The Tulare County Board of Supervisors on June 24 unanimously approved a request from the county Health and Human Services Agency Behavioral Health Branch to opt out of the county’s locally run Assisted Outpatient Treatment program, commonly called Laura’s Law, beginning July 1, 2025. The board approved staff’s recommendation that people who would be eligible for AOT be served by the county’s Care Court program and expanded high-intensity field services instead.

Behavioral Health Director Natalie Bullen told the board the county has seen low referrals and participation in AOT and has built out Care Court and related field-based services since December 2024 to serve people with untreated schizophrenia and related psychotic disorders. "Care Court progress — care program staff have provided 36 outreach and educational presentations to community partners," Bullen said, and the program was designed to serve up to 100 people across the two service arms.

The county presented program costs and funding sources. Bullen said the 10-month cost for the AOT program was $7,046,8,455 (speaker corrected to one number during the meeting) with projected year-end costs and identified funding including federal financial participation (FFP), 1991 realignment and Mental Health Services Act funds. She asked the board to authorize the Behavioral Health Branch to opt out of the unfunded AOT program beginning July 1, 2025, "to ensure fiscal sustainability of all mandated services, including Care Court and all those programs and sites that will support SB 43 implementation and traditional specialty mental health services," she said.

Board members pressed staff on whether the eight people previously served by AOT would continue to receive intensive care. Bullen and the department clarified that those individuals would be eligible for Care Court or the expanded care-at-risk arm and "would not... fall through any crack," she said. Supervisors expressed support for the opt-out after staff described the county’s expanded local services and the ramp-up for Senate Bill 43, the state law that expands criteria for involuntary LPS holds to include severe substance use disorder beginning in January 2026.

The board’s action was a formal motion by Supervisor McCarrie, seconded by Supervisor Townsend, and the motion passed unanimously. The county will continue to develop local infrastructure to support SB 43 including planned locked treatment beds at Casa Grande and a psychiatric health facility in Dinuba that behavioral health expressed support for.

The board also requested follow-up reporting on the transition and program outcomes as Care Court enrollment and SB 43 implementation proceed.