1 | A bill to be entitled |
2 | An act relating to mental health and substance abuse; |
3 | amending s. 394.4572, F.S.; revising provisions relating |
4 | to employment screening requirements for mental health |
5 | personnel; revising the definition of the term "mental |
6 | health personnel"; removing an exemption from screening |
7 | requirements for certain mental health personnel; creating |
8 | s. 394.4996, F.S.; authorizing the Agency for Health Care |
9 | Administration, in consultation with the Department of |
10 | Children and Family Services, to establish a licensure |
11 | category for facilities providing integrated adult mental |
12 | health crisis stabilization unit and addictions receiving |
13 | facility services; authorizing such facilities to provide |
14 | integrated mental health and substance abuse services to |
15 | adults who meet certain criteria; providing for standards, |
16 | procedures, and requirements for services; providing |
17 | rulemaking authority; amending s. 394.655, F.S.; revising |
18 | purpose of the Criminal Justice, Mental Health, and |
19 | Substance Abuse Policy Council; amending s. 394.656, F.S.; |
20 | requiring the department and the agency to develop local |
21 | treatment and service delivery infrastructures in |
22 | coordination with counties receiving grants under the |
23 | Criminal Justice, Mental Health, and Substance Abuse |
24 | Reinvestment Grant Program; amending s. 394.657, F.S.; |
25 | providing additional duties of certain county planning |
26 | councils and committees; amending s. 394.659, F.S.; |
27 | providing additional duties of the Criminal Justice, |
28 | Mental Health, and Substance Abuse Technical Assistance |
29 | Center; requiring an annual report; amending s. 394.67, |
30 | F.S.; revising the definition of the term "residential |
31 | treatment center for children and adolescents"; providing |
32 | for such centers to be licensed by the agency; amending s. |
33 | 394.674, F.S.; revising eligibility requirements for |
34 | substance abuse and mental health services funded by the |
35 | department; providing rulemaking authority; creating s. |
36 | 394.9086, F.S.; creating the "Community Mental Health and |
37 | Substance Abuse Treatment and Crime Reduction Act"; |
38 | providing goals; providing definitions; creating a |
39 | community mental health and substance abuse treatment |
40 | forensic treatment system; providing criteria for |
41 | eligibility; providing responsibilities of the department; |
42 | establishing demonstration sites; providing rulemaking |
43 | authority; amending s. 409.906, F.S.; authorizing the |
44 | agency to seek federal approval to implement home and |
45 | community-based services; amending s. 553.80, F.S.; |
46 | providing for enforcement of the Florida Building Code |
47 | construction regulations for secure mental health |
48 | treatment facilities by the department; amending s. |
49 | 916.111, F.S.; revising provisions governing the training |
50 | of mental health experts; requiring forensic evaluator |
51 | training courses to be offered annually; providing |
52 | requirements for being placed on or removed from the |
53 | department's forensic evaluator registry; amending s. |
54 | 916.115, F.S.; revising provisions relating to appointment |
55 | of experts by the court to evaluate the mental condition |
56 | of a criminal defendant; requiring experts to complete |
57 | forensic evaluator training within a specified period of |
58 | time to remain on the department's registry; providing |
59 | conditions under which certain persons may assist in |
60 | forensic evaluations; amending s. 916.13, F.S.; creating |
61 | an exception to involuntary commitment for defendants |
62 | adjudicated incompetent in the custody of the Department |
63 | of Corrections; providing duties of the department |
64 | relating to treatment for defendants adjudicated |
65 | incompetent to proceed due to mental illness; revising |
66 | duties of the department and the court; specifying |
67 | timeframes for the filing of reports, the commitment and |
68 | placement of defendants, and the holding of hearings; |
69 | amending s. 916.15, F.S.; creating an exception for the |
70 | involuntary commitment of defendants adjudicated not |
71 | guilty by reason of insanity in the custody of the |
72 | Department of Corrections; revising duties of the |
73 | department and the court; specifying timeframes for the |
74 | filing of reports, the commitment and placement of |
75 | defendants, and the holding of hearings; amending s. |
76 | 916.17, F.S.; providing conditions for placement of a |
77 | defendant in a community residential facility in a |
78 | demonstration area established under the act under certain |
79 | circumstances; providing criteria for such placement; |
80 | providing an effective date. |
81 |
|
82 | Be It Enacted by the Legislature of the State of Florida: |
83 |
|
84 | Section 1. Paragraph (d) of subsection (1) of section |
85 | 394.4572, Florida Statutes, is redesignated as paragraph (c), |
86 | and present paragraphs (a) and (c) of that subsection are |
87 | amended to read: |
88 | 394.4572 Screening of mental health personnel.-- |
89 | (1)(a) The department and the Agency for Health Care |
90 | Administration shall require employment screening for mental |
91 | health personnel using the standards for level 2 screening set |
92 | forth in chapter 435. "Mental health personnel" includes all |
93 | program directors, professional clinicians, staff members, and |
94 | volunteers working in public or private mental health programs |
95 | and facilities who have direct contact with unmarried patients |
96 | under the age of 18 years. For purposes of this chapter, |
97 | employment screening of mental health personnel shall also |
98 | include, but is not limited to, employment screening as provided |
99 | under chapter 435. |
100 | (c) Mental health personnel working in a facility licensed |
101 | under chapter 395 who have less than 15 hours per week of direct |
102 | contact with patients or who are health care professionals |
103 | licensed by the Agency for Health Care Administration or a board |
104 | thereunder are exempt from the fingerprinting and screening |
105 | requirements, except for persons working in mental health |
106 | facilities where the primary purpose of the facility is the |
107 | treatment of minors. |
108 | Section 2. Section 394.4996, Florida Statutes, is created |
109 | to read: |
