San Francisco Poised to Implement Laura’s Law

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

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Published on June 29, 2014 with 6 Comments

Laura's Law

By Ralph E. Stone

June 29, 2014

The Board of Supervisors appears poised to finally implement Laura’s Law in San Francisco at a meeting tentatively set for July 8.  Supervisor David Campos, a long-time opponent of involuntary treatment of the mentally ill, reportedly agreed to support the move if certain amendments are added.  With Campos’ vote, Laura’s Law is likely to pass avoiding a November referendum on the issue.

The amendments are window dressing in an attempt to appease opponents of Laura’s Law.  To qualify for treatment, a person must have been hospitalized or jailed stemming from mental health issues twice in the past three years and have been violent to themselves or someone else in the past four years. The treatment would be administered at an outpatient facility and would not permit compelled medication.

Laura’s Law is an assisted outpatient treatment (AOT) program that allows court-ordered, intensive outpatient treatment for persons with severe mental illness who refuse medication because their illness impairs their ability to make rational decisions.

California implemented Laura’s Law in 2002 and has been extended to 2017, but only Nevada and Orange counties have implemented it fully with Los Angeles County opting for a small pilot project.  Forty-five states permit the use of assisted outpatient treatment.

One of the Campos amendments would prohibit compelled medication.  This amendment illustrates a common misconception about Laura’s Law.  AOT orders cannot authorize forced medication. Before a person can be compelled to take medication, a Riese hearing is required.  In a Riese hearing, the person has a right to an advocate or counsel.  In other words, if a person does not follow AOT treatment plan, a Riese hearing can be invoked.  In short, an AOT plan can include medication only by an order issued by a judge.

Laura’s Law is not about the physical act of forced medication. Forced medication can — and should –- only happen at a licensed medical facility.  One of the goals of Laura’s Law is to eliminate the need for forced medication.

Opponents of Laura’s Law argue that any involuntary treatment trample the civil rights of the mentally ill. The response to these opponents was well stated by Don Edward Green, former Contra Costa County probate judge:

“Laura’s Law provides a very thorough protection of the civil rights of the persons with severe mental illness. But, you may hear claims that Laura’s Law is an infringement of civil rights. At the core of our civil rights is our ability to choose to do what we want. When a person is unable to understand the nature and consequences of their decisions because of their illness, that person is fundamentally deprived of the ability to exercise any civil rights…  We make a mockery of civil rights when we ignore people with severe mental illness, leaving them on the streets until they do something we characterize as a crime, then we lock them in our overcrowded jails and prisons.”

I urge the Board of Supervisors to implement Laura’s Law with or without the unnecessary amendments.

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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  1. In Augutst 2014, Placer County became the 6th county to implement Laura’s Law.

  2. On July 15, 2014, Los Angeles County voted to fully implement Laura’s Law. Previously the county had a small pilot program.

  3. On July 8, 2014, the San Francisco Board of Supervisors voted to fully implement Laura’s Law.

  4. Nate Miller, Proposition 63 passed in 2004, established a one percent tax on personal income above $1 million to fund expanded health services for mentally ill children, adults, and seniors. SB 664 makes it clear that Proposition 63 funds can be used to support a Laura’s Law program.

    • Great… Still seems like the money would be much better spent on the huge group of people who are currently getting the run around, willfully trying to access mental health care.

  5. Where is all of this extra money going to come from? I used to work in a homeless drop-in center and there were hundreds of people who were desperate for voluntary mental health services who were not able to access them. Before she got cut, we had a psychiatrist who came for a half day. the only person available to serve the 500 people (or the portion of them who sought medical mental health treatment) who came in the doors, daily.

    Some people came in with such a need that in one case a woman tried to stab herself in the eye with a syringe just so she could get 5150d. I saw her in the street 3 hours later, already released from the hospital. Things like this happened regularly. While I agree that there are a lot of people who need help, forcing people who aren’t interested seems counterproductive in building a relationship with them for future services, and a huge waste of money as there are so many people who are already trying to get them.