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tv   [untitled]    July 20, 2010 12:00am-12:30am PST

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the right thing to do. we are not talking about every person with mental thomas. we're talking about the people that are a danger to others or to themselves. -- we're not talking about every person with mental on this. the current laws do not have the ability to mandate treatment when someone is a danger to themselves or others. that is a big hole in the mental health laws that we currently have. i think that laura's law would fill the hole and promote more public safety for all of us. think you. >> a couple of questions. citywide, you see patience dealing with psychoses and psychotic breaks, severe mental health issues. what is the treatment uc as meeting their needs? >> we are working with some of
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the most severely ill people. the treatment is assertive and intensive. we do not wait for people to come to us. we go to them. we go to their hotels. we out reach people when they are not coming in for medication. when entice them to help them get entitlements and housing. -- we entice them to help them get entitlements and hous anding. medication and intensive case management. it is the package together. >> laura's law does not mandate medication? >> no law can force medication under laura's law. >> it would essentially allow us to be accounting that would create an plan that could include medication, along with assisted outpatient treatment. that would be part of the treatment plan. >> as long as you go through a
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hearing and it is court ordered. >> we do have a court system that can create the mandate or planned for treatment. that could include treatment at a hero held court we would like to and from a something new that we're talking about today. >> you have to commit a crime to be in behavioral and help court. that is on the other end. we are trying to prevent those people from committing those crimes and having the victims. we want to get the mandated to treatment before they do that. >> laura's law would be through that department of public health that would mandate the treatment. there would be other systems in place that would direct a client
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to petition the court ordered or directed-ordered treatment. it could be hospitals, probation officers, police officers, parole officers with this legislation. there are already this kind of criminal element already involved in a way to mandate the need for the implementation of laura's law. i am not sure there is a need since we are to have the system. >> their only for great disabilities. they're not for danger to themselves or others. that is a big hole in our voluntary commitment laws right now. we know people and who consistently go off their medications and commit violent acts. we cannot reach them with this. it has to be a great disability.
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that is the crux of this. supervisor chu: did you want to add anything, supervisor alioto- pier? supervisor alioto-pier: i will wait until public comments. >> i was interested in listening to the various comments. i think there are some important points to make. we recognize there is a broad range of mental illness. we support the concept that a broad spectrum of services need to be offered. we further feel that involuntary treatment would be the preferred model. nonetheless, there is a small number of people who are a danger to themselves and others who would need this kind of court ordered outpatient treatment. there is the need for that. to me, the data is so
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overwhelming and astonishing in terms of the effectiveness of this as a tool. it is another tool. you have heard the data about intra- -- kendra's law. nevada and los angeles county have implemented it. lar was killed nine years ago. nick and i miss her every single day. the mentally ill person who killed laura was found not guilty by reason of insanity. we agreed with the verdict. he was sentenced to napa state hospital. he was very responsive to treatment once he finally received treatment after killing three people. now he has to live every day of his life knowing what he did. he has to live with that. clearly, there has to be a better way for his family and
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for our family and our communities. thank you. thank you for introducing this. >> i am randall hager, director of government affairs for the california system. maybe i can answer some questions more specifically. the procedures and laura's law are civil procedures. they do not take place in a criminal court or before, judge. they are in a civil setting. it is the design of the law to be able to intervene when people are deteriorating and have a history that determines that they are going to have a predictable result of either committing a crime, going back to the hospital, or something else. the ability of anybody to petition for this is pretty much as you spoke.
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the behavior of help department refers the matter for investigation and a petition to the court. the court makes the determination according to the criteria in the law. i do not know if that helps parse out why laura's law is different from behavioral adult court. in terms of what i understand about a system in san francisco, the services are very much the same. the court is ordering people to have a treatment plan. it is pretty much the same. the distinction is the civil process that allows earlier intervention for people with a history. in a few moments i have left, i wanted to put a few other things on the record. there is a voluntary settlement agreement. there is a misnomer that someone bypasses the court process. if voluntary settlement agreement is court order. the person just forgoes the
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hearing if they agree to it. i do not need to go to the hearing and have a contested adversarial proceeding. it is not only a civil procedure which is an early intervention tool, but it allows people to live in their homes in the community instead of inpatient treatment. you need to keep that in mind. maybe i will wrap up with this. patient attitudes and quality of life have been studied with kendra's law in new york. people appreciate having their lives given back to them. [tone!] some people talk about stigmatizing and running from services afterwards. the data does not bear that out. i urge you to support this measure in san francisco.