110 | 394.4996 Integrated adult mental health crisis |
111 | stabilization unit and addictions receiving facility services.-- |
112 | (1) Beginning July 1, 2008, the Agency for Health Care |
113 | Administration, in consultation with the Department of Children |
114 | and Family Services, is authorized to license facilities that |
115 | integrate services provided in an adult mental health crisis |
116 | stabilization unit with services provided in an adult addictions |
117 | receiving facility. The services provided shall be designated as |
118 | "integrated adult mental health crisis stabilization unit and |
119 | addictions receiving facility services," and the facility |
120 | providing those services shall be licensed as an adult crisis |
121 | stabilization unit by the agency and shall meet all licensure |
122 | requirements for crisis stabilization units that provide these |
123 | integrated services. |
124 | (2) An integrated adult mental health crisis stabilization |
125 | unit and addictions receiving facility may provide services |
126 | under this section to adults 18 years of age or older who: |
127 | (a) Meet the requirements for voluntary admission for |
128 | mental health treatment under s. 394.4625; |
129 | (b) Meet the criteria for involuntary examination for |
130 | mental illness under s. 394.463; |
131 | (c) Qualify for voluntary admission for substance abuse |
132 | treatment under s. 397.601; or |
133 | (d) Meet the criteria for involuntary admission for |
134 | substance abuse impairment under s. 397.675. |
135 | (3) The department, in consultation with the agency, shall |
136 | adopt by rule standards that address eligibility criteria; |
137 | clinical procedures; staffing requirements; operational, |
138 | administrative, and financing requirements; and the |
139 | investigation of complaints. Standards that are implemented |
140 | specific to substance abuse treatment services shall meet or |
141 | exceed existing standards, in accordance with rule 65D-30.005, |
142 | Florida Administrative Code, for addictions receiving |
143 | facilities. |
144 | Section 3. Paragraph (b) of subsection (11) of section |
145 | 394.655, Florida Statutes, is amended to read: |
146 | 394.655 The Substance Abuse and Mental Health Corporation; |
147 | powers and duties; composition; evaluation and reporting |
148 | requirements.-- |
149 | (11) |
150 | (b) The purpose of the council shall be to: |
151 | 1. Align policy initiatives in the criminal justice, |
152 | juvenile justice, and mental health systems to ensure the most |
153 | effective use of resources and to coordinate the development of |
154 | legislative proposals and budget requests relating to the shared |
155 | needs of adults and juveniles who have a mental illness, |
156 | substance abuse disorder, or co-occurring mental health and |
157 | substance abuse disorders who are in, or at risk of entering, |
158 | the criminal justice system. |
159 | 2. Provide consultation in the development of |
160 | comprehensive and cost-effective community-based mental health |
161 | and substance abuse treatment services for individuals with |
162 | mental illnesses receiving services in forensic facilities, |
163 | prisons, jails, and juvenile justice centers. The council shall |
164 | appoint an advisory committee to review and monitor the |
165 | implementation of the Community Mental Health and Substance |
166 | Abuse Treatment and Crime Reduction Act. The advisory committee |
167 | shall include at least one person who has received services and |
168 | one family member of a person receiving services under the act. |
169 | Section 4. Subsection (1) of section 394.656, Florida |
170 | Statutes, is amended to read: |
171 | 394.656 Criminal Justice, Mental Health, and Substance |
172 | Abuse Reinvestment Grant Program.-- |
173 | (1) There is created within the Department of Children and |
174 | Family Services the Criminal Justice, Mental Health, and |
175 | Substance Abuse Reinvestment Grant Program. The purpose of the |
176 | program is to provide funding to counties with which they can |
177 | plan, implement, or expand initiatives that increase public |
178 | safety, avert increased spending on criminal justice, and |
179 | improve the accessibility and effectiveness of treatment |
180 | services for adults and juveniles who have a mental illness, |
181 | substance abuse disorder, or co-occurring mental health and |
182 | substance abuse disorders and who are in, or at risk of |
183 | entering, the criminal or juvenile justice systems. In |
184 | implementing the Community Mental Health and Substance Abuse |
185 | Treatment and Crime Reduction Act, the department and the agency |
186 | shall work in coordination with counties that received grants |
187 | under the Criminal Justice, Mental Health, and Substance Abuse |
188 | Reinvestment Grant Program pursuant to this section to develop |
189 | local treatment and service delivery infrastructures. |
190 | Section 5. Subsection (1) of section 394.657, Florida |
191 | Statutes, is amended to read: |
192 | 394.657 County planning councils or committees.-- |
193 | (1) Each board of county commissioners shall designate the |
194 | county public safety coordinating council established under s. |
195 | 951.26, or designate another criminal or juvenile justice mental |
196 | health and substance abuse council or committee, as the planning |
197 | council or committee. The public safety coordinating council or |
198 | other designated criminal or juvenile justice mental health and |
199 | substance abuse council or committee shall: |
200 | (a) Coordinate, in coordination with the county offices of |
201 | planning and budget and, shall make a formal recommendation to |
202 | the board of county commissioners regarding how the Criminal |
203 | Justice, Mental Health, and Substance Abuse Reinvestment Grant |
204 | Program may best be implemented within a community. The board of |
205 | county commissioners may assign any entity to prepare the |
206 | application on behalf of the county administration for |
207 | submission to the corporation for review. A county may join with |
208 | one or more counties to form a consortium and use a regional |
209 | public safety coordinating council or another county-designated |
210 | regional criminal or juvenile justice mental health and |
211 | substance abuse planning council or committee for the geographic |
212 | area represented by the member counties. |
213 | (b) Provide consultation regarding the planning and |
