HB 7085

1
A bill to be entitled
2An act relating to mental health and substance abuse;
3amending s. 394.4572, F.S.; revising provisions relating
4to employment screening requirements for mental health
5personnel; revising the definition of the term "mental
6health personnel"; removing an exemption from screening
7requirements for certain mental health personnel; creating
8s. 394.4996, F.S.; authorizing the Agency for Health Care
9Administration, in consultation with the Department of
10Children and Family Services, to establish a licensure
11category for facilities providing integrated adult mental
12health crisis stabilization unit and addictions receiving
13facility services; authorizing such facilities to provide
14integrated mental health and substance abuse services to
15adults who meet certain criteria; providing for standards,
16procedures, and requirements for services; providing
17rulemaking authority; amending s. 394.655, F.S.; revising
18purpose of the Criminal Justice, Mental Health, and
19Substance Abuse Policy Council; amending s. 394.656, F.S.;
20requiring the department and the agency to develop local
21treatment and service delivery infrastructures in
22coordination with counties receiving grants under the
23Criminal Justice, Mental Health, and Substance Abuse
24Reinvestment Grant Program; amending s. 394.657, F.S.;
25providing additional duties of certain county planning
26councils and committees; amending s. 394.659, F.S.;
27providing additional duties of the Criminal Justice,
28Mental Health, and Substance Abuse Technical Assistance
29Center; requiring an annual report; amending s. 394.67,
30F.S.; revising the definition of the term "residential
31treatment center for children and adolescents"; providing
32for such centers to be licensed by the agency; amending s.
33394.674, F.S.; revising eligibility requirements for
34substance abuse and mental health services funded by the
35department; providing rulemaking authority; creating s.
36394.9086, F.S.; creating the "Community Mental Health and
37Substance Abuse Treatment and Crime Reduction Act";
38providing goals; providing definitions; creating a
39community mental health and substance abuse treatment
40forensic treatment system; providing criteria for
41eligibility; providing responsibilities of the department;
42establishing demonstration sites; providing rulemaking
43authority; amending s. 409.906, F.S.; authorizing the
44agency to seek federal approval to implement home and
45community-based services; amending s. 553.80, F.S.;
46providing for enforcement of the Florida Building Code
47construction regulations for secure mental health
48treatment facilities by the department; amending s.
49916.111, F.S.; revising provisions governing the training
50of mental health experts; requiring forensic evaluator
51training courses to be offered annually; providing
52requirements for being placed on or removed from the
53department's forensic evaluator registry; amending s.
54916.115, F.S.; revising provisions relating to appointment
55of experts by the court to evaluate the mental condition
56of a criminal defendant; requiring experts to complete
57forensic evaluator training within a specified period of
58time to remain on the department's registry; providing
59conditions under which certain persons may assist in
60forensic evaluations; amending s. 916.13, F.S.; creating
61an exception to involuntary commitment for defendants
62adjudicated incompetent in the custody of the Department
63of Corrections; providing duties of the department
64relating to treatment for defendants adjudicated
65incompetent to proceed due to mental illness; revising
66duties of the department and the court; specifying
67timeframes for the filing of reports, the commitment and
68placement of defendants, and the holding of hearings;
69amending s. 916.15, F.S.; creating an exception for the
70involuntary commitment of defendants adjudicated not
71guilty by reason of insanity in the custody of the
72Department of Corrections; revising duties of the
73department and the court; specifying timeframes for the
74filing of reports, the commitment and placement of
75defendants, and the holding of hearings; amending s.
76916.17, F.S.; providing conditions for placement of a
77defendant in a community residential facility in a
78demonstration area established under the act under certain
79circumstances; providing criteria for such placement;
80providing an effective date.
81
82Be It Enacted by the Legislature of the State of Florida:
83
84     Section 1.  Paragraph (d) of subsection (1) of section
85394.4572, Florida Statutes, is redesignated as paragraph (c),
86and present paragraphs (a) and (c) of that subsection are
87amended to read:
88     394.4572  Screening of mental health personnel.--
89     (1)(a)  The department and the Agency for Health Care
90Administration shall require employment screening for mental
91health personnel using the standards for level 2 screening set
92forth in chapter 435. "Mental health personnel" includes all
93program directors, professional clinicians, staff members, and
94volunteers working in public or private mental health programs
95and facilities who have direct contact with unmarried patients
96under the age of 18 years. For purposes of this chapter,
97employment screening of mental health personnel shall also
98include, but is not limited to, employment screening as provided
99under chapter 435.
100     (c)  Mental health personnel working in a facility licensed
101under chapter 395 who have less than 15 hours per week of direct
102contact with patients or who are health care professionals
103licensed by the Agency for Health Care Administration or a board
104thereunder are exempt from the fingerprinting and screening
105requirements, except for persons working in mental health
106facilities where the primary purpose of the facility is the
107treatment of minors.
