Looking into Laura’s Law
Supervisors order study on implementing assisted outpatient treatment in Butte County
On a February morning in 2003, Donovan Phipps sped along The Esplanade in his father’s truck, blowing through red lights as he fled phantoms only he was aware of, and not realizing he was putting others’ lives in real danger. Juan Carlos Lugo, a 21-year-old Chico State student, had just dropped off his younger brother at Chico High School and was pulling onto First Avenue when Phipps’ truck collided with his sedan, ejecting Lugo from the vehicle.
Lugo died, and Phipps was charged with murder and sentenced to 32 years to life, a term he’s currently serving at Salinas Valley State Prison.
Though Phipps’ parents, Colleen and Larry, mourned Lugo’s death and empathized with his family, they also felt their son had been underserved by the mental health system, and that the incident could have been avoided. Donovan was diagnosed with bipolar disorder in the mid-1990s, and was unmedicated and in the midst of a severe psychotic episode at the time of his crime. The Phippses had reached out for help to authorities and mental health personnel several times in the weeks before the incident to have him hospitalized on a 72-hour psychiatric hold, but they couldn’t convince those parties that he was an imminent danger to himself or others, Colleen Phipps said.
Shortly after their son’s conviction, the Phippses began advocating for local implementation of Laura’s Law. Also known as Assembly Bill 1421, Laura’s Law was enacted in 2002 following the 2001 shooting of mental health care worker Laura Wilcox at a clinic in Nevada County. Her killer was Scott Thorpe, another man resistant to mental health care whose family had long sought help.
Laura’s Law allows for assisted outpatient treatment, so people who are unaware of their mental illness or otherwise deny treatment can get court-ordered mental health care. It also expands the range of those who can request treatment to include family members and other adults living with the afflicted. The law can be applied only to individuals over 18 who have a history of violence and resisting treatment, have been incarcerated or hospitalized at least twice in the last three years, and who health professionals determine may not survive without supervision.
Larry Phipps died in 2010, but Colleen has kept up the fight, and had the opportunity to tell her story and advocate for the law at the Butte County Board of Supervisors meeting Tuesday (April 12).
Though it’s been on the books for over a decade, only 13 counties have implemented Laura’s Law. The presentation at Tuesday’s board meeting by Dorian Kittrell, director of Butte County Behavioral Health, was intended to give the supervisors an overview of the law for future consideration.
Kittrell acknowledged AB 1421 has been controversial since inception due to civil rights issues related to ordering unwanted treatment, but that dissension has largely quieted over the years.
“Generally speaking, we’re not hearing that much resistance anymore,” he said. “In surveys, a lot of people indicated they are happy to have gotten the help.”
Kittrell outlined the law’s criteria and the process by which patients can receive assisted outpatient therapy. He said interagency collaboration is the biggest key to its success.
Addressing issues with Laura’s Law, Kittrell said, “It lacks some significant enforcement. We can’t force anyone to take their medication outside of an institution. The court can order someone into the hospital … but once they’re well enough to go back into the community, they have the choice.”
That prompted Supervisor Maureen Kirk to ask if the cycle is simply repeated.
“Oftentimes, refusing medication becomes less of an issue because of all the wrap-around-type services we’re providing,” he said, noting that Laura’s Law goes beyond medication to include other forms of therapy. He also noted the “black robe effect,” meaning that once a judge orders treatment, people are more likely to comply.
Part of the reason Laura’s Law hasn’t been more widely implemented is because of costs and the personnel required, and because it is not mandated by the state. Kittrell explained existing programs can’t be reduced or have funds cut to pay for Laura’s Law services. He also said the North State has a shortage of mental health professionals, so attracting new staff is always an issue for his department. Furthermore, the law requires patients be housed while receiving court-ordered services.
Kittrell said that, since it’s been slow to roll out and existing programs are small and generally serve only a handful of people, the law’s overall efficacy is still unknown. He said the California Department of Health Care Services has yet to complete a legislative report on the law’s effects that was due in May 2015.
However, he also noted counties have reported generally positive impacts, including less jail time and fewer service calls, leading to fiscal benefits. He said Kendra’s Law, a 1999 New York law on which the California law is based, has reported significant positive results.
Despite the law’s shortcomings, Supervisor Larry Wahl suggested the board take immediate action. Ultimately, the supervisors directed county staff to collaborate with other involved agencies, look at funding options and report back in 60 days. Having expected only to give a presentation, Kittrell told the board the decision was the best outcome he could imagine.
Outside the meeting chambers, Phipps was elated with thedecision.
“After giving so many presentations and talking about [Laura’s Law] for so long, it’s very exciting to see some actual movement happen,” Phipps said.