214 | implementation of the Community Mental Health and Substance |
215 | Abuse Treatment and Crime Reduction Act by the local governing |
216 | bodies. |
217 | Section 6. Paragraphs (g), (h), (i), and (j) are added to |
218 | subsection (1) of section 394.659, Florida Statutes, to read: |
219 | 394.659 Criminal Justice, Mental Health, and Substance |
220 | Abuse Technical Assistance Center.-- |
221 | (1) There is created a Criminal Justice, Mental Health, |
222 | and Substance Abuse Technical Assistance Center at the Louis de |
223 | la Parte Florida Mental Health Institute at the University of |
224 | South Florida, which shall: |
225 | (g) In coordination with the department, develop minimum |
226 | competencies and proficiencies required for communities and |
227 | service providers. |
228 | (h) Identify evidence-based practices and deliver |
229 | necessary training and consultation to service providers. |
230 | (i) Assist the department with the development of outcome |
231 | measures. |
232 | (j) Provide an annual report to the Governor, the |
233 | President of the Senate, the Speaker of the House of |
234 | Representatives, the Chief Justice of the Florida Supreme Court, |
235 | and the State Courts Administrator on the status of the |
236 | implementation of the Community Mental Health and Substance |
237 | Abuse Treatment and Crime Reduction Act. For those areas that |
238 | also have a grant under s. 394.656, the institute shall prepare |
239 | a joint report to avoid duplication. |
240 | Section 7. Subsection (21) of section 394.67, Florida |
241 | Statutes, is amended to read: |
242 | 394.67 Definitions.--As used in this part, the term: |
243 | (21) "Residential treatment center for children and |
244 | adolescents" means a 24-hour residential program, including a |
245 | therapeutic group home, which provides mental health services to |
246 | emotionally disturbed children or adolescents as defined in s. |
247 | 394.492(5) or (6) and which is a private for-profit or not-for- |
248 | profit corporation licensed by the agency under contract with |
249 | the department which offers a variety of treatment modalities in |
250 | a more restrictive setting. |
251 | Section 8. Subsections (1) and (4) of section 394.674, |
252 | Florida Statutes, are amended to read: |
253 | 394.674 Client Clinical eligibility for publicly funded |
254 | substance abuse and mental health services; fee collection |
255 | requirements.-- |
256 | (1) To be eligible to receive substance abuse and mental |
257 | health services funded by the department, a person must be a |
258 | member of one of the department's priority populations target |
259 | groups approved by the Legislature, pursuant to s. 216.0166. The |
260 | priority populations include: |
261 | (a) For adult mental health services: |
262 | 1. Adults who have severe and persistent mental illness, |
263 | as designated by the department using criteria that include |
264 | severity of diagnosis, duration of the mental illness, ability |
265 | to independently perform activities of daily living, and receipt |
266 | of disability income for a psychiatric condition. Within this |
267 | group priority populations include: |
268 | a. Older adults in crisis. |
269 | b. Older adults who are at risk of being placed in a more |
270 | restrictive environment because of their mental illness. |
271 | c. Persons deemed incompetent to proceed or not guilty by |
272 | reason 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 |
275 | health and substance abuse disorders. |
276 | 2. Adults experiencing an acute mental or emotional crisis |
277 | as 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 |
284 | history of intravenous drug use. |
285 | 2. Persons dually diagnosed as having co-occurring mental |
286 | health and substance abuse disorders. |
287 | 3. Parents who put children at risk due to a substance |
288 | abuse disorder. |
289 | 4. Persons who have a substance abuse disorder and have |
290 | been 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 |
294 | not under the supervision of a court or in the custody of a |
295 | state agency. |
296 | 8. Persons identified as a priority population as a |
297 | condition for receiving services funded through the Substance |
298 | Abuse Prevention and Treatment Block Grant. |
299 | (4) The department shall adopt rules to implement client |
300 | the clinical eligibility, client enrollment, and fee collection |
301 | requirements for publicly funded substance abuse and mental |
302 | health services. The rules must require that each provider under |
303 | contract with the department that enrolls eligible persons into |
304 | treatment to develop a sliding fee scale for persons who have a |
305 | net family income at or above 150 percent of the Federal Poverty |
306 | Income Guidelines, unless otherwise required by state or federal |
307 | law. The sliding fee scale must use the uniform schedule of |
308 | discounts by which a provider under contract with the department |
309 | discounts its established client charges for services supported |
310 | with state, federal, or local funds, using, at a minimum, |
311 | factors such as family income, financial assets, and family size |
312 | as declared by the person or the person's guardian. The rules |
313 | must include uniform criteria to be used by all service |
314 | providers in developing the schedule of discounts for the |
315 | sliding fee scale. The rules must address the most expensive |
316 | types of treatment, such as residential and inpatient treatment, |
317 | in order to make it possible for a client to responsibly |
318 | contribute to his or her mental health or substance abuse care |
319 | without jeopardizing the family's financial stability. A person |
320 | who is not eligible for Medicaid and whose net family income is |
321 | less than 150 percent of the Federal Poverty Income Guidelines |
322 | must pay a portion of his or her treatment costs which is |
323 | comparable to the copayment amount required by the Medicaid |
324 | program for Medicaid clients pursuant to s. 409.9081. The rules |
325 | must require that persons who receive financial assistance from |
326 | the Federal Government because of a disability and are in long- |
327 | term residential treatment settings contribute to their board |
328 | and care costs and treatment costs and must be consistent with |
329 | the provisions in s. 409.212. |
330 | Section 9. Section 394.9086, Florida Statutes, is created |
