HB 1327

1	A bill to be entitled
2	An act relating to forensic mental health; amending s.
3	394.457, F.S.; providing additional responsibilities for
4	certain contractors of the Department of Children and
5	Family Services; requiring the department to examine
6	opportunities for set-asides for service providers that
7	have supportive employment programs; authorizing the
8	department to make certain training available to
9	correctional personnel; amending s. 394.4655, F.S.;
10	providing for involuntary outpatient treatment plans that
11	require patients to take all prescribed medications in
12	certain circumstances; amending s. 916.107, F.S.;
13	requiring that certain adults with serious and persistent
14	mental illnesses in the state correctional system who do
15	not pose a public safety risk receive a forensic mental
16	health transition plan for treatment in a residential
17	setting; providing plan requirements; amending s. 916.13,
18	F.S.; providing timeframes for competency hearings to be
19	held for defendants adjudicated incompetent; amending s.
20	916.15, F.S.; providing timeframes for commitment hearings
21	to be held for defendants adjudicated not guilty by reason
22	of insanity; amending s. 916.145, F.S.; reducing from 5
23	years to 2 years the period after which charges may be
24	dismissed without prejudice against a defendant
25	adjudicated incompetent to proceed due to the defendant's
26	mental illness, but permitting a judge to extend the
27	period to a maximum of 5 years; providing for dismissal of
28	charges in a shorter period of time if the defendant
29	agrees to a conditional release plan meeting specified
30	requirements; amending s. 916.17, F.S.; limiting the
31	duration of conditional release orders issued for
32	defendants in lieu of an involuntary commitment to a
33	facility; providing for periodic review of such orders;
34	providing for modification of such orders for medication
35	compliance; providing for issuance of a new conditional
36	release order upon expiration of such an order; amending
37	s. 945.025, F.S.; requiring that prison medical facilities
38	include specialized mental health treatment wards whenever
39	possible; requiring the Department of Corrections to,
40	within current resources, create crisis intervention teams
41	to respond to behavioral outbursts by mentally ill
42	inmates; amending s. 945.48, F.S.; requiring the
43	Department of Corrections to, within current available
44	resources, provide mental health training to correctional
45	personnel who are likely to come in contact with mentally
46	ill inmates; requiring the department to adopt policies
47	and procedures concerning the use of chemical restraints
48	on mentally ill inmates; amending s. 948.001, F.S.;
49	defining the term "department" for purposes of ch. 948,
50	F.S.; creating s. 948.0395, F.S.; providing for creation
51	of a forensic mental health probation and parole program;
52	providing program requirements; providing for designation
53	of certain correctional probation officers as forensic
54	probation officers; providing for establishment of
55	requirements for such officers; providing duties for such
56	officers; providing for an advisory workgroup; authorizing
57	the chief judge of each circuit judge to establish a
58	mental health court; providing requirements for such
59	courts; authorizing specified activities by such courts;
60	requiring each court to have a coordinator for certain
61	aspects of the court's operations; requiring that such
62	courts be funded from existing revenues or from a
63	specified grant program; requiring the Department of
64	Children and Family Services to adopt certain rules
65	relating to supportive housing for persons released from
66	inpatient forensic mental health programs; requiring a
67	study of causes that impact the incarceration of the
68	mentally ill in state and local correctional facilities by
69	the Office of Program Policy Analysis and Government
70	Accountability; requiring a report to the Legislature by a
71	specified date; providing an effective date.
72
73	Be It Enacted by the Legislature of the State of Florida:
74
75	Section 1. Paragraphs (c) and (d) are added to subsection
76	(2) of section 394.457, Florida Statutes, and subsections (8)
77	and (9) are added to that section, to read:
78	394.457 Operation and administration.-
79	(2) RESPONSIBILITIES OF THE DEPARTMENT.-The department is
80	responsible for:
81	(c) Ensuring that each state contract mental health agency
82	that works with individuals who are under forensic mental health
83	probation and parole:
84	1. Ensures that each person enrolled in the probation and
85	parole program shall have a forensic case manager who is working
86	towards reducing the need for institutional placement.