108     Section 2.  Section 394.4996, Florida Statutes, is created
109to read:
110     394.4996  Integrated adult mental health crisis
111stabilization unit and addictions receiving facility services.--
112     (1)  Beginning July 1, 2008, the Agency for Health Care
113Administration, in consultation with the Department of Children
114and Family Services, is authorized to license facilities that
115integrate services provided in an adult mental health crisis
116stabilization unit with services provided in an adult addictions
117receiving facility. The services provided shall be designated as
118"integrated adult mental health crisis stabilization unit and
119addictions receiving facility services," and the facility
120providing those services shall be licensed as an adult crisis
121stabilization unit by the agency and shall meet all licensure
122requirements for crisis stabilization units that provide these
123integrated services.
124     (2)  An integrated adult mental health crisis stabilization
125unit and addictions receiving facility may provide services
126under this section to adults 18 years of age or older who:
127     (a)  Meet the requirements for voluntary admission for
128mental health treatment under s. 394.4625;
129     (b)  Meet the criteria for involuntary examination for
130mental illness under s. 394.463;
131     (c)  Qualify for voluntary admission for substance abuse
132treatment under s. 397.601; or
133     (d)  Meet the criteria for involuntary admission for
134substance abuse impairment under s. 397.675.
135     (3)  The department, in consultation with the agency, shall
136adopt by rule standards that address eligibility criteria;
137clinical procedures; staffing requirements; operational,
138administrative, and financing requirements; and the
139investigation of complaints. Standards that are implemented
140specific to substance abuse treatment services shall meet or
141exceed existing standards, in accordance with rule 65D-30.005,
142Florida Administrative Code, for addictions receiving
143facilities.
144     Section 3.  Paragraph (b) of subsection (11) of section
145394.655, Florida Statutes, is amended to read:
146     394.655  The Substance Abuse and Mental Health Corporation;
147powers and duties; composition; evaluation and reporting
148requirements.--
149     (11)
150     (b)  The purpose of the council shall be to:
151     1.  Align policy initiatives in the criminal justice,
152juvenile justice, and mental health systems to ensure the most
153effective use of resources and to coordinate the development of
154legislative proposals and budget requests relating to the shared
155needs of adults and juveniles who have a mental illness,
156substance abuse disorder, or co-occurring mental health and
157substance abuse disorders who are in, or at risk of entering,
158the criminal justice system.
159     2.  Provide consultation in the development of
160comprehensive and cost-effective community-based mental health
161and substance abuse treatment services for individuals with
162mental illnesses receiving services in forensic facilities,
163prisons, jails, and juvenile justice centers. The council shall
164appoint an advisory committee to review and monitor the
165implementation of the Community Mental Health and Substance
166Abuse Treatment and Crime Reduction Act. The advisory committee
167shall include at least one person who has received services and
168one family member of a person receiving services under the act.
169     Section 4.  Subsection (1) of section 394.656, Florida
170Statutes, is amended to read:
171     394.656  Criminal Justice, Mental Health, and Substance
172Abuse Reinvestment Grant Program.--
173     (1)  There is created within the Department of Children and
174Family Services the Criminal Justice, Mental Health, and
175Substance Abuse Reinvestment Grant Program. The purpose of the
176program is to provide funding to counties with which they can
177plan, implement, or expand initiatives that increase public
178safety, avert increased spending on criminal justice, and
179improve the accessibility and effectiveness of treatment
180services for adults and juveniles who have a mental illness,
181substance abuse disorder, or co-occurring mental health and
182substance abuse disorders and who are in, or at risk of
183entering, the criminal or juvenile justice systems. In
184implementing the Community Mental Health and Substance Abuse
185Treatment and Crime Reduction Act, the department and the agency
186shall work in coordination with counties that received grants
187under the Criminal Justice, Mental Health, and Substance Abuse
188Reinvestment Grant Program pursuant to this section to develop
189local treatment and service delivery infrastructures.
190     Section 5.  Subsection (1) of section 394.657, Florida
191Statutes, is amended to read:
192     394.657  County planning councils or committees.--
193     (1)  Each board of county commissioners shall designate the
194county public safety coordinating council established under s.
195951.26, or designate another criminal or juvenile justice mental
196health and substance abuse council or committee, as the planning
197council or committee. The public safety coordinating council or
198other designated criminal or juvenile justice mental health and
199substance abuse council or committee shall:
200     (a)  Coordinate, in coordination with the county offices of
201planning and budget and, shall make a formal recommendation to
202the board of county commissioners regarding how the Criminal
203Justice, Mental Health, and Substance Abuse Reinvestment Grant
204Program may best be implemented within a community. The board of
205county commissioners may assign any entity to prepare the
206application on behalf of the county administration for
207submission to the corporation for review. A county may join with
208one or more counties to form a consortium and use a regional
209public safety coordinating council or another county-designated
210regional criminal or juvenile justice mental health and
211substance abuse planning council or committee for the geographic
212area represented by the member counties.
213     (b)  Provide consultation regarding the planning and
214implementation of the Community Mental Health and Substance
215Abuse Treatment and Crime Reduction Act by the local governing
216bodies.
