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homeless tent under a freeway overpass

State Assemblymembers Miguel Santiago (D-Los Angeles) and Laura Friedman (D-Glendale) introduced legislation Wednesday to change the criteria by which local governments are able to provide critical medical care to homeless individuals who are mentally ill.

AB 1971’s introduction comes a day after the Los Angeles County Board of Supervisors voted to approve such legislation.

“It is inhumane to be a bystander when we have the power to do something to save lives in this vulnerable population,” Santiago said. “We need to ensure there is proper medical care for homeless individuals with mental illness who are suffering on the streets with serious physical ailments.”

The legislation will serve as a placeholder for language requested by the Supervisors Tuesday to change the definition of “grave disability” to consider urgently needed medical treatment as a basic human need when assessing an individual’s need for conservatorship.

State law defines “gravely disabled” as a “condition in which a person, as a result of a mental health disorder, is unable to provide for his or her basic personal needs for food, clothing, or shelter.” This standard is used when considering conservatorship.

Supervisors Kathryn Barger and Mark Ridley-Thomas and Assemblymembers Santiago and Friedman believe that this definition does not go far enough. AB 1971 will amend the state’s definition to include “or medical treatment where the lack or failure of such treatment may result in substantial physical harm or death.”

“It’s no secret that in Los Angeles, and communities across California, we’re grappling with a homeless crisis,” Friedman said. “If we can open the door to treatment for those struggling with severe mental illness, we can get our most vulnerable the health care they need and get them off of the streets.”

On October 31, 2017, Supervisors approved a motion jointly authored by Barger and Ridley-Thomas that directed the county’s Department of Mental Health to work with county agencies, mental health advocacy groups, civil rights organizations, and other stakeholders to develop legislative recommendations to tackle the growing number of homeless deaths in the county.

Numerous mental health professionals and advocates voiced support and participated in the effort, including Dr. Susan Patrovi, Medical Director of Homeless Healthcare LA, Brittney Weissman, Executive Director of the National Alliance on Mental Illness Los Angeles County Council, and Los Angeles City Councilmember David Ryu.

LADMH and its partners engaged stakeholders from various statewide and local organizations and received overwhelmingly positive feedback on modifying the current grave disability standard.

“More than 830 homeless people died on the streets of L.A. County last year,” Barger said. “Many of these deaths were preventable with proper medical attention. It’s time for California to join 37 other states that consider medical treatment a basic human need for those suffering from a mental illness.

“I am pleased that Assemblymembers Santiago and Freidman are moving forward on this vital effort, and look forward to working with them to add California to the list of 37 other states who consider medical treatment a basic human need for those suffering from a mental illness,” Barger said.

According to local data, there is an increased death rate among the homeless population in Los Angeles County. A significant number of these deaths were due to preventable and/or treatable medical conditions such as cardiovascular disease, pneumonia, diabetes, cancer, cirrhosis, severe bacterial infection and other treatable conditions.

Although these numbers do not indicate whether or not the deceased homeless individuals suffered from mental illness that impaired their willingness to seek care, Los Angeles County has seen a 28 percent increase in homeless individuals suffering from a mental illness from 2015-2017.

By expanding the “gravely disabled” definition to include consideration of medical need where the lack or failure of such treatment may result in substantial physical harm or death, those involved hope to be able to provide care for more homeless individuals and save lives.

AB 1971 will be amended to include substantive language in early March and will be considered in policy committees thereafter.

The text of Tuesday’s Board of Supervisor’s motion can be found here.

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