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>> my name is star when olson. and a friend of california mental help clients. i am speaking from my own observation. what concerns me about the law is the medication and how it is given. from my observation with family members, it seems they get over medicated. they do not understand what is going on after that. they can rarely -- barely walk or talk because of the medication. as much as i feel for them, i lost my youngest son last year. that was through his own hands. my concern is who will be watching or regulating if this does pass the doctors and clinicians medicating the patients. a lot of times, they're way
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over-medicated. you can go to the clinics and see that. my mother worked at eps in santa clara county as an emergency escort. she got involved because of the over medication of patients. that is my basic concern. a lot of pharmaceutical companies are pushing their drugs on to the doctors and whatever. i just want to make sure that someone is aware of what is going on in these establishments with the over medication of patients. >> supervisor chu: thank you. if there are any other public speakers, please line up or we will conclude public comment. >> i am a parent of the consumer who's doing really well, fortunately. the point i would like to make is he is doing well for several reasons. he has had a choice of
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medications with his psychiatrist to choose the medication that best fits him and also to work on the dosage. he is going down right now. he is doing really well. all of these medications have severe side effects. they make him feel not very well. -- they make him feel not very well all the time. if this law is passed, and like to see that the patients have the ability to work with a psychiatrist. it is important for them to be empowered and have self- determination as well and to have and holistic approach to mental illness and not just medications. my son is doing really well. he is going to school. he is been helped with job training and placement. he is doing exercise. he has safe housing. he has medication. it is a whole package, not just the medications. it is really very important that the patient have a say on their
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treatment. thank you. supervisor chu: let me make one comment. it has been set a few times. -- it has been set a few times. you can stay or set them -- sit down. laura's law does not require medication. it certainly does not allow for forced medication. under any law in the united states, it has to be given in a licensed medical facility. we're not talking about people out in the community just passing out drugs. what is so important and vital about the program is that some patients may need a vacation. they have to go through a hearing and a number of steps to get it. or they do not. if they do not, aot helps them through that. the consumer does have choices. they do have a say.
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we've heard a lot about force. this is not about shoving something down someone's throat. it is about taking them out of a situation where they could wind up in jail or something will be forced on them and putting it into a setting that is more independent where a patient does have more say, particularly those who are very sick. supervisor alioto-pier: when you look at statistics, people with schizophrenia and bipolar three times more likely to be in prison than hospitalized. those are people who should not be in prison. they need to be in hospitals. they need to have the type of attention to take care of themselves. putting them in the prison is going to exacerbate a problem. it will make it worse. they will never heal from it. laura's law is essentially about taking people at high risk with
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schizophrenia and bipolar, we're talking about serious diseases. it is pulling them out of the jail system and putting them into an aot. you are not even in a hospital. you have a treatment program outside the hospital to take care of it. that is just mental health. when you look at the disabled community in general, last thing someone with a disability once is institutionalized care. the last thing people want is to be ostracized. this is about gaining independence. this is not about being institutionalized. this is about living in an institutionalized life. with this program and a zerot services are about is dealing with mental illnesses in that same way. we've gone so far away from institutionalizing people. you cannot do that now. we're more focused on in home
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care and services for the physically disabled. while we have moved so far with the physically disabled, we have left the mentally disabled far behind. laura's law pulls in a lot of these theories that we know are accurate and true. the oregon plant back in 1992 listed ihhs services as the number one need for people with disabilities. and yet the mental health community was left with back. career 20 years later talking about establishing -- here we are 20 years later talking about establishing the same programs for mental illness to help people obtain the levels of independence that they need. [applause] i want to make that clear. kelly? come on up, officer. we're still in public comment.
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>> i want to respond to that. my concern about whether there is mandated or forced medication through laura's law -- it obviously does not exactly mandate it. but the treatment for people have psychosis, a schizophrenic, or bipolar involves medication. if there is a treatment plan mandated, it will mandate medication as part of the plan for those types of illnesses. in a way, we are creating a mandated form of medication through that process. it may be a two-step process to get there, but it is a mandated type of medication. that is my consent about this. that is my concern about wanting to approver resolution that would accept laura's law of the
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law of the land in san francisco. i do not feel comfortable with that. i know we still have cpublic comment, but i felt i needed to respond. supervisor avalos: supervisor alioto-pier: during the last hearing, judge anderson testified about how the program works. let me read a bit of his testimony. it is interesting and important to note that none of this is done haphazardly. we're talking about a section of the population that incorporates people schizophrenia and bipolar. it is a very small percentage of what we're talking about. in situations like that, we have found that when people are off their mends that they do not always want to have that push. in most cases, the city would get proposition 3 funding for
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voluntary services only. forced or involuntary, that is not our focus. we do not receive benefits as the county for that. what happens in most cases is that people go into these programs. we can still have hearings. right now, you get if hearing. a hearing if you are locked up in jail. you go back and may still be locked in jail. if you get a hearing before you get locked up, there is hope it will not happen and someone will not be incarcerated. they are very strict guidelines for the increase hearing. you have to go in front of the judge. you are actually in court. supervisor avalos: what would trigger someone having to go to a lrees hearing? supervisor alioto-pier: let me
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finish this and then officer dunn can talk about it. he was described in nevada as simple and straightforward. the petition as bob with the director of behavioral health and nevada county. the director examines the petition to determine if the criteria has been met. it has been met, a petition is filed with the court. the clerk of the court schedules a hearing at 4:00 on that date or the following day. the public defender is notified so there will be council available for the consumer. we have had conversations with the public defender who represents people right now in our behavioral court system. they are very supportive. the personal defender who does this is very supportive. i am not at liberty to discuss her because she has not had an opportunity to talk to the public defender about it. the attorney likes the blade -- the way the behavioral court system works. before the hearing, a discussion
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as had with the individual. the proposed treatment plant is explained. they get input into whether it should be modified. if they agree with the treatment plan, there is a settlement. no hearing is conducted. if they do not agree and wish to contest the treatment plant, a hearing is conducted. the hearing takes about 20 minutes. the order is issued or not issued. the provider report regularly to the courts on the individual's progress and program. since laura's law was implemented in 2008, six petitions have been filed with the court. there have been 22 referrals. only one has resulted in an actual hearing. all but two resulted in accepting voluntary treatment. the numbers are showing it works. the idea of force, in most cases is not at all.