217     Section 6.  Paragraphs (g), (h), (i), and (j) are added to
218subsection (1) of section 394.659, Florida Statutes, to read:
219     394.659  Criminal Justice, Mental Health, and Substance
220Abuse Technical Assistance Center.--
221     (1)  There is created a Criminal Justice, Mental Health,
222and Substance Abuse Technical Assistance Center at the Louis de
223la Parte Florida Mental Health Institute at the University of
224South Florida, which shall:
225     (g)  In coordination with the department, develop minimum
226competencies and proficiencies required for communities and
227service providers.
228     (h)  Identify evidence-based practices and deliver
229necessary training and consultation to service providers.
230     (i)  Assist the department with the development of outcome
231measures.
232     (j)  Provide an annual report to the Governor, the
233President of the Senate, the Speaker of the House of
234Representatives, the Chief Justice of the Florida Supreme Court,
235and the State Courts Administrator on the status of the
236implementation of the Community Mental Health and Substance
237Abuse Treatment and Crime Reduction Act. For those areas that
238also have a grant under s. 394.656, the institute shall prepare
239a joint report to avoid duplication.
240     Section 7.  Subsection (21) of section 394.67, Florida
241Statutes, is amended to read:
242     394.67  Definitions.--As used in this part, the term:
243     (21)  "Residential treatment center for children and
244adolescents" means a 24-hour residential program, including a
245therapeutic group home, which provides mental health services to
246emotionally disturbed children or adolescents as defined in s.
247394.492(5) or (6) and which is a private for-profit or not-for-
248profit corporation licensed by the agency under contract with
249the department which offers a variety of treatment modalities in
250a more restrictive setting.
251     Section 8.  Subsections (1) and (4) of section 394.674,
252Florida Statutes, are amended to read:
253     394.674  Client Clinical eligibility for publicly funded
254substance abuse and mental health services; fee collection
255requirements.--
256     (1)  To be eligible to receive substance abuse and mental
257health services funded by the department, a person must be a
258member of one of the department's priority populations target
259groups approved by the Legislature, pursuant to s. 216.0166. The
260priority populations include:
261     (a)  For adult mental health services:
262     1.  Adults who have severe and persistent mental illness,
263as designated by the department using criteria that include
264severity of diagnosis, duration of the mental illness, ability
265to independently perform activities of daily living, and receipt
266of disability income for a psychiatric condition. Within this
267group priority populations include:
268     a.  Older adults in crisis.
269     b.  Older adults who are at risk of being placed in a more
270restrictive environment because of their mental illness.
271     c.  Persons deemed incompetent to proceed or not guilty by
272reason of insanity under chapter 916.
273     d.  Other persons involved in the criminal justice system.
274     e.  Persons dually diagnosed as having co-occurring mental
275health and substance abuse disorders.
276     2.  Adults experiencing an acute mental or emotional crisis
277as defined in s. 394.67(17).
278     (b)  For children's mental health services:
279     1.  Children who have a serious emotional disturbance.
280     2.  Children who have an emotional disturbance.
281     3.  Children who are at risk of emotional disturbance.
282     (c)  For substance abuse services:
283     1.  Adults who have substance abuse disorders and have a
284history of intravenous drug use.
285     2.  Persons dually diagnosed as having co-occurring mental
286health and substance abuse disorders.
287     3.  Parents who put children at risk due to a substance
288abuse disorder.
289     4.  Persons who have a substance abuse disorder and have
290been ordered by the court to receive treatment.
291     5.  Children at risk for initiating drug use.
292     6.  Children under state supervision.
293     7.  Children who have a substance abuse disorder but are
294not under the supervision of a court or in the custody of a
295state agency.
296     8.  Persons identified as a priority population as a
297condition for receiving services funded through the Substance
298Abuse Prevention and Treatment Block Grant.
299     (4)  The department shall adopt rules to implement client
300the clinical eligibility, client enrollment, and fee collection
301requirements for publicly funded substance abuse and mental
302health services. The rules must require that each provider under
303contract with the department that enrolls eligible persons into
304treatment to develop a sliding fee scale for persons who have a
305net family income at or above 150 percent of the Federal Poverty
306Income Guidelines, unless otherwise required by state or federal
307law. The sliding fee scale must use the uniform schedule of
308discounts by which a provider under contract with the department
309discounts its established client charges for services supported
310with state, federal, or local funds, using, at a minimum,
311factors such as family income, financial assets, and family size
312as declared by the person or the person's guardian. The rules
313must include uniform criteria to be used by all service
314providers in developing the schedule of discounts for the
315sliding fee scale. The rules must address the most expensive
316types of treatment, such as residential and inpatient treatment,
317in order to make it possible for a client to responsibly
318contribute to his or her mental health or substance abuse care
319without jeopardizing the family's financial stability. A person
320who is not eligible for Medicaid and whose net family income is
321less than 150 percent of the Federal Poverty Income Guidelines
322must pay a portion of his or her treatment costs which is
323comparable to the copayment amount required by the Medicaid
324program for Medicaid clients pursuant to s. 409.9081. The rules
325must require that persons who receive financial assistance from
326the Federal Government because of a disability and are in long-
327term residential treatment settings contribute to their board
328and care costs and treatment costs and must be consistent with
329the provisions in s. 409.212.