331 | to read: |
332 | 394.9086 Community Mental Health and Substance Abuse |
333 | Treatment 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 |
336 | Reduction Act." |
337 | (2) LEGISLATIVE FINDINGS AND INTENT.--The Legislature |
338 | finds that many inmates with serious mental illnesses who are |
339 | committed to state forensic mental health treatment facilities |
340 | for competency restoration could be served effectively and at |
341 | less cost in community-based alternative programs. The |
342 | Legislature further finds that many individuals with serious |
343 | mental illnesses who have been discharged from state forensic |
344 | mental health treatment facilities could avoid returning to the |
345 | criminal justice and forensic mental health system if they |
346 | received specialized treatment in the community. It is therefore |
347 | the intent of the Legislature to create the Community Mental |
348 | Health and Substance Abuse Forensic Treatment System to serve |
349 | individuals with mental illnesses or co-occurring mental health |
350 | and substance abuse disorders who are involved in or at risk of |
351 | entering forensic facilities, prisons, jails, juvenile justice |
352 | centers, and civil treatment facilities. |
353 | (3) GOALS.--The goals of the community mental health and |
354 | substance abuse forensic treatment system are to: |
355 | (a) Ensure that forensic competency restoration services |
356 | are provided in the least restrictive, least costly, and most |
357 | efficient environment. |
358 | (b) Provide competency restoration services in the |
359 | community, when appropriate, based on consideration of public |
360 | safety, needs of the individual, and available resources. |
361 | (c) Reduce admissions for competency restoration to state |
362 | forensic mental health treatment facilities. |
363 | (d) Reduce rates of arrest, incarceration, and recidivism |
364 | for individuals in the program. |
365 | (e) Ensure public safety. |
366 | (f) Increase outreach and services to individuals at risk |
367 | of criminal justice system, juvenile justice system, and |
368 | forensic mental health system involvement. |
369 | (g) Support collaboration among local law enforcement, |
370 | judicial, correctional, governmental, service provider, and |
371 | community stakeholders to implement diversion and problem- |
372 | solving strategies to reduce the demand for forensic mental |
373 | health placements. |
374 | (4) DEFINITIONS.-- |
375 | (a) "Agency" means the Agency for Health Care |
376 | Administration. |
377 | (b) "Community residential facility" means a community- |
378 | based residential treatment setting licensed by the agency under |
379 | s. 394.875 or s. 429.075 or licensed by the department under s. |
380 | 397.401. |
381 | (c) "Department" means the Department of Children and |
382 | Family Services. |
383 | (d) "Evidence-based practices" means interventions and |
384 | strategies that, based on the best available empirical research, |
385 | demonstrate effective and efficient outcomes in the care and |
386 | treatment of individuals diagnosed with mental illnesses or co- |
387 | occurring mental health and substance abuse disorders. |
388 | (e) "Forensic intensive care management" means activities |
389 | that address the comprehensive psychiatric, social, and support |
390 | needs of individuals diagnosed with serious and persistent |
391 | mental illnesses or severe emotional disturbances who are |
392 | involved in the justice system and receive services under this |
393 | section. Activities include, but are not limited to, service |
394 | planning, service coordination, monitoring, and assistance with |
395 | accessing federal, state, and local benefits necessary to |
396 | sustain an individual in the community. |
397 | (f) "Forensic treatment system" means a community mental |
398 | health and substance abuse forensic treatment system that |
399 | includes the comprehensive set of services and supports provided |
400 | to individuals under this section. |
401 | (g) "Geographic area" means a county, circuit, regional, |
402 | or multiregional area in the state. |
403 | (5) COMMUNITY MENTAL HEALTH AND SUBSTANCE ABUSE FORENSIC |
404 | TREATMENT SYSTEM.--The department, in consultation with the |
405 | agency, shall develop and implement a community mental health |
406 | and substance abuse forensic treatment system. The forensic |
407 | system shall build on the local community diversion and re-entry |
408 | initiatives and strategies that are consistent with those |
409 | identified and supported under s. 394.658(1)(b). |
410 | (a) The forensic system initiatives and strategies may |
411 | include, 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 |
418 | justice, and treatment services professionals; |
419 | 7. Specialized probation officers at the state and county |
420 | levels to serve individuals under correctional control in the |
421 | community; |
422 | 8. Collateral services such as housing, transitional |
423 | housing, and supported employment; and |
424 | 9. Reentry services to create or expand mental health and |
425 | substance abuse treatment and supports for affected individuals. |
426 | (b) The forensic system must include a comprehensive |
427 | continuum of care and services that use evidence-based practices |
428 | to address co-occurring mental health and substance abuse |
429 | disorders. The forensic system must include the following |
430 | minimum elements: |
431 | 1. Competency restoration and treatment services provided |
432 | in a variety of settings from least restrictive to progressively |
433 | more 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 |
439 | of sexual, physical, and emotional abuse or trauma experienced |
440 | by individuals with mental illnesses involved in the criminal |
441 | justice system. These services may include behavioral therapies, |
442 | desensitization therapies, grounding techniques, and other |
443 | services; |
444 | 7. Residential services to address crisis episodes and |
445 | short-term residential treatment. In addition, alternate models |
446 | for services in crisis stabilization units or short-term |
447 | residential treatment facilities may be used that provide care |
448 | in a less restrictive setting and at lower cost; |
449 | 8. Treatment for co-occurring mental health and substance |
450 | abuse disorders; and |
451 | 9. Other services or supports identified by the department |
