MOORLACH UPDATE — Laura’s Law Resolution Passes — May 13, 2014

It has been a long journey, but today’s Board of Supervisors meeting resulted in a unanimous vote to approve the resolution to implement Laura’s Law in Orange County. The news stories are already online. And, as I will be at the annual California State Association of Counties Legislative Conference in Sacramento for the next two days, I’m providing the UPDATE now.

The OC Register’s piece starts off the discussion. The Newport Beach-Corona del Mar Patch’s piece from City News Service is the second piece. The Voice of OC had a preparatory piece, which is the third below. And the San Juan Capistrano Patch is the fourth piece, which discusses our upcoming budget deliberations and includes Laura’s Law.

My thanks to all of those who patiently shared their concerns and support for Laura’s Law. Thanks, too, to those who presented opposing views in a professional and thought-provoking manner. After all of the reading, discussions and presentations, I believe that the arguments in favor of Laura’s Law greatly outweigh those in opposition. This tool will now be available to those who fit within the narrow requirements – and, as is good practice with all new programs, the County will gather data to assess its effectiveness. May it be the source of assistance that impacted family members have been seeking.

O.C. approves forced treatment for seriously mentally ill

Orange is the state’s 2nd – and largest – county to embrace Laura’s Law. The move comes in the wake of Kelly Thomas’ 2011 death.

By TERI SFORZA

After invoking God’s guidance and listening to at times heartbreaking and furious public input, the Orange County Board of Supervisors voted Tuesday to adopt the controversial Laura’s Law, which will allow assisted outpatient treatment for the seriously mentally ill, even if such treatment is against the patient’s wishes.

This makes Orange only the second county in California to fully embrace Laura’s Law, and by far the largest. It now becomes a laboratory for the rest of the state, which is watching closely to see what works and what doesn’t as officials struggle to get a grip on intractable problems like homelessness, drug use and repeated incarceration, which often go hand-in-hand with severe mental illness.

The move was denounced as an attack on civil liberty and individual freedom by sometimes-furious critics who suggested that the law was a declaration of war on the mentally ill, but the board was unanimous in its support.

“I draw the line with those who testify about liberty,” said Supervisor Todd Spitzer. “You don’t have liberty when you can’t control your own destiny."

Laura’s Law became a passion project of outgoing Supervisor John Moorlach in the wake of Kelly Thomas’ death in 2011. Some say that if Orange County had Laura’s Law on the books then, Thomas might never have been on the streets in Fullerton that July day when he was gruesomely beaten by police.

Krista Adams Dolan spoke first, telling the packed meeting room how she was diagnosed with bipolar II disorder, but had refused to take her prescribed medications. At first, it was because that suggested the person she really was inside was not OK; and then later, because the medications were so hard on her body and mind. “It was easier to stay in my miserable existence,” she said.

After she wound up on suicide watch, she decided something must change. “I saw the worth of being part of my own recovery,” she said, and she began to work with her doctors rather than against them. She is now married, works in the mental health field and has an “amazing” son. She urged the board to adopt Laura’s Law because it would be “a tremendous benefit” to people who are like she was – with little awareness of the struggle that ensnared them.

“Laura’s Law – assisted outpatient treatment – would provide a treatment plan they could help develop,” Dolan said. “I support this because it would be a way for consumers to realize their potential.”

The majority of speakers were also in support, sometimes choking back tears as they recounted how beloved brothers and adult children died after spiraling out of control, and how powerless family members were to do anything to help.

“My brother John lived with schizo-affective disorder for 50 years and died virtually alone,” said Steve Pitman of the National Alliance on Mental Illness, his voice breaking. “He had periods of normalcy punctuated by periods of mania and psychosis. His life was a very long, painful, downhill spiral. I cannot help but wonder how John’s life might have been different if the mental health system would have been able to provide him help even if he did not desire it.”

Staff writer Erika Ritchie contributed to this report.

Contact the writer: tsforza

County to Spend Millions on Outpatient Services for the Mentally Ill

The program is expected to begin in October.

Posted by Penny Arévalo

By PAUL ANDERSON
City News Service

Orange County supervisors today unanimously approved creating an outpatient program for the severely mentally ill that could provide for court-ordered treatment under the state Laura’s Law.

County officials estimate the program will cost $5.7 million to $6.1 million annually for the treatment of about 120 patients.

Supporters of the law, including some who have struggled with mental health issues, encouraged supervisors to approve the program while critics said it would inhibit civil liberties and would not help the intended anyway.

Ron Thomas, father of Kelly Thomas — the homeless man beaten to death in a struggle with Fullerton police — told supervisors that a version of Laura’s Law may have helped his son, who he said had struggled with schizophrenia.

When his son decided he didn’t want to be on medication anymore is the time "he spiraled down," Thomas said.

"That’s why we need Laura’s Law, so that the mentally ill won’t have that option" to refuse help.

Thomas said the law likely "would not have saved Kelly" the night he was fatally beaten, "but prior to that he may not have been in Fullerton if Laura’s Law was here."

Michael Sitton held up before-and-after pictures of his daughter, who has struggled with mental health problems.

