1 | A bill to be entitled |
2 | An act relating to forensic mental health policy; amending |
3 | s. 394.655, F.S.; deleting provisions establishing a |
4 | Criminal Justice, Mental Health, and Substance Abuse |
5 | Policy Council within the Florida Substance Abuse and |
6 | Mental Health Corporation; providing for creation of a |
7 | workgroup to review state policy and budgeting issues |
8 | affecting adults with serious mental illness who also have |
9 | involvement with the state criminal justice system; |
10 | providing for administrative oversight and assistance; |
11 | providing for membership, organization, and meetings; |
12 | specifying that members serve at their own expense; |
13 | providing for certain workgroup expenses; specifying |
14 | components of the review; authorizing use of outside |
15 | research organizations; providing for interim and final |
16 | reports; providing for future termination of the workgroup |
17 | and repeal of the provisions creating it; providing an |
18 | effective date. |
19 |
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20 | Be It Enacted by the Legislature of the State of Florida: |
21 |
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22 | Section 1. Subsections (11) and (12) of section 394.655, |
23 | Florida Statutes, are amended to read: |
24 | 394.655 The Substance Abuse and Mental Health Corporation; |
25 | powers and duties; composition; evaluation and reporting |
26 | requirements.-- |
27 | (11)(a) There is established a Criminal Justice, Mental |
28 | Health, and Substance Abuse Policy Council within the Florida |
29 | Substance Abuse and Mental Health Corporation. The members of |
30 | the council are: |
31 | 1. The chairperson of the corporation; |
32 | 2. The Secretary of Children and Family Services; |
33 | 3. The Secretary of Corrections; |
34 | 4. The Secretary of Health Care Administration; |
35 | 5. The Secretary of Juvenile Justice; |
36 | 6. The Secretary of Elderly Affairs; and |
37 | 7. The State Courts Administrator. |
38 | (b) The purpose of the council shall be to align policy |
39 | initiatives in the criminal justice, juvenile justice, and |
40 | mental health systems to ensure the most effective use of |
41 | resources and to coordinate the development of legislative |
42 | proposals and budget requests relating to the shared needs of |
43 | adults and juveniles who have a mental illness, substance abuse |
44 | disorder, or co-occurring mental health and substance abuse |
45 | disorders who are in, or at risk of entering, the criminal |
46 | justice system. |
47 | (c) The council shall work in conjunction with counties |
48 | that have been awarded a Criminal Justice, Mental Health, and |
49 | Substance Abuse Reinvestment grant to ensure that effective |
50 | strategies identified by those counties are disseminated |
51 | statewide and to establish a dialogue for purposes of policy and |
52 | budget development and system change and improvement. The |
53 | council shall coordinate its efforts with the Criminal Justice, |
54 | Mental Health, and Substance Abuse Technical Assistance Center. |
55 | (d) Each member agency of the council shall designate an |
56 | agency liaison to assist in the work of the council. |
57 | (11)(12) This section expires on October 1, 2011, unless |
58 | reviewed and reenacted by the Legislature before that date. |
59 | Section 2. (1) There is created a workgroup to review |
60 | state policy and budgeting issues affecting adults with serious |
61 | mental illness who also have involvement with the state criminal |
62 | justice system. The Secretary of Children and Family Services, |
63 | in conjunction with the Secretary of Corrections and the |
64 | Secretary of Health Care Administration, shall oversee and |
65 | provide staff and other administrative assistance to the |
66 | workgroup within funds appropriated. |
67 | (2) The workgroup shall consist of the following members: |
68 | (a) One member from the Substance Abuse and Mental Health |
69 | Corporation. |
70 | (b) One member appointed by Florida Legal Services, Inc. |
71 | (c) One member appointed by the Florida Psychiatric |
72 | Society. |
73 | (d) One member appointed by the Correctional Medical |
74 | Authority. |
75 | (e) One member appointed by the Florida Prosecuting |
76 | Attorneys Association. |
77 | (f) One member appointed by the Florida Public Defender |
78 | Association. |
79 | (g) One member appointed by the Florida Association of |
80 | Court Clerks. |
81 | (h) One member appointed by the Florida Assisted Living |
82 | Affiliation. |
83 | (i) One member appointed by the Florida Council for |
84 | Community Mental Health. |
85 | (j) One member appointed by the Department of Children and |
86 | Family Services. |
87 | (k) One member appointed by the Agency for Health Care |
88 | Administration. |
89 | (l) One member appointed by the Department of Corrections. |