330     Section 9.  Section 394.9086, Florida Statutes, is created
331to read:
332     394.9086  Community Mental Health and Substance Abuse
333Treatment and Crime Reduction Act.--
334     (1)  SHORT TITLE.--This section may be cited as the
335"Community Mental Health and Substance Abuse Treatment and Crime
336Reduction Act."
337     (2)  LEGISLATIVE FINDINGS AND INTENT.--The Legislature
338finds that many inmates with serious mental illnesses who are
339committed to state forensic mental health treatment facilities
340for competency restoration could be served effectively and at
341less cost in community-based alternative programs. The
342Legislature further finds that many individuals with serious
343mental illnesses who have been discharged from state forensic
344mental health treatment facilities could avoid returning to the
345criminal justice and forensic mental health system if they
346received specialized treatment in the community. It is therefore
347the intent of the Legislature to create the Community Mental
348Health and Substance Abuse Forensic Treatment System to serve
349individuals with mental illnesses or co-occurring mental health
350and substance abuse disorders who are involved in or at risk of
351entering forensic facilities, prisons, jails, juvenile justice
352centers, and civil treatment facilities.
353     (3)  GOALS.--The goals of the community mental health and
354substance abuse forensic treatment system are to:
355     (a)  Ensure that forensic competency restoration services
356are provided in the least restrictive, least costly, and most
357efficient environment.
358     (b)  Provide competency restoration services in the
359community, when appropriate, based on consideration of public
360safety, needs of the individual, and available resources.
361     (c)  Reduce admissions for competency restoration to state
362forensic mental health treatment facilities.
363     (d)  Reduce rates of arrest, incarceration, and recidivism
364for individuals in the program.
365     (e)  Ensure public safety.
366     (f)  Increase outreach and services to individuals at risk
367of criminal justice system, juvenile justice system, and
368forensic mental health system involvement.
369     (g)  Support collaboration among local law enforcement,
370judicial, correctional, governmental, service provider, and
371community stakeholders to implement diversion and problem-
372solving strategies to reduce the demand for forensic mental
373health placements.
374     (4)  DEFINITIONS.--
375     (a)  "Agency" means the Agency for Health Care
376Administration.
377     (b)  "Community residential facility" means a community-
378based residential treatment setting licensed by the agency under
379s. 394.875 or s. 429.075 or licensed by the department under s.
380397.401.
381     (c)  "Department" means the Department of Children and
382Family Services.
383     (d)  "Evidence-based practices" means interventions and
384strategies that, based on the best available empirical research,
385demonstrate effective and efficient outcomes in the care and
386treatment of individuals diagnosed with mental illnesses or co-
387occurring mental health and substance abuse disorders.
388     (e)  "Forensic intensive care management" means activities
389that address the comprehensive psychiatric, social, and support
390needs of individuals diagnosed with serious and persistent
391mental illnesses or severe emotional disturbances who are
392involved in the justice system and receive services under this
393section. Activities include, but are not limited to, service
394planning, service coordination, monitoring, and assistance with
395accessing federal, state, and local benefits necessary to
396sustain an individual in the community.
397     (f)  "Forensic treatment system" means a community mental
398health and substance abuse forensic treatment system that
399includes the comprehensive set of services and supports provided
400to individuals under this section.
401     (g)  "Geographic area" means a county, circuit, regional,
402or multiregional area in the state.
403     (5)  COMMUNITY MENTAL HEALTH AND SUBSTANCE ABUSE FORENSIC
404TREATMENT SYSTEM.--The department, in consultation with the
405agency, shall develop and implement a community mental health
406and substance abuse forensic treatment system. The forensic
407system shall build on the local community diversion and re-entry
408initiatives and strategies that are consistent with those  
409identified and supported under s. 394.658(1)(b).
410     (a)  The forensic system initiatives and strategies may
411include, but are not limited to:
412     1.  Mental health courts;
413     2.  Diversion programs;
414     3.  Alternative prosecution and sentencing techniques;
415     4.  Crisis intervention teams;
416     5.  Treatment accountability services;
417     6.  Specialized training for criminal justice, juvenile
418justice, and treatment services professionals;
419     7.  Specialized probation officers at the state and county
420levels to serve individuals under correctional control in the
421community;
422     8.  Collateral services such as housing, transitional
423housing, and supported employment; and
424     9.  Reentry services to create or expand mental health and
425substance abuse treatment and supports for affected individuals.
