BILL ANALYSIS Ó AB 59 Page 1 ASSEMBLY THIRD READING AB 59 (Waldron) As Amended January 6, 2016 Majority vote ------------------------------------------------------------------ |Committee |Votes|Ayes |Noes | | | | | | | | | | | | | | | | |----------------+-----+----------------------+--------------------| |Health |16-0 |Bonta, Maienschein, | | | | |Burke, Chávez, Chiu, | | | | |Gomez, Gonzalez, | | | | |Lackey, Nazarian, | | | | |Patterson, | | | | |Ridley-Thomas, | | | | |Rodriguez, Santiago, | | | | |Thurmond, Waldron, | | | | |Wood | | | | | | | |----------------+-----+----------------------+--------------------| |Judiciary |7-0 |Mark Stone, Wagner, |Mark Stone, Alejo, | | | |Chiu, Gallagher, |Cristina Garcia, | | | |Cristina Garcia, |O'Donnell | | | |Maienschein, | | | | |O'Donnell | | | | | | | |----------------+-----+----------------------+--------------------| |Appropriations |17-0 |Gomez, Bigelow, | | | | |Bloom, Bonilla, | | AB 59 Page 2 | | |Bonta, Calderon, | | | | |Chang, Daly, Eggman, | | | | |Gallagher, Eduardo | | | | |Garcia, Holden, | | | | |Jones, Quirk, Wagner, | | | | |Weber, Wood | | | | | | | | | | | | ------------------------------------------------------------------ SUMMARY: Authorizes the Assisted Outpatient Treatment (AOT) Demonstration Project Act, known as "Laura's Law", for an additional five years, until January 1, 2022, and removes a duplicative reporting requirement. EXISTING LAW: 1)Permits counties to provide AOT services for people with serious mental illnesses when a court determines that a person's recent history of hospitalizations or violent behavior, and noncompliance with voluntary treatment, indicates the person is likely to become dangerous or gravely disabled without the court-ordered outpatient treatment. 2)Permits a petition for a court order authorizing AOT to be filed by the county mental health director, or his or her designee, in the superior court in the county where the person requiring treatment is present. 3)Grants any person subject to a petition for an order of AOT the right to legal counsel at all steps of the hearing process. 4)Requires the Department of Health Care Services to submit a report and evaluation to the Governor and the Legislature of AB 59 Page 3 all counties implementing an AOT program by July 1, 2015. FISCAL EFFECT: According to the Assembly Appropriations Committee, negligible state fiscal effect. COMMENTS: According to the author, AOT or "Laura's Law" provides family members with important tools for initiating outpatient treatment for severely mentally ill adults who are incapable of seeking help on their own. The author states that it helps to identify when a patient's condition is significantly worsening and to intervene before the patient becomes too ill and is subject to involuntary civil confinement. The author further states that based on previous evidence, the first six months in the program demonstrate significant improvements in self-care and community living, social functioning, task performance, and incidents of harmful behaviors in patients. According to the author, studies also show that improvement takes time therefore, to insure full stability of patients once the initial period is complete, this bill will require counties with available funding to implement this program and extend it from six months to one year. The AOT Demonstration Project allows courts in participating counties to order a person into an AOT program if the court finds that the individual either meets existing involuntary commitment requirements pursuant to Welfare and Institutions Code Section 5150 (is gravely disabled or is a danger to self or others), or the person meets non-5150 criteria including that the person has refused treatment, their mental health condition is substantially deteriorating, and AOT would be the least restrictive level of care necessary to ensure the person's recovery and stability in the community. The law is only operative in those counties in which the county board of supervisors, by resolution, authorizes its application and makes a finding that no voluntary mental health program serving adults, and no children's mental health program, was reduced in AB 59 Page 4 order to implement the law. The California Medical Association (CMA) states in support of a previous version of this bill that Laura's Law provides for community-based, AOT services to a small population of individuals who meet specific criteria and as a result of their mental illness are unable to voluntarily access community mental health services. The CMA notes that Nevada County, which has fully implemented the law, has seen increased access to mental health treatment and a reduction of cost to the county in the amount of $500,000 through avoidance of hospitalizations and incarcerations. Disability Rights California (DRC) writes in opposition to a previous version of this bill that it removes many provisions in current law that protect the rights of individuals subject to AOT. DRC states that to the extent it continues to be authorized in California, counties should retain local control and AOT should be at their election and not imposed on them by the state. The California State Association of Counties and the County Behavioral Health Directors Association write in opposition to a previous version of this bill, stating that it is critical that county Boards of Supervisors retain the authority and flexibility to determine whether implementing Laura's Law AOT services in their community is appropriate. Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2097 FN: 0002601 AB 59 Page 5