Time to Implement Laura’s Law

Written by Ralph E. Stone. Posted in Crime, Healthcare, Law, Opinion, Politics

Tagged: , , , , , , ,

Published on February 23, 2013 with 15 Comments

Laura L. Wilcox, March 5, 1981 – January 10, 2001 was murdered by a mentally-ill  patient. Laura's death was the impetus for AB 1421 known as Laura's Law.

Laura L. Wilcox, March 5, 1981 – January 10, 2001 was murdered by a mentally-ill patient. Laura’s death was the impetus for AB 1421 known as Laura’s Law.

By Ralph E. Stone

February 23, 2013

AB 1569 was recently signed into law, which means authority in the Laura’s Law statute for a county to operate, establish or continue a program of Assisted Outpatient Treatment (AOT), has been extended until December 31, 2017.

On June 8, 2010 Board of Supervisors Resolution (#100751) was issued authorizing the implementing of Laura’s Law in the City and County of San Francisco, but was never voted on by the Board.

The Department of Public Health initiated a voluntary version of the law last year to treat a handful of people who were patients in the psychiatric ward of San Francisco General Hospital.  However, under San Francisco’s Community Independence Pilot Project, patients must voluntarily agree to participate once they’re already hospitalized.  But it puts the severely mentally ill in charge of their own self-destructive and dangerous behavior.  This is not Laura’s Law.

It is time for San Francisco to implement Laura’s Law, not a watered-down version.

Laura’s Law in a nutshell:

Laura Wilcox, a 19-year old sophomore from Haverford College, was working at Nevada County’s public mental health clinic during her winter break from college. On January 10, 2001, she and two other people were shot to death by Scott Harlan Thorpe, a 41-year old mental patient who resisted his family’s attempt to seek treatment. Thorpe was found incompetent to stand trial and was sent to Atascadero State Hospital and was later transferred to California’s Napa State Hospital.

Laura Wilcox’s death was the impetus for passage of AB 142 in 2002, an AOT program, which has since become known as Laura’s Law.

For the uninitiated, an AOT program allows court-ordered, intensive outpatient treatment for people with severe mental illnesses who refuse medication because their illness impairs their ability to make rational decisions.

People with psychotic disorders who received court-ordered treatment for 180 days had significantly better outcomes than those who were given either intensive treatment alone, or a court order alone.  Thus, AB 1421 provides for a 180 day period of intensive treatment under the supervision of the court.  Currently AOT can only be used if a county’s board of supervisors enacts a resolution to implement and independently fund a discrete Laura’s Law program.  Now, an AOT program is available statewide as a tool that can be, but is not required to be, used to efficiently treat the most problematic patients.

A 2000 Duke University study demonstrated that people with psychotic disorders who received court-ordered treatment for 180 days reduced hospitalizations by up to 74 percent, reduced arrests by 74 percent, reduced violence up to 50 percent, reduced victimization by 43 percent, and improved treatment compliance by 58 percent.  That’s why AB 1421 incorporates these findings by providing for 180 day periods of intensive treatment under the supervision of the court.

AB 1421 was modeled after New York’s “Kendra’s Law.”  Among the targeted hard-to-treat population, Kendra’s Law resulted in 74 percent fewer homeless; 83 percent fewer arrests; 87 percent49 percent less alcohol abuse; and 48 percent less drug abuse. Assisted outpatient programs have also worked in Iowa, North Carolina, Hawaii, and Arizona.

Kendra’s Law was held in all respects to be constitutional.  (In re Urcuyo, 714 NYS.2d 862 (Sup. Ct. Kings County, 2000))  If challenged, I have no doubt that the constitutionality of Laura’s Law would also be upheld.

Fortunately, money should no longer be an issue since voters overwhelmingly passed Proposition 63 in 2004, which established a one percent tax on personal income above $1 million to fund expanded health services for mentally ill children, adults, and seniors.  Nothing in Proposition 63 prevents these funds from being used to implement Laura’s Law.  Nevada County, for example, is now using Proposition 63 funds to implement Laura’s Law.

Laura’s Law has been implemented in Nevada County and Los Angeles County opted for a small pilot project of AOT. That means 56 of the 58 California counties have not enacted Laura’s Law.  In Nevada County, where the killings took place, the law has been fully implemented and proven so successful that the county was honored in 2010 by the California State Association of Counties. In announcing the recognition, CSAC said Nevada County offset public costs of $80,000 with savings estimated at $203,000 that otherwise would have been spent on hospitalization and incarceration of program participants.

We have heard much hand-wringing about what to do with the homeless — many of whom are chronically mentally ill — who are picked up off the streets.  They may or may not be placed in a treatment facility, if one is available.  Once they complete treatment, they are too often dumped back on the streets with no housing, jobs, money, or followup by a professional case manager.  In a short time, these homeless are back on the street. Laura’s Law could be invoked for those who refuse medication because their illness impairs their ability to make rational decisions, and utilize court-ordered outpatient treatment and provide for a 180 day case-managed followup.

