Title
Health and Human Services Agency recommending the Board:
1) Adopt and authorize the Chair to sign Resolution 227-2018, thereby authorizing the continuation of the Assisted Outpatient Treatment Program in County of El Dorado, also known as Laura’s Law, with an identified funding total of $34,862 in fiscal year 2018-2019 to fund costs related to HHSA's continuum of behavioral health services, for adults with severe mental illness; and
2) Find that no voluntary services shall be reduced as a result of the continuation of the Assisted Outpatient Treatment Program.
FUNDING: Funded with a blend of State AB109 Realignment funds (71%) and Mental Health Services Act (MHSA) funds (29%).
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DISCUSSION / BACKGROUND:
The Assisted Outpatient Treatment Demonstration Project Act of 2002 (Welfare and Institutions Code (WIC) Section 5345 - 5349.4, also known as Laura’s Law) allows for categories of outpatient mental health services that have been ordered by a court.
On August 25, 2015, the Board of Supervisors adopted Resolution 141-2015, which allowed for the implementation of an Assisted Outpatient Treatment (AOT) Pilot Program in the County of El Dorado through fiscal year 2017-2018, with a sunset date of July 31, 2018. (File ID: 15-0844: Agenda No. 20).
The County of El Dorado Health and Human Services Agency (HHSA) has established a continuum of behavioral health services for adults with severe mental illness. The Mental Health Services Act, passed in 2004, has allowed HHSA to expand this continuum of care through the implementation of the Intensive Case Management Team, Transitional Housing (T-House) Program, and the Wellness Center.
The implementation of the AOT Program expanded the availability of services for people with severe mental illness.
People eligible for the program are County of El Dorado residents, 18 years or older, and suffering from mental illness who are unlikely to remain safely in the community without supervision. In addition, the person must have been hospitalized or incarcerated in a forensic or other mental health unit of a state correctional facility or local correctional facility (not including any period during which the person was hospitalized or incarcerated immediately preceding the filing of the petition) twice in the last 36 months as a result of their mental illness; or their mental illness must have resulted in violence or attempted violence to themselves or others within the last 48 months (not including any period in which the person was hospitalized or incarcerated immediately preceding the filing of the petition).
The AOT Program has provided mechanisms to assist people with mental illness who meet the specified criteria: First is the ability to mandate someone to AOT through the use of court-ordered treatment if they have refused to participate in voluntary treatment; and second, is the ability to mandate the transport of an existing AOT patient for the purpose of receiving a psychiatric assessment. In this instance, it is only necessary for the provider’s clinical judgment to warrant the request to transport the patient, even if they do not meet the WIC Section 5150 criteria of being a danger to self or others. It is expected that there will only be a small number of people who will need to utilize this law as there are many voluntary services available. However, for those few who need the treatment made available by this law to have a successful recovery, it is quite significant.
Over the course of the AOT Pilot Program, HHSA has reviewed the cases, engaged, and attempted to engage multiple County of El Dorado residents with serious mental illness. HHSA’s continuation of the AOT program will further benefit community members with serious mental illness.
ALTERNATIVES:
The Board could decline to adopt the attached Resolution authorizing continuation of the AOT Program, in which case the current system of outpatient mental health services for adults would continue without the ability to mandate services for those individuals who meet the criteria for Assisted Outpatient Treatment.
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel on October 1, 2018.
CAO RECOMMENDATION:
It is recommended that the Board approve this item.
FINANCIAL IMPACT:
There is no Net County Cost associated with this Agenda item. Sufficient appropriations were included in the fiscal year 2018-19 budget, and will be included in future budgets for the duration of the AOT Program.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on two (2) Resolutions.
2) Clerk of the Board to return one (1) certified Resolution to the HHSA Contracts Unit at 3057 Briw Road.
STRATEGIC PLAN COMPONENT:
County of El Dorado Strategic Plan Goal - Healthy Communities: Improved health, well-being and self-sufficiency of El Dorado County communities, residents and visitors.
CONTACT
Patricia Charles-Heathers, Ph.D., M.P.A., Director