87	2. Coordinates between the forensic probation and parole
88	program, mental health court, and other agencies needed to help
89	improve access to care.
90	(d) All forensic mental health programs and contracts
91	shall be supervised by the central office staff of the
92	department in cooperation with each circuit administrator.
93	(8) SUPPORTIVE EMPLOYMENT PROGRAMS.- The department,
94	within current resources, shall examine opportunities to
95	generate cost savings through the use of set-aside agreements
96	with supportive employment programs that serve forensic mental
97	health consumers living in the community under plans of
98	conditional release.
99	(9) TRAINING FOR CORRECTIONAL PERSONNEL.-The department
100	may make available training on the special needs of adult
101	forensic mental health inmates incarcerated in state
102	correctional facilities operated by the Department of
103	Corrections or a private vendor to the staffs of these
104	institutions.
105	Section 2. Paragraph (a) of subsection (2) of section
106	394.4655, Florida Statutes, is amended to read:
107	394.4655 Involuntary outpatient placement.-
108	(2) INVOLUNTARY OUTPATIENT PLACEMENT.-
109	(a)1. A patient who is being recommended for involuntary
110	outpatient placement by the administrator of the receiving
111	facility where the patient has been examined may be retained by
112	the facility after adherence to the notice procedures provided
113	in s. 394.4599. The recommendation must be supported by the
114	opinion of a psychiatrist and the second opinion of a clinical
115	psychologist or another psychiatrist, both of whom have
116	personally examined the patient within the preceding 72 hours,
117	that the criteria for involuntary outpatient placement are met.
118	However, in a county having a population of fewer than 50,000,
119	if the administrator certifies that a psychiatrist or clinical
120	psychologist is not available to provide the second opinion, the
121	second opinion may be provided by a licensed physician who has
122	postgraduate training and experience in diagnosis and treatment
123	of mental and nervous disorders or by a psychiatric nurse. Any
124	second opinion authorized in this subparagraph may be conducted
125	through a face-to-face examination, in person or by electronic
126	means. Such recommendation must be entered on an involuntary
127	outpatient placement certificate that authorizes the receiving
128	facility to retain the patient pending completion of a hearing.
129	The certificate shall be made a part of the patient's clinical
130	record.
131	2. If the patient has been stabilized and no longer meets
132	the criteria for involuntary examination pursuant to s.
133	394.463(1), the patient must be released from the receiving
134	facility while awaiting the hearing for involuntary outpatient
135	placement. Before filing a petition for involuntary outpatient
136	treatment, the administrator of a receiving facility or a
137	designated department representative must identify the service
138	provider that will have primary responsibility for service
139	provision under an order for involuntary outpatient placement,
140	unless the person is otherwise participating in outpatient
141	psychiatric treatment and is not in need of public financing for
142	that treatment, in which case the individual, if eligible, may
143	be ordered to involuntary treatment pursuant to the existing
144	psychiatric treatment relationship.
145	3. The service provider shall prepare a written proposed
146	treatment plan in consultation with the patient or the patient's
147	guardian advocate, if appointed, for the court's consideration
148	for inclusion in the involuntary outpatient placement order. The
149	service provider shall also provide a copy of the proposed
150	treatment plan to the patient and the administrator of the
151	receiving facility. The treatment plan must specify the nature
152	and extent of the patient's mental illness, address the
153	reduction of symptoms that necessitate involuntary outpatient
154	placement, and include measurable goals and objectives for the
155	services and treatment that are provided to treat the person's
156	mental illness and assist the person in living and functioning
157	in the community or to prevent a relapse or deterioration.