Laura’s Law cannot be used to forcibly medicate people.  Forced medication can – and should – only happen in a licensed hospital. It is about prioritizing highest-need patients and the monitoring and case management that accompanies those patients under the law so that they have the support to stay on their treatment plan, which may include medication.

An estimated 3.6 million Americans suffer from untreated severe bipolar disorder or schizophrenia.  Oftentimes, they are too ill to recognize their own need for treatment.  AOT does not take away someone’s civil rights. Severe mental illness, not its treatment, restricts civil liberties. By assuring timely and effective intervention for the disabling medical condition of severe mental illness, AOT restores the capacity to exercise civil liberties and reduces the likelihood of the loss of liberty or life as a result of arrest, incarceration, hospitalization, victimization, suicide, and other common outcomes of non-treatment.

While we as a society must safeguard the civil rights of the unfortunate, we also have an obligation to care for those who are unable to care for themselves.  Laura’s Law provides such safeguards.

San Francisco has stuck its big toe in the water with a pilot project.  Now is the time to take the plunge and implement Laura’s Law.

Ralph E. Stone

Ralph E. Stone

I was born in Massachusetts; graduated from Middlebury College and Suffolk Law School; served as an officer in the Vietnam war; retired from the Federal Trade Commission (consumer and antitrust law); travel extensively with my wife Judi; and since retirement involved in domestic violence prevention and consumer issues.

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  • Richmondman

    Thank you. Lock these sorry folks up in rehab. It will at least give them a chance.

  • David

    Laura’s needs to be FULLY implemented. San Francisco is a city of compassion, lets show it by helping the chronic mental ill homeless folks that exists on the streets of Ssn Francisco. It is a crime against these people not to apply Laura’s Law.

  • Eric Brooks

    Laura’s Law is a dangerous, cynical tool of the pharmaceutical industry to expand the sale of its products, which is already booming because of maneuvers it has undertaken such as the forcing of millions of young school children onto mind and life destroying drugs like Ritalin to supposedly cure ‘ADHD’.

    Once again mister Stone, as with your support of nuclear power, you are spreading extremely dangerous industry propaganda to the public in the guise of news reporting.

    The primary group lobbying for punitive police state laws like Laura’s law (which will indeed force innocent victims trapped in the criminal justice system, against their will, onto psychiatric pharmaceuticals) is an ‘organization’ called NAMI (the National Alliance on Mental Illness) which receives vast amounts of its funding, and other supports, from the pharmaceutical industry.

    To see a report on this relationship of NAMI with the drug industry go to: http://www.pharmalot.com/2009/10/nami-astrazeneca-is-a-strong-effective-partner/

    To see a report on how the Big Pharma has similarly used faux ‘advocacy organization’ front groups like CHADD to trick tens of millions of people into taking destructive pharmaceuticals for the concocted disease ‘ADHD’ go to: http://www.cchrint.org/psycho-pharmaceutical-front-groups/chadd/

    And another good roundup on all of this vile, industry driven hooking of our nation on Big Pharma’s drugs is at: http://www.cchrint.org/psycho-pharmaceutical-front-groups/

  • David

    Eric I agree with most of your comment, what is your solution to the many mental ill homeless people living on the streets of San Francisco?
    Some have the mental capacity of a 6 year old, would you allow a 6 year old to live and fend for its self on the streets?

    • See my response to Ralph above. Families and people with mental and emotional challenges need vastly increased supportive services, not drugs.

  • Ralph E. Stone

    Eric, yours is a knee-jerk reaction to Laura’s Law. I too have been critical of big PHARMA (www.fogcityjournal.com/Wordpress/3217/is-the-American-psychiatric-association-in-bed-with-big-PHARMA) but It is a big leap from criticism of big PHARMA to a condemnation of Laura’s Law. What’s the alternative, leave the mentally ill, who are unable to make rational decisions, to forever wander the streets? San Francisco can do better than that. Laura’s Law may not be the complete answer, but, in my opinion, it will certainly help.

    • There is nothing knee-jerk whatsoever in pointing out the clear, unambiguous, and blatantly outrageous conflict of interest; that the main ‘organization’ promoting Laura’s Law, NAMI, is a paid front group of pharmaceutical corporations.

      What people with mental and emotional problems need, is vastly more funds to be spent on supportive housing, job placement, counseling, and interactive cognitive and behavioral therapy; not the cheap cop-out of paying pharmaceutical corporations to put them all on mind numbing and often extremely dangerous drugs which cause serious health problems and other serious side effects; often including the inducement of suicidal, violent and homicidal behavior. Such ‘treatment’ puts the public in -greater- danger, not less danger.

      There is indeed an epidemic in this country. And that epidemic is the knee-jerk reaction of school districts and governments who don’t want to spend real money providing real improvements to their constituents lives, and instead are throwing tens of millions of people (including over 2 million school children) onto mind altering drug hamster wheels from which most of them will never escape, and which permanently ruin their lives.