90 | (m) One member appointed by the Florida Sheriffs |
91 | Association. |
92 | (n) One member appointed by the Florida Police Benevolent |
93 | Association. |
94 | (o) One member appointed by the Florida chapter of the |
95 | National Alliance for the Mentally Ill. |
96 | (p) One member appointed by the director of the Office of |
97 | Program Policy Analysis and Government Accountability. |
98 | (q) One member appointed by the President of the Senate. |
99 | (r) One member appointed by the Speaker of the House of |
100 | Representatives. |
101 | (s) One member appointed by the Governor. |
102 | (3)(a) Members of the workgroup shall serve without |
103 | compensation for such service. Any member of the workgroup who |
104 | is a public employee is entitled to reimbursement for per diem |
105 | and travel expenses as provided in s. 112.061, Florida Statutes. |
106 | (b) Expenses of the workgroup, other than member travel |
107 | expenses, shall be paid from funds appropriated to the |
108 | Department of Children and Family Services, the Department of |
109 | Corrections, and the Agency for Health Care Administration. |
110 | (c) Each meeting of the workgroup shall be held in |
111 | Tallahassee at the offices of the Department of Children and |
112 | Family Services. The workgroup shall meet four times per year |
113 | and may use electronic means of communication for members unable |
114 | to attend, which may include, but are not limited to, conference |
115 | calls, webinars, and video conferencing. |
116 | (4)(a) The workgroup shall organize and conduct its |
117 | meetings in accordance with Robert's Rules of Order. |
118 | (b) The workgroup is authorized to request the Louis de la |
119 | Parte Florida Mental Health Institute at the University of South |
120 | Florida under its contract with the Department of Children and |
121 | Family Services to conduct research or analysis of data projects |
122 | identified by the chair and the members. |
123 | (5) The review conducted by the workgroup under this |
124 | section shall include: |
125 | (a) The identification of all state funds being expended |
126 | on the care of adults with mental illnesses who have legal |
127 | involvement with state and county courts, including funds |
128 | expended on care in any correctional facility and funds expended |
129 | on medication, courts, attorneys, state institutions, contracts |
130 | with private institutions, community-based programs, Medicaid |
131 | services, state-funded substance abuse services, state-funded |
132 | mental health services, and managed care plans. |
133 | (b) A detailed examination of community-based service |
134 | delivery systems, including utilization issues, housing issues, |
135 | psychiatric emergency crisis response outcomes, effective |
136 | practices, and programs targeting individuals at risk for court |
137 | or legal involvement. |
138 | (c) A detailed review of data, utilization, and cost |
139 | analysis for individuals involved with the county courts, state |
140 | courts, state prisons, and state and private institutions who |
141 | have been charged with misdemeanors or felonies and who have a |
142 | diagnosis of serious and persistent mental illness. |
143 | (d) A detailed review of utilization data and costs for |
144 | individuals with traumatic brain injuries who have involvement |
145 | with state courts, state prisons, county courts, or county jails |
146 | and who have involvement with state-funded substance abuse and |
147 | mental health services. |
148 | (e) A review of the role and costs of early discharge and |
149 | inappropriate placement on the use of state prisons and county |
150 | jails from public crisis stabilization units, community |
151 | inpatient psychiatric hospitals, and state and private |
152 | institutions that care for persons with serious and persistent |
153 | mental illness. |
154 | (f) A review of the criminal code, including penalties and |
155 | sentencing guidelines, and other laws pertaining to the forensic |
156 | mentally ill to assess where changes could be made to protect |
157 | public safety while ensuring that the needs of the mentally ill |
158 | are met in a cost-effective manner, with a goal to create a plan |
159 | that will reduce reliance on state prisons and county jails. |
160 | (g) The identification of programs, practices, and |
161 | innovative solutions emerging in the state that would reduce the |
162 | need for incarceration, improve cost-effectiveness, and help |
163 | reduce the impact on the state budget and improve public safety. |
164 | (h) A process for requesting and reviewing innovative |
165 | proposals that would help the state optimize the use of state |
166 | funding by examining the use of special pilot projects, mental |
167 | health courts, changes in emergency psychiatric care, new |
168 | approaches to law enforcement practices and court diversion |
