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San Francisco Health Network
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Assisted Outpatient Treatment (AOT)

(left to right: Jose Orbeta, Erick Reijerse, Stephanie Dupuy, Marley Shepard-Ohta, Charles Houston)

Introduction to AOT

This webpage is designed to provide additional information about Assisted Outpatient Treatment (AOT). This program, which is often referred to as Laura’s Law, is a new intervention tool that allows a clinical team to outreach and engage individuals with known mental illness, who are not engaged in care, and are on a downward spiral. San Francisco’s implementation of this program has a particular focus on community-based services that allow multiple opportunities for an individual to engage in voluntary treatment. The ultimate goal of this program is to provide intensive outpatient services to these individuals in an effort to improve their quality of life, as well as prevent decompensation and cycling through acute services (e.g., psychiatric hospitalization) and incarceration.

If this is a psychiatric or medical emergency, dial 9-1-1

History of Assisted Outpatient Treatment (AOT)?

Assisted Outpatient Treatment, also known as "Laura's Law," was passed by the California Legislature in 2002 as AB1421. This law allows for court ordered outpatient treatment for individuals with a mental illness who meet strict legal criteria (More information about the law).

What will Assisted Outpatient Treatment look like in San Francisco?

In July 2014 the San Francisco Board of Supervisors adopted AOT with added conditions to make sure that the law is used to engage individuals in voluntary treatment (More information about the Health Code). This includes having individuals work with a "Care Team," of:

  1. a Clinical psychologist who oversees the program,
  2. a Clinical Supervisor
  3. Two clinicians, and
  4. Two team members that provide peer and family support

How many people will meet criteria for Assisted Outpatient Treatment?

Based on national data, it is expected that less than 100 individuals in San Francisco will meet criteria for the program.

What is the goal of Assisted Outpatient Treatment?

The goal of this program is to provide intensive outpatient services to referred individuals to improve their quality of life, as well as prevent mental health crises and cycling through emergency services or incarceration.

If you have any questions, feel free to contact Angelica Almeida, Ph.D. (Director of Assisted Outpatient Treatment) at (415) 255-3722.

Please see the Assisted Outpatient Treatment Fact Sheet (English | Chinese | Russian | Spanish | Tagalog | Vietnamese) for additional details on the referral and engagement process as well as frequently asked questions (FAQ's).

In addition to AOT, the team will be critical in the implementation of the Housing Conservatorship. This legislation provides treatment to San Francisco residents who, due to mental illness and substance use cycle in and out of psychiatric crisis and are deteriorating in the community. The AOT team looks forward to being able to expand our services to provide support to more San Franciscans in need.

Who is eligible?

Generally, Assisted Outpatient Treatment (AOT) is a program that is designed to outreach individuals with a known mental illness, who are not engaged in care, and are on a downward spiral.

If you are unsure if an individual qualifies for the program, please contact the AOT Care Team at (415) 255-3936 or the toll free number (844) 255-4097 to discuss the case with a team member.

The law requires that an individual must meet all of the following criteria to qualify for Assisted Outpatient Treatment (AOT):

  1. 18 years of age or older;
  2. Suffering from a mental illness (Welfare and Institutions Code §5600.3 (b)(2) and (3));
  3. Clinical determination that the person is unlikely to survive safely in the community without supervision, per clinical determination;
  4. History of lack of compliance with treatment for his or her mental illness, in that at least one of the following is true:
    a) The person's mental illness has, at least twice within the last 36 months, been a substantial factor in necessitating hospitalization or receipt of services in a forensic or other mental health unit of a state correctional facility or local correctional facility, not including any period during which the person was hospitalized or incarcerated immediately preceding the filing of the petition; or
    b) The person's mental illness has resulted in one or more acts of serious and violent behavior toward himself or herself or another within the last 48 months not including any period during which the person was hospitalized or incarcerated immediately preceding the filing of the petition;
  5. Been offered an opportunity to participate in treatment and continues to fail to engage in treatment;
  6. Substantially deteriorating;
  7. Participation in AOT would be the least restrictive placement needed to ensure the person's recovery and stability;
  8. In need of AOT in order to prevent a relapse or deterioration that would be likely to result in grave disability or serious harm to himself or herself, or to others; and
  9. Likely to benefit from AOT

Who can refer?

A request for Assisted Outpatient Treatment can be made by the following adults (age 18+):

  1. Any adult who lives with the individual with mental illness;
  2. A parent, spouse, sibling, or adult child of the individual with mental illness;
  3. The director of a mental health institution in which the individual with mental illness lives;
  4. The director of a hospital where the individual with mental illness is hospitalized;
  5. A licensed mental health provider supervising the treatment of the individual; or
  6. A peace, parole, or probation officer assigned to supervise the individual.

How do I refer?

If you would like to refer an individual to the Assisted Outpatient Treatment (AOT) program, please:

  1. Complete the referral form (English | Chinese | Russian | Spanish | Tagalog | Vietnamese) and fax it to (415) 255-3798 or email it to AOT-SF@sfdph.org

  2. OR

  3. Call (415) 255-3936, the toll free number (844) 255-4097, or the TDD at (888) 484-7200 and leave a clear message and number where you can be reached.

