ECLECTIC RANT: San Francisco Poised to Implement Laura’s Law

Ralph E. Stone
Friday July 04, 2014 - 12:13:00 PM

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 passed Laura’s law in 2002 and it 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.