158	Service providers may select and supervise other individuals to
159	implement specific aspects of the treatment plan. The services
160	in the treatment plan must be deemed clinically appropriate by a
161	physician, clinical psychologist, psychiatric nurse, mental
162	health counselor, marriage and family therapist, or clinical
163	social worker who consults with, or is employed or contracted
164	by, the service provider. The service provider must certify to
165	the court in the proposed treatment plan whether sufficient
166	services for improvement and stabilization are currently
167	available and whether the service provider agrees to provide
168	those services. If the service provider certifies that the
169	services in the proposed treatment plan are not available, the
170	petitioner may not file the petition.
171	4. If the patient is to be supervised by a forensic mental
172	health case manager, the plan may require the patient to take
173	all prescribed medications.
174	Section 3. Subsection (12) is added to section 916.107,
175	Florida Statutes, to read:
176	916.107 Rights of forensic clients.-
177	(12) FORENSIC MENTAL HEALTH TRANSITION PLAN.-Adults with
178	serious and persistent mental illnesses who are incarcerated in
179	state correctional facilities and who do not pose a public
180	safety risk as determined by a judge and can be cared for in a
181	less expensive residential setting that will generate state
182	savings are eligible to participate in a forensic mental health
183	transition plan created by the Department of Corrections in
184	cooperation with the Department of Children and Family Services.
185	The forensic mental health transition plan shall allow a person
186	with serious and persistent mental illness to be transitioned to
187	a licensed and Department of Children and Family Services
188	approved step-down bed under a court-approved plan of
189	conditional release for the purpose of improving the care and
190	treatment of psychiatric symptoms while ensuring public safety.
191	Section 4. Subsection (2) of section 916.13, Florida
192	Statutes, is amended to read:
193	916.13 Involuntary commitment of defendant adjudicated
194	incompetent.-
195	(2) A defendant who has been charged with a felony and who
196	has been adjudicated incompetent to proceed due to mental
197	illness, and who meets the criteria for involuntary commitment
198	to the department under the provisions of this chapter, may be
199	committed to the department, and the department shall retain and
200	treat the defendant.
201	(a) Within No later than 6 months after the date of
202	admission and at the end of any period of extended commitment,
203	or at any time the administrator or designee has shall have
204	determined that the defendant has regained competency to proceed
205	or no longer meets the criteria for continued commitment, the
206	administrator or designee shall file a report with the court
207	pursuant to the applicable Florida Rules of Criminal Procedure.
208	(b) Within 20 days after the court receives notification
209	that a defendant is competent to proceed or no longer meets the
210	criteria for continued commitment, the defendant shall be
211	transported back to jail pursuant to s. 916.107(10) for the
212	purpose of holding a competency hearing, unless the defendant
213	can be transported directly to the competency hearing without
214	first returning to a county jail. Whenever feasible, defendants
215	should be released to community placement without returning to a
216	county jail.
217	(c) A competency hearing must be held within 30 days after
218	a court receives notification that the defendant is competent to
219	proceed or no longer meets criteria for continued commitment.
220	Section 5. Subsection (4) of section 916.15, Florida
221	Statutes, is renumbered as subsection (5), and a new subsection
222	(4) is added to that section to read:
223	916.15 Involuntary commitment of defendant adjudicated not
224	guilty by reason of insanity.-
225	(4)(a) Within 20 days after the court is notified that a
226	defendant no longer meets the criteria for involuntary
227	commitment placement, the defendant shall be transported back to
228	jail for the purpose of holding a commitment hearing, unless the
229	defendant can be transported directly to the commitment hearing
230	without first returning to a county jail. Whenever feasible,
231	defendants should be released to community placement without
232	returning to a county jail.
233	(b) The commitment hearing must be held within 30 days
234	after the court receives notification that the defendant no
235	longer meets the criteria for continued commitment placement.
236	Section 6. Section 916.145, Florida Statutes, is amended
237	to read:
238	916.145 Dismissal of charges.-
239	(1) The charges against any defendant adjudicated
240	incompetent to proceed due to the defendant's mental illness
241	shall be dismissed without prejudice to the state if the
242	defendant remains incompetent to proceed 2 5 years after such
243	determination or the court believes that an extension is needed,
244	in which case the court may extend the period for 1 additional
245	year at a time until the total time since the determination has
246	been 5 years, unless the court in its order specifies its
247	reasons for believing that the defendant will become competent
248	to proceed within the foreseeable future and specifies the time
249	within which the defendant is expected to become competent to
250	proceed. The charges against the defendant are dismissed without
251	prejudice to the state to refile the charges should the
252	defendant be declared competent to proceed in the future.
