| 1 | Representative Adkins offered the following: |
| 2 |
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| 3 | Amendment (with title amendment) |
| 4 | Between lines 2317 and 2318, insert: |
| 5 | Section 52. (1) There is created a workgroup to review |
| 6 | state policy and budgeting issues affecting adults with serious |
| 7 | mental illness who also have involvement with the state criminal |
| 8 | justice system. |
| 9 | (2) The workgroup shall consist of the following members: |
| 10 | (a) One member from the Substance Abuse and Mental Health |
| 11 | Corporation. |
| 12 | (b) One member appointed by Florida Legal Services, Inc. |
| 13 | (c) One member appointed by the Florida Psychiatric |
| 14 | Society. |
| 15 | (d) One member appointed by the Correctional Medical |
| 16 | Authority. |
| 17 | (e) One member appointed by the Florida Prosecuting |
| 18 | Attorneys Association. |
| 19 | (f) One member appointed by the Florida Public Defender |
| 20 | Association. |
| 21 | (g) One member appointed by the Florida Association of |
| 22 | Court Clerks. |
| 23 | (h) One member appointed by the Florida Assisted Living |
| 24 | Affiliation. |
| 25 | (i) One member appointed by the Florida Council for |
| 26 | Community Mental Health. |
| 27 | (j) One member appointed by the Department of Children and |
| 28 | Family Services. |
| 29 | (k) One member appointed by the Agency for Health Care |
| 30 | Administration. |
| 31 | (l) One member appointed by the Department of Corrections. |
| 32 | (m) One member appointed by the Florida Sheriffs |
| 33 | Association. |
| 34 | (n) One member appointed by the Florida Police Benevolent |
| 35 | Association. |
| 36 | (o) One member appointed by the Florida chapter of the |
| 37 | National Alliance for the Mentally Ill. |
| 38 | (p) One member appointed by the Florida Hospital |
| 39 | Association representing private receiving facilities. |
| 40 | (q) One member appointed by the Florida Psychological |
| 41 | Association. |
| 42 | (r) One member appointed by the President of the Senate. |
| 43 | (s) One member appointed by the Speaker of the House of |
| 44 | Representatives. |
| 45 | (t) One member appointed by the Governor. |
| 46 | (3) Members of the workgroup shall serve without |
| 47 | compensation for such service. However, each member may request |
| 48 | reimbursement from the member's employing entity for per diem |
| 49 | and travel expenses as provided in s. 112.061, Florida Statutes. |
| 50 | (4) Each meeting of the workgroup shall be held in |
| 51 | Tallahassee. The workgroup shall meet four times per year and |
| 52 | may use electronic means of communication, which may include, |
| 53 | but are not limited to, conference calls, web seminars, and |
| 54 | video conferencing. |
| 55 | (5) The workgroup shall organize and conduct its meetings |
| 56 | in accordance with Robert's Rules of Order. |
| 57 | (6) The review conducted by the workgroup under this |
| 58 | section must include: |
| 59 | (a) The identification of all state funds being expended |
| 60 | on the care of adults with mental illnesses who have legal |
| 61 | involvement with state and county courts, including funds |
| 62 | expended on care in correctional facilities and funds expended |
| 63 | on medication, courts, attorneys, state institutions, contracts |
| 64 | with private institutions, community-based programs, Medicaid |
| 65 | services, state-funded substance abuse services, state-funded |
| 66 | mental health services, and managed care plans. |
| 67 | (b) A detailed examination of community-based service |
| 68 | delivery systems, including utilization issues, housing issues, |
| 69 | psychiatric emergency crisis response outcomes, effective |
| 70 | practices, and programs directed toward individuals who are at |
| 71 | risk for court or legal involvement. |
| 72 | (c) A detailed review of data, utilization, and cost |
| 73 | analysis for individuals who are involved with the county |
| 74 | courts, state courts, state prisons, and state and private |
| 75 | institutions, have been charged with misdemeanors or felonies, |
| 76 | and have a diagnosis of serious and persistent mental illness. |
| 77 | (d) A detailed review of utilization data and costs for |
| 78 | individuals who have traumatic brain injuries, have involvement |
| 79 | with state courts, state prisons, county courts, or county |
| 80 | jails, and have involvement with state-funded substance abuse |
| 81 | and mental health services. |
| 82 | (e) A review of the cost and impact of early discharge |
| 83 | from public crisis-stabilization units, community inpatient |
| 84 | psychiatric hospitals, and state and private institutions that |
| 85 | care for persons with serious and persistent mental illness and |
| 86 | inappropriate placement into state prisons and county jails. |
| 87 | (f) A review of the Criminal Punishment Code, including |
| 88 | penalties and sentencing guidelines, and other laws pertaining |
| 89 | to the forensic mentally ill in order to assess where changes |
| 90 | could be made that protect public safety while ensuring that the |
| 91 | needs of the mentally ill are met in a cost-effective manner, |
| 92 | with a goal to create a plan that will reduce reliance on state |
| 93 | prisons and county jails. |
| 94 | (g) The identification of programs, practices, and |
| 95 | innovative solutions emerging in the state that would reduce the |
| 96 | need for incarceration, improve cost-effectiveness, help reduce |
| 97 | the impact on the state budget, and improve public safety. |
| 98 | (h) A process for requesting and reviewing innovative |
