Santa Clara County Supervisors Vote To Implement Laura's Law

SANTA CLARA COUNTY, CA — The Santa Clara County Board of Supervisors voted unanimously to implement Laura’s Law during a meeting Tuesday, paving the way for court-ordered treatment for people with severe mental illness and a history of hospitalization or incarceration.

Laura’s Law, also known as assisted outpatient treatment (AOT), mandates 90 days of mental health treatment for those who have had run-ins with the law and are determined to have symptoms of severe mental illness. The law is intended to be a temporary mechanism and serve as a bridge to recovery, and medication cannot be forced upon a patient.

The number of people in the county affected by the law will range from between 60 to 100 per year, according to Supervisor Otto Lee, who added that AOT is not a “silver bullet” to solving homelessness.

“But these are also the people who have the most severe mental health needs,” Lee said. “Therefore, I believe this program is long overdue. I believe it will save lives, and also provide relief to families who know the needs of their loved ones best.”

The board heard from numerous speakers during public comment who told stories of family members suffering from mental illness and needing assistance.

“This is the voice of a desperate mother,” said one speaker whose son has been diagnosed with bipolar disorder and has been incarcerated.

Laura’s Law was passed in California in 2001 following the death of Laura Wilcox, a 19-year-old who worked at the Nevada County Department of Behavioral Health and was killed by a former patient with severe mental illness who had resisted treatment. The law was modeled after Kendra’s Law, a similar statute enacted in New York.

Advocates say it is a tool to help prevent recidivism and help unhoused residents who struggle with mental health issues. But the law has faced backlash from those who say it unfairly targets the unhoused population, does little to address the root cause of homelessness and takes away civil liberties.

Supervisor Susan Ellenberg called the court-mandated treatment “inappropriate, likely ineffective and ultimately unenforceable.” But she supported the item because she didn’t believe the county’s existing programs to support mental health resources and homelessness were enough.

“The attention of the public to AOT now is positive in that it compels us to invest in ways that we should’ve done years ago,” Ellenberg said.

The county supervisors had delayed discussing the law in 2019 in favor of looking into other mental health services, but with the passage of Assembly Bill 1976 last year, counties are automatically opted into Laura’s Law unless they vote to oppose it.

The supervisors voted against the recommendation of county staff, who suggested to the county’s Health and Hospital Committee earlier this year that the county opt out of Laura’s Law, according to Supervisor Joe Simitian.

Simitian, who was a first-term member of the California State Assembly in 2002 when the law was brought to the floor, said that back then it was a controversial topic. But with the benefit of time, Simitian said that concerns over civil liberties have been properly addressed, the treatment has worked in other counties in the state that have chosen to implement it and the law should be viewed as a “right to service.”

“We can help people who aren’t getting the help,” Simitian said. “We can reduce hospitalization. We can reduce incarceration. We can reduce homelessness. We can do it in a thoughtful way. It is not a cure all. It’s not a panacea. But for the people it will matter to, it will make all the difference in the world, in my view.”

Santa Clara joins four other Bay Area counties — San Francisco, Contra Costa, Alameda and San Mateo — and 21 other counties in the state to implement Laura’s Law. The cost of implementing the program will be more than $10 million annually, according to the Santa Clara County Behavioral Health Services Department, with 18 full-time employees added to implement the program.

In San Francisco, an evaluation after three years of implementation of the AOT program found that the cost of treating the 129 participants dropped by 83 percent per month after they entered the program.

Under Laura's Law, counties are prohibited from diverting resources to fund AOT, so this will be an expansion to services.

There are also specific requirements for one to be considered for AOT under Laura's Law including recent hospitalizations within the last 36 months, demonstrated violence against themselves or others or history of refused treatment.

Typically, a judge will order AOT but family members and caregivers can also request individuals be referred to the treatment program.

Over 400 local mental health business and community leaders signed a letter submitted by San Jose City Councilmember Matt Mahan in favor of the county implementing Laura’s Law.

“I realize the voluntary programs have been successful for many individuals, but I believe that we need options for severely mentally-ill family members and neighbors who sometimes don’t fully recognize or accept the care that they fully need, despite desperate pleas from friends and family members,” Mahan, who also held a news briefing Monday on Laura’s Law, told the board.

County Executive Jeff Smith said he disagreed with the supervisors’ decision, but the county will continue to support measures to address mental illness. He cautioned that Laura’s Law will not fix the broader issue.

“Severe mental illness is not a problem that’s solved by one or two visits to the jury or to the judge,” Smith said. “It’s a long-term life chronic problem. It requires persistent support for a long period of time. I just am very nervous that some people think AOT is going to be some magic bullet that’s suddenly going to solve homelessness, and it’s not going to do that.”

Bay City News contributed to this report.