CS/CS/CS/HB 349

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

CODING: Words stricken are deletions; words underlined are additions.