426     (b)  The forensic system must include a comprehensive
427continuum of care and services that use evidence-based practices
428to address co-occurring mental health and substance abuse
429disorders. The forensic system must include the following
430minimum elements:
431     1.  Competency restoration and treatment services provided
432in a variety of settings from least restrictive to progressively
433more restrictive settings;
434     2.  Forensic intensive care management;
435     3.  Supported housing;
436     4.  Supported employment;
437     5.  Medication management;
438     6.  Trauma-specific services for treatment of the effects
439of sexual, physical, and emotional abuse or trauma experienced
440by individuals with mental illnesses involved in the criminal
441justice system. These services may include behavioral therapies,
442desensitization therapies, grounding techniques, and other
443services;
444     7.  Residential services to address crisis episodes and
445short-term residential treatment. In addition, alternate models
446for services in crisis stabilization units or short-term
447residential treatment facilities may be used that provide care
448in a less restrictive setting and at lower cost;
449     8.  Treatment for co-occurring mental health and substance
450abuse disorders; and
451     9.  Other services or supports identified by the department
452working with the agency, the Substance Abuse and Mental Health
453Corporation, and local governing bodies.
454     (6)  ELIGIBILITY.--The department may serve individuals who
455meet the criteria in paragraphs (a)-(c). The department shall
456give highest priority for services provided under this section
457to the following in rank order:
458     (a)  Adults who are adjudicated incompetent to proceed or
459not guilty by reason of insanity under chapter 916, who have
460been ordered by the court into forensic commitment, whose
461current most serious charge is a third degree or nonviolent
462second degree felony, and who meet public safety criteria
463established by the court and treatability criteria established
464by the department for placement in a community setting.
465     (b)  Adults who are released or pending release into the
466community by the courts after completing competency restoration
467services at a state forensic mental health treatment facility.
468     (c)  Adults who experience serious and persistent mental
469illnesses who are at risk of entering or who are already
470involved with the criminal justice system as evidenced by their
471frequency of contact with the system.
472     (7)  DEPARTMENT RESPONSIBILITIES.--The department shall
473develop a continuum of services to implement the community
474mental health and substance abuse forensic treatment system in
475accordance with subsection (5). The department shall:
476     (a)  Establish standards for all providers, including, but
477not limited to, community-based providers that administer
478competency restoration services in a community residential
479facility or a less restrictive setting.
480     (b)  Define requirements for all providers in the forensic
481system and set ongoing performance expectations.
482     (c)  Select demonstration sites for participation based on
483the criteria in subsection (8) that demonstrate active and
484sustained participation in and collaboration with the community.
485     (d)  Enter into memorandums of agreement with county
486planning councils or committees identified in s. 394.657 that
487are included in the demonstration sites.
488     (e)  Identify providers to implement the continuum of
489services. The department shall consult with county planning
490councils or committees when selecting providers.
491     (f)  Enter into contracts with appropriate providers.
492     (g)  Establish performance measures and reporting
493requirements for providers participating in the forensic system.
494The measures shall include, at a minimum:
495     1.  Number of individuals diverted from state forensic
496facilities;
497     2.  Number of individuals diverted from the criminal
498justice system;
499     3.  Rates of arrest, incarceration, and recidivism for new
500criminal offenses;
501     4.  Rates of employment;
502     5.  Number of days in jails, prisons, and forensic
503facilities on an annual basis; and
504     6.  Satisfaction of key community stakeholder participants
505and local partners with the initiative, including, at a minimum,
506input from individuals who have received services under this
507section and family members of individuals receiving services
508under this section, county planning councils or committees, and
509participating providers.
510     (h)  Monitor contracts for compliance with terms and, at
511least annually, to the extent possible, perform joint onsite
512monitoring with the agency, the Substance Abuse and Mental
513Health Corporation, and the Criminal Justice, Mental Health, and
514Substance Abuse Technical Assistance Center established under s.
515394.659 to assess performance as evidenced by the quality,
516efficiency, and effectiveness of the care provided.
517     (8)  DEMONSTRATION SITES.--The department in consultation
518with the agency shall identify up to three geographic areas of
519the state for initial implementation of this section.
520     (a)  In at least one area, the department shall establish a
521single point of accountability for the forensic system and, if
522feasible, contract with a managing entity as defined in s.
523394.9082 to provide operational oversight of subcontractors and
524daily operations. When feasible, payment for these services
525shall be based on a prepaid capitation rate.
526     (b)  All areas shall be selected based on a determination
527of community readiness and the potential for impacting the
528greatest number of individuals entering the forensic mental
529health and criminal justice systems. Criteria for selection may
530include:
531     1.  Community readiness to deliver services as outlined in
532subsection (5) and demonstrated by well-established community
533collaboration plans and local partnerships as evidenced by
534memorandums of agreement that are submitted to and approved by
535the department;
536     2.  A high forensic bed utilization rate in the state
537mental health treatment facilities;
538     3.  Successful application for implementation grant funding
539under s. 394.656, the Criminal Justice, Mental Health, and
540Substance Abuse Reinvestment Grant Program; and
541     4.  Other elements determined by the department in
542consultation with the agency.
543     (9)  RULEMAKING AUTHORITY.--The department shall adopt
544rules to implement the Community Mental Health and Substance
545Abuse Treatment and Crime Reduction Act.
