Santa Clara County Officials will Revisit Laura’s Law Debate

Audrey Vallen’s 22-year-old daughter lives with Bipolar I disorder, experiences paranoia and was charged with a felony last year that she says could have been avoided if the county had opted into Laura’s Law.

The law, passed 18 years ago in the California Legislature, allows court-ordered treatment for people with a history of serious mental illness. But it’s optional for counties to enact and has been a contentious topic in Santa Clara County for years as regional leaders have so far chosen not to participate for a list of reasons, including a lack of funding for such a program and questions of whether it violates civil liberties.

But whatever the reasons, Vallen is pushing for the law that she thinks could have kept her daughter out of Elmwood women’s correctional facility in Milpitas, where she’s currently incarcerated.

“She never thought she was seriously ill,” Vallen says. “In the days leading up to the event that put her in jail, I reached out her psychiatrist and therapist to no avail.”

Even after reaching out to the sheriff’s office and mobile crisis response, Vallen says, no one would help bring her daughter into a psychiatric facility.

“Twenty four hours later, she attacked me with a pair of scissors and now she is in jail,” Vallen says. “If this program was in place I would hope that my beautiful college-educated daughter would get the help she needs… instead of having a felony and mental illness.”

It’s those kinds of emotional and personal testimonies paired with the hurdles to enact the law that county supervisors will weigh when they cast a final vote on whether or not to opt in to Laura’s Law at their May 25 regular meeting.

Time’s Up

Laura’s Law was named for 19-year-old Laura Wilcox, who was killed in 2001 while working as a receptionist at the Nevada County Department of Behavioral Health. Her killer was a former patient of the county’s outpatient mental health clinic, who had been diagnosed with severe mental illness.

The AOT Demonstration Project Act—known colloquially as Laura’s Law, in honor of Wilcox—was signed into law in 2002 giving counties the option to pursue “Assisted Outpatient Treatment,” or AOT. The intensive court-ordered treatment is intended for those suffering from severe mental illness and meant to be temporary until patients are well enough to care for themselves.

Santa Clara County never opted in, though supervisors have considered it several times. County Supervisor Joe Simitian voted in favor of Laura’s Law when he was a state assemblyman in 2002.

But criticisms of the law have abounded since its passage, including fears that the law disproportionately affects people of color. Others say it denies individuals the right to due process, autonomy and other civil liberties. Some say that without dedicated funding, it won’t make a difference in the county.

But calls to implement the program are getting stronger. The Santa Clara County chapter of the National Alliance on Mental Illness (NAMI) recently endorsed the program.

“[AOT] is the only option for families having a loved one living with mental illness; these families are often desperate to get treatment for family members but are generally barred from helping, even to warn of potentially volatile behavior,” the NAMI Board of Directors wrote in a March 24 letter to the county’s Board of Supervisors.

When county supervisors took up the topic in 2019, they passed on adopting the program, but didn’t make a formal resolution to opt out. This year, supervisors will be forced to make a decision because of an Assembly bill that gives the county until June 30 to notify the state of a decision.

To date, only 19 of California’s 58 counties have opted in to the program, according to the California Association of Local Behavioral Health ​Boards & Commissions. San Jose’s City Council in 2019 considered endorsing Laura’s Law, after council member Raul Peralez and former councilman Johnny Khamis advocated for its implementation.

Khamis learned of Laura’s Law after the death of San Jose police officer Michael Johnson, who was killed by a suicidal man in March 2015. Khamis directed his staff to research ways to prevent a tragedy like Johnson’s death from happening again, and stumbled across AOT.

“I want to get some of the dangerous, mentally ill residents off the streets and into care,” Khamis says. “The county would have you think that this law is enforcement, but it’s not. This law is an involuntary conservatorship, and it’s meant to be temporary.”

Advocates for the law, including NAMI, argue mentally ill residents will remain ill and cause undue harm to themselves, their families and the community unless someone else steps in. “With AOT in place, we have an opportunity to help these individuals start along the road to recovery and to a more fulfilling life,” the NAMI letter to county officials states.

A Model

Some Bay Area counties have already opted into the program.

In San Mateo County, the program costs about $1.3 million per year for a caseload of about 50 people—or about $27,000 per client annually. Mark Cloutier, CEO of Caminar, a behavioral health services company, says that the program has had its successes, but there are still major barriers to overcome.

About 73% of San Mateo’s AOT clients are stable and housed, while another 23% are homeless. The remaining 4% are either incarcerated or in locked psychiatric facilities.

“We have an experience with the mandated clients that housing is a key motivator for people participating in the program,” Cloutier said during a recent Santa Clara County Health and Hospital Committee meeting. “When people graduate from AOT they lose their housing subsidy, which is a demotivator to go somewhere else and can lead to… regression of the client.”

Under Laura’s Law, people can only be placed in outpatient treatment if they meet a list of “exhaustive conditions,” such as being hospitalized or jailed twice within the last 36 months. “There’s a very high resistance to treatment in this cohort,” Cloutier admits.

Most clients remain in an AOT program for an average of two years, Cloutier says, and to avoid a backslide, clients need “stepping down” programs after their AOT program is over. Burnout among caseworkers is also high, Cloutier says, because of the verbal abuse and difficulty of working with clients who really don’t want treatment.

Khamis says one aspect that needs to be discussed more openly is the number of people an AOT program would assist—likely between 40 and 50 individuals at a time, based on San Mateo’s numbers.

“Some would say it’s a very small number of people to focus on,” Khamis says. “However if you ask police officers or firefighters, those people are the majority of their calls.”

