Florida Senate - 2011 SB 1784 By Senator Storms 10-00259-11 20111784__ 1 A bill to be entitled 2 An act relating to forensic mental health; amending s. 3 394.457, F.S.; providing additional responsibilities 4 for certain contractors of the Department of Children 5 and Family Services; requiring that the department 6 make certain training available to correctional 7 personnel; amending s. 394.4655, F.S.; providing for 8 involuntary outpatient treatment plans that require 9 patients to take all prescribed medications in certain 10 circumstances; amending s. 394.78, F.S.; providing for 11 set-asides for service providers that have supportive 12 employment programs; amending s. 948.001, F.S.; 13 defining the term “department” for purposes of ch. 14 948, F.S.; creating s. 948.0395, F.S.; providing for 15 the creation of a forensic mental health probation and 16 parole program; providing program requirements; 17 providing for designation of certain correctional 18 probation officers as forensic probation officers; 19 requiring establishment of requirements for such 20 officers; providing duties for such officers; 21 authorizing the Department of Corrections to establish 22 an advisory workgroup to assist with the program; 23 requiring that the department adopt rules; authorizing 24 the chief judge of each circuit to establish a mental 25 health court; providing requirements for such courts; 26 authorizing specified activities by such courts; 27 requiring each court to have a coordinator for certain 28 aspects of the court’s operations; requiring that such 29 courts be funded from existing revenues or from a 30 specified grant program; requiring that the Department 31 of Children and Family Services adopt rules relating 32 to supportive housing; requiring that the Office of 33 Program Policy Analysis and Government Accountability 34 perform a study of the forensic mental health system; 35 requiring that the study examine the causes impacting 36 the incarceration of the mentally ill in state and 37 local correctional facilities; requiring that a report 38 of such study be submitted to the Legislature by a 39 specified date; providing an effective date. 40 41 Be It Enacted by the Legislature of the State of Florida: 42 43 Section 1. Paragraphs (c) and (d) are added to subsection 44 (2) of section 394.457, Florida Statutes, and subsection (8) is 45 added to that section, to read: 46 394.457 Operation and administration.— 47 (2) RESPONSIBILITIES OF THE DEPARTMENT.—The department is 48 responsible for: 49 (c) Ensuring that each state contract mental health agency 50 that works with individuals who are under forensic mental health 51 probation and parole: 52 1. Ensures that each person enrolled in the probation and 53 parole program has a forensic case manager who is working 54 towards reducing the need for institutional placement. 55 2. Coordinates between the forensic probation and parole 56 program, mental health court, and other agencies needed to help 57 improve access to care. 58 (d) In cooperation with each circuit administrator, 59 supervising all forensic mental health programs and contracts, 60 which shall be carried out by the department’s central office 61 staff. 62 (8) TRAINING FOR CORRECTIONAL PERSONNEL.—The department may 63 make available training on the special needs of adult forensic 64 mental health inmates incarcerated in state correctional 65 facilities operated by the Department of Corrections or a 66 private vendor to the staffs of these institutions. 67 Section 2. Paragraph (a) of subsection (2) of section 68 394.4655, Florida Statutes, is amended to read: 69 394.4655 Involuntary outpatient placement.— 70 (2) INVOLUNTARY OUTPATIENT PLACEMENT.— 71 (a)1. A patient who is being recommended for involuntary 72 outpatient placement by the administrator of the receiving 73 facility where the patient has been examined may be retained by 74 the facility after adherence to the notice procedures provided 75 in s. 394.4599. The recommendation must be supported by the 76 opinion of a psychiatrist and the second opinion of a clinical 77 psychologist or another psychiatrist, both of whom have 78 personally examined the patient within the preceding 72 hours, 79 that the criteria for involuntary outpatient placement are met. 80 However, in a county having a population of fewer than 50,000, 81 if the administrator certifies that a psychiatrist or clinical 82 psychologist is not available to provide the second opinion, the 83 second opinion may be provided by a licensed physician who has 84 postgraduate training and experience in diagnosis and treatment 85 of mental and nervous disorders or by a psychiatric nurse. Any 86 second opinion authorized in this subparagraph may be conducted 87 through a face-to-face examination, in person or by electronic 88 means. Such recommendation must be entered on an involuntary 89 outpatient placement certificate that authorizes the receiving 90 facility to retain the patient pending completion of a hearing. 