452 | working with the agency, the Substance Abuse and Mental Health |
453 | Corporation, and local governing bodies. |
454 | (6) ELIGIBILITY.--The department may serve individuals who |
455 | meet the criteria in paragraphs (a)-(c). The department shall |
456 | give highest priority for services provided under this section |
457 | to the following in rank order: |
458 | (a) Adults who are adjudicated incompetent to proceed or |
459 | not guilty by reason of insanity under chapter 916, who have |
460 | been ordered by the court into forensic commitment, whose |
461 | current most serious charge is a third degree or nonviolent |
462 | second degree felony, and who meet public safety criteria |
463 | established by the court and treatability criteria established |
464 | by the department for placement in a community setting. |
465 | (b) Adults who are released or pending release into the |
466 | community by the courts after completing competency restoration |
467 | services at a state forensic mental health treatment facility. |
468 | (c) Adults who experience serious and persistent mental |
469 | illnesses who are at risk of entering or who are already |
470 | involved with the criminal justice system as evidenced by their |
471 | frequency of contact with the system. |
472 | (7) DEPARTMENT RESPONSIBILITIES.--The department shall |
473 | develop a continuum of services to implement the community |
474 | mental health and substance abuse forensic treatment system in |
475 | accordance with subsection (5). The department shall: |
476 | (a) Establish standards for all providers, including, but |
477 | not limited to, community-based providers that administer |
478 | competency restoration services in a community residential |
479 | facility or a less restrictive setting. |
480 | (b) Define requirements for all providers in the forensic |
481 | system and set ongoing performance expectations. |
482 | (c) Select demonstration sites for participation based on |
483 | the criteria in subsection (8) that demonstrate active and |
484 | sustained participation in and collaboration with the community. |
485 | (d) Enter into memorandums of agreement with county |
486 | planning councils or committees identified in s. 394.657 that |
487 | are included in the demonstration sites. |
488 | (e) Identify providers to implement the continuum of |
489 | services. The department shall consult with county planning |
490 | councils or committees when selecting providers. |
491 | (f) Enter into contracts with appropriate providers. |
492 | (g) Establish performance measures and reporting |
493 | requirements for providers participating in the forensic system. |
494 | The measures shall include, at a minimum: |
495 | 1. Number of individuals diverted from state forensic |
496 | facilities; |
497 | 2. Number of individuals diverted from the criminal |
498 | justice system; |
499 | 3. Rates of arrest, incarceration, and recidivism for new |
500 | criminal offenses; |
501 | 4. Rates of employment; |
502 | 5. Number of days in jails, prisons, and forensic |
503 | facilities on an annual basis; and |
504 | 6. Satisfaction of key community stakeholder participants |
505 | and local partners with the initiative, including, at a minimum, |
506 | input from individuals who have received services under this |
507 | section and family members of individuals receiving services |
508 | under this section, county planning councils or committees, and |
509 | participating providers. |
510 | (h) Monitor contracts for compliance with terms and, at |
511 | least annually, to the extent possible, perform joint onsite |
512 | monitoring with the agency, the Substance Abuse and Mental |
513 | Health Corporation, and the Criminal Justice, Mental Health, and |
514 | Substance Abuse Technical Assistance Center established under s. |
515 | 394.659 to assess performance as evidenced by the quality, |
516 | efficiency, and effectiveness of the care provided. |
517 | (8) DEMONSTRATION SITES.--The department in consultation |
518 | with the agency shall identify up to three geographic areas of |
519 | the state for initial implementation of this section. |
520 | (a) In at least one area, the department shall establish a |
521 | single point of accountability for the forensic system and, if |
522 | feasible, contract with a managing entity as defined in s. |
523 | 394.9082 to provide operational oversight of subcontractors and |
524 | daily operations. When feasible, payment for these services |
525 | shall be based on a prepaid capitation rate. |
526 | (b) All areas shall be selected based on a determination |
527 | of community readiness and the potential for impacting the |
528 | greatest number of individuals entering the forensic mental |
529 | health and criminal justice systems. Criteria for selection may |
530 | include: |
531 | 1. Community readiness to deliver services as outlined in |
532 | subsection (5) and demonstrated by well-established community |
533 | collaboration plans and local partnerships as evidenced by |
534 | memorandums of agreement that are submitted to and approved by |
535 | the department; |
536 | 2. A high forensic bed utilization rate in the state |
537 | mental health treatment facilities; |
538 | 3. Successful application for implementation grant funding |
539 | under s. 394.656, the Criminal Justice, Mental Health, and |
540 | Substance Abuse Reinvestment Grant Program; and |
541 | 4. Other elements determined by the department in |
542 | consultation with the agency. |
543 | (9) RULEMAKING AUTHORITY.--The department shall adopt |
544 | rules to implement the Community Mental Health and Substance |
545 | Abuse Treatment and Crime Reduction Act. |
546 | Section 10. Subsection (26) is added to section 409.906, |
547 | Florida Statutes, to read: |
548 | 409.906 Optional Medicaid services.--Subject to specific |
549 | appropriations, the agency may make payments for services which |
550 | are optional to the state under Title XIX of the Social Security |
551 | Act and are furnished by Medicaid providers to recipients who |
552 | are determined to be eligible on the dates on which the services |
553 | were provided. Any optional service that is provided shall be |
554 | provided only when medically necessary and in accordance with |
555 | state and federal law. Optional services rendered by providers |
556 | in mobile units to Medicaid recipients may be restricted or |
557 | prohibited by the agency. Nothing in this section shall be |
