does not include any enforcement — clients can refuse to comply with the order.

“The main objective it hopes to achieve is, by having a civil court process, direction from a judge will encourage the individual to engage in care,” Gleghorn said.

Supervisors called it the “black robe effect.”

Petitions can be filed by police officers, health care providers, people who live with the person, and others. The petitions are evaluated by a mental health director to determine if people are eligible, and whether to file with the court, County Counsel Michael Ghizzoni said.

People whom petitions are filed against are given legal representation, either by their personal attorney or a public defender, if cases go to court, he added.

The assisted outpatient treatment can be court-ordered, a court-approved settlement, or a person can voluntarily agree to services during the process.

In 10 months of implementing Laura’s Law in Los Angeles County, 297 people were referred, and only one case resulted in court-ordered treatment, Ghizzoni said. The majority of people were diverted into voluntary services, he added.

Arguments for implementing Laura’s Law say the program is a mechanism for engaging those who don’t recognize their mental illness and don’t voluntarily participate in treatment, Gleghorn said.

Advocates also say it is a way to increase referrals to the mental health system, have oversight and accountability by the court system, and adds another tool for mental health professionals.

Critics of the law say there are ethical concerns with court-ordered treatment and airing someone’s mental health and treatment history in a public process.

There are also concerns regarding the lack of mental health professionals in the civil court process, and the lack of enforcement to carry out court-ordered treatment.

The cost is another concern, since Laura’s Law funding can’t replace existing voluntary services, county staff said.

The supervisors had asked Gleghorn to come back with options for implementing Laura’s Law, and she presented two ways to expand the ACT program – Assertive Community Treatment – along with options to start a pilot program or full implementation of Laura’s Law.

The supervisors decided to pursue a three-year pilot program, estimated to cost $606,000 per year for 10 spots, with safe and supportive housing as needed.

Many people supported a pilot program during public comment, including family members of people with mental illness and members of the Santa Barbara County Mental Health Commission, National Association on Mental Illness, and Families ACT.

“What we’re doing is inefficient — Laura’s Law no doubt will help,” said Suzanne Riordan, founder of Families ACT!.

Tom Franklin, a member of the Mental Health Commission, has a family member with mental illness, and said the man has been to the hospital twice, on the street for a month, and in jail twice since the board last discussed the issue in December.

Some people don’t recognize that they’re ill and wouldn’t seek treatment if there was a clinic on every corner, he said.

“We don’t want your sympathy, we just want action,” he said.

Noozhawk managing editor Giana Magnoli can be reached at .(JavaScript must be enabled to view this email address). Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.

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