91 The certificate shall be made a part of the patient’s clinical 92 record. 93 2. If the patient has been stabilized and no longer meets 94 the criteria for involuntary examination pursuant to s. 95 394.463(1), the patient must be released from the receiving 96 facility while awaiting the hearing for involuntary outpatient 97 placement. Before filing a petition for involuntary outpatient 98 treatment, the administrator of a receiving facility or a 99 designated department representative must identify the service 100 provider that will have primary responsibility for service 101 provision under an order for involuntary outpatient placement, 102 unless the person is otherwise participating in outpatient 103 psychiatric treatment and is not in need of public financing for 104 that treatment, in which case the individual, if eligible, may 105 be ordered to involuntary treatment pursuant to the existing 106 psychiatric treatment relationship. 107 3. The service provider shall prepare a written proposed 108 treatment plan in consultation with the patient or the patient’s 109 guardian advocate, if appointed, for the court’s consideration 110 for inclusion in the involuntary outpatient placement order. The 111 service provider shall also provide a copy of the proposed 112 treatment plan to the patient and the administrator of the 113 receiving facility. The treatment plan must specify the nature 114 and extent of the patient’s mental illness, address the 115 reduction of symptoms that necessitate involuntary outpatient 116 placement, and include measurable goals and objectives for the 117 services and treatment that are provided to treat the person’s 118 mental illness and assist the person in living and functioning 119 in the community or to prevent a relapse or deterioration. 120 Service providers may select and supervise other individuals to 121 implement specific aspects of the treatment plan. The services 122 in the treatment plan must be deemed clinically appropriate by a 123 physician, clinical psychologist, psychiatric nurse, mental 124 health counselor, marriage and family therapist, or clinical 125 social worker who consults with, or is employed or contracted 126 by, the service provider. The service provider must certify to 127 the court in the proposed treatment plan whether sufficient 128 services for improvement and stabilization are currently 129 available and whether the service provider agrees to provide 130 those services. If the service provider certifies that the 131 services in the proposed treatment plan are not available, the 132 petitioner may not file the petition. 133 4. If the patient is to be supervised by a forensic mental 134 health case manager, the plan may require the patient to take 135 all prescribed medications. 136 Section 3. Subsection (7) is added to section 394.78, 137 Florida Statutes, to read: 138 394.78 Operation and administration; personnel standards; 139 procedures for audit and monitoring of service providers; 140 resolution of disputes.— 141 (7) The department, subject to current resources, shall 142 examine opportunities to generate cost savings through the use 143 of set-aside agreements with supportive employment programs that 144 serve forensic mental health clients living in the community 145 under plans of conditional release. 146 Section 4. Subsections (6) through (13) of section 948.001, 147 Florida Statutes, are renumbered as subsections (7) through 148 (14), respectively, and a new subsection (5) is added to that 149 section to read: 150 948.001 Definitions.—As used in this chapter, the term: 151 (5) “Department” means the Department of Corrections. 152 Section 5. Section 948.0395, Florida Statutes, is created 153 to read: 154 948.0395 Forensic probation and parole program.— 155 (1) The department shall create a forensic mental health 156 probation and parole program that is responsible for the reentry 157 of mentally ill inmates back into the community. 158 (2) The forensic probation and parole program shall focus 159 on compliance with care, supervision of conditional plans of 160 release, tracking information, and reducing inappropriate 161 placements and jail utilization. The department shall make sex 162 offenders a high priority for supervision and for placement in 163 safe housing that is not located near children. 164 (3) This program shall be established within the current 165 department funding and the secretary may reorganize the 166 probation and parole staff and programs to assist with the 167 development of the forensic mental health program. The 168 department may have a probation officer serve in a dual role as 169 a trained forensic mental health probation officer as well as an 170 officer for persons subject to general probation and parole. 