Laura's Law, Mental Health Services Act (MHSA) & Serious Mental Illness in California - Mental Illness Policy Org
Laura’s Law, Mental Health Services Act (MHSA) & Serious Mental Illness in California 2017-11-20T15:08:38+00:00

Mental illness in CA

Laura's Law, Mental Health Services Act (MHSA) and Serious Mental Illness in California


Join our “Serious mental Illness in California” Facebook group

Laura’s Law (Assisted Outpatient Treatment/AOT) and the Mental Health Services Act (MHSA) were both enacted to help the most  seriously mentally ill. MHSA funds may be used for individuals in Laura’s Law, but mental health commissioners divert MHSA funds to the highest-functioning, and tell their Boards of Supervisors that they need incremental funds for those in Laura’s Law. This is discrimination against the seriously ill that MHSA was intended for. It explains why the seriously mentally ill in California are sent to shelters, jails, prisons and morgues rather than treatment in spite of the over $1.5 billion raised annually by MHSA. This site details Laura’s Law and MHSA and provides county by county information.

Intro to Laura’s Law

“Laura’s Law” is California’s version of Assisted Outpatient Treatment (AOT). It allows courts–after extensive due process, to order a small subset of people with serious mental illness who have been noncompliant with treatment and meet very narrowly defined criteria to accept treatment as a condition of living in the community. It also allows courts to order the recalcitrant mental health system to provide treatment. National research shows AOT works. Research in California shows it works. For example, Nevada County found:

  • Hospitalization was reduced 46%;
  • Incarceration reduced 65%;
  • Homelessness reduced 61%;
  • Emergency Contacts reduced 44%;
  • Saved of $1.81-$2.52 for every dollar spent as result of reducing incarceration, arrest, and hospitalization.

17 counties implemented Laura’s Law as of 2/2017: Alameda, Contra Costa, El Dorado, Kern, Los Angeles, Mendocino, Nevada, Orange, Placer, San Diego, San Francisco, San Luis Obispo, San Mateo, Shasta, Santa Barbara, Ventura, Yolo

Guide to Laura’s Law

Functional outline

Political summary (including eligibility numbers)

Intro to MHSA

In 2004, California voters altruistically passed Proposition 63 (Mental Health Services Act (MHSA), a 1% tax on millionaires to help people with “severe mental illness” and to “prevent mental illness from becoming severe and disabling.” It raises over $1.5 billion annually and is an important program that does a lot of good. But mental health commissioners, CalMHSA and the oversight commission (MHSOAC) encouraged social services programs that have little to do with serious mental illness to masquerade as mental illness programs to enable them to claim MHSA funds. This leads to programs that fail to serve the seriously ill being showered with funds while those that do serve the seriously ill go unfunded. Our report, MHSA: A Bait and Switch found this unmitigated mission-creep, insider dealing, and lack of oversight, found

Why is public in dark about this? $11 million in MHSA funds went to hire a P.R. firm that works to convince the media that all is well. They continually issue press releases and call editorial boards to extol the virtues of the program. County mental health directors and recipients of the diverted funds benefit from the status quo and therefore defend it. Governor Brown, former state Senator Steinberg and his successors appointed recipients of MHSA funds to sit on the Oversight Commission. As a result of this conflict, MHSA is being overseen by beneficiaries of funds and cheerleaders for mission creep, rather than stewards of the public purse. This is not what voters wanted to happen or were told would happen. Money is not the issue. Leadership is.

Laura’s Law Fact Sheets

Guide to Laura’s Law

Functional outline

Political summary (including eligibility numbers)

Laura’s Law Facebook page

Results in two sample California counties

Studies show AOT works throughout country (PDF)

Laura’s Law criminal justice fact sheet (PDF)

List of known supporters (PDF version here)

California Assoc of Psychiatric Technicians endorses

Myths about Laura’s Law (PDF version here)

Voluntary services are not a substitute for AOT (PDF)

Consumers who experience AOT support it (PDF)

Laura’s Law Funding Addressed

SB 585 Allows MHSA funds for Laura’s Law

CCR Reg. §3400 Counties can’t refuse services to Laura’s Law participants

DMH approves counties using MHSA funds for AOT

MHSA can be used for AOT – legal analysis – MIPO

MHSA funds can be used to fund AOT – legal analysis – TAC

MHSA funds can be used for Laura’s Law – legal analysis – MIPO (CA)

Ideas to clarify Laura’s Law’s interaction with MHSA

MHSA funds misused to stop Laura’s Law


Laura’s Law could save California $19 million

AOT saves Nevada County money – presentation

Savings in CA and elsewhere

ER expensive way to treat mental illness – LA Times, 2011

Judge Anderson on savings from Laura’s Law – article

Laura’s Law Source Documents

Proforma Resolution to approve Laura’s Law

Text of Laura’s Law

Draft Laura’s Law regulations (Code of Regs)

