CS/HB 349

1
A bill to be entitled
2An act relating to forensic mental health policy; amending
3s. 394.655, F.S.; deleting provisions establishing a
4Criminal Justice, Mental Health, and Substance Abuse
5Policy Council within the Florida Substance Abuse and
6Mental Health Corporation; providing for creation of a
7workgroup to review state policy and budgeting issues
8affecting adults with serious mental illness who also have
9involvement with the state criminal justice system;
10providing for administrative oversight and assistance;
11providing for membership, organization, and meetings;
12specifying that members serve at their own expense;
13providing for certain workgroup expenses; specifying
14components of the review; authorizing use of outside
15research organizations; providing for interim and final
16reports; providing for future termination of the workgroup
17and repeal of the provisions creating it; providing an
18effective date.
19
20Be It Enacted by the Legislature of the State of Florida:
21
22     Section 1.  Subsections (11) and (12) of section 394.655,
23Florida Statutes, are amended to read:
24     394.655  The Substance Abuse and Mental Health Corporation;
25powers and duties; composition; evaluation and reporting
26requirements.--
27     (11)(a)  There is established a Criminal Justice, Mental
28Health, and Substance Abuse Policy Council within the Florida
29Substance Abuse and Mental Health Corporation. The members of
30the 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
39initiatives in the criminal justice, juvenile justice, and
40mental health systems to ensure the most effective use of
41resources and to coordinate the development of legislative
42proposals and budget requests relating to the shared needs of
43adults and juveniles who have a mental illness, substance abuse
44disorder, or co-occurring mental health and substance abuse
45disorders who are in, or at risk of entering, the criminal
46justice system.
47     (c)  The council shall work in conjunction with counties
48that have been awarded a Criminal Justice, Mental Health, and
49Substance Abuse Reinvestment grant to ensure that effective
50strategies identified by those counties are disseminated
51statewide and to establish a dialogue for purposes of policy and
52budget development and system change and improvement. The
53council shall coordinate its efforts with the Criminal Justice,
54Mental Health, and Substance Abuse Technical Assistance Center.
55     (d)  Each member agency of the council shall designate an
56agency liaison to assist in the work of the council.
57     (11)(12)  This section expires on October 1, 2011, unless
58reviewed and reenacted by the Legislature before that date.
59     Section 2.  (1)  There is created a workgroup to review
60state policy and budgeting issues affecting adults with serious
61mental illness who also have involvement with the state criminal
62justice system. The Secretary of Children and Family Services,
63in conjunction with the Secretary of Corrections and the
64Secretary of Health Care Administration, shall oversee and
65provide staff and other administrative assistance to the
66workgroup within funds appropriated.
67     (2)  The workgroup shall consist of the following members:
68     (a)  One member from the Substance Abuse and Mental Health
69Corporation.
70     (b)  One member appointed by Florida Legal Services, Inc.
71     (c)  One member appointed by the Florida Psychiatric
72Society.
73     (d)  One member appointed by the Correctional Medical
74Authority.
75     (e)  One member appointed by the Florida Prosecuting
76Attorneys Association.
77     (f)  One member appointed by the Florida Public Defender
78Association.
79     (g)  One member appointed by the Florida Association of
80Court Clerks.
81     (h)  One member appointed by the Florida Assisted Living
82Affiliation.
83     (i)  One member appointed by the Florida Council for
84Community Mental Health.
85     (j)  One member appointed by the Department of Children and
86Family Services.
87     (k)  One member appointed by the Agency for Health Care
88Administration.
89     (l)  One member appointed by the Department of Corrections.
90     (m)  One member appointed by the Florida Sheriffs
91Association.
92     (n)  One member appointed by the Florida Police Benevolent
93Association.
94     (o)  One member appointed by the Florida chapter of the
95National Alliance for the Mentally Ill.
96     (p)  One member appointed by the director of the Office of
97Program 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
100Representatives.
101     (s)  One member appointed by the Governor.
102     (3)(a)  Members of the workgroup shall serve without
103compensation for such service. Any member of the workgroup who
104is a public employee is entitled to reimbursement for per diem
105and travel expenses as provided in s. 112.061, Florida Statutes.
106     (b)  Expenses of the workgroup, other than member travel
107expenses, shall be paid from funds appropriated to the
108Department of Children and Family Services, the Department of
109Corrections, and the Agency for Health Care Administration.
110     (c)  Each meeting of the workgroup shall be held in
111Tallahassee at the offices of the Department of Children and
112Family Services. The workgroup shall meet four times per year
113and may use electronic means of communication for members unable
114to attend, which may include, but are not limited to, conference
115calls, webinars, and video conferencing.
116     (4)(a)  The workgroup shall organize and conduct its
117meetings in accordance with Robert's Rules of Order.
118     (b)  The workgroup is authorized to request the Louis de la
119Parte Florida Mental Health Institute at the University of South
120Florida under its contract with the Department of Children and
121Family Services to conduct research or analysis of data projects
122identified by the chair and the members.
123     (5)  The review conducted by the workgroup under this
124section shall include:
125     (a)  The identification of all state funds being expended
126on the care of adults with mental illnesses who have legal
127involvement with state and county courts, including funds
128expended on care in any correctional facility and funds expended
129on medication, courts, attorneys, state institutions, contracts
130with private institutions, community-based programs, Medicaid
131services, state-funded substance abuse services, state-funded
132mental health services, and managed care plans.
