Stronger ‘Laura’s law’ wins Assembly approval

Legislation to strengthen California’s 2002 “Laura’s Law,” which gives family members a legal tool to get treatment for their severely mentally ill relatives, has been approved 77-0 by the state Assembly, despite opposition from some California counties, behavioral health directors and a labor union representing employees in local mental-health programs.

The Assembly’s approval on Wednesday for the bill, AB 1976 by Assemblywoman Susan Eggman, D-Stockton, would also make “Laura’s Law” permanent, ending the sunset provision which required “reauthorization hearings” every five years. The measure was sent to the Senate.

The action comes nearly two decades after contentious hearings on the original law, by then-Assemblywoman Helen Thomson, D-Davis, which had intense opposition from disability rights groups and county mental health directors.

Some counties are balking at a key provision of the Eggman bill that would require them to publicly explain — in writing — why they are “opting out” of participation in the program, which has had considerable success in reducing hospitalizations, homelessness and incarceration in the 20 counties where it has been adopted.  Under current law, county participation is voluntary.

The bill earlier sailed through two major Assembly committees, despite opposition, and was unanimously approved in recent weeks by the Assembly Health Committee (15-0) and Appropriations Committee (18-0).

Laura’s Law is named for 19-year-old Laura Wilcox, who was a college student working in a Nevada County mental-health clinic during her winter break in 2001, when she was shot and killed by a severely mentally ill man who went on a shooting rampage that killed three and injured three others.

“Now is a good time. We are passing things we’ve never passed before.” — Susan Eggman

“This bill would bring it full circle,” said Laura’s mother, Amanda Wilcox, who with her husband Nick became tireless legislative advocates for mental-health and gun-control legislation in California.

A similar bill to strengthen Laura’s Law, also by Eggman, failed in 2015, but she is optimistic about the current legislation. Likening the mental-health crisis playing out in plain view throughout California to “a wildfire in our streets,” she said there is growing support for major policy improvements in the state’s historically fractured mental-health care system, brought into even sharper relief by a global pandemic — as thousands of mentally ill Californians cycle in and out of emergency rooms and jails, or wander the streets.

“How is that dignity for anybody?” said Eggman, a former social worker and Sacramento State professor, in an interview with Capitol Weekly. “The human rights and public-health crisis is not fair to families, and I think it has become a stark reality for everybody. Now is a good time. We are passing things we’ve never passed before.”

In a May 29 letter to Assembly Appropriations Chair Lorena Gonzalez, the California State Association of Counties and the County Behavioral Health Directors Association, said they were not opposed to making the nearly 20-year-old “Laura’s Law” permanent, eliminating the five-year sunset provision that has dogged the law since its inception. A subsequent letter June 8 from the behavioral health directors and the Service Employees International Union said they “regretfully” oppose the bill because it “would place a virtual mandate on counties to participate [in Laura’s Law],” and would “increase staff workload.”

The sweeping, bipartisan vote in the Assembly – with one abstention, by Assemblyman Ash Kalra, D-San Jose – clearly sent a message to the counties that Laura’s Law is here to stay in California.

“At the end of the day, the opposition was not compelling,” said Randall Hagar, longtime legislative advocate for the California Psychiatric Association, which supports the bill, along with the California Medical Association and the California Hospital Association.

The 20 counties that have “opted in” to start Laura’s Law programs account for an estimated 70% to 80%  of the state’s population, but some county mental health directors and employees continue to oppose the bill’s requirement that counties choosing to “opt out” of the program must state their reasons in writing after public discussion.

“The notion that [the law] interferes with the counties is bogus.” — Judge Thomas Anderson

They also dislike adding judges to the list of individuals – which currently includes family members, health-care professionals and law enforcement – who can ask the local mental-health director to file a civil court petition for treatment under Laura’s Law, which in many cases is voluntary and does not require judicial intervention. And advocates point to statistics that show the law saves court costs by reducing incarceration and preventing costly conservatorships and criminal interventions.

Farah McDaid Ting, health policy representative for CSAC, argued that the existing “opt-in” provision of the original law, constitutes a public declaration.

“The ‘opt-in’ process is on the record,” she said. “The county has to budget for it, and the board [of supervisors] has to do this in public session.” While ‘Laura’s Law’ has proven to save money in reduced hospitalizations, incarceration and homelessness — and is partially supported by state funding from the Mental Health Services Act, the “millionaire’s tax” passed by voters as Prop. 63 in 2004 — there is no state budget appropriation in the original law, or the current bill. Counties argue there are “up-front” costs to establish such programs, and have long been opposed to any perceived “mandate.”

“The notion that [the law] interferes with the counties is bogus,” says Nevada County Superior Court Judge Thomas Anderson, a former public defender who was the defense attorney for Laura’s killer, has long supported Laura’s Law and helped start Mental Health Courts in Nevada County, one of the first counties in California to adopt the law. “And they’re wasting money by not having these services.”

“We always listen to the concerns of opponents or other members,” he said, “but we think [Laura’s Law] has proven to be effective.” — David Stammerjohan

Hagar says some counties that have chosen not to adopt “Laura’s Law” programs – including Sacramento County, which is surrounded by other counties with successful programs —  have done so quietly and behind the scenes, with little or no public discussion. “All we’re asking is that the counties have a public dialogue, put it on the record, explain their reasons for ‘opting out’,” he said. “It’s not a mandate.”

