A state law signed in September is designed to help get mentally ill homeless people off the street. But it's up to individual counties to decide whether to adopt it and it comes with no funding.

Proponents say the law, which makes it easier to force medication upon the mentally ill, will pay for itself. Opponents say it denies such individuals basic human rights and that funding it would take money from other much needed and more beneficial programs. The bill was sponsored by Helen Thomson, D-Davis, a former psychiatric nurse. She said several counties are considering implementing the law.

"I know Los Angeles is looking at it," Thomson said, shortly after the bill was signed. "San Francisco is looking at it. Throughout the state (advocates) will be going to their board of supervisors."

Thomson said implementation may take some time, but she believes the law will be beneficial in the long run.

"I think it will show it's successful, that it's more humane and we've reduced costs of hospitalization and jail," she said.

Thomson's legislation amends the Lanterman-Petris-Short Act of 1968, a landmark law that gave mentally ill individuals greater rights, particularly in the area of choosing whether they wished to receive treatment.

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Leaning toward adoption

Rudy Lopez, director of San Bernardino County Behavioral Health, said he is leaning toward recommending that the county adopt the law.

"We have to take a look at our current structure and how we would redirect staff to carry on this function," Lopez said. "It's much too early to say we have the wherewithal to do it."

Lopez expected to have a proposal on implementing the law by the first of the year.

If the law is adopted, he said, the impact on the county will be more court time, with an increased load on the county counsel, and more responsibility for his department in designing an effective way to implement required treatments.

Individuals who are placed in conservatorship and required to take medication will be seen as outpatients. Lopez agreed that it still may be rather easy for such people to continue to avoid treatment.

"Part of the theory behind this is if you bring it up to the level of the court, that we will be able to have a greater impact with this individual, versus having no recourse whatsoever," he said. "But we will have individuals that will not comply anyway."

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Cost concerns

Another part of the theory is that the cost savings of not having such individuals in jail or in the hospital quite so often will allow implementation of the program with no additional taxpayer money. Services already provided for other mentally ill people also are not supposed to be impacted.

Lopez thinks that's ridiculous.

"C'mon," he said, "You only have so much of the pie to cut up."

Cost concerns will keep Riverside County from adopting the new law, spokesman Ray Smith said.

"I think the rough estimate for us is it would be about $ 1 million to cover about 100 people," Smith said. "It would be very helpful in certain cases, but mental health is looking at approximately a $ 1.7 million reduction from the state budget for the current year."

Bill Fry said the financial concern alone should make counties balk at implementing the new law. Fry has been San Bernardino County's patient rights advocate for 15 years. For 12 years before that, he held the same position in Riverside County.

Adopting the new law, Fry said, "will take away from limited resources available for persons seeking treatment on a voluntary basis. In a sense, the people motivated to ask for treatment are the ones most likely to benefit from the treatment and it's possible those people could be turned away.

"To spend the money on voluntary treatment is the better option," he adds. "That's the position of the patients-rights community."

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Ambivalence about coercion

Edward Garner has been working in behavioral health for San Bernardino County for 19 years. His office deals with the mentally ill homeless population and sees 800 to 1,000 cases each year. Because of an outreach program, Garner estimates his office is reaching more than half of the mentally ill people living on the streets.

"At least one-third of all homeless people have a severe mental illness," Garner said. But he isn't sure about implementing the new law.

"I have some ambivalence about the idea of coercion," he said, referring to forced medication. "But if people are so mentally ill they can't take care of themselves, maybe we do need some type of minimal intrusion into their lives to help them."