133     (b)  A detailed examination of community-based service
134delivery systems, including utilization issues, housing issues,
135psychiatric emergency crisis response outcomes, effective
136practices, and programs targeting individuals at risk for court
137or legal involvement.
138     (c)  A detailed review of data, utilization, and cost
139analysis for individuals involved with the county courts, state
140courts, state prisons, and state and private institutions who
141have been charged with misdemeanors or felonies and who have a
142diagnosis of serious and persistent mental illness.
143     (d)  A detailed review of utilization data and costs for
144individuals with traumatic brain injuries who have involvement
145with state courts, state prisons, county courts, or county jails
146and who have involvement with state-funded substance abuse and
147mental health services.
148     (e)  A review of the role and costs of early discharge and
149inappropriate placement on the use of state prisons and county
150jails from public crisis stabilization units, community
151inpatient psychiatric hospitals, and state and private
152institutions that care for persons with serious and persistent
153mental illness.
154     (f)  A review of the criminal code, including penalties and
155sentencing guidelines, and other laws pertaining to the forensic
156mentally ill to assess where changes could be made to protect
157public safety while ensuring that the needs of the mentally ill
158are met in a cost-effective manner, with a goal to create a plan
159that will reduce reliance on state prisons and county jails.
160     (g)  The identification of programs, practices, and
161innovative solutions emerging in the state that would reduce the
162need for incarceration, improve cost-effectiveness, and help
163reduce the impact on the state budget and improve public safety.
164     (h)  A process for requesting and reviewing innovative
165proposals that would help the state optimize the use of state
166funding by examining the use of special pilot projects, mental
167health courts, changes in emergency psychiatric care, new
168approaches to law enforcement practices and court diversion
169programs, and the use of modified sentencing or waivers relative
170to the criminal code.
171     (i)  The development, in conjunction with the Agency for
172Health Care Administration, of a proposal for legislative
173consideration that would establish an innovative Medicaid waiver
174that would help support stable housing and services for those
175individuals defined as at risk of court-related involvement. For
176the purposes of this subsection, the term "at risk of court-
177related involvement" means a person who has been charged with a
178misdemeanor or felony and diagnosed with a serious and
179persistent mental illness.
180     (j)  A review of the impact of substance abuse on the
181system and methods to create integration and the use of Medicaid
182waivers like the Medicaid 1915c Home and Community-Based Waiver
183to provide a more integrated approach to treating substance
184abuse in the community.
185     (k)  The use of the involuntary outpatient commitment
186requirements under the Baker Act and the need for changes to
187those requirements that would help reduce or mitigate the
188potential for court involvement in this process. This review
189shall include the use of the Florida Medication Algorithm
190Project and its implications for improved outcomes relative to
191individuals at risk of court-related involvement.
192     (l)  A review of the current status of the use of
193electronic medical records, the need for broader use of
194electronic medical records for individuals at risk of court
195involvement, and the fiscal impact in terms of the savings this
196type of client information system would have on reducing state
197expenditures and improving access to care for those considered
198most at risk. The workgroup may request experts in the field to
199make presentation and respond to questions. The workgroup shall
200make recommendations in response as provided in subsection (7).
201     (m)  A review and comparison of the practices and standards
202used in correctional facilities in providing mental health care
203for individuals who are incarcerated in county jails, state
204prisons, or state or private state mental health forensic
205institutions.
206     (n)  The consideration of plans and recommendations
207concerning appropriate methods of diverting mentally ill inmates
208to less restrictive and less expensive alternatives using
209conditional release or probation.
210     (o)  A review of probation and parole requirements for
211recommended modifications to assist with improving community
212placement and community control for persons with serious and
213persistent mental illnesses who are eligible for probation. This
214shall include a review of rules and policies and
215recommendations.
216     (p)  A review of practices associated with the discharge of
217individuals with a serious mental illness from the Department of
218Corrections and from state-operated and state-funded forensic
219mental health institutions for compliance with interagency
220agreements regarding placement in the community, recidivism to a
221jail or institutional setting, and utilization of hospital
222emergency rooms, involuntary commitment services, and crisis
223stabilization units.
224     (6)  The Department of Children and Family Services, the
225Department of Corrections, and the Agency for Health Care
226Administration may use outside research organizations,
227including, but not limited to, the Office of Program Policy
228Analysis and Government Accountability, to help collect
229information for the workgroup to use in assessing the factors
230contributing to the rise in the numbers of adults with serious
231mental illness in the criminal justice system.
232     (7)  The workgroup shall make recommendations in its
233interim and final reports regarding proposed changes to the
234state penal code, sentencing guidelines, state mental health
235policy, and related strategies that would improve public safety
236through better integration of behavioral health care at all
237levels of the criminal justice system, with a goal of reducing
238reliance on county jails and state prisons. The workgroup shall
239submit an interim report with findings and recommendations to
240the President of the Senate, the Speaker of the House of
241Representatives, and the Governor no later than January 5, 2010,
242and its final report with recommendations and findings by
243January 5, 2011.
244     (8)  The workgroup terminates and this section expires July
2451, 2011.
246     Section 3.  This act shall take effect July 1, 2009.


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