Mendocino County was added to a short list of California counties that participate in Laura”s Law Monday, after the Board of Supervisors agreed to move forward with a pilot program slated to start July 1.
Of California”s 58 counties, including Mendocino County, only six participate in the law, according to the Treatment Advocacy Center, a nonprofit organization for the mentally ill. However, outstanding questions also led the supervisors to include a motion for a staff update 90 days from now.
“It”s definitely a positive first step,” said Sonya Nesch of the National Alliance on Mental Illness Mendocino. “I”m hoping there will be some leadership to fast track it. I think a lack of information at the county level, and fear of change and how to do it, is why it has taken so long.”
Nesch said she and another advocate and affected parent first spoke to the supervisors in 2011, and that it has taken three years to get to this point.
“It seems to me, county staff has set-up multiple obstacles to stop this,” Nesch said.
She has been a member of NAMI since 1986, and has worked with family members and friends who have mental illness. In 1992, she helped facilitate the NAMI Family Support Groups in Fort Bragg, she said.
A growing awareness of mental illness is apparent not only in Mendocino County, but across the United States. According to a 2013 report by NAMI, approximately 4 percent of the adult population suffers from schizophrenia and bipolar disorder.
Based on Mendocino County”s 2013 population, approximately 3,200 suffer from illnesses such as schizophrenia and bipolar disorder, according to Kathryn Cohen, an attorney with the Treatment Advocacy Center. Of California”s 2014 total adult population of about 29 million, 317,000 have schizophrenia, and 634,000 have bipolar disorder, the Treatment Advocacy Center reports.
What is Laura”s Law?
Laura”s Law, or AB 1421, was passed in California on Jan. 1, 2003, and creates an Assisted Outpatient Treatment program to provide specialized treatment for those who can”t access community provided services voluntarily because of their mental illness, the law states.
The program may also help mentally ill patients with housing options, assistance with filings like Social Security, or Medi-Cal, psychiatric medication and provide substance abuse counseling and treatment.
The law was established after Laura Wilcox, who was working as a part-time receptionist at the Nevada County Behavioral Health Department, was killed on Jan. 10, 2001, by Scott Thorpe, a mentally ill man, who shot her and two others in the Health Education and Welfare building, according to a Nevada County court document.
Even though the law was implemented statewide, it is only available in counties where the Board of Supervisors has passed a resolution authorizing its use, the law”s documentation states. Nevada County was the first in the state to pass the law.
Accordingly, the law allows for family members to request help for suspected mentally ill relatives, help non-compliant people in obtaining treatment and in some cases, allows courts to order involuntary outpatient treatment.
Nesch said she expects some of the homeless and transient population in Mendocino County to be treated under the law as well.
“There will definitely be people in the homeless population who will qualify,” Nesch said.
However, the AOT criteria must be met, and space is limited to four participants initially, the Mendocino County Health and Human Services said.
“I think we need to find one professional who is a nine or 10 in compassion, who has a rapport with clients and shows intelligence,” Nesch said about the impending case manager who will oversee the program. “I think this person, who is likely to be contracted by the county, needs to be trained in Nevada County, and come back to an office here and start case management right away.”
Nesch said referrals will come from law enforcement, family members and mental health professionals, for example.
Mendocino County Interim County Counsel Doug Losak said the county counsel department will be handling a lot of the referral process, which includes reviewing applications. Losak expects as many as 30 applications initially, with somewhere around 18 or 19 after implementation.
What will it cost?
A total cost for the first-year pilot is estimated to be $160,000, which includes $60,000 in Mental Health Services Act funding for assisted outpatient therapy, according to the HHSA.
The $100,000 would be used for the referral documentation process, the Public Defender”s Office, and HHSA training, evaluations and administrative purposes.
The HHSA said in 2012, the ability to use MHSA funds was unclear, and in September 2013, it was determined by the state that MHSA funds could be used to cover the cost of treatment only. The MHSA provides for funding to county mental health programs around the state, according to the California Department of Health Care Services.
“The funding is undefined for the district attorney”s office,” Mendocino County District Attorney David Eyster told the supervisors Monday. “This is basically a civil program. My obligation is going to be dealing with the criminal justice system of the process. The challenge for us is our population is spread over 3,500 square miles.”
County CEO Carmel Angelo said she believes the money for the pilot program is still in question.
“I support a general fund commitment, but I don”t want this to die three years from now,” said Mendocino County Sheriff Tom Allman. “Let”s say Mendocino County is in. But, this is for the severely mentally ill. It doesn”t mean we”ve solved our problem here. We will have Laura”s Law, but we will still have mental illness. We can be one of the leaders if not statewide, but nationwide.”
Does it work?
There are many reports made by the Treatment Advocacy Center documenting statistics across the country that try to prove programs like Laura”s Law are effective in treating the mentally ill.
A Laura”s Law Fact Sheet released by the Treatment Advocacy Center documents a similar AOT program in New York, or Kendra”s Law, that estimates 74 percent fewer of the mentally ill have experienced homelessness; 77 percent fewer experienced psychiatric hospitalization; 83 percent fewer were arrested and 87 percent fewer were actually jailed.
“I think we still have a lot of questions that need to be answered, and a lot of misconceptions of what Laura”s Law does,” said John McCowen, 2nd District county supervisor. “There”s a lot of people out there who won”t fit the criteria.”