      My only question for you Ralph, is to ask you to describe how much of your report was a cut and paste job from whatever press release you got from the pharmaceutical industry and its NAMI puppets (including the photo, which a quick search finds plastered all over the web, in similar ‘reports’ like yours).

      Your text certainly reads as such.

      Being led by the nose by corporations is not journalism.

  • David

    Eric, spend some time at SF General Emergency Center, get the statics on SF Homeless Psychotics that they deal with daily, most are repeats, weekly or every few weeks. They clean them up treat their needs and after a few days discharge them, where they return to the streets.
    Also the cost money wise to SF is a group of 477 individuals costs the city more than $20 million in emergency medical services in one year.

    • The reality is that the people who have serious enough brain disorders to require medication are -very- few. Casting a net like Laura’s law around thousands of others who do not need medication (but will forced onto it anyway because they lack the resources to fight the system) just to ensure the treatment of those few, is a slippery slope into a big brother security state resembling the world of THX 1138.

  • I can speak for myself regarding being a patient and being diagnosed as a soft bi-polar…meaning I can still manage myself physically and mentally….I have multi medical conditions that I think had emerged after I took prescribed drugs for psoriatic arthritis ….and had adverse reactions. Been a cancer survivor,(had major surgery to remove the ovarian cancer) had small bowel obstruction after the surgery, for six years until I had to have major surgery again,.to fix the obstruction. I saw a social worker at the SFGH and she referred me to a place where I am staying now, where I can get better independently…..and I think they used the Laura’s law on me….which i appreciate very much….and my social worker’s name is “Laura” no kidding.

  • David

    Eric you talk the talk, but what are you doing to handle the psychotic homeless folks that lives in the streets of San Francisco.?

    • I am a grassroots organizer, who, among many other goals, fights for expanded social services and affordable housing. But the interesting question is – what if I wasn’t? Lots of people have to serve coffee to make a living. In a democracy, should those people be disenfranchised from a say in their community’s response to mental and emotional problems? I think not. Especially in a society that has become so prescription drug crazy that one of those baristas may be the next, to be duped or forced, into taking unnecessary and dangerous medications.

  • Ralph E. Stone

    How can anyone oppose a 180-day assisted outpatient treatment (AOT) program considering the phenomenal results shown in the Duke study, Kendra’s Law, and Laura’s Law in Nevada County? Are prescription drugs sometimes used in the treatment of the mentally ill? Of course, but i am not aware of any studies showing that Kendra’s Law or Laura’s Law in Nevada County, resulted in over medication.

    In addition, I can find no evidence that the pharmaceutical industry is directly or indirectly involved in the implementation of Laura’s Law. In fact, one of the primary proponents of Laura’s Law implementation is the Treatment Advocacy Center (www.treatmentadvocacycenter.org), who does not accept any money from pharmaceutical companies.

    Regardless, Laura’s Law is not merely about medication – and is not about the physical act of “forcibly medicating.” Forced medication can—and should—only happen in a licensed hospital following a Riese hearing. Laura’s Law is about prioritizing highest-need patients and the monitoring and case management that accompanies those patients under the law so that they have the support to stay on their treatment plan, which may include medication.

    • Luke, honestly… Why do you continue to allow this shameless corporate mouthpiece ‘reporter’ to regurgitate industry propaganda in what is otherwise your excellent news source? Please cut Ralph cold turkey. He is a disgrace to real journalism and to Fog City Journal.

      And to address Ralph’s complete bs response to my critique above, let me simply repeat (with web links):

      Laura’s Law is a dangerous, cynical tool of the pharmaceutical industry to expand the sale of its products, which is already booming because of maneuvers it has undertaken such as the forcing of millions of young school children onto mind and life destroying drugs like Ritalin to supposedly cure ‘ADHD’.

      Once again mister Stone, as with your support of nuclear power, you are spreading extremely dangerous industry propaganda to the public in the guise of news reporting.

      The primary group lobbying for punitive police state laws like
      Laura’s law (which will indeed force innocent victims trapped in the criminal justice system, against their will, onto psychiatric
      pharmaceuticals) is an ‘organization’ called NAMI (the National Alliance on Mental Illness) which receives vast amounts of its funding, and other supports, from the pharmaceutical industry.

      To see a report on this relationship of NAMI with the drug industry go to: http://www.pharmalot.com/2009/10/nami-astrazeneca-is-a-strong-effective-partner/

      To see a report on how the Big Pharma has similarly used faux
      ‘advocacy organization’ front groups like CHADD to trick tens of
      millions of people into taking destructive pharmaceuticals for the
      concocted disease ‘ADHD’ go to: http://www.cchrint.org/psycho-pharmaceutical-front-groups/chadd/

      And another good roundup on all of this vile, industry driven hooking of our nation on Big Pharma’s drugs is at: http://www.cchrint.org/psycho-pharmaceutical-front-groups/

  • Ralph E. Stone

    Brooks, your ad hominen, bluster response is journalism/comment at its worst. In the end, Laura’s Law wins and you lose. Your website are not even on point.