Transcript Outpatient Services Programs Workgroup: Laura’s Law May 29, 2014 Laura’s Law • Laura’s Law was passed by the California legislature in 2002 and is the.

Outpatient Services Programs
Workgroup:
Laura’s Law
May 29, 2014
Laura’s Law
• Laura’s Law was passed by the California legislature in 2002
and is the state law that allows for outpatient civil
commitment.
• The statute can only be utilized in jurisdictions that choose to
implement that law.
• Until recently, the law was only fully implemented in Nevada
County. In May 2014, Orange County supervisors voted
unanimously to implement the law. San Francisco is also
considering implementing the law.
Components of Laura’s Law
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Investigations and the Petition Process
Treatment Criteria
Court Hearings
Treatment Plan
Renewals and Remedies for Non Adherence
Rights of Individuals Subject to Petitions
Investigations and Petition Process
• Only the county mental health director may file a petition with the court in
the county where the individual is present.
• The following persons may request that the county health department
investigate whether to file a petition for the treatment of an individual:
– Any adult with whom the person resides;
– An adult parent, spouse, sibling, or adult child of the person;
– If the person is receiving inpatient treatment, the director of a hospital;
– The director of any public or private agency, treatment facility,
charitable organization, or licensed residential care facility providing
mental health services to the individual in whose institution the subject
of the petition resides;
– A treating or supervising licensed mental health treatment provider; or
– A peace officer.
Investigations and Petition Process
• Upon receiving a request, the county mental health director is required to
conduct an investigation. A petition is only filed if all the necessary
elements for an outpatient civil commitment petition can be proven by clear
and convincing evidence.
• The petition must state:
• that the person is present or believed to be present in the county where the
petition was filed;
– all the criteria necessary for placement in outpatient civil commitment;
– the facts supporting the belief that the person meets all the criteria; and
– that the subject of the petition has been represented by counsel.
• The petition must include an affidavit of a licensed mental health treatment
provider designated by the county mental health director that the
individual was examined in person or appropriate attempts were made to
examine the individual.
Treatment Criteria
• 18 years of age or older;
• Has a mental illness;
• Is unlikely to survive safely in the community without supervision,
based on a clinical determination;
• Has a history of lack of compliance with treatment and at least one
of the following is true:
• The individual has been hospitalized, or received services in other
specified settings (a mental health unit of a state or local correctional
facility) at least twice in the past 36 months; or
• The individual has harmed, threated , or attempted to, harm to
themselves or another individual in the past 48 months;
Treatment Criteria
• Has been offered an opportunity to participate in a treatment plan
fails to engage in treatment;
• The person’s condition is substantially deteriorating;
• The outpatient civil commitment program would be the least
restrictive placement;
• In view of the person’s treatment history and current behavior, the
person is in need of outpatient civil commitment treatment in order
to prevent a relapse or deterioration that would be likely to result in
grave disability or serious harm to himself/herself or others; and
• Is likely that the person will benefit from outpatient civil
commitment treatment.
Court Hearings
• The person who is subject to the petition has the right to be represented
by counsel at all stages of an outpatient civil commitment hearing.
• The court will hear testimony and, if advisable, examine the person.
• If after hearing all relevant evidence, the court finds that the person
does not meet the criteria for outpatient civil commitment, the court
will dismiss the petition.
• If the court finds that the person meets the criteria for outpatient civil
commitment, the court may order the person to receive outpatient
services for up to six months.
• If outpatient civil commitment is ordered, the court shall specify the
services that the person is to receive. The court may not require any
treatment that is not included in the proposed treatment plan submitted
by the examining mental health treatment provider.
Treatment Plans
• The court, in consultation with the county mental health
director, must find the following:
– That the ordered services are available for the duration of
the court order;
– That the ordered services have been offered on a voluntary
basis and the person has refused or failed to engage in
treatment;
– That all the elements of the petition have been met; and
– The treatment plan incorporated in the order will be
delivered to the county director of mental health, or the
appropriate designee.
Renewals and Remedies for Non
Adherence
• Renewals: The procedures and requirements for obtaining a renewal
order are the same as for obtaining an initial order.
• Remedy for Non adherence: A licensed mental health treatment
provider and designated individuals may take a person under an
outpatient civil commitment order to a hospital to be held for up to a
72-hour examination to determine if the subject of the order meets the
criteria for inpatient hospitalization. The treatment provider may only
make such a request after determining that:
– The person has failed or refused or failed to comply with courtordered treatment;
– Efforts were made to solicit compliance; and
– The person may need involuntary admission to a hospital for
evaluation.
Rights of Individuals Subject to
Petitions
• A person subject to a petition for outpatient civil commitment has
the right to:
– Retain counsel or utilize a court-appointed public defender;
– Adequate notice of the hearings (parties designated by the
subject of the petition also must receive adequate notice);
– Receive a copy of the court-ordered evaluation;
– Present evidence, call witnesses, and cross-examine adverse
witnesses;
– Be informed of his or her right to judicial review; and
– Be present at the hearing, unless he or she waives this right; and
– Appeal decisions, and to be informed of his or her right to
appeal.
Sources
• California Welfare and Institution Code, Section 5345-5349.5
http://www.leginfo.ca.gov/cgibin/displaycode?section=wic&group=0500106000&file=5345-5349.5
• San Francisco Supervisors Get Behind Laura's Law Mental Health
Program, http://www.latimes.com/local/lanow/la-me-lnsan-francisco-lauras-law-20140520-story.html
• O.C. First Large County in State to Adopt Laura’s Law,
http://www.latimes.com/local/lanow/la-me-ln-oc-lauraslaw-20140513-story.html