| 99 | proposals that would help the state optimize the use of state |
| 100 | funding through special pilot projects, mental health courts, |
| 101 | changes in emergency psychiatric care, new approaches to law |
| 102 | enforcement practices and court diversion programs, and the use |
| 103 | of modified sentencing or waivers relative to the Criminal |
| 104 | Punishment Code. |
| 105 | (i) The development of a proposal for legislative |
| 106 | consideration that would establish an innovative Medicaid waiver |
| 107 | that would help support stable housing and services for those |
| 108 | individuals defined as at risk of court-related involvement. For |
| 109 | the purposes of this subsection, the term "at risk of court- |
| 110 | related involvement" means having been charged with a |
| 111 | misdemeanor or felony and diagnosed with a serious and |
| 112 | persistent mental illness. |
| 113 | (j) A review of the effect of substance abuse on the |
| 114 | system and methods to create integration and the use of Medicaid |
| 115 | waivers, such as the Medicaid 1915c Home and Community-Based |
| 116 | Waiver, to provide a more integrated approach to treating |
| 117 | substance abuse in the community. |
| 118 | (k) The use of involuntary outpatient commitment |
| 119 | requirements under the Baker Act and the need for changes to |
| 120 | those requirements that would help reduce or mitigate the |
| 121 | potential for court involvement in this process. This review |
| 122 | shall include the use of the Florida Medication Algorithm |
| 123 | Project and its implications for improved outcomes relative to |
| 124 | individuals at risk of court-related involvement. |
| 125 | (l) A review of the current status of the use of |
| 126 | electronic medical records, the need for broader use of |
| 127 | electronic medical records for individuals at risk of court |
| 128 | involvement, and the fiscal impact in terms of the savings that |
| 129 | this type of client information system would have on reducing |
| 130 | state expenditures and improving access to care for those |
| 131 | considered most at risk. The workgroup may request experts in |
| 132 | the field to make presentations and respond to questions. The |
| 133 | workgroup shall make recommendations as provided in subsection |
| 134 | (7). |
| 135 | (m) A review and comparison of the practices and standards |
| 136 | used in correctional facilities to provide mental health care |
| 137 | for individuals who are incarcerated in county jails, state |
| 138 | prisons, or state or private state mental health forensic |
| 139 | institutions. |
| 140 | (n) The consideration of plans and recommendations |
| 141 | concerning appropriate methods of diverting mentally ill inmates |
| 142 | to less restrictive and less expensive alternatives using |
| 143 | conditional release or probation. |
| 144 | (o) A review of probation and parole requirements for |
| 145 | recommended modifications in order to assist with improving |
| 146 | community placement and community control for persons with |
| 147 | serious and persistent mental illness who are eligible for |
| 148 | probation. This shall include a review of rules and policies and |
| 149 | recommendations. |
| 150 | (p) A review of practices associated with the discharge of |
| 151 | individuals with a serious mental illness from correctional |
| 152 | facilities and from state-operated and state-funded forensic |
| 153 | mental health institutions for compliance with interagency |
| 154 | agreements regarding placement in the community, recidivism to a |
| 155 | jail or institutional setting, and utilization of hospital |
| 156 | emergency rooms, involuntary commitment services, and crisis |
| 157 | stabilization units. |
| 158 | (7) The workgroup shall make recommendations in its |
| 159 | interim and final reports regarding proposed changes to the |
| 160 | state penal code, sentencing guidelines, state mental health |
| 161 | policy, and related strategies that would improve public safety |
| 162 | through better integration of behavioral health care at all |
| 163 | levels of the criminal justice system, with a goal of reducing |
| 164 | reliance on county jails and state prisons. The workgroup shall |
| 165 | submit an interim report with findings and recommendations to |
| 166 | the Governor, the President of the Senate, and the Speaker of |
| 167 | the House of Representatives by January 5, 2010, and its final |
| 168 | report with recommendations and findings by January 5, 2011. |
| 169 | (8) The workgroup terminates and this section expires July |
| 170 | 1, 2011. |
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| 175 | ----------------------------------------------------- |
| 176 | T I T L E A M E N D M E N T |
| 177 | Remove lines 113-114 and insert: |
| 178 | substance abuse and mental health services; providing for |
| 179 | the creation of a workgroup to review state policy and |
| 180 | budgeting issues affecting adults with serious mental |
| 181 | illness who also have involvement with the state criminal |
| 182 | justice system; providing for membership, organization, |
| 183 | and meetings; specifying that members serve without |
| 184 | compensation, but may be reimbursed for expenses; |
| 185 | specifying components of the review; authorizing use of |
| 186 | outside research organizations; providing for interim and |
| 187 | final reports; providing for future termination of the |
| 188 | workgroup and expiration of the provisions creating it; |
| 189 | providing an effective date. |
| 190 |
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