In the lead-up to the floor vote, David Stammerjohan, Eggman’s chief of staff, said the the “opt-out” requirements would remain in the bill, despite opposition from the counties. “We always listen to the concerns of opponents or other members,” he said, “but we think [Laura’s Law] has proven to be effective. Let’s have the counties actually have a conversation [about opting out], examine it from a public perspective, and then make a decision.”

As Assisted Outpatient Treatment (AOT or Laura’s Law in California) has gained supporters throughout the country – and shown widespread success in providing needed treatment, reducing hospitalizations, homelessness and incarceration, with significant cost savings – it nonetheless remains a little-known option for families of the mentally ill, who are often desperate to get treatment for family members but are generally barred from helping, even to warn of potentially volatile behavior, although they often are expected to serve as de facto caretakers.

Before Laura’s Law, the only real resource for families under existing law was the so-called “5150,”  a reference to that section of the state Welfare and Institutions Code governing 72-hour mental-health holds for someone deemed a danger to “self or others.” But invoking that provision involves law enforcement and usually means that an individual is soon released back to the streets, long before being stabilized on medication, or getting any treatment at all. Often, they return to families ill-equipped to help them, with sometimes tragic results.

Following their daughter’s tragic death, Laura’s parents, Amanda and Nick Wilcox, were determined to see legislation passed in California to give families options to get mentally ill relatives into treatment.

The valedictorian of her high school class, Laura Wilcox was a college sophomore on Jan. 10, 2001, working in a Nevada County mental health clinic during her winter break from Haverford College in Pennsylvania, when she was killed by a delusional clinic patient whose family had repeatedly tried to alert local mental-health authorities about his rapidly deteriorating condition – but they had refused to listen.

Scott Thorpe, then 40, a former school custodian, showed up at the clinic for an 11:30 a.m. appointment, and opened fire with a 9 mm semiautomatic handgun, killing Laura and a caregiver who had brought another patient to an appointment, and causing serious injury to two other clinic employees. He then drove to a nearby restaurant – which he thought was poisoning him – and killed the assistant manager, severely wounding a cook who tried to flee.

Thorpe’s brother, Kent, then a Sacramento Police sergeant and hostage negotiator, and his wife Sharon, had repeatedly attempted to alert clinic therapists about Scott’s increasingly alarming behavior, to no avail. “They wouldn’t listen,” said Kent Thorpe, who ultimately helped convince his brother to surrender peacefully later that day.

Scott remains in Napa State Hospital for the criminally insane, where he was sent after pleading Not Guilty by Reason of Insanity in Nevada County Superior Court.

“Some of those early hearings were uncomfortable. We were personally accused of  being ‘violence mongers’ and ‘spreading stigma.’” — Nick Wilcox

Following their daughter’s tragic death, Laura’s parents, Amanda and Nick Wilcox, were determined to see legislation passed in California to give families options to get mentally ill relatives into treatment. The resulting “Laura’s Law” has since been adopted by 20 of California’s 58 counties, including several of the state’s largest counties. But it has always been a voluntary process for California counties to “opt in” to start the Assisted Outpatient Treatment (AOT) programs that have been widely adopted in various forms, with considerable success, in 46 states throughout the U.S.

It was based on a similar law in New York, “Kendra’s Law,” passed in 1999, following the horrific death of 32-year-old Kendra Webdale, who was pushed in front of a subway train by a deranged man who had been hospitalized at least a dozen times, including six weeks before Kendra’s death. Unlike California, the New York Legislature made the law mandatory throughout the state, with state funding and stunning results.

In California, the path to adopting “Laura’s Law” was arduous at best, although it was strongly supported by the families of the mentally ill – including Scott Thorpe’s – and by victims, like Amanda and Nick Wilcox. Counties balked – many still do — at what they saw as an additional burden on already overwhelmed local mental-health systems.

Disability rights activists opposed the law, saying it infringed on the rights of the mentally ill to refuse treatment, and held noisy demonstrations on the Capitol lawn and in hearings on the original bill, many wearing yellow t-shirts with the triangular symbol for concentration-camp inmates deemed “mentally defective.” Then-Assemblywoman Thomson, a former psychiatric nurse who is the author of the original law, was heckled and called “Nurse Ratched,” after the abusive nurse in Ken Kesey’s “One Flew over the Cuckoo’s Nest,” about a fictional psychiatric hospital.

“Some of those early hearings were uncomfortable,” recalls Nick Wilcox, then an environmental scientist for the state Water Resources Control Board. “We were personally accused of  being ‘violence mongers’ and ‘spreading stigma’.  The first time I testified in 2001, I told the Assembly Judiciary Committee that I believe in civil rights. But when your civil rights interfere with someone’s right to live, it’s gone too far. Laura had a right to live.”

Now experienced legislative advocates, responsible for helping to pass dozens of bills on mental-health and gun-control issues in California, the Wilcox’ are optimistic about the current bill. “Bills grow legs,” Nick Wilcox said, “and this has very sturdy legs.”
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Editor’s Note: UPDATES earlier and RECASTS lead with Assembly approval, EDITS throughout to conform. Sigrid Bathen is a veteran Sacramento journalist and former Sacramento Bee reporter who has covered mental-health and related issues for several publications, for more than 40 years. She has taught journalism and communications at Sacramento State since 1988. She has written for Capitol Weekly since 2005, on a variety of subjects, including education and health care.