558 | construed to prevent or limit the agency from adjusting fees, |
559 | reimbursement rates, lengths of stay, number of visits, or |
560 | number of services, or making any other adjustments necessary to |
561 | comply with the availability of moneys and any limitations or |
562 | directions provided for in the General Appropriations Act or |
563 | chapter 216. If necessary to safeguard the state's systems of |
564 | providing services to elderly and disabled persons and subject |
565 | to the notice and review provisions of s. 216.177, the Governor |
566 | may direct the Agency for Health Care Administration to amend |
567 | the Medicaid state plan to delete the optional Medicaid service |
568 | known as "Intermediate Care Facilities for the Developmentally |
569 | Disabled." Optional services may include: |
570 | (26) HOME AND COMMUNITY-BASED MENTAL HEALTH SERVICES.--The |
571 | agency is authorized to seek federal approval through a state |
572 | plan amendment to implement home and community-based services |
573 | under the authority of and in compliance with s. 1915(i) of the |
574 | Social Security Act for services for individuals who have been |
575 | determined by an independent evaluation to have disabilities |
576 | that cause them to become, or put them at risk of becoming, |
577 | involved with the criminal justice system due to mental illness. |
578 | In accordance with allowances under the authority of s. 1915(i) |
579 | of the Social Security Act, these services may be limited to a |
580 | select number of eligible individuals, in select geographic |
581 | areas as identified by the agency. An eligible individual may |
582 | have an income of up to 150 percent of the federal poverty |
583 | level. The agency shall coordinate with the department to select |
584 | and define the services to be submitted in the state plan |
585 | amendment and provided under this subsection. The agency must |
586 | receive approval from the Legislature or the Legislative Budget |
587 | Commission before implementing the state plan amendment. |
588 | Section 11. Subsection (1) of section 553.80, Florida |
589 | Statutes, is amended to read: |
590 | 553.80 Enforcement.-- |
591 | (1) Except as provided in paragraphs (a)-(g) (a)-(f), each |
592 | local government and each legally constituted enforcement |
593 | district with statutory authority shall regulate building |
594 | construction and, where authorized in the state agency's |
595 | enabling legislation, each state agency shall enforce the |
596 | Florida Building Code required by this part on all public or |
597 | private buildings, structures, and facilities, unless such |
598 | responsibility has been delegated to another unit of government |
599 | pursuant to s. 553.79(9). |
600 | (a) Construction regulations relating to correctional |
601 | facilities under the jurisdiction of the Department of |
602 | Corrections and the Department of Juvenile Justice shall are to |
603 | be enforced exclusively by those departments. |
604 | (b) Construction regulations relating to elevator |
605 | equipment under the jurisdiction of the Bureau of Elevators of |
606 | the Department of Business and Professional Regulation shall be |
607 | enforced exclusively by that department. |
608 | (c) Construction regulations relating to secure mental |
609 | health treatment facilities under the jurisdiction of the |
610 | Department of Children and Family Services shall be enforced |
611 | exclusively by that department. |
612 | (d)(c) In addition to the requirements of s. 553.79 and |
613 | this section, facilities subject to the provisions of chapter |
614 | 395 and part II of chapter 400 shall have facility plans |
615 | reviewed and construction surveyed by the state agency |
616 | authorized to do so under the requirements of chapter 395 and |
617 | part II of chapter 400 and the certification requirements of the |
618 | Federal Government. |
619 | (e)(d) Building plans approved under s. 553.77(3) and |
620 | state-approved manufactured buildings, including buildings |
621 | manufactured and assembled offsite and not intended for |
622 | habitation, such as lawn storage buildings and storage sheds, |
623 | are exempt from local code enforcing agency plan reviews except |
624 | for provisions of the code relating to erection, assembly, or |
625 | construction at the site. Erection, assembly, and construction |
626 | at the site are subject to local permitting and inspections. |
627 | Lawn storage buildings and storage sheds bearing the insignia of |
628 | approval of the department are not subject to s. 553.842. Such |
629 | buildings that do not exceed 400 square feet may be delivered |
630 | and installed without need of a contractor's or specialty |
631 | license. |
632 | (f)(e) Construction regulations governing public schools, |
633 | state universities, and community colleges shall be enforced as |
634 | provided in subsection (6). |
635 | (g)(f) The Florida Building Code as it pertains to toll |
636 | collection facilities under the jurisdiction of the turnpike |
637 | enterprise of the Department of Transportation shall be enforced |
638 | exclusively by the turnpike enterprise. |
639 |
|
640 | The governing bodies of local governments may provide a schedule |
641 | of fees, as authorized by s. 125.56(2) or s. 166.222 and this |
642 | section, for the enforcement of the provisions of this part. |
643 | Such fees shall be used solely for carrying out the local |
644 | government's responsibilities in enforcing the Florida Building |
645 | Code. The authority of state enforcing agencies to set fees for |
646 | enforcement shall be derived from authority existing on July 1, |
647 | 1998. However, nothing contained in this subsection shall |
648 | operate to limit such agencies from adjusting their fee schedule |
649 | in conformance with existing authority. |
650 | Section 12. Section 916.111, Florida Statutes, is amended |
651 | to read: |
652 | 916.111 Training of mental health experts.--The evaluation |
653 | of defendants for competency to proceed or for sanity at the |
654 | time of the commission of the offense shall be conducted in such |
655 | a way as to ensure uniform application of the criteria |
656 | enumerated in Rules 3.210 and 3.216, Florida Rules of Criminal |
657 | Procedure. |
658 | (1) A forensic evaluator training course approved by the |
659 | department must be offered at least annually to ensure that |
660 | mental health experts have the opportunity to qualify to be |
