CS/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 under the American Recovery
67and Reinvestment Act of 2009.
68     (2)  The workgroup shall consist of the following members:
69     (a)  One member from the Substance Abuse and Mental Health
70Corporation.
71     (b)  One member appointed by Florida Legal Services, Inc.
72     (c)  One member appointed by the Florida Psychiatric
73Society.
74     (d)  One member appointed by the Correctional Medical
75Authority.
76     (e)  One member appointed by the Florida Prosecuting
77Attorneys Association.
78     (f)  One member appointed by the Florida Public Defender
79Association.
80     (g)  One member appointed by the Florida Association of
81Court Clerks.
82     (h)  One member appointed by the Florida Assisted Living
83Affiliation.
84     (i)  One member appointed by the Florida Council for
85Community Mental Health.
86     (j)  One member appointed by the Department of Children and
87Family Services.
88     (k)  One member appointed by the Agency for Health Care
89Administration.
90     (l)  One member appointed by the Department of Corrections.
91     (m)  One member appointed by the Florida Sheriffs
92Association.
93     (n)  One member appointed by the Florida Police Benevolent
94Association.
95     (o)  One member appointed by the Florida chapter of the
96National Alliance for the Mentally Ill.
97     (p)  One member appointed by the Florida Hospital
98Association representing private receiving facilities.
99     (q)  One member appointed by the President of the Senate.
100     (r)  One member appointed by the Speaker of the House of
101Representatives.
102     (s)  One member appointed by the Governor.
103     (3)(a)  Members of the workgroup shall serve without
104compensation for such service. Any member of the workgroup who
105is a public employee is entitled to reimbursement for per diem
106and travel expenses as provided in s. 112.061, Florida Statutes.
107     (b)  Expenses of the workgroup, other than member travel
108expenses, shall be paid from funds appropriated to the
109Department of Children and Family Services, the Department of
110Corrections, and the Agency for Health Care Administration.
111     (c)  Each meeting of the workgroup shall be held in
112Tallahassee at the offices of the Department of Children and
113Family Services. The workgroup shall meet four times per year
114and may use electronic means of communication for members unable
115to attend, which may include, but are not limited to, conference
116calls, webinars, and video conferencing.
117     (4)(a)  The workgroup shall organize and conduct its
118meetings in accordance with Robert's Rules of Order.
119     (b)  The workgroup is authorized to request the Louis de la
120Parte Florida Mental Health Institute at the University of South
121Florida to conduct research or analysis of data projects
122identified by the chair and the members, within existing
123contractual agreements with the Department of Children and
124Family Services.
125     (5)  The review conducted by the workgroup under this
126section shall include:
127     (a)  The identification of all state funds being expended
128on the care of adults with mental illnesses who have legal
129involvement with state and county courts, including funds
130expended on care in any correctional facility and funds expended
131on medication, courts, attorneys, state institutions, contracts
132with private institutions, community-based programs, Medicaid
133services, state-funded substance abuse services, state-funded
134mental health services, and managed care plans.
135     (b)  A detailed examination of community-based service
136delivery systems, including utilization issues, housing issues,
137psychiatric emergency crisis response outcomes, effective
138practices, and programs targeting individuals at risk for court
139or legal involvement.
140     (c)  A detailed review of data, utilization, and cost
141analysis for individuals involved with the county courts, state
142courts, state prisons, and state and private institutions who
143have been charged with misdemeanors or felonies and who have a
144diagnosis of serious and persistent mental illness.
145     (d)  A detailed review of utilization data and costs for
146individuals with traumatic brain injuries who have involvement
147with state courts, state prisons, county courts, or county jails
148and who have involvement with state-funded substance abuse and
149mental health services.
150     (e)  A review of the role and costs of early discharge and
151inappropriate placement on the use of state prisons and county
152jails from public crisis stabilization units, community
153inpatient psychiatric hospitals, and state and private
154institutions that care for persons with serious and persistent
155mental illness.