Protection & Advocacy Opinion

2015: Two bills make it easier to implement Laura’s Law


Judge Tom Anderson encourages all counties to adopt AOT

Behavioral Health Dir.: Nevada County’s success with Laura’s Law

Laura’s Law presentation – Drs. Quanbeck & Tsai

Laura’s Law works says Judge Anderson

Laura’s Law helps recover – Tsai, Psych. Journal

Disability Advocates CA opposes Laura’s Law (also legal opinion)

Other California Issues


LPS Task Force Report (2012)

Linnea Lomax and the need to reform LPS Act

Hospital bed shortage

Severe psychiatric hospital bed shortage data

Stephen Seager on NAPA State Hospital – Video

Psychiatric beds empty. Prisoners wait for care – 5/15, LA Times

Future of psychiatric services in California – Torrey

Criminal Justice

Untreated mentally ill drain CA law enforcement (Police Survey) (PDF version)

CA can comply with Brown v. Plata by treating mentally ill parolees

Involuntary medication of incompetent to stand trial (2011 bill)

Selected Laura’s Law op-eds and articles

Helen Thomas (Laura’s Law author) on renewal – 2016

San Don’t blame police for CA mental health system failures – 2015, SD UT

NBC on Teresa Pasquini’s fight for better care, 2015

Don’t delay Laura’s Law – SF Chron, 2013

Op-ed, editorial, article SF Chronicle – Jacobs, 2012

Seal Beach salon shooting shows need for Laura’s Law – 2011, HuffPo

Laura’s Law – 10 year anniversary of her death – 2011, HuffPo

Mentally ill Kelly Thomas dies in police encounter – 2011, HuffPo

Why California needs Laura’s Law – 2011, Daily Journal

Ignore mentally ill and court disaster – Tsai SF Chron, 2011

Will California Adopt Laura’s Law – Time Mag., 2011

Student video explains Laura’s Law

Video on Nevada County implementation of Laura’s Law

Disability Advocates op-ed

MHSA Fact Sheets

First Little Hoover Commission finds problems

Second Little Hoover Commission finds lack of oversight

California State Auditor finds lack of oversight

California Finance Department finds problems

MHSA “Bait and Switch” report – summary

MHSA “Bait and Switch” – entire report

$1-2 billion PEI funds diverted 

$2.5 billion FSP funds spent without oversight

$23 million to MHSOAC insider dealing

$129 million to ineffective suicide and PR programs

$7 million to anti-treatment efforts

Social services masquerade as mental illness programs

County Directors uses stakeholder input to justify diverting funds

State Legislators raid MHSA fund

Who is responsible for MHSA failures?

2013: Sen. Darrell Steinberg asks taxpayers to pay twice

How to fix MHSA

How to fix Mental Health Services Act

Letter to Jerry Brown: Replace MHSOAC Commissioners

2015: Our fixes to MHSOAC regs designed to divert PEI MHSA funds

2014: Joy Torres fixes to regs designed to divert MHSA funds

2013: Our fixes to PEI regs designed to divert funds

Pre-2013 Oversight Commission used regulatory process to divert funds

MHSA Source Documents and Links to Agencies

2016 text of MHSA

2013 Text of MHSA

Laws, Codes and Bills

Assemblymen Logue & Nestande ask for MHSA audit

California Mental Health Services Oversight and Accountability Commission -supposed to oversee MHSA spending

California Department of Health Care Services – has some MHSA oversight responsibilities

California Institute of Mental Health – provides policy direction

California Mental Health Services Authority – “Joint Authority” pools MHSA funds to run multi-county programs

3 year plan requirements for counties -2005

MHSOAC 2/09 minutes on 2 tier system

Rose King’s Whistleblower complaint

Two Tier mental health system (F.A.C.T.S)

MHSA Problems Rose King – 2012 memo to auditor

MHSA Media

Misspending on MHSA – Jaffe, SD Union Trib.

Little Hoover Commish fix wrong fix for MHSA – Day/Jaffe, SacBee

MHSA funds wasted – Jaffe/Bernard, collection

MHSA audit shows problems – Kazakoff, SF  Chron.

Audit finds funds for mental health services misspent – Yanello SF Chron.

SF Chronicle: Mental “health” industry diverts MHSA – SF Chron.

