February 18, 2025
Mario Gardea
Board of Supervisor, Dist. 1
[email protected]
Paul Canepa
Board of Supervisor, Dist. 2
[email protected]
Sonny Dhaliwal
Board of Supervisor, Dist. 3
[email protected]
Steven J. Ding
Board of Supervisor, Dist. 4
[email protected]
Robert Rickman
Board of Supervisor, Dist. 5
[email protected]
Sandy Regalo
County Administrator
[email protected]
Re: Assembly Bill 1976 (Laura’s Law/Assisted Outpatient Treatment) To the Honorable Members of the Board of Supervisors and Ms. Regalo:
In October 2021, the City Council for the City of Manteca sent the attached letter to the Board of Supervisors. In response, the County of San Joaquin (“County”) indicated that it would monitor the matter, but at that time preferred to rely on the County’s “InSPIRE” program. As nearly four years have passed since the City of Manteca made this initial request, the City is once again imploring the County to opt-in to the Laura’s Law on or before June 30, 2025. After studying this matter in some detail, the City of Manteca believes that Laura’s Law and its related principle of Assisted Outpatient Treatment (or “AOT”) would be a great benefit for the residents of San Joaquin County.
For some background, AOT was initiated in California following the 2001 killing of Laura Wilcox in Nevada County by an individual suffering from severe mental illness. This individual was engaged in treatment services and regularly visited a mental health clinic; the individual was not, however, engaged to the degree necessary to prevent decompensation or the stabilization of symptoms. As it now stands, AOT is a system of laws found in California’s Welfare and Institutions Code to provide compelled mental health treatment without having to place individuals in conservatorship. In practice, AOT is a collaboration between several county agencies, the courts, members of the public, and/or non-profits who take an interest in the assistance of individuals most at risk for the negative consequences of not receiving treatment.
California’s “Laura’s Law” (fashioned after New York’s “Kendra’s Law”) was enacted in 2002. In contrast to current County programs, AOT is a sustained and intensive court-ordered outpatient treatment for individuals with mental illness who may be at risk of grave disability, deterioration in life skills and functioning, self-harm, and/or violence towards others. AOT is not an alternative to voluntary treatment; instead, it is a way to get services to those County residents in need who refuse voluntary treatment.
Under Laura’s Law, individuals who meet specific criteria will have a petition filed with the court, recommending that the individual be ordered to participate in mental health services. The individual is represented in court by a public defender; the County is represented by an attorney from the County Counsel’s Office, with the client being BHS. AOT services must include, but are not limited to, the following:
1. Community-based, mobile, multidisciplinary, highly trained mental health teams that use high staff-to-client ratios of no more than 10:1.
2. A service planning and delivery process that includes plan and design of mental health services, including provision for services for physically-disabled individuals, older adults, and consultation with family members.
3. Each client shall have a clearly designated mental health personal services coordinator.
4. Individual services plans shall ensure that persons receive age-appropriate, gender-appropriate, and culturally appropriate services.
5. The individual personal services plan must describe the service array. (Welf. & Inst. Code, § 5348.)
To date, the majority of California counties (thirty-one (31) or 53.4%) have opted-in to Laura’s Law, making San Joaquin County in the minority statewide in providing these services to our residents. As noted in the footnote below, our neighbors to the west, north, and south have opted-in to Laura’s Law.
Additionally, a county that operates an AOT program must report certain data to the State Department of Health Care Services, including an evaluation of the effectiveness of the strategies employed by each program in reducing homelessness and hospitalization of persons in the program and in reducing involvement with local law enforcement by persons in the program. (Welf. & Inst. Code, § 5348, subd. (d).) The following chart provides a basic comparison between AOT and current county programs:
PROGRAM
COURT-ORDERD
VOLUNTARY
HOMELESSNESS COMPONENT BY STATUTE
MANDATED COORDINATION WITH LOCAL LAW ENFORCEMENT
Other County Programs
X
Laura’s Law
X
X
X
As it now stands, a portion of the population within San Joaquin County (i.e., the higher risk category of individuals) do not have access to court-ordered AOT. Moreover, Laura’s Law results in coordination between the county and local jurisdictions to collaborate on getting assistance to higher risk individuals with a mandated focus on homelessness. Indeed, in practice throughout California counties where Laura’s Law is implemented, local law enforcement and counties collaborate on providing services to those individuals who need them the most.
Based on the above analysis, the City of Manteca once again requests that your Board reconsider its vote to opt out of Laura’s Law; the City submits that AOT is necessary to address and assist an important and vulnerable segment of the population not only in the City of Manteca, but throughout San Joaquin County. The City of Manteca is requesting that the County opt-in to Laura’s Law on or before June 30, 2025.
Very truly yours,
Gary Singh
Mayor, City of Manteca
cc: L. David Nefouse, City Attorney
Edward J. Kiernan, County Counsel
The following counties have implemented Laura’s Law in California: Alameda | Contra Costa | El Dorado | Fresno | Humboldt | Kern | Kings | Los Angeles | Marin | Mariposa | Mendocino | Napa | Nevada | Orange | Placer | Riverside | Sacramento | San Diego | San Francisco | San Luis Obispo | San Mateo | Santa Barbara | Santa Clara | Shasta | Siskiyou | Solano | Stanislaus | Tehama | Tulare | Ventura | Yolo.
San Joaquin County Board of Supervisors
February 18, 2025