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Regular-Health & Human Services # 34.
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| Board of Supervisors |
Adult & Aging |
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| Subject |
| Receive cost savings update on Assertive Outpatient Treatment program (Laura's Law). (No general fund impact) (Larsen) |
| Recommended Action |
| Receive cost savings update on Assertive Outpatient Treatment program (Laura's Law). |
| Strategic Plan Goal(s) |
Thriving Residents
Safe Communities |
| Reason for Recommended Action/Background |
Laura's Law refers to California legislation targeting community-based, assisted outpatient treatment (AOT) to a small population of individuals who meet strict and specific legal criteria and who – as a result of their mental illness – are unable to voluntarily access community mental health services. The law is named for Laura Wilcox, who was shot and killed at the age of 19 by a man with untreated severe mental illness. Laura’s Law is fashioned after New York’s Kendra’s Law. On October 22, 2013, the Yolo County Board of Supervisors adopted a budget resolution to increase the then Department of Alcohol, Drug and Mental Health’s 2013/14 budget by $64,523 to be used to fund the implementation of the AOT Pilot. The AOT Pilot was paired with the Mental Health Services Act (MHSA) Assertive Community Treatment (ACT) program to include no less than five (5) additional Full Service Partnership slots, thereby maintaining the number of Full Service Partnerships available to the MHSA ACT program clients.
On September 12, 2017, the Board of Supervisors received a presentation regarding Yolo County AOT Outcomes to-date. During that presentation, the Board requested that staff return with additional information regarding the cost savings associated with each of the Outcome Domains highlighted in the presentation. This agenda item will address that request.
Yolo County’s AOT program is implemented as follows:
Voluntary services are being provided to individuals with serious mental illness whose condition is deteriorating, and/or who are unlikely to survive safely in the community without supervision or locked inpatient psychiatric care. Requirements include that AOT services be requested by one or more of the following parties:
- The individual’s parent, spouse, sibling or child who is 18 or over;
- Adults who reside with the individual;
- The Director of the individual’s treating agency, organization, facility or hospital;
- The treating licensed mental health professional; or
- A Peace Officer, Parole or Probation Officer supervising the individual.
Following referral, the HHSA Director must confirm the individual’s eligibility to all 14 AOT criteria as outlined in the Laura’s Law legislation. Once accepted, the referral is forwarded to the treating agency for engagement with the individual.
Outcomes and Cost Savings to-date:
16 unduplicated individuals received AOT services between October 22, 2013 and August 30, 2017. Collected data includes Psychiatric Hospital Days, Incarceration Days and Emergency Room Visits, comparing the numbers and associated costs in the 12-months pre-enrollment into AOT, as compared with numbers and costs during the initial 12 months receiving services in AOT.
- Psychiatric Hospital Days - 572 days pre-treatment versus 339 days post treatment, resulting in an overall decrease of 233 days. The average cost for an inpatient bed stay is $1,355.16.
- Incarceration Days - 203 days pre-treatment versus 165 days post treatment, resulting in an overall decrease of 38 days. The average cost for an incarceration day is $119.86.
- Emergency Visits – 49 visits pre-treatment versus 37 visits post treatment, resulting in a 12 visit decrease. The average cost per emergency visit is $3,707.25.
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| Collaborations (including Board advisory groups and external partner agencies) |
Turning Point Community Programs
Public Guardian
County Counsel
Public Defender
District Attorney
Courts |
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| Fiscal Impact |
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| Source of Funds for this Expenditure |
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