CS/CS/CS/CS/HB 349

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

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