"Everybody that spoke to her said she is completely insane, and yet they say she has the right to choose" treatment, Sitton said.

Thomas said, "I really sympathize with this gentleman," and wished he had also brought pictures of his son. In the photos that show him looking normal, Kelly Thomas was on medication, his father said.

One woman who has struggled with mental illness implored supervisors to approve the new program.

"… I hope you pass it because it will save lives. I don’t want to die again," she said.

Supervisor John Moorlach, who brought the issue to the board, noted the suicide of Saddleback Church Pastor Rick Warren’s son, Matthew, last year.

"That made national news," Moorlach said. "We cannot allow our jails to be the predominant location for the mentally ill… This is a real leadership opportunity."

Supervisor Todd Spitzer pushed for strict oversight of the program to make sure it is having an effect, but he otherwise supported it. Spitzer criticized the civil libertarians who opposed the law.

"You don’t have your liberty when you can’t control your own person," Spitzer said. "When you’re not in control of your destiny, society has obligations."

Supervisor Patricia Bates, once a social worker, said the county has a "moral obligation" to help the mentally ill when possible.

Supervisor Janet Nguyen said the law was "long overdue," and advised opponents of the law that the patients still have "due process" to challenge any court-ordered treatment.

Board Chairman Shawn Nelson knocked critics who said the program was unproven.

"Without trying something how else would we know if it works or not?" Nelson said.

Orange County Health Care Agency’s Behavioral Health Services Director said the law applies to adults suffering from a mental illness who are deemed unlikely to survive without supervision. They must also show a history of not participating in needed mental health treatment and their health must be "substantially deteriorating."

Other necessary requirements include at least two psychiatric hospitalizations or jailings within the prior three years or engagement in a violent or attempted violent incident over the past four years.

Those who can request the treatment are immediate family, adults living with the ill person, a director of a treatment agency or organization, a licensed mental health professional treating the subject or law enforcement official supervising the individual.

The process of determining who would be placed in treatment would be handled as a civil matter in the courts. The Orange County Public Defender’s Office will help advise those who resist the treatment.

There are no civil or criminal penalties for violating a court order or treatment plan.

A hearing can be called to challenge continued treatment every two months.

No one can be forced to take medication, and the treatment programs will have a 1-to-10 patient to staff ratio.

The program is expected to begin in October.

–City News Service

Will Supervisors Pass Controversial Mental Health Law?

By TRACY WOOD

A cautious Orange County Board of Supervisors is scheduled today to decide whether Orange will be the first large California county to adopt Laura’s Law, authorizing court-ordered outpatient treatment of severely mentally ill adults.

The debate pits two of the state’s largest mental health advocacy groups against each other — the federal and state grant-financed nonprofit Disability Rights California vs. the medical and pharmaceutical industry funded National Alliance on Mental Illness or NAMI.

Disability Rights California and others argue that Laura’s Law infringes on the rights of adults to refuse treatment, while NAMI and its supporters contend some cases of mental illness are so severe that medications are a necessity.

In the middle, according to advocates on both sides, are families of severely mentally ill adults and the seriously mentally ill adults themselves.

Supervisors generally have supported attempts to bring Laura’s Law to Orange County, but have moved cautiously on the volatile issue at least partly out of fear of lawsuits.

“It’s a very broad, complex and subjective area,” said Supervisor John Moorlach, who has led Orange County efforts to adopt the 12-year-old Laura’s Law. “The issue is, parents are asking for an assist and it just seems we should make it available in those cases where it might be helpful.”

How It Would Work

If supervisors approve county use of Laura’s Law, it would go into effect in October. An estimated 120 adults a year could qualify for the court-ordered, outpatient treatment.

The projected cost would be more than $5.4 million, with roughly $4.4 million in state mental health tax funds and about $1 million more to be allocated later from the county’s general fund. State law prohibits the county from using mental health funds to pay court costs and the public defender’s office for their work on Laura’s Law.

Orange County receives more than $100 million annually in state mental health dollars.

If adopted, Laura’s Law would apply to severely mentally ill county residents 18-years-old or older who’ve had two psychiatric hospitalizations or incarcerations in the past three years. And, according to the law, in the past four years the actions of these adults would have to result in violence or attempted violence toward themselves or others.

Further, they must be unlikely to safely survive in the community without supervision and their condition must be “substantially deteriorating.”

If all of those conditions exist, immediate family members, law enforcement officers or medical professionals could ask the court to order these individuals to receive medical treatment on an outpatient basis.

If a person refuses, there are no civil or criminal penalties. The mentally ill adult would be represented by a public defender and could challenge the order every two months.

The purpose, according to supporters of Laura’s Law, is to employ a “black robe effect,” using the courts to help convince severely mentally adults they need medical treatment.

This is needed, supporters say, because one of the most difficult aspects of mental illness is that many patients don’t realize they are mentally ill.

In addition, medicines for treating many severe conditions have significant side effects that cause patients to stop taking them.

Historical Abuses Mean Caution Today

Orange County began looking at adoption of Laura’s Law in 2011, weeks after mentally ill transient Kelly Thomas was beaten to death by Fullerton police.

