The controversial law that can compel treatment of the mentally ill -- Laura's Law -- was passed Tuesday by the Board of Supervisors, making The City the third jurisdiction in the state, and the first major city, to implement the state law locally.
Backers of the measure argue that it is another tool for a city plagued by a large population of mentally ill, many homeless, who refuse or are unable to find treatment and clog up the jails and justice system in the process.
Opponents fear the law will further criminalize an already-vulnerable population that simply needs more service options, not court-ordered treatment.
"People are falling through the cracks," said Supervisor Mark Farrell, who introduced the bill. "Parents, families and friends should not be helpless."
But Supervisor Eric Mar, who, along with Supervisor John Avalos, opposed the law's passage Tuesday on civil-rights grounds, said that it had the potential to be abused.
Laura's Law has been state law since 2002, but must be authorized by local jurisdictions before it can be implemented. The law allows court-ordered mental health treatment for people with a history of unsuccessful treatment. Family members and probation officers are among the people authorized to request treatment.
How It Works
To begin Laura's Law treatment, one of several authorized people must request the treatment through the county mental health director, who then, if in agreement, petitions the Superior Court for assisted outpatient treatment.
The petition must include a signed affidavit from a mental health professional who has recently assessed the patient and can only be filed if the patient meets a certain criteria. If the petition's requirements are met, a judge may order a total of six months of treatment.
In San Francisco, the civil-court order will be implemented by the Department of Public Health.
"Laura's Law provides a strict list of eligibility requirements for participation and is explicitly intended for individuals who are in crisis or recovering from a crisis caused by severe mental illness and for whom voluntary services are, unfortunately, not working," a DPH statement about the law said.
If a patient refuses to cooperate, at most, they can be put on a 72-hour physiological hold, but only if they meet the criteria already set by law.
Failure to comply is not a basis for involuntary commitment at a medical facility or contempt of court. Involuntary medication is not authorized without a separate court order.
The department initially expects about 100 people in San Francisco to be impacted by the law.
One key amendment the supervisors supported is the creation of a Care Team, a group that would engage with people prior to court-ordered treatment with the aim of steering people toward voluntary treatment.
Supervisor Jane Kim also added an amendment Tuesday that will require an outside evaluation of the law's impacts in 2017.
Jennifer Friedenbach, executive director of San Francisco's Coalition on Homelessness, has said the law's passage in The City will not fix the lack of treatment options.
"It traumatizes someone suffering from a health condition by putting him or her into the hands of our criminal justice system and removes fundamental rights to voice in health care decisions," she said.
No funds have been set aside to pay for the program.
Nevada and Orange counties have also passed the state law.