Will more involuntary treatment lead to less homelessness?

Everyone around him saw this coming.

No one managed to stop it.

For years, family members of James Mark Rippee—a blind, homeless Vacaville man with a traumatic brain injury and paranoid schizophrenia—have fought to get him into treatment. He resisted. And official after official cited California's involuntary treatment laws in explaining to his family why there was nothing they could do.

On the evening of Feb. 12, Rippee stepped off the center divide of a dimly lit Vacaville street into the path of an oncoming vehicle, police say. Now he's facing multiple surgeries, said his sister Linda Privatte—for a fractured skull, a brain bleed, a shattered elbow, a dislocated shoulder and a crushed leg.

Like many other families, Rippee's sisters place much of the blame on the mental health implications of a 1967 state law, Lanterman-Petris-Short. It imposed specific time frames for involuntary confinement and limited involuntary holds to those deemed a danger to themselves or others, or gravely disabled.

But families like Rippee's are ratcheting up the pressure to change the controversial law.

And policymakers seem to be listening. Gov. Gavin Newsom, in his State of the State address, said: “Clearly it's time to respond to the concerns of experts who argue that thresholds for conservatorships are too high and need to be revisited.”

After watching the speech, Rippee's sisters aren't yet convinced. They've been circulating a petition begging the governor to pay attention to Rippee's situation and act to help him.

“It's easy to stand up and say what needs to happen,” Privatte said. “What is he really going to do about it? What's the plan? I watched it twice, and I didn't hear one.”

An audit of Lanterman-Petris-Short is due out later this spring, and could suggest a possible path forward for the state. The governor's office did not respond to requests for comment or provide any details about what exactly he would do to respond to change the rules surrounding involuntary treatment of people with mental illness. While the governor has not yet outlined a specific plan for the state, he did sign a bill to pilot expanded conservatorships in San Francisco.

Privatte and her twin sister, Catherine Hanson, recognize that making it easier to conserve people isn't a simple fix, either. Disability rights advocates are concerned that involuntary treatment is ineffective and jeopardizes people's civil rights. County public guardians say they are overwhelmed with an influx of new clients, while the number of facilities available to treat them shrinks.

Even if Rippee were to be conserved, very few facilities in the state accept patients with traumatic brain injuries, Gerald Huber, the county's director of Health and Social Services, said in an interview late last year.

Rippee himself, when I found him huddled at the edge of a Vallejo strip mall last year, told me he wants to live in a home with a shower and someone to care for him. But not a locked facility, he emphasized.

“To leave a blind man outside, you know, I just figured the county could do better than that,” he said.

A string of close calls

This was not the first time Rippee has wandered into traffic. People who know his family regularly reach out to tell them they have pulled him out of danger, or have themselves almost hit him. In September, he was struck by a car and ended up hospitalized with a brain abscess. But after a couple weeks, his sisters said, the hospital discharged him to a board-and-care. Soon after that, he returned to the streets.

Lt. Mark Donaldson, of the Vacaville police department, said his officers regularly respond to calls about Rippee stepping into traffic.

“You have to go out and deal with these same people over and over again, and you know what the end result is going to be, because there's no place to take them,” he said.

“I got into this job to help people above all else, and we like to be problem solvers, and when you simply don't have the tools to solve these problems, it's devastating,” he said. “It's so frustrating. Your heart hurts for him and his family. There simply is no place; there's nothing we can do.”

Privatte says she doesn't blame the driver who struck her brother earlier this month.

“I just blame the whole situation of him still being out there,” Privatte said. “Sometimes I'm just amazed at how he does survive.”

She and Hanson say their brother has refused necessary medical treatments while in the hospital, including blood transfusions.

Rippee's sisters have been fighting to get him into involuntary treatment for years. They testified on behalf of state legislation that sought to redefine “gravely disabled” to include those who don't seek needed medical treatment. It failed. They attended Solano County board of supervisors meetings. They asked the police for welfare checks. They sent thousands of emails, and administer a Facebook group about their brother's situation, which currently has more than 2,500 members.

“What we're doing is unacceptable,” Solano County Supervisor Skip Thomson told Privatte as she wept during a board of supervisors meeting in 2018. Thomson declined to comment on Rippee's most recent accident.

“I've struggled with this for the five years I've been here,” Huber, the county's director of Health and Social Services, said last year. “The street is not an appropriate place for him to live.”