13 Comments

  1. I’d say we cannot have it both ways. We cannot protest when a police officer shots or harms a violent mentally ill person, AND not give family members an option for help when they see the family member at risk of harming themselves or another person.

  2. They need to move forward with Laura’s Law in this County. The legal advocates are out of their minds when they say things like:

    “Others say it denies individuals the right to due process, autonomy and other civil liberties.”

    So, ok – you’d prefer the status quo? Where instead of getting someone help out of fear their civil liberties may be in jeopardy – you have them sleep by the creek, or on a park bench? Or a pile of dirt somewhere?

    This argument no longer makes sense – because the situation is that severe, and this unfounded fear based on the history of institutions, does not factor in the progress made in providing care – and that these programs can be monitored to root out abuse.

    This would force the County to finally do something, and put resources to where they are more needed (instead of just building an apartment), in relation to mental health treatment for those with severe mental illness or substance abuse. You can’t walk downtown without seeing at least 3-4 people having a psychotic episode on a street corner while people walk by pretending like it is not happening. It’s time for that to end.

  3. Cynthiar: Well said. The liberal mind cannot comprehend your basic statement. This same lack of basic reason is why we have so many homeless people. They are not homeless because of a lack of housing, they are homeless because the are drug/alcohol addicted, mentally ill, or engage in anti-social behavior. (of course I am aware that not all homelessness is caused by these problems). And, the County and the cities refuse to push for laws that would give them the tools to help this poor people who are left to die early on the streets while the destroy the cities and cost the taxpayers billions. The Homeless Hucksters cost us more than in-patient care would cost us.

    The Left is trying to demoralize our police forces by this mind trick which serves no one well except as virtue signaling for their reelection bids.

  4. If we locked up all the drunks, crazies, and sexual deviants in Santa Clara county, there would be no one left to run the Government !

  5. Let’s make sure Johnny Khamis is elected to Santa Clara County Board of Supervisors. He’s a politician that is not afraid to take a stand on a controversial topic. Unlike the current 5 Board of Supervisors who throw millions on wasteful projects to scratch each other’s backs rather than do right by a population that so needs help and in so much need of government interventions. The mentally ill and their families can’t help themselves. They need forced treatments. Mr. Khamis’ statement makes so much sense that this intervention is a “temporary conservatorship.” What is so difficult to comprehend here? How could county elected government pretend there may be a better option and to hold on to the decision until maybe their musical chair moves up or down. Spend the money to help real people in need of mental health treatment especially when a loving family members are asking for it and will do their part to make the intervention a success.

  6. Pass the resolution Board! Do it now and ensure the County Mental Health Department does its job. Right now, the only people helped are those who want it. The homelessness issue is squarely, solely, the issue of mentally challenged individuals who just want to be left alone and government agencies avoiding what has to be done. Adopt the law!!!

  7. If you read closely, you will see this is not much different than services that already exists. This is mandating outpatient treatment not locking people up in a psychiatric facility. If you follow the San Mateo model, they state you need housing for these clients to be successful and many are homeless during and after treatment. SCC does much of these services now. If you put these 50+ SCC clients in housing with intensive services it is the same thing. The county just needs to commit to the increased funding targeting the population.

  8. You have one hell of a Propaganda machine going here .Thats for sure.Villify and Criminalize spreading fear and hostility to those who are most impacted by Gentrification.

  9. Poetry 11/27/19
    Paul Soto

    Mental health, under the weight of your wealth. suffers striving for dignity.

    Our humanity under your apathy, our significance beneath your indifference challenges our collective resiliency.

    Eyes see, ears listen, let sentient hearts pray, for those with an obsession, who welcome oppression to those living in San Jose.

    The Greedy know nothing with regard to Justice. They know only about “just us”.

    “Examine my heart” “Search my soul” says San Jose. “What has become of me?” When I look into the eyes, ignoring the cries of those “who are the least of these”.

    Compassion escorted me along the creeks, “These share not in San Jose’s wealth” holding apathy’s nose because it wreaked. Said it is of no matter, they brought in on themselves.
    Along the Guadalupe, poverty mourning, as developers and banks keep oligarchs yearning, providing the means for gentrification, plotting the insolvents decimation.

    Instead of new homes, they erect tombstones, casting its shadow along the river. Building your towers, demonstrating your power, in whose shadow the homeless shiver.

    This poem’s goal is to remind, we have a mandate to be kind, upon which our humanity is built. Woe to those in haughtiness who chose to suppress the soul’s pangs of guilt.

  10. Santa Clara County has struggled with court corruption and public trust issues for the last two decades. Money from Silicon Valley has made this county ripe for the worst corruption and the fact that the most mentally unstable and abusive ” advocates” in this county are aligned with the elected officials should require more reporting on this topic. We live in a county where the DA is married to a family court judge who operates adoption and foster care cases in a courtroom secreted from the public. Complaints from our family courts have been filed over and over to complicit state watchdogs and indifferent local politicians. Family courts have been defacto conserving spouses in divorce cases merely because one spouse has the money and attorneys who can get those orders, when paid enough to assure them. Court appointed ” doctors ” and ” therapists” operated with court appointment immunity and they inject junk science into a case to justify an order. Reporters have no idea how to report on these issues and should not merely be vomiting the words of the elected officials. Follow the money and the motive. Pay attention to the noise in family court cases and the next time judges and a corrupt DA come up for re- election, make an informed vote.

  11. Think about what our government has done!
    In 1955 we had 600,000 mental beds with a population of 190 million…Now with a population of approximately 400 million we have 60,000 mental beds..States chose to close mental institutions, changed institution laws, where did they spend that money? Now two days in jail,or a medical hospital and turned back out to the streets…

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