The California law was named for 19-year-old Laura Wilcox, who was killed in 2001 by a mental patient in Nevada County.

Until the late 1960s, California, like many states, operated a series of large mental hospitals for long-term care of adults with serious mental disabilities.

In 1967, the Legislature passed and Gov. Ronald Reagan signed the Lanterman-Petris-Short Act, ending involuntary, indefinite commitment of mental patients to institutions in California. The state was leading a national trend away from locking up for years people with mental illnesses.

The idea, said the late Assemblyman Frank Lanterman, R-La Canada, at the time, was to have community clinics treat the long-term patients. But the Legislature never provided the money for the local treatment centers.

Laura’s Law was approved by the 2002 Legislature and went into effect in 2003. But each county had to independently vote to adopt it and up to now, only Nevada County has fully implemented the law. Los Angeles and Yolo Counties have pilot programs underway.

One deterrent to fuller implementation was uncertainty about whether tax funds from Proposition 63, approved by voters in 2004 as the Mental Health Services Act could be used to finance the program. The money comes from a tax on income above $1 million.

Last year, with support from Moorlach and the board of supervisors, the Legislature made it clear the Prop. 63 money could be used for Laura’s Law.

Opposing the change, among other groups, was the 36-year-old Disability Rights California, which lobbies and files law suits on behalf of individuals with disabilities, a group with a long history of facing discrimination, including mental health issues.

It argues better law enforcement training, expanded voluntary treatment programs and more state and local community programs are a more appropriate approach than court-ordered, outpatient medical treatment.

On the opposite side is NAMI and its supporters, like Carla Jacobs of Tustin, who was instrumental in helping get Laura’s Law adopted.

Jacobs’ sister-in-law, Elizabeth Jacobs, was severely mentally ill but family members couldn’t get treatment for her.

In October 1990, Elizabeth Jacobs dressed in military fatigues, took a taxi from her Anaheim home to La Canada Flintridge, then stabbed and shot her 78-year-old mother while the woman was pleading for help on the telephone with sheriff’s deputies.

The 43-year-old Elizabeth Jacobs was found mentally incompetent to stand trial for the murder and was sent to a state mental hospital. She remains in one today.

"We tried everything to get her help," said Carla Jacobs. "She never received treatment until she murdered her mother."

Please contact Tracy Wood directly at twood and follow her on Twitter: twitter.com/tracyVOC.

Proposed Orange County Budget Seeks a 1% Increase in Spending

Officials do not envision any major service cuts or layoffs.

Posted by Penny Arévalo

Orange County budget officials today unveiled a $5.4 billion spending plan for the coming fiscal year, about a 1 percent increase over last year.

Officials do not envision any major service cuts or layoffs despite owing the state about $148 million from a past tax dispute. The county has six years to pay off the tax debt with the bill only being $5 million in the coming fiscal year. The county’s budget officials, however, set aside the money in dispute before it was resolved so they are confident it can be paid off without putting a dent into services.

This fiscal year’s budget projects spending $60.8 million more than the current fiscal year.

"To me, the news in the budget is the county being able to spend money and invest in programs such as Laura’s Law," said Orange County Chief Financial Officer Frank Kim. "Laura’s Law" is a state law that enables judges to order mentally ill people to get outpatient treatment.

Since the economic collapse of 2008, most of the budget discussions have revolved around how many layoffs and service cuts would be needed to get by as well as how much the county would have to dip into its reserves to keep necessary programs running.

By contrast, the coming fiscal year’s budget has set aside $3.6 million for the operation of potential year-round emergency homeless shelters.

"It’s the county getting back to what it normally does, which is take care of its facilities, take care of its citizens, and on a small programs basis be able to invest in some new initiatives that might help," Kim said.

County officials expect a 2 percent growth in property taxes and a 3 percent increase in public safety sales tax revenue from Prop. 172. The sheriff receives 80 percent of the Prop. 172 money with the District Attorney getting the rest.

The Affordable Care Act has even led the county to add 144 new positions, according to Orange County Budget Director Michelle Aguirre.

The county expects to maintain the 18,035 positions in this fiscal year, while adding nine more. Three are for a new District Attorney-led social services fraud unit and five positions to implement Laura’s Law.

Supervisor John Moorlach requested a discussion on Laura’s Law at Tuesday’s board meeting. The in-custody death of transient Kelly Thomas in Fullerton led to a push for the program with some proponents arguing it may have saved the homeless man’s life.

The obstacle in the past to implementing a local version of Laura’s Law was funding, Moorlach said. The state, however, has come up with some funding for it.

"Now we have the revenues to at least cover the healthcare costs," Moorlach said.

Opponents argue that the law could force some unwilling commitments to mental health institutions.

"There are strong arguments on both ides whether or not Laura’s Law will work," Moorlach said. "These parents (of the mentally ill) are looking for another tool in the tool box."

There’s still due process and a mental health professional would have to testify in court that a patient needs to be committed, but the individual in question can still refuse the treatment, Moorlach said.

"But it provides a 72-hour hold," Moorlach said. "They want to use that time to in a sense persuade the person to go into the program."

–City News Service

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