253	(2)(a) The charges against any defendant adjudicated
254	incompetent to proceed due to the defendant's mental illness may
255	be dismissed before the period provided in subsection (1) has
256	expired if the defendant enters into an agreement with the
257	department and the prosecution to participate in a plan of
258	conditional release as follows:
259	1. The department shall create a plan for compliance that
260	requires treatment of the defendant's mental illness.
261	2. The plan shall allow a forensic probation officer and
262	the department to track the defendant's compliance with the
263	plan.
264	3. The supervision of the plan is conducted by a forensic
265	case manager and a forensic probation officer.
266	(b) The criminal charges against a defendant who agrees to
267	the plan shall be continued without final disposition for a
268	period set out in the plan after the date the defendant was
269	released to the plan, if the defendant's participation in the
270	plan is satisfactory.
271	(c) Resumption of pending criminal proceedings shall be
272	undertaken at any time if the forensic case manager or state
273	attorney finds that the defendant is not fulfilling his or her
274	obligations under this plan or if the public interest so
275	requires.
276	(d) At the end of the period set out in the plan, the
277	forensic case manager and forensic probation officer shall
278	recommend:
279	1. That the case revert to normal channels for prosecution
280	when the defendant's participation in the plan has been
281	unsatisfactory;
282	2. That the defendant is in need of further supervision;
283	or
284	3. That dismissal of charges without prejudice shall be
285	entered in instances in which prosecution is not deemed
286	necessary.
287	Section 7. Section 916.17, Florida Statutes, is amended to
288	read:
289	916.17 Conditional release.-
290	(1)(a) Except for an inmate currently serving a prison
291	sentence, the committing court may order a conditional release
292	of any defendant in lieu of an involuntary commitment to a
293	facility pursuant to s. 916.13 or s. 916.15 based upon an
294	approved plan for providing appropriate outpatient care and
295	treatment for a period not to exceed 24 months after the date of
296	the order. Upon a recommendation that outpatient treatment of
297	the defendant is appropriate, a written plan for outpatient
298	treatment, including recommendations from qualified
299	professionals, must be filed with the court, with copies to all
300	parties. Such a plan may also be submitted by the defendant and
301	filed with the court with copies to all parties. The plan shall
302	include:
303	1.(a) Special provisions for residential care or adequate
304	supervision of the defendant.
305	2.(b) Provisions for outpatient mental health services.
306	3.(c) If appropriate, recommendations for auxiliary
307	services such as vocational training, educational services, or
308	special medical care.
309	4. Medication compliance requirements while under
310	conditional release.
311
312	In its order of conditional release, the court shall specify the
313	conditions of release based upon the release plan and shall
314	direct the appropriate agencies or persons to submit periodic
315	reports to the court regarding the defendant's compliance with
316	the conditions of the release and progress in treatment, with
317	copies to all parties.
318	(b) The court shall review the conditional release and the
319	defendant's compliance with those provisions at least once every
320	6 months or, in the court's discretion, more frequently.
321	(c) The court may, upon good cause shown, modify the
322	conditional release order at any time to expand the conditions
323	of the order to comply with the defendant's physician-prescribed
324	medication regimen.
325	(2) Upon the filing of an affidavit or statement under
326	oath by any person that the defendant has failed to comply with
327	the conditions of release, that the defendant's condition has
328	deteriorated to the point that inpatient care is required, or
329	that the release conditions should be modified, the court shall
330	hold a hearing within 7 days after receipt of the affidavit or
331	statement under oath. After the hearing, the court may modify
332	the release conditions. The court may also order that the
333	defendant be returned to the department if it is found, after
334	the appointment and report of experts, that the person meets the
335	criteria for involuntary commitment under s. 916.13 or s.