171 (4)(a) The department may designate correctional probation 172 officers as forensic probation officers. 173 (b) The department shall establish requirements for such 174 forensic mental health probation officers. 175 (c) Forensic mental health probation officers shall 176 coordinate issues and compliance with the Department of Children 177 and Family Services’ forensic case manager and establish plans 178 having the goal of improving plan compliance and reducing the 179 need for incarcerations due to violations. 180 (d) Forensic mental health probation officers shall work 181 with all relevant agencies to further the goals of the forensic 182 mental health program. 183 (5) The department may establish an advisory workgroup to 184 assist the department in gathering input, providing professional 185 expertise, and developing appropriate policies and procedures to 186 ensure implementation of this section. 187 (6) The department shall adopt rules pursuant to ss. 188 120.536(1) and 120.54 to implement the provisions of this 189 section conferring duties upon it. 190 Section 6. (1) The chief judge of each circuit may 191 establish a mental health court to help reduce the cost of 192 managing cases that pertain to persons with mental illnesses who 193 have court involvement. The chief judge shall supervise the 194 mental health court. 195 (2) Each mental health court shall: 196 (a) Have an advisory workgroup for the purpose of providing 197 input, which shall serve as a coordinating workgroup to help 198 improve access to community-based services and improve access to 199 care for persons involved with the criminal justice system. 200 (b) Establish eligibility criteria. A person charged with a 201 felony who, upon evaluation, is considered to be a minimal 202 threat to public safety may be considered for mental health 203 court involvement. 204 (c) Focus on improving compliance with mental health care 205 and treatment and may require state agencies to comply with its 206 orders and directives. 207 (d) Supervise the processing of felonies and misdemeanors 208 and determine which cases shall be referred for criminal 209 prosecution and incarceration and which are eligible for 210 diversion programs and alternatives. 211 (e) Be the ongoing contact with the criminal justice system 212 for persons found incompetent to proceed under s. 916.145, 213 Florida Statutes. 214 (f) Process all evaluations for each person charged with a 215 felony and require evaluations for competency to proceed or a 216 determination of not guilty by reason of insanity. 217 (3) A mental health court may: 218 (a) Establish drug repository programs and accept unused 219 medications from nursing homes and licensed assisted living 220 facilities to be repackaged and used for mental health court 221 participants who need medications. 222 (b) Provide a waiver of charges and allow the court 223 flexibility in dispositions. 224 (c) Authorize the use of medication algorithms for mental 225 health court participants. 226 (d) Require individuals who are enrolled in Medicaid, 227 prepaid mental health plans, or Medicaid health maintenance 228 organizations to obtain maximum available reimbursement for all 229 medically necessary services. 230 (4)(a) Each mental health court shall have a coordinator to 231 run the day-to-day elements of the program. 232 (b) The coordinator shall supervise the forensic mental 233 health case managers and receive reports from the case managers. 234 (c) The coordinator shall evaluate a participant’s threat 235 to public safety and make recommendations to the court regarding 236 compliance or appropriateness for court involvement. 237 (5) A mental health court may supervise compliance with the 238 assisted outpatient treatment laws as such laws relate to court 239 requirements that outpatients take their medications. 240 (6) Mental health courts shall be funded from within 241 existing resources or from grants under s. 394.658, Florida 242 Statutes. 243 Section 7. The Department of Children and Family Services 244 shall adopt rules relating to supportive housing. In 245 establishing these rules, the department shall define the term 246 “supportive housing” and shall address consumer health and 247 safety and the use of state subsidies. 248 Section 8. The Office of Program Policy Analysis and 249 Government Accountability shall perform a study of the forensic 250 mental health system. The study shall examine the causes that 251 impact the incarceration of the mentally ill in state and local 252 correctional facilities. The report shall be submitted to the 253 President of the Senate and the Speaker of the House of 254 Representatives by December 31, 2011. 255 Section 9. This act shall take effect July 1, 2011.