661 | placed on the department's forensic evaluator registry. |
662 | (a) Beginning July 1, 2009, an expert shall remain on the |
663 | registry if he or she has completed or retaken the required |
664 | training within the previous 5 years. Those who have not |
665 | completed the required training within the previous 5 years |
666 | shall be removed from the registry and may not conduct |
667 | evaluations for the courts. |
668 | (b) A mental health professional who has completed the |
669 | training course within the previous 5 years is responsible for |
670 | maintaining documentation of completion of the required training |
671 | and providing the department with current contact information |
672 | during the 5-year period. |
673 | (2) The department shall develop, and may contract with |
674 | accredited institutions: |
675 | (a)(1) To provide: |
676 | 1.(a) A plan for training mental health professionals to |
677 | perform forensic evaluations and to standardize the criteria and |
678 | procedures to be used in these evaluations; |
679 | 2.(b) Clinical protocols and procedures based upon the |
680 | criteria of Rules 3.210 and 3.216, Florida Rules of Criminal |
681 | Procedure; and |
682 | 3.(c) Training for mental health professionals in the |
683 | application of these protocols and procedures in performing |
684 | forensic evaluations and providing reports to the courts; and |
685 | (b)(2) To compile and maintain the necessary information |
686 | for evaluating the success of this program, including the number |
687 | of persons trained, the cost of operating the program, and the |
688 | effect on the quality of forensic evaluations as measured by |
689 | appropriateness of admissions to state forensic facilities and |
690 | to community-based care programs. |
691 | Section 13. Subsection (1) of section 916.115, Florida |
692 | Statutes, is amended to read: |
693 | 916.115 Appointment of experts.-- |
694 | (1) The court shall appoint no more than three experts to |
695 | determine the mental condition of a defendant in a criminal |
696 | case, including competency to proceed, insanity, involuntary |
697 | placement, and treatment. The experts may evaluate the defendant |
698 | in jail or in another appropriate local facility or in a |
699 | facility of the Department of Corrections. |
700 | (a) To the extent possible, the Appointed experts must |
701 | shall have completed forensic evaluator training as provided in |
702 | s. 916.111 approved by the department, and each shall be a |
703 | psychiatrist, licensed psychologist, or physician. |
704 | (b) Graduate students completing a practicum or |
705 | internship, psychological specialists or counselors, and |
706 | postdoctoral fellows at the state's mental health treatment |
707 | facilities may assist in the evaluation process as long as their |
708 | reports are overseen and signed by a supervising evaluator who |
709 | has completed forensic evaluator training within the previous 5 |
710 | years. |
711 | (c)(b) The department shall maintain and annually provide |
712 | the courts with a forensic evaluator registry list of available |
713 | mental health professionals who have completed the approved |
714 | training as experts. |
715 | Section 14. Section 916.13, Florida Statutes, is amended |
716 | to read: |
717 | 916.13 Involuntary commitment of defendant adjudicated |
718 | incompetent.-- |
719 | (1) Every defendant who is charged with a felony and who |
720 | is adjudicated incompetent to proceed, except a defendant who is |
721 | serving a sentence in the custody of the Department of |
722 | Corrections, may be involuntarily committed for treatment upon a |
723 | finding by the court of clear and convincing evidence that: |
724 | (a) The defendant has a mental illness and because of the |
725 | mental illness: |
726 | 1. The defendant is manifestly incapable of surviving |
727 | alone or with the help of willing and responsible family or |
728 | friends, including available alternative services, and, without |
729 | treatment, the defendant is likely to suffer from neglect or |
730 | refuse to care for herself or himself and such neglect or |
731 | refusal poses a real and present threat of substantial harm to |
732 | the defendant's well-being; or |
733 | 2. There is a substantial likelihood that in the near |
734 | future the defendant will inflict serious bodily harm on herself |
735 | or himself or another person, as evidenced by recent behavior |
736 | causing, attempting, or threatening such harm; |
737 | (b) All available, less restrictive treatment |
738 | alternatives, including treatment in community residential |
739 | facilities or community inpatient or outpatient settings, which |
740 | would offer an opportunity for improvement of the defendant's |
741 | condition have been judged to be inappropriate; and |
742 | (c) There is a substantial probability that the mental |
743 | illness causing the defendant's incompetence will respond to |
744 | treatment and the defendant will regain competency to proceed in |
745 | the reasonably foreseeable future. |
746 | (2)(a) A defendant who has been charged with a felony and |
747 | who has been adjudicated incompetent to proceed due to mental |
748 | illness, and who meets the criteria for involuntary commitment |
749 | to the department under the provisions of this chapter, may be |
750 | committed to the department, and the department shall retain and |
751 | treat the defendant. No later than 6 months after the date of |
752 | admission and at the end of any period of extended commitment, |
753 | or at any time the administrator or designee shall have |
754 | determined that the defendant has regained competency to proceed |
755 | or no longer meets the criteria for continued commitment, the |
756 | administrator or designee shall file a report with the court |
757 | pursuant to the applicable Florida Rules of Criminal Procedure. |
758 | (b) A defendant who is serving a sentence in the custody |
759 | of the Department of Corrections and who has been charged with a |
760 | new felony, or a defendant who is entitled to a mandatory appeal |
761 | pursuant to Rule 3.851, Florida Rules of Criminal Procedure, and |
762 | who has been adjudicated incompetent to proceed due to mental |
763 | illness shall be retained in the physical custody of the |
764 | Department of Corrections, which shall administer a lesson plan |
765 | for competency restoration training provided by the department. |
766 | No later than 6 months after the date on which the lesson plan |