Audit finds lack of MHSA oversight – LA Times

Prop 63 missing Goals – SacBee

AP  Reveals MHSA misspending

Taxpayer money isn’t free money Chico-Enterprise Editorial

Prop 63 money is used unwisely – Contra Costa Times Editorial

MHSA spending lacks accountability – Press-Enterprise Editorial

Legislators call for Prop 63 audit

NAMI CA members say MHSA fails

MHSA creates haves and have-nots -Yannello Sac News

MHSA co-author Rose King on MHSA problems

Whistleblower says Prop 63 not working

County by county info

California 24 hour crisis intervention lines by county

Names, phone, email addresses: California Behavioral Health Directors

List of 2012 MHSA funded programs by county (PDF)

Contacts: County PEI Coordinators

2012 MHSA fund payments to each county

Alameda County

Alameda Behavioral Health Home Page

11/2015: Alameda adopts Laura’s Law pilot project

1/2015 Supervisor Wilma Chan urges Alameda to adopt Laura’s Law

2014 – Supervisors delays Laura’s Law

Preventable mental Illness tragedies in Alameda

Supporter answers critic – Berkeley Planet

Forced treatment criticized – Berkeley Planet

Laura’s Law in a nutshell – Berkeley Planet

2013 – Mental Health Dept. refuses to implement Laura’s Law

Contra Costa County

Contra Costa Laura’s Law Savings/Cost Analysis – 2017

Contra Costa MH Crisis White Paper

Contra Costa MHSA Home Page

11/2016 County evaluation of Laura’s Law

Summary: Families of Mentally Ill Report on Laura’s Law

Families of Mentally Ill Full Report

2/15: Contra Costa implements Laura’s Law

1/15: Board of Supervisors resolution on Laura’s Law

10/14 Work Group Recommendations on Laura’s Law

2012  ContraCosta County MHSA Plan

2014 Health Committee recommends pilot Laura’s Law program

Eldorado County

8/15: Board of Supervisors adopts Laura’s Law

Kern County

7/15 Kern County adopts Laura’s Law

Kern County  Mental Health Dept.

County by County Information (cont.)

Los Angeles County

2017 Memo to Board on improving care in LA

2017 Laura’s Law Numbers (not results)

Los Angeles adopts Laura’s Law – 7/2014

How to make a Laura’s Law referral

Laura’s Law Brochure

Results in Nevada and Los Angeles (PDF Version)

Board of Supervisors votes for statewide Laura’s Law

Treat, don’t jail, mentally ill – Jaffe, LA Times letter

2012 LA County favors renewing Laura’s Law

2011 Mental Health Dept. says Laura’s Law pilot works

2011 Supervisor Antonovich endorses

2011 Press -Telegram endorses AOT

LA MHSA Stakeholder Process fatally flawed

Marin County

2/2017: Novato supports Laura’s Law

1/17: Marin County Supervisors support Laura’s Law

10/16: Behavioral Health Dept. pretends Laura’s Law not needed

4/15: Marin County police and firefighters endorse

9/14 Marin County mulls Laura’s Law

Mendocino County

Mendocino sheriff helps mentally ill – 2/2017

Mendocino adopts, but refuses to use Laura’s Law – 3/16

Mendocino delays implementing Laura’s Law – 6/15

Mendocino supervisors reconsider Laura’s Law – 11/14

Mental Health Dept convinces Sups to not implement – 7/12

James Bassler: AOT could have stopped son from Ft. Bragg killing

James Bassler: the logic of Laura’s Law

Manhunt for Aaron Bassler due to mental health failure – LA Times

Letter to Editor: Mendocino needs Laura’s Law – Jaffe

Laura’s Law might save county money – Ft. Bragg Advocate

Mendocino County Proposition 63/MHSA Home Page

MHSA Plan 2013 Update

Mental Health Dept convinces Supervisors to not use Laura’s Law – 7/12

Ft. Bragg Advocate on Laura’s Law

Nevada County

2014-2015 Results in Nevada County

Results in Nevada and Los Angeles Counties (PDF Version)

Grand Jury Report on Laura’s Law – 2012

Judge Anderson encourages all counties to adopt Laura’s Law

County Behavioral Health Dir. on Laura’s Law

Q&A: Laura’s Law by Nevada County officials

Laura’s Law success in Nevada County – Video

DMH to NV County: OK to use MHSA for LL

2012 Grand Jury Report on Laura’s Law

2008 Nevada County adopts Laura’s Law

Orange County

2015 OC Grand Jury Mental Health Report

Misspending Plagues Orange County MHSA programs

9/2015 OC stashing, not using MHSA funds

2/15 OC refusing to use Laura’s Law

5/14 OC Register, LA Times, NBC, NPR, Voice of OC on OC adopting Laura’s Law

Preventable Tragedies in Orange County (PDF Version)

OC should adopt Laura’s Law (Voice of OC)