336	916.15.
337	(3) If at any time it is determined after a hearing that
338	the defendant who has been conditionally released under
339	subsection (1) no longer requires court-supervised followup
340	care, the court shall terminate its jurisdiction in the cause
341	and discharge the defendant.
342	(4) If a new conditional release order is recommended by
343	the department at the end of the period specified in the order
344	under subsection (1), the department must present competent
345	evidence that establishes the need for continued court
346	supervision due to a public safety threat or risk of violence
347	that might require continued court supervision in order to
348	obtain such an order. If the court concludes that this need has
349	been established, the court shall grant a new conditional
350	release order.
351	Section 8. Subsection (2) of section 945.025, Florida
352	Statutes, is amended to read:
353	945.025 Jurisdiction of department.-
354	(2) In establishing, operating, and utilizing these
355	facilities, the department shall attempt, whenever possible, to
356	avoid the placement of nondangerous offenders who have potential
357	for rehabilitation with repeat offenders or dangerous offenders.
358	Medical, mental, and psychological problems shall be diagnosed
359	and treated and prison medical facilities shall include
360	specialized mental health treatment wards whenever possible. The
361	department shall, within current resources, also create crisis
362	intervention teams within the state correctional system to
363	respond to behavioral outbursts of mentally ill inmates. The
364	Department of Children and Family Services and the Agency for
365	Persons with Disabilities shall cooperate to ensure the delivery
366	of services to persons under the custody or supervision of the
367	department. When it is the intent of the department to transfer
368	a mentally ill or retarded prisoner to the Department of
369	Children and Family Services or the Agency for Persons with
370	Disabilities, an involuntary commitment hearing shall be held
371	according to the provisions of chapter 393 or chapter 394.
372	Section 9. Subsection (1) of section 945.48, Florida
373	Statutes, is amended, and subsection (7) is added to that
374	section, to read:
375	945.48 Rights of inmates provided mental health treatment;
376	procedure for involuntary treatment.-
377	(1) RIGHT TO QUALITY TREATMENT.-An inmate in a mental
378	health treatment facility has the right to receive treatment
379	that is suited to his or her needs and that is provided in a
380	humane psychological environment. Such treatment shall be
381	administered skillfully, safely, and humanely with respect for
382	the inmate's dignity and personal integrity. The department
383	shall, within current available resources, provide mental health
384	training, such as crisis intervention training, to correctional
385	personnel who are likely to come in contact with mentally ill
386	inmates.
387	(7) CHEMICAL RESTRAINTS.-The department shall adopt
388	policies and procedures that must be followed before chemical
389	agents may be used to control behavior of mentally ill inmates.
390	Section 10. Subsections (4) through (10) of section
391	948.001, Florida Statutes, are renumbered as subsections (5)
392	through (11), respectively, and a new subsection (4) is added to
393	that section to read:
394	948.001 Definitions.-As used in this chapter, the term:
395	(4) "Department" means the Department of Corrections.
396	Section 11. Section 948.0395, Florida Statutes, is created
397	to read:
398	948.0395 Forensic probation and parole program.-
399	(1) The department shall create a forensic mental health
400	probation and parole program that shall be responsible for
401	reentry of mentally ill inmates back into the community.
402	(2) The forensic probation and parole program shall be
403	focused on compliance with care, supervision of conditional
404	plans of release, tracking information, and reducing
405	inappropriate placements and jail utilization. The department
406	shall make sex offenders with a mental illness a high priority
407	for supervision and for placement in safe housing that is not
408	located near locations where children regularly congregate.
409	(3) This program shall be established within the current
410	department funding and the secretary may reorganize the
411	probation and parole staff and programs to assist with the
412	development of the forensic mental health program. The
413	department may have a probation officer serve in a dual role as
414	a trained forensic mental health probation officer as well as an
415	officer for persons who have general probation and parole.
416	(4)(a) The department may designate correctional probation
417	officers as forensic probation officers.
