SLO County moves ahead with Laura’s Law pilot program

Calling it a public safety tool, the San Luis Obispo County Board of Supervisors directed county Health Department staff to begin drawing up a Laura’s Law pilot program, a measure that allows civil courts to force certain mentally ill and violent people into compulsory outpatient psychiatric care.

County Supervisors Adam Hill and Debbie Arnold will serve on a subcommittee that will oversee development of the program. The program would have to be approved by the full Board of Supervisors at a later date.

“I think we need to do this,” Hill said. “If it prevents one tragedy, it transcends the cost.”

Anne Robin, the county’s behavioral health administrator, estimated there are probably 10 individuals in the county who would be suitable for the program annually. The program is designed to treat people with mental illness who have a history of noncompliance with treatment and who have had one or more acts of violence in the past two years.

Cost was a major issue for supervisors as they grappled with moving ahead with the program. Depending on how the program is set up, it could cost as much as $50,000 per patient to get the program up and running.

Hill said he would like to get the cost down to about $20,000 per patient, which is more in line with the cost other counties experience. The program is expensive because it requires hiring three to five full-time employees to run it and includes housing, which is expensive in San Luis Obispo County, Robin said.

Funding for the program would come from a variety of sources, including Medi-Cal/Medicare reimbursements, Mental Health Services Act funds and county general fund money.

If supervisors eventually move ahead with the program, the county will join only 12 other counties in California that have approved a Laura’s Law program. (Only six of those counties have active programs in place.) The state law was originally passed in 2002 but requires counties to implement it locally.

Jeff Hamm, the county’s health agency director, said it has taken the county 13 years to get to this point because of the complexity and restrictions of the Laura’s Law program. For example, no current program can be cut or reduced to fund a new Laura’s Law program.

Many counties also have concerns about civil liberties, Robin said. Forcing people with mental illnesses into an outpatient program via the courts could have the effect of criminalizing mental health issues.

Eric Greening of Atascadero told the supervisors that he was concerned about the compulsory nature of the program, particularly regarding the danger that someone could be misdiagnosed.

“Doctors make mistakes,” Greening said.

However, the program received broad support among supervisors. San Luis Obispo County Sheriff Ian Parkinson said he also supports the program because people with mental illnesses are often incarcerated where they do not get the treatment they need.

“If we are having an issue with someone, if families are having an issue with someone, why wouldn’t we want to use this as a tool of prevention?” Parkinson asked.

Robin said she expects to come back to supervisors with a pilot program in January. This would give the county time to include the program in the 2016-17 budget. If approved by supervisors, county officials would need nine months to get the program running.

Officially called Assisted Outpatient Treatment, the program is most often known as Laura’s Law, named after Laura Wilcox, who was fatally shot along with two other people in 2001 while working at a mental health clinic in Northern California. The man who shot them had refused psychiatric treatment.

This story was originally published November 24, 2015 at 8:21 PM with the headline "SLO County moves ahead with Laura’s Law pilot program."