546     Section 10.  Subsection (26) is added to section 409.906,
547Florida Statutes, to read:
548     409.906  Optional Medicaid services.--Subject to specific
549appropriations, the agency may make payments for services which
550are optional to the state under Title XIX of the Social Security
551Act and are furnished by Medicaid providers to recipients who
552are determined to be eligible on the dates on which the services
553were provided. Any optional service that is provided shall be
554provided only when medically necessary and in accordance with
555state and federal law. Optional services rendered by providers
556in mobile units to Medicaid recipients may be restricted or
557prohibited by the agency. Nothing in this section shall be
558construed to prevent or limit the agency from adjusting fees,
559reimbursement rates, lengths of stay, number of visits, or
560number of services, or making any other adjustments necessary to
561comply with the availability of moneys and any limitations or
562directions provided for in the General Appropriations Act or
563chapter 216. If necessary to safeguard the state's systems of
564providing services to elderly and disabled persons and subject
565to the notice and review provisions of s. 216.177, the Governor
566may direct the Agency for Health Care Administration to amend
567the Medicaid state plan to delete the optional Medicaid service
568known as "Intermediate Care Facilities for the Developmentally
569Disabled." Optional services may include:
570     (26)  HOME AND COMMUNITY-BASED MENTAL HEALTH SERVICES.--The
571agency is authorized to seek federal approval through a state
572plan amendment to implement home and community-based services
573under the authority of and in compliance with s. 1915(i) of the
574Social Security Act for services for individuals who have been
575determined by an independent evaluation to have disabilities
576that cause them to become, or put them at risk of becoming,
577involved with the criminal justice system due to mental illness.
578In accordance with allowances under the authority of s. 1915(i)
579of the Social Security Act, these services may be limited to a
580select number of eligible individuals, in select geographic
581areas as identified by the agency. An eligible individual may
582have an income of up to 150 percent of the federal poverty
583level. The agency shall coordinate with the department to select
584and define the services to be submitted in the state plan
585amendment and provided under this subsection. The agency must
586receive approval from the Legislature or the Legislative Budget
587Commission before implementing the state plan amendment.
588     Section 11.  Subsection (1) of section 553.80, Florida
589Statutes, is amended to read:
590     553.80  Enforcement.--
591     (1)  Except as provided in paragraphs (a)-(g) (a)-(f), each
592local government and each legally constituted enforcement
593district with statutory authority shall regulate building
594construction and, where authorized in the state agency's
595enabling legislation, each state agency shall enforce the
596Florida Building Code required by this part on all public or
597private buildings, structures, and facilities, unless such
598responsibility has been delegated to another unit of government
599pursuant to s. 553.79(9).
600     (a)  Construction regulations relating to correctional
601facilities under the jurisdiction of the Department of
602Corrections and the Department of Juvenile Justice shall are to
603be enforced exclusively by those departments.
604     (b)  Construction regulations relating to elevator
605equipment under the jurisdiction of the Bureau of Elevators of
606the Department of Business and Professional Regulation shall be
607enforced exclusively by that department.
608     (c)  Construction regulations relating to secure mental
609health treatment facilities under the jurisdiction of the
610Department of Children and Family Services shall be enforced
611exclusively by that department.
612     (d)(c)  In addition to the requirements of s. 553.79 and
613this section, facilities subject to the provisions of chapter
614395 and part II of chapter 400 shall have facility plans
615reviewed and construction surveyed by the state agency
616authorized to do so under the requirements of chapter 395 and
617part II of chapter 400 and the certification requirements of the
618Federal Government.
619     (e)(d)  Building plans approved under s. 553.77(3) and
620state-approved manufactured buildings, including buildings
621manufactured and assembled offsite and not intended for
622habitation, such as lawn storage buildings and storage sheds,
623are exempt from local code enforcing agency plan reviews except
624for provisions of the code relating to erection, assembly, or
625construction at the site. Erection, assembly, and construction
626at the site are subject to local permitting and inspections.
627Lawn storage buildings and storage sheds bearing the insignia of
628approval of the department are not subject to s. 553.842. Such
629buildings that do not exceed 400 square feet may be delivered
630and installed without need of a contractor's or specialty
631license.
632     (f)(e)  Construction regulations governing public schools,
633state universities, and community colleges shall be enforced as
634provided in subsection (6).
635     (g)(f)  The Florida Building Code as it pertains to toll
636collection facilities under the jurisdiction of the turnpike
637enterprise of the Department of Transportation shall be enforced
638exclusively by the turnpike enterprise.
639
640The governing bodies of local governments may provide a schedule
641of fees, as authorized by s. 125.56(2) or s. 166.222 and this
642section, for the enforcement of the provisions of this part.
643Such fees shall be used solely for carrying out the local
644government's responsibilities in enforcing the Florida Building
645Code. The authority of state enforcing agencies to set fees for
646enforcement shall be derived from authority existing on July 1,
6471998. However, nothing contained in this subsection shall
648operate to limit such agencies from adjusting their fee schedule
649in conformance with existing authority.
650     Section 12.  Section 916.111, Florida Statutes, is amended
651to read:
652     916.111  Training of mental health experts.--The evaluation
653of defendants for competency to proceed or for sanity at the
654time of the commission of the offense shall be conducted in such
655a way as to ensure uniform application of the criteria
656enumerated in Rules 3.210 and 3.216, Florida Rules of Criminal
657Procedure.
