Orange County, as a direct result of the Kelly Thomas case, could become the first large California county to implement Laura’s Law, legislation that allows the courts to order outpatient treatment for seriously mentally ill adults, Supervisor John Moorlach said Wednesday.
Moorlach championed local adoption of Laura’s Law in the months after Thomas, who was diagnosed with schizophrenia and living on the streets, died after a July 5, 2011, beating by six Fullerton police officers. Moorlach said in a telephone interview that if plans stay on schedule, the new law could go into effect in Orange County as early as July or August.
“It would be one of the things I’d like to accomplish in my last year,” said the termed-out Republican supervisor, who has announced he is running for a seat in the House of Representatives. “I’m seeing it through.”
In an email to his constituents, Moorlach stated he was unaware of Laura’s Law until supporters of mental health programs for adults came to the Board of Supervisors after Thomas’ death.
Now, Moorlach wrote, the county’s Health Care Agency is organizing the management duties necessary to implement the law, the Mental Health Services Act Steering Committee already has approved both the program and funding for the fiscal year that begins July 1 and a plan should be finalized by March.
By May, according to Moorlach, the Board of Supervisors should vote on a resolution to begin the program, and then money will be provided in the 2014-2015 budget. That would allow the courts to begin hearing cases for outpatient treatment of mentally ill adults under Laura’s Law as early as July.
“This would be a major policy decision for a major county,” Moorlach wrote.
Laura’s Law was enacted in 2002 and named for Laura Wilcox, a college student who was murdered by a Nevada County mental patient during the years the bill was making its way through the state Legislature. The law gives the courts authority in the most severe cases to order an adult to accept specific outpatient treatment.
But the Legislature left it to each county to implement the law, and none except Nevada County did. When Moorlach raised the possibility of Orange County adopting the law after Thomas’ death, the county counsel’s office said the county couldn’t finance it from Proposition 63, the 2004 ballot proposition that raised money specifically for mental health treatment.
But last year, Senate President Pro Tem Darrell Steinberg, D–Sacramento, authored legislation that made it clear counties could spend Proposition 63 money on Laura’s Law. The supervisors endorsed Steinberg’s bill, and Moorlach and Health Care Agency Director Mark Refowitz traveled to Sacramento while the bill was pending to help round up support.
The bill specifies that counties may use Proposition 63 money to treat adults who either are unaware they are severely mentally ill or simply refuse medication.
To protect adults from being wrongly forced into treatment, Laura’s Law requires county health officials to work with the patient to seek voluntary treatment.
Only if that fails would the adult be brought before a judge, who could order the person to participate as an outpatient in medical treatment. During the court proceedings, a public defender would be assigned to protect the rights of the adult.
Those court costs, estimated at about $1 million a year, wouldn’t be covered under Laura’s Law, but other county health expenses would. Nevada County officials said that in their experience, few patients go all the way to court before agreeing to treatment. The propects of facing a judge, known as the “black robe effect,” causes patients to cooperate, officials said.
A key benefit of the new legislation is it will help families obtain outpatient treatment for their adult children. Currently, once people turn 18, they are considered an adult and may refuse treatment, even if family and medical professionals have previously been providing medical help for mental illnesses.
When adult mental patients are hospitalized, privacy laws often keep families uninformed about help that a relative needs, said mental health activists.
“The system separates the family from a mentally ill person,” said Steve Pitman, a board member of the Orange County branch of the National Alliance on Mental Illness, known as NAMI.
Patients often refuse to take medications, because either they don’t believe they are ill or to avoid the sometimes strong side effects.
Approximately 25 percent of the U.S. population experiences a diagnosable mental illness of some type, including depression, during their lifetimes, said Pitman. But, he said, mental illness carries a stigma that can prevent patients from seeking or accepting treatment.
“No one would think of leaving a cancer untreated,” he said. “It’s [adult mental illness and accompanying problems such as homelessness] something we’ve chosen not to address, and it’s to the detriment of us all.”
Serious adult mental illness is a major contributor to homelessness. As many as 40 percent of the street population suffers from untreated mental problems, according to some estimates. As a result, untrained police rather than trained mental health professionals often are left to deal with mentally ill adults.
According to the Los Angeles County Sheriff’s Department, the Los Angeles County jail is the largest mental hospital in the U.S.
Thomas, 37, had been in and out of treatment for severe schizophrenia before being confronted by Fullerton police in the parking lot of the city’s bus station. Three officers were charged with second-degree murder or involuntary manslaughter, but a jury Monday acquitted two of the former officers on all charges, and charges against the third are being dropped.
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.
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