418	(b) The department shall establish requirements for such
419	forensic mental health probation officers.
420	(c) Forensic mental health probation officers shall
421	coordinate issues and compliance with the Department of Children
422	and Family Services' forensic case manager and establish plans
423	with the goal of improving plan compliance and reducing the need
424	for incarcerations due to violations.
425	(d) Forensic mental health probation officers shall work
426	with all relevant agencies to further the goals of the forensic
427	mental health program.
428	(5) The department may establish an advisory workgroup to
429	assist it with gathering input, providing professional
430	expertise, and assisting in developing appropriate policies and
431	procedures to ensure implementation of this section.
432	(6) The department shall adopt rules pursuant to ss.
433	120.536(1) and 120.54 to implement the provisions of this
434	section conferring duties upon it.
435	Section 12. (1) The chief judge of each circuit may
436	establish a mental health court to help reduce the cost of
437	managing cases that pertain to persons with mental illnesses who
438	have court involvement and shall supervise the court.
439	(2) Each mental health court shall:
440	(a) Have an advisory workgroup for the purpose of
441	providing input, which shall serve as a coordinating workgroup
442	to help improve access to community-based services and improve
443	access to care for individuals involved with the criminal
444	justice system.
445	(b) Establish eligibility criteria. Individuals charged
446	with felonies who upon evaluation are considered a minimal
447	threat to public safety may be considered for mental health
448	court involvement.
449	(c) Be focused on improving compliance with mental health
450	care and treatment and may require state agencies to comply with
451	its orders and directives.
452	(d) Supervise the processing of felonies and misdemeanors
453	and determine which cases shall be referred for criminal
454	prosecution and incarceration and those who would be eligible
455	for diversion programs and alternatives.
456	(e) Be the ongoing contact with the criminal justice
457	system for persons found incompetent to proceed and supervise
458	the community control for such persons under s. 916.145(2),
459	Florida Statutes.
460	(f) Process all evaluations for persons charged with a
461	felony and require evaluations for competency to proceed or not
462	guilty by reason of insanity determinations.
463	(3) A mental health court may:
464	(a) Establish drug repository programs and accept unused
465	medications from nursing homes and licensed assisted living
466	facilities to be repackaged and used for mental health court
467	participants who need medications.
468	(b) Provide a waiver of charges and allow the court
469	flexibility in dispositions.
470	(c) Authorize the use of medication algorithms for mental
471	health court participants.
472	(d) Require individuals who are enrolled in Medicaid,
473	prepaid mental health plans, or Medicaid HMOs to obtain maximum
474	available reimbursement for all medically necessary services.
475	(4)(a) Each mental health court shall have a coordinator
476	to run the day-to-day elements of the program.
477	(b) The coordinator shall supervise the forensic mental
478	health case managers and shall receive reports from the case
479	managers.
480	(c) The coordinator shall evaluate the threat to public
481	safety and make recommendations to the court regarding
482	compliance or appropriateness for court involvement.
483	(5) A mental health court may supervise compliance with
484	the assisted outpatient treatment laws as such laws relate to
485	court requirements that outpatients take their medications.
486	(6) Mental health courts shall be funded from within
487	existing resources or from grants under s. 394.658, Florida
488	Statutes.
489	Section 13. The Department of Children and Family Services
490	shall adopt rules pursuant to ss. 120.536(1) and 120.54, Florida
491	Statutes, that relate to supportive housing for persons released
492	from inpatient forensic mental health programs to define such
493	housing and to address the health and safety of and the use of
494	any state subsidies appropriated for such housing.
495	Section 14. The Office of Program Policy Analysis and
496	Government Accountability (OPPAGA) shall perform a study of the
497	forensic mental health system. The study shall examine the
498	causes that impact the incarceration of the mentally ill in
499	state and local correctional facilities. The report shall be
500	submitted to the President of the Senate and the Speaker of the
501	House of Representatives by December 31, 2010.
502	Section 15. This act shall take effect July 1, 2010.

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