658     (1)  A forensic evaluator training course approved by the
659department must be offered at least annually to ensure that
660mental health experts have the opportunity to qualify to be
661placed on the department's forensic evaluator registry.
662     (a)  Beginning July 1, 2009, an expert shall remain on the
663registry if he or she has completed or retaken the required
664training within the previous 5 years. Those who have not
665completed the required training within the previous 5 years
666shall be removed from the registry and may not conduct
667evaluations for the courts.
668     (b)  A mental health professional who has completed the
669training course within the previous 5 years is responsible for
670maintaining documentation of completion of the required training
671and providing the department with current contact information
672during the 5-year period.
673     (2)  The department shall develop, and may contract with
674accredited institutions:
675     (a)(1)  To provide:
676     1.(a)  A plan for training mental health professionals to
677perform forensic evaluations and to standardize the criteria and
678procedures to be used in these evaluations;
679     2.(b)  Clinical protocols and procedures based upon the
680criteria of Rules 3.210 and 3.216, Florida Rules of Criminal
681Procedure; and
682     3.(c)  Training for mental health professionals in the
683application of these protocols and procedures in performing
684forensic evaluations and providing reports to the courts; and
685     (b)(2)  To compile and maintain the necessary information
686for evaluating the success of this program, including the number
687of persons trained, the cost of operating the program, and the
688effect on the quality of forensic evaluations as measured by
689appropriateness of admissions to state forensic facilities and
690to community-based care programs.
691     Section 13.  Subsection (1) of section 916.115, Florida
692Statutes, is amended to read:
693     916.115  Appointment of experts.--
694     (1)  The court shall appoint no more than three experts to
695determine the mental condition of a defendant in a criminal
696case, including competency to proceed, insanity, involuntary
697placement, and treatment. The experts may evaluate the defendant
698in jail or in another appropriate local facility or in a
699facility of the Department of Corrections.
700     (a)  To the extent possible, the Appointed experts must
701shall have completed forensic evaluator training as provided in
702s. 916.111 approved by the department, and each shall be a
703psychiatrist, licensed psychologist, or physician.
704     (b)  Graduate students completing a practicum or
705internship, psychological specialists or counselors, and
706postdoctoral fellows at the state's mental health treatment
707facilities may assist in the evaluation process as long as their
708reports are overseen and signed by a supervising evaluator who
709has completed forensic evaluator training within the previous 5
710years.
711     (c)(b)  The department shall maintain and annually provide
712the courts with a forensic evaluator registry list of available
713mental health professionals who have completed the approved
714training as experts.
715     Section 14.  Section 916.13, Florida Statutes, is amended
716to read:
717     916.13  Involuntary commitment of defendant adjudicated
718incompetent.--
719     (1)  Every defendant who is charged with a felony and who
720is adjudicated incompetent to proceed, except a defendant who is
721serving a sentence in the custody of the Department of
722Corrections, may be involuntarily committed for treatment upon a
723finding by the court of clear and convincing evidence that:
724     (a)  The defendant has a mental illness and because of the
725mental illness:
726     1.  The defendant is manifestly incapable of surviving
727alone or with the help of willing and responsible family or
728friends, including available alternative services, and, without
729treatment, the defendant is likely to suffer from neglect or
730refuse to care for herself or himself and such neglect or
731refusal poses a real and present threat of substantial harm to
732the defendant's well-being; or
733     2.  There is a substantial likelihood that in the near
734future the defendant will inflict serious bodily harm on herself
735or himself or another person, as evidenced by recent behavior
736causing, attempting, or threatening such harm;
737     (b)  All available, less restrictive treatment
738alternatives, including treatment in community residential
739facilities or community inpatient or outpatient settings, which
740would offer an opportunity for improvement of the defendant's
741condition have been judged to be inappropriate; and
742     (c)  There is a substantial probability that the mental
743illness causing the defendant's incompetence will respond to
744treatment and the defendant will regain competency to proceed in
745the reasonably foreseeable future.
746     (2)(a)  A defendant who has been charged with a felony and
747who has been adjudicated incompetent to proceed due to mental
748illness, and who meets the criteria for involuntary commitment
749to the department under the provisions of this chapter, may be
750committed to the department, and the department shall retain and
751treat the defendant. No later than 6 months after the date of
752admission and at the end of any period of extended commitment,
753or at any time the administrator or designee shall have
754determined that the defendant has regained competency to proceed
755or no longer meets the criteria for continued commitment, the
756administrator or designee shall file a report with the court
757pursuant to the applicable Florida Rules of Criminal Procedure.
758     (b)  A defendant who is serving a sentence in the custody
759of the Department of Corrections and who has been charged with a
760new felony, or a defendant who is entitled to a mandatory appeal
761pursuant to Rule 3.851, Florida Rules of Criminal Procedure, and
762who has been adjudicated incompetent to proceed due to mental
763illness shall be retained in the physical custody of the
764Department of Corrections, which shall administer a lesson plan
765for competency restoration training provided by the department.