169 | programs, and the use of modified sentencing or waivers relative |
170 | to the criminal code. |
171 | (i) The development, in conjunction with the Agency for |
172 | Health Care Administration, of a proposal for legislative |
173 | consideration that would establish an innovative Medicaid waiver |
174 | that would help support stable housing and services for those |
175 | individuals defined as at risk of court-related involvement. For |
176 | the purposes of this subsection, the term "at risk of court- |
177 | related involvement" means a person who has been charged with a |
178 | misdemeanor or felony and diagnosed with a serious and |
179 | persistent mental illness. |
180 | (j) A review of the impact of substance abuse on the |
181 | system and methods to create integration and the use of Medicaid |
182 | waivers like the Medicaid 1915c Home and Community-Based Waiver |
183 | to provide a more integrated approach to treating substance |
184 | abuse in the community. |
185 | (k) The use of the involuntary outpatient commitment |
186 | requirements under the Baker Act and the need for changes to |
187 | those requirements that would help reduce or mitigate the |
188 | potential for court involvement in this process. This review |
189 | shall include the use of the Florida Medication Algorithm |
190 | Project and its implications for improved outcomes relative to |
191 | individuals at risk of court-related involvement. |
192 | (l) A review of the current status of the use of |
193 | electronic medical records, the need for broader use of |
194 | electronic medical records for individuals at risk of court |
195 | involvement, and the fiscal impact in terms of the savings this |
196 | type of client information system would have on reducing state |
197 | expenditures and improving access to care for those considered |
198 | most at risk. The workgroup may request experts in the field to |
199 | make presentation and respond to questions. The workgroup shall |
200 | make recommendations in response as provided in subsection (7). |
201 | (m) A review and comparison of the practices and standards |
202 | used in correctional facilities in providing mental health care |
203 | for individuals who are incarcerated in county jails, state |
204 | prisons, or state or private state mental health forensic |
205 | institutions. |
206 | (n) The consideration of plans and recommendations |
207 | concerning appropriate methods of diverting mentally ill inmates |
208 | to less restrictive and less expensive alternatives using |
209 | conditional release or probation. |
210 | (o) A review of probation and parole requirements for |
211 | recommended modifications to assist with improving community |
212 | placement and community control for persons with serious and |
213 | persistent mental illnesses who are eligible for probation. This |
214 | shall include a review of rules and policies and |
215 | recommendations. |
216 | (p) A review of practices associated with the discharge of |
217 | individuals with a serious mental illness from the Department of |
218 | Corrections and from state-operated and state-funded forensic |
219 | mental health institutions for compliance with interagency |
220 | agreements regarding placement in the community, recidivism to a |
221 | jail or institutional setting, and utilization of hospital |
222 | emergency rooms, involuntary commitment services, and crisis |
223 | stabilization units. |
224 | (6) The Department of Children and Family Services, the |
225 | Department of Corrections, and the Agency for Health Care |
226 | Administration may use outside research organizations, |
227 | including, but not limited to, the Office of Program Policy |
228 | Analysis and Government Accountability, to help collect |
229 | information for the workgroup to use in assessing the factors |
230 | contributing to the rise in the numbers of adults with serious |
231 | mental illness in the criminal justice system. |
232 | (7) The workgroup shall make recommendations in its |
233 | interim and final reports regarding proposed changes to the |
234 | state penal code, sentencing guidelines, state mental health |
235 | policy, and related strategies that would improve public safety |
236 | through better integration of behavioral health care at all |
237 | levels of the criminal justice system, with a goal of reducing |
238 | reliance on county jails and state prisons. The workgroup shall |
239 | submit an interim report with findings and recommendations to |
240 | the President of the Senate, the Speaker of the House of |
241 | Representatives, and the Governor no later than January 5, 2010, |
242 | and its final report with recommendations and findings by |
243 | January 5, 2011. |
244 | (8) The workgroup terminates and this section expires July |
245 | 1, 2011. |
246 | Section 3. This act shall take effect July 1, 2009. |