2011 OC Health Care report to supervisors is wrong – MIPO

2011 OC Health Care Agency report to supervisors is wrong – NAMI OC & TAC

Health Care Agency misleads supes on Laura’s Law – OC Register

2011 Health Care Agency Report to Supervisors on LL

Ending Homelessness in OC – testimony

Seal Beach Salon shooting shows need for Laura’s Law

Letter in OC Register – Jaffe

Seal Beach Salon shooting and Laura’s Law

Mentally ill Kelly Thomas shooting shows need for Laura’s Law


9/2014 Placer County adopts Laura’s Law

Could Laura’s Law come to Placer County


Mental illness tragedies in Sacramento

Grand Jury finds “shameful neglect of mentally ill” – 7/15

7/15: editorial on Grand Jury Report – SacBee, 7/15

Laura’s Law languishes – Sac. News/Review

San Diego County

Mental illness tragedies in San Diego

Problems in San Diego, Jaffe, Union Trib

Video explaining Laura’s Law in San Diego – 2016

Laura’s Law might have prevented this horror – NBC, 4/16

San Diego Supervisors adopt Laura’s Law – 4/15

County stashing, not using mental health funds – 2015

San Diego moves closer to adopting – NBC, 2015

San Diego approves LL planning – 1/15

SD rubber stamps misspending MHSA funds – Jaffe/Bish (PDF) 2013

County report says ‘implement LL’ – 2013

2013 Supervisors authorize Laura’s Law study

Laura’s Law: pro and con – SD City Beat

get the book

Available in all formats at Amazon and Barnes and Noble

County by County (cont.)

 San Francisco County

SF annual AOT report -3/2017

How to access Laura’s Law – 2/2017

Laura’s Law working in SF – 1/2017

San Francisco Annual AOT report – 2017

San Francisco Adopts Laura’s Law – 7/14

NBC News on Teresa Pasquini’s fight for better care – 7/15

San Francisco Examiner says implement LL (PDF) – 12/20/13

Preventable Mental Illness Tragedies in San Francisco (PDF)

Op-ed, editorial, article SF Chronicle

SF Mayoral candidates misunderstand Laura’s Law

SF Ignores mentally ill

SF Chronicle op-ed: Support Laura’s Law (DJ Jaffe)

Why Laura’s Law has such limited impact (SF Chronicle)

Ignore mentally ill and court disaster (SF Chronicle)

Where the Mayoral Candidates stand

San Luis Obispo

SLO Prop 63 Home Page


NIMBY groups defeat housing for mentally ill 11/2016

Board of Sups tells MH Dept. to plan to implement Laura’s Law – 11/2015

Untreated mentally Ill woman kills mom due to lack of LL

SLO Tribune report on mental illness

San Mateo County

San Mateo County MHSA Home Page

Preventable Tragedies in San Mateo (PDF here)

San Mateo approves Laura’s Law – 6/24

San Mateo Mental Health Dept. recommends Laura’s Law – 2015

San Mateo Health System Chief Jean S. Fraser, misleads on LL 2013

2011 Analysis of San Mateo Officials Claims About Laura’s Law

San Mateo Health Dept and NAMI Presentations to Board of Supervisors Committee

Presentation on Laura’s Law by local mental health officials

Preventable Tragedies in San Mateo (PDF Version here)

Santa Barbara County

9/2017 Report: 58% AOT of referrals unserved

2/2017: Diverting incarcerated mentally ill to treatment

2/2017: Status of Laura’s Law in Santa Barbara

Santa Barbara MH Dept presentation to MH Commission (PDF)

(3/20/15) Status of Laura’s Law in Santa Barbara (3/20/15)

Santa Maria Sun endorses

Santa Barbara prison mental health services questioned

Shasta County

MHSA Funded Suicide Prevention Activities Fail

Siskiyou County

Tragedies are preventable

Sonoma County

12/2016: Shifting mentally ill from jail to treatment

2011 Health Care Director defends status quo (and read our response)


8/2017 Analysis: Results Group Report Inaccurate

7/2017 Results Group Report

2/2017: Forum to consider Laura’s Law

2/2017: Advocates push for Laura’s Law

1/2017: Stanislaus to study Laura’s Law

1/2017 Supervisor Olson favors Laura’s Law

11/2016: Doug Dunn leads push for Laura’s Law

11/2016: Stanislaus considers Laura’s Law

Ventura County

1/2017: Laura’s Law set to start

1/2017 Laura’s Law starts

10/2016: Ventura jails mentally ill

Yolo County

Yolo gets great results – 10/2017

Yolo county gets good results -6/2015

6/14/14 Yolo Supervisors approve full implementation –  6/2014

Yolo supervisors approve Laura’s Law Pilot – 6/2013

Yolo residents want Laura’s Law – 6/2013 Sups Meeting

Yolo ADMH Report on Laura’s Law