766No later than 6 months after the date on which the lesson plan
767for competency restoration training is provided, and every 12
768months thereafter, or at any time the department has determined
769that the defendant has regained competency to proceed, the
770department shall file a report with the court pursuant to the
771applicable Florida Rules of Criminal Procedure.
772     (3)  Whether housed in a department facility or a
773Department of Corrections facility, within 15 days after the
774court receives notification from the department that the
775defendant is competent to proceed or no longer meets the
776criteria for continued commitment, the defendant shall be
777transported back to jail pursuant to s. 916.107(10) for the
778purpose of holding a competency hearing.
779     (4)  A competency hearing shall be held within 30 days
780after a court receives notice from the department that a
781defendant is competent to proceed.
782     Section 15.  Section 916.15, Florida Statutes, is amended
783to read:
784     916.15  Involuntary commitment of defendant adjudicated not
785guilty by reason of insanity.--
786     (1)  The determination of whether a defendant is not guilty
787by reason of insanity shall be determined in accordance with
788Rule 3.217, Florida Rules of Criminal Procedure.
789     (2)  A defendant who is acquitted of criminal charges
790because of a finding of not guilty by reason of insanity, except
791a defendant who is serving a sentence in the custody of the
792Department of Corrections, may be involuntarily committed
793pursuant to such finding if the defendant has a mental illness
794and, because of the illness, is manifestly dangerous to himself
795or herself or others.
796     (3)  Every defendant acquitted of criminal charges by
797reason of insanity and found to meet the criteria for
798involuntary commitment, except a defendant who is serving a
799sentence in the custody of the Department of Corrections, may be
800committed to the department and treated in accordance with the
801provisions of this section and the applicable Florida Rules of
802Criminal Procedure. The department shall admit a defendant so
803adjudicated to an appropriate facility or program for treatment
804and shall retain and treat such defendant.
805     (a)  No later than 6 months after the date of admission,
806prior to the end of any period of extended commitment, or at any
807time the administrator or designee shall have determined that
808the defendant no longer meets the criteria for continued
809commitment placement, the administrator or designee shall file a
810report with the court pursuant to the applicable Florida Rules
811of Criminal Procedure.
812     (b)  Whether housed in a department facility or a
813Department of Corrections facility, within 15 days after the
814court receives notification from the department that the
815defendant no longer meets the criteria for continued commitment,
816the defendant shall be transported back to jail pursuant to s.
817916.107(10) for the purpose of holding a competency hearing.
818     (c)  A commitment hearing shall be held within 30 days
819after the court receives notification from the department that a
820defendant no longer meets the criteria for continued commitment
821placement.
822     (4)  A defendant who is serving a sentence in the custody
823of the Department of Corrections and who has been charged with a
824new felony and has been adjudicated not guilty by reason of
825insanity shall be retained in the physical custody of the
826Department of Corrections for the remainder of the defendant's
827sentence. No later than 30 days prior to the anticipated release
828date, the department shall evaluate the defendant and file a
829report with the court requesting that the defendant be returned
830to the court's jurisdiction to determine if the defendant
831continues to meet the criteria for continued commitment
832placement.
833     (5)(4)  In all proceedings under this section, both the
834defendant and the state shall have the right to a hearing before
835the committing court. Evidence at such hearing may be presented
836by the hospital administrator or the administrator's designee as
837well as by the state and the defendant. The defendant shall have
838the right to counsel at any such hearing. In the event that a
839defendant is determined to be indigent pursuant to s. 27.52, the
840public defender shall represent the defendant. The parties shall
841have access to the defendant's records at the treating
842facilities and may interview or depose personnel who have had
843contact with the defendant at the treating facilities.
844     Section 16.  Subsections (2) and (3) of section 916.17,
845Florida Statutes, are renumbered as subsections (3) and (4),
846respectively, and a new subsection (2) is added to that section
847to read:
848     916.17  Conditional release.--
849     (2)  A defendant who otherwise meets the criteria for
850involuntary commitment under s. 916.13 but whose current most
851serious charge is a third degree or nonviolent second degree
852felony must be placed in a community residential facility for
853competency restoration in demonstration areas established under
854the Community Mental Health and Substance Abuse Treatment and
855Crime Reduction Act in s. 394.9086, unless bed space or funding
856is unavailable for the community placement or the trial court
857makes an explicit finding that the defendant cannot be safely
858managed in such a placement. In making the determination under
859this subsection, the court shall consider all of the following:
860     (a)  The nature and seriousness of the crime or crimes
861allegedly committed.
862     (b)  The individual's criminal history.
863     (c)  The individual's psychiatric history.
864     (d)  The individual's history of violent behavior or
865threats of violent behavior and risk of harm to self or others.
866     (e)  The likelihood that the individual will comply with
867and benefit from the mental health treatment and services being
868recommended.
869     (f)  Availability of appropriate community-based services
870and treatment settings.
871     (g)  Other information considered relevant by the court.
872     Section 17.  This act shall take effect July 1, 2008.


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