767 | for competency restoration training is provided, and every 12 |
768 | months thereafter, or at any time the department has determined |
769 | that the defendant has regained competency to proceed, the |
770 | department shall file a report with the court pursuant to the |
771 | applicable Florida Rules of Criminal Procedure. |
772 | (3) Whether housed in a department facility or a |
773 | Department of Corrections facility, within 15 days after the |
774 | court receives notification from the department that the |
775 | defendant is competent to proceed or no longer meets the |
776 | criteria for continued commitment, the defendant shall be |
777 | transported back to jail pursuant to s. 916.107(10) for the |
778 | purpose of holding a competency hearing. |
779 | (4) A competency hearing shall be held within 30 days |
780 | after a court receives notice from the department that a |
781 | defendant is competent to proceed. |
782 | Section 15. Section 916.15, Florida Statutes, is amended |
783 | to read: |
784 | 916.15 Involuntary commitment of defendant adjudicated not |
785 | guilty by reason of insanity.-- |
786 | (1) The determination of whether a defendant is not guilty |
787 | by reason of insanity shall be determined in accordance with |
788 | Rule 3.217, Florida Rules of Criminal Procedure. |
789 | (2) A defendant who is acquitted of criminal charges |
790 | because of a finding of not guilty by reason of insanity, except |
791 | a defendant who is serving a sentence in the custody of the |
792 | Department of Corrections, may be involuntarily committed |
793 | pursuant to such finding if the defendant has a mental illness |
794 | and, because of the illness, is manifestly dangerous to himself |
795 | or herself or others. |
796 | (3) Every defendant acquitted of criminal charges by |
797 | reason of insanity and found to meet the criteria for |
798 | involuntary commitment, except a defendant who is serving a |
799 | sentence in the custody of the Department of Corrections, may be |
800 | committed to the department and treated in accordance with the |
801 | provisions of this section and the applicable Florida Rules of |
802 | Criminal Procedure. The department shall admit a defendant so |
803 | adjudicated to an appropriate facility or program for treatment |
804 | and shall retain and treat such defendant. |
805 | (a) No later than 6 months after the date of admission, |
806 | prior to the end of any period of extended commitment, or at any |
807 | time the administrator or designee shall have determined that |
808 | the defendant no longer meets the criteria for continued |
809 | commitment placement, the administrator or designee shall file a |
810 | report with the court pursuant to the applicable Florida Rules |
811 | of Criminal Procedure. |
812 | (b) Whether housed in a department facility or a |
813 | Department of Corrections facility, within 15 days after the |
814 | court receives notification from the department that the |
815 | defendant no longer meets the criteria for continued commitment, |
816 | the defendant shall be transported back to jail pursuant to s. |
817 | 916.107(10) for the purpose of holding a competency hearing. |
818 | (c) A commitment hearing shall be held within 30 days |
819 | after the court receives notification from the department that a |
820 | defendant no longer meets the criteria for continued commitment |
821 | placement. |
822 | (4) A defendant who is serving a sentence in the custody |
823 | of the Department of Corrections and who has been charged with a |
824 | new felony and has been adjudicated not guilty by reason of |
825 | insanity shall be retained in the physical custody of the |
826 | Department of Corrections for the remainder of the defendant's |
827 | sentence. No later than 30 days prior to the anticipated release |
828 | date, the department shall evaluate the defendant and file a |
829 | report with the court requesting that the defendant be returned |
830 | to the court's jurisdiction to determine if the defendant |
831 | continues to meet the criteria for continued commitment |
832 | placement. |
833 | (5)(4) In all proceedings under this section, both the |
834 | defendant and the state shall have the right to a hearing before |
835 | the committing court. Evidence at such hearing may be presented |
836 | by the hospital administrator or the administrator's designee as |
837 | well as by the state and the defendant. The defendant shall have |
838 | the right to counsel at any such hearing. In the event that a |
839 | defendant is determined to be indigent pursuant to s. 27.52, the |
840 | public defender shall represent the defendant. The parties shall |
841 | have access to the defendant's records at the treating |
842 | facilities and may interview or depose personnel who have had |
843 | contact with the defendant at the treating facilities. |
844 | Section 16. Subsections (2) and (3) of section 916.17, |
845 | Florida Statutes, are renumbered as subsections (3) and (4), |
846 | respectively, and a new subsection (2) is added to that section |
847 | to read: |
848 | 916.17 Conditional release.-- |
849 | (2) A defendant who otherwise meets the criteria for |
850 | involuntary commitment under s. 916.13 but whose current most |
851 | serious charge is a third degree or nonviolent second degree |
852 | felony must be placed in a community residential facility for |
853 | competency restoration in demonstration areas established under |
854 | the Community Mental Health and Substance Abuse Treatment and |
855 | Crime Reduction Act in s. 394.9086, unless bed space or funding |
856 | is unavailable for the community placement or the trial court |
857 | makes an explicit finding that the defendant cannot be safely |
858 | managed in such a placement. In making the determination under |
859 | this subsection, the court shall consider all of the following: |
860 | (a) The nature and seriousness of the crime or crimes |
861 | allegedly 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 |
865 | threats of violent behavior and risk of harm to self or others. |
866 | (e) The likelihood that the individual will comply with |
867 | and benefit from the mental health treatment and services being |
868 | recommended. |
869 | (f) Availability of appropriate community-based services |
870 | and treatment settings. |
871 | (g) Other information considered relevant by the court. |
872 | Section 17. This act shall take effect July 1, 2008. |