Please note that email is not a secure form of communication. If you choose to email the referral form, your information will be reviewed and a member of the AOT Care Team will contact you via phone to discuss the case further.

A member of the AOT Care Team will contact you within one business day of receiving the referral. The AOT Care Team works standard business hours Monday through Friday; however, may not be available to answer incoming phone calls.

Please see the Intake Flow Chart (English | Chinese | Russian | Spanish | Tagalog | Vietnamese) for an overview of the process.


Care Team

Chris Wright, Psy.D (AOT Program Manager)

Dr. Wright joins the team as the AOT Program Manager with a long history of working with clients with severe mental illness, complex trauma, substance use, and poverty. Prior to joining AOT, she worked as a senior counselor/trainer with CAAP Counseling and the Director of Mental Health at BAART Community Healthcare.



Marley Shepard-Ohta
Marley Shepard-Ohta, ASW (AOT Clinician)

Dr. Wright joins the team as the AOT Program Manager with a long history of working with clients with severe mental illness, complex trauma, substance use, and poverty. Prior to joining AOT, she worked as a senior counselor/trainer with CAAP Counseling and the Director of Mental Health at BAART Community Healthcare.

Marley Shepard-Ohta is an Associate Social Worker after graduating from California State University East Bay's Master of Social Work Program. Before getting his Master’s Degree, Marley worked with homeless and at-risk youth in Harlem and then in college access programming in Los Angeles. Since then Marley has narrowed his focus to working with the city’s vulnerable adult population. Marley has gained clinical experience in the non-profit sector, the criminal justice system, as well as community-based clinics. Marley most recently worked with the Human Services Agency Disability Evaluation and Consultation Unit to secure Social Security benefits for adults with disabilities.






Jose Orbeta (Team Member)

Jose Luis Orbeta has been working as a peer counselor for 6 years and has been in recovery for 7 plus years. He started as a volunteer group facilitator for Dual Recovery Anonymous and then was hired as a paid employee. In 2015 he joined the staff for the Hummingbird Peer Respite, the first peer run and peer created program of its kind in San Francisco funded by the MHSA. In 2017 he became a Peer Specialist/Counselor for Richmond Area Multi-Services and in 2018 he was hired to work as a health worker for AOT. Jose was recently honored by the County Behavioral Health Directors Association with a Community Behavioral Health Consumer Award on December 16, 2018.







Stephanie Dupuy, ASW (AOT Clinician)

Stephanie Dupuy joined the Assisted Outpatient Treatment as an Associate Social Worker after graduating from California State University East Bay's Masters of Social Work Program. Before getting her Master's Degree, Stephanie studied at San Francisco State University where she earned a Bachelor's Degree in Social Science, with an emphasis on the non-profit sector. Stephanie's clinical experience includes working with youth in the foster care system and adults with serious mental illness. After graduating from college, Stephanie spent many years working in the San Francisco County Jail where she provided support to the medical and behavioral health staff.




Charles Houston

Charles Houston (Team Member)

Charles Houston enthusiastically joins the AOT Care Team with a great deal of experience working at a local outpatient mental health center as a peer educator, systems navigator, and health and safety associate. He is well versed in working with drug treatment programs and has participated in committees to promote recovery and wellness within the San Francisco Department of Public Health. Mr. Houston is passionate about supporting families and working with community programs to ensure that individuals are receiving the support needed.






Charles Houston

Erick Reijerse, LCSW (AOT Clinical Supervisor)

Erick Reijerse is a Licensed Clinical Social Worker working with adults living with severe mental illness for the past 10 years. In 2010 he graduated from San Francisco State University’s Masters of Social Work Program where he also earned his degrees in Psychology and Spanish Language. Erick started in this field as an intern with UCSF CityWide – CrossCurrents team and has worked as an Intensive Clinical Case Manager with Family Service Agency, and more recently with the SFDPH SF FIRST ICM Team. Erick also has experience working with emancipated foster youth, monitoring court-ordered parental visitations and reunifications, and working with adults and transition-aged youth with developmental disabilities.






Additional Information

Prior to implementation, Dr. Almeida provided numerous trainings on San Francisco's Implementation of Assisted Outpatient Treatment to interested stakeholders. Please review the PowerPoint presentation for additional information.

Treatment Resources

If this is a psychiatric or medical emergency, dial 9-1-1

San Francisco Suicide Prevention, 415-781-0500

Resources in a Mental Health Crisis

Treatment Access Programs:

Mental Health and Substance Abuse Treatment
Behavioral Health Access Center (BHAC) and Treatment Access Program (TAP)
1380 Howard Street, 1st Floor
415-255-3737
8:00 am- 5:00 pm (Monday – Friday)
* provides assessment for treatment
* 24 hour hotline available at 415-255-3737 or 888-246-3333 (TDD: 888-484-7200)

Community Behavioral Health Provider List

Call 2-1-1 or visit 211.org for additional local resources.


Family and Peer Support:

National Alliance on Mental Illness (NAMI)
415-905-6264
www.namisf.org

Warm Line
855-845-7415
11:00 AM - 11:00 PM Monday - Friday;
11:00 AM - 7:00 PM Saturday


Printable Resource List (English | Chinese | Russian | Spanish | Tagalog | Vietnamese)

Mental Health Board of San Francisco