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one of the speakers said that choice is essential for recovery. this is about choice, independence, giving people the opportunity to use a lot of the services we currently have that they do not qualify for because they have not committed a crime. we have all of these city services but the only way to reach them is to break the law. with laura's law, we're opening up the services so that people can use them and take advantage of them without having to go to jail first. [applause] supervisor chu: i would like to ask the crowd to refrain from applause. i would like to finish a public comment. supervisor avalos: there are a lot of services the city provides that could get people into treatment that are not mandated.
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people can access them at various points. they can access it through police officers, resource centers, a formal network. they can get access to services. there are ways to get people involved in treatment in the city. the city has a broad array of those services. that is compared to nevada county, especially. they're concentrated around the city and allow for greater access than laura's law would create. i do not think it is an apples to apples comparison between san francisco and nevada. we do have a strong network that creates the possibility for assistance for people who need that kind of support, there, and medication as well. supervisor chu: officer dunn --
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lets have members of the public finnish public comment first. i see there is one more person to speak on public comment. if any other individuals have not had their names called gatt and would like to speak -- called yet and would like to speak, please lineups' we have a sense of how many. >> i am officer kelly dunn with the psychiatric liaison unit. we do have an amazing amount of services in the city. they are wonderful. i started at napa state hospital on the criminally insane unit. i was a technician there prior to coming into the police department. i worked there before i came into the city. a couple of things were discovered. i want to share a few quick profound stories. there was only the -- there was
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a lady who had to go into the i see you. this was when i was in mobile crisis. the reason why was because her beliefs system said it should all of our nutrients from the sun. she lived in pacific heights. she had a bunch of money and a beautiful home, but she was slowly killing herself. i understand the scariness of forcing people to take medication. on the other side of that, i dealt with the transgendered person who had a belief system that someone was the devil. she almost stabbed someone to death. after medication, she was able to comprehend what she had done. she committed suicide. i understand your thoughts about forcing medication. to assess who is completely out of touch with reality, it to
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make a decision about what is best for them when they think that the sun will provide all of their food or that a random stranger walking down the street as the devil and has to be killed does not work for me. everyday i have to read police reports of crimes that happen. i get all of the police reports related to mental health and criminal stuff in san francisco. it makes me very sad to think that they believed what they were doing to be completely true. then they have done something that can never be taken back. it was because of them not being able to be cha -- properly treated medically. i have seen that people are not forced with medications. it is a very small number. you have to be literally physically out of control trying to hurt someone else or yourself to a level of gravely disabled where you are not even able to care for your basic needs.
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supervisor chu: thank you. >> good afternoon. in 1981, and is diagnosed with bipolar disorder. since then i have suffered approximately seven years where i was completely incapacitated, unable to work for take care of myself. the idea that people with mental illness are refusing treatment because of their mental illness is not totally true. i have had to make decisions since 1981 about sacrificing my physical health in order to take the medications that are going to help me manage my bipolar disorder. as a result of that, i now have the essential tremor. it is incurable. i have metabolic syndrome.
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that is a host of conditions known to be caused by psychiatric medications. i have had to make those choices. these are some of the reasons why people with mental illness suffered shorter lifespans. it is not simply because they are mentally ill. is because the treatment that is available to them at a price -- comes at a price. i have sat in help commission meetings for the past three years during budget times. time again, people from various community agencies have come up to argue that their program is going to save money. that argument has rarely held sway with the commission, with the exception of the mayor's proposal to create the health court he was in favor of. the argument that they were going to save money suddenly became an invalid one -- a valid
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one. this is hypocrisy. public policies are not necessarily about helping people as much as getting them through that system in the same way that public education to get people through a system without teaching them to learn to read or write. there is no exit strategy for the system. there is no way of people graduating into a truly independent life. dph acknowledged this two years ago. [tone!] their strategies have been about cutting exactly the kinds of services we're talking about. citywide, there's a huge cut proposed. it is true we have lots of resources. they are not coordinated. the safety net is defined differently depending on who you
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ask. ultimately, it is a morass in which the greatest struggle for someone with mental -- [tone!] -- making their way through that system. supervisor chu: are there any other comments? with that, public comments are closed. let me just say supervisor avalos mentioned that nevada county and san francisco do not think we did do things exactly the same way. part of what this legislation does is it means sitting down with public health and figuring out how sentences would navigate through the system. to give you an idea of how said francisco -- and figuring out how seven cisco would