156     (f)  A review of the criminal code, including penalties and
157sentencing guidelines, and other laws pertaining to the forensic
158mentally ill to assess where changes could be made to protect
159public safety while ensuring that the needs of the mentally ill
160are met in a cost-effective manner, with a goal to create a plan
161that will reduce reliance on state prisons and county jails.
162     (g)  The identification of programs, practices, and
163innovative solutions emerging in the state that would reduce the
164need for incarceration, improve cost-effectiveness, and help
165reduce the impact on the state budget and improve public safety.
166     (h)  A process for requesting and reviewing innovative
167proposals that would help the state optimize the use of state
168funding by examining the use of special pilot projects, mental
169health courts, changes in emergency psychiatric care, new
170approaches to law enforcement practices and court diversion
171programs, and the use of modified sentencing or waivers relative
172to the criminal code.
173     (i)  The development, in conjunction with the Agency for
174Health Care Administration, of a proposal for legislative
175consideration that would establish an innovative Medicaid waiver
176that would help support stable housing and services for those
177individuals defined as at risk of court-related involvement. For
178the purposes of this subsection, the term "at risk of court-
179related involvement" means a person who has been charged with a
180misdemeanor or felony and diagnosed with a serious and
181persistent mental illness.
182     (j)  A review of the impact of substance abuse on the
183system and methods to create integration and the use of Medicaid
184waivers like the Medicaid 1915c Home and Community-Based Waiver
185to provide a more integrated approach to treating substance
186abuse in the community.
187     (k)  The use of the involuntary outpatient commitment
188requirements under the Baker Act and the need for changes to
189those requirements that would help reduce or mitigate the
190potential for court involvement in this process. This review
191shall include the use of the Florida Medication Algorithm
192Project and its implications for improved outcomes relative to
193individuals at risk of court-related involvement.
194     (l)  A review of the current status of the use of
195electronic medical records, the need for broader use of
196electronic medical records for individuals at risk of court
197involvement, and the fiscal impact in terms of the savings this
198type of client information system would have on reducing state
199expenditures and improving access to care for those considered
200most at risk. The workgroup may request experts in the field to
201make presentation and respond to questions. The workgroup shall
202make recommendations in response as provided in subsection (7).
203     (m)  A review and comparison of the practices and standards
204used in correctional facilities in providing mental health care
205for individuals who are incarcerated in county jails, state
206prisons, or state or private state mental health forensic
207institutions.
208     (n)  The consideration of plans and recommendations
209concerning appropriate methods of diverting mentally ill inmates
210to less restrictive and less expensive alternatives using
211conditional release or probation.
212     (o)  A review of probation and parole requirements for
213recommended modifications to assist with improving community
214placement and community control for persons with serious and
215persistent mental illnesses who are eligible for probation. This
216shall include a review of rules and policies and
217recommendations.
218     (p)  A review of practices associated with the discharge of
219individuals with a serious mental illness from the Department of
220Corrections and from state-operated and state-funded forensic
221mental health institutions for compliance with interagency
222agreements regarding placement in the community, recidivism to a
223jail or institutional setting, and utilization of hospital
224emergency rooms, involuntary commitment services, and crisis
225stabilization units.
226     (6)  The Department of Children and Family Services, the
227Department of Corrections, and the Agency for Health Care
228Administration may use outside research organizations,
229including, but not limited to, the Office of Program Policy
230Analysis and Government Accountability, to help collect
231information for the workgroup to use in assessing the factors
232contributing to the rise in the numbers of adults with serious
233mental illness in the criminal justice system.
234     (7)  The workgroup shall make recommendations in its
235interim and final reports regarding proposed changes to the
236state penal code, sentencing guidelines, state mental health
237policy, and related strategies that would improve public safety
238through better integration of behavioral health care at all
239levels of the criminal justice system, with a goal of reducing
240reliance on county jails and state prisons. The workgroup shall
241submit an interim report with findings and recommendations to
242the President of the Senate, the Speaker of the House of
243Representatives, and the Governor no later than January 5, 2010,
244and its final report with recommendations and findings by
245January 5, 2011.
246     (8)  The workgroup terminates and this section expires July
2471, 2011.
248     Section 3.  This act shall take effect July 1, 2009.


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