The following is a real-time transcript taken as closed captioning during the oral argument proceedings, and as such, may contain errors. This service is provided solely for the purpose of assisting those with disabilities and should be used for no other purpose. These are not legal documents, and may not be used as legal authority. This transcript is not an official document of the Florida Supreme Court.
FLORIDA SUPREME COURT 2007
MENTAL HEALTH SUMMIT
11/14/07
>> FRIENDS PLEASE WELCOME THE
GOVERNOR OF THE STATE OF FLORIDA
, CHARLIE CRIST.
[APPLAUSE]
[APPLAUSE]
FRIENDS WELCOME TO THE FLORIDA
SUPREME COURT, AND THE 2,007
MENTAL HEALTH SUMMIT.
THERE BEEN SO MANY PEOPLE THAT
HAVE WORKED SO HARD TO MAKE THIS
DAY HAPPEN.
HISTORICALLY, BACK IN THE SUMMER
OF 2006, A SEED WAS PLANTED AND
WE IN THE COURT SYSTEM WOULD
BEGIN EVALUATING AND STUDYING
THE INTERACTION OF THOSE
SUFFERING FROM MENTAL ILLNESSES
AND THOSE HAVING EMOTIONAL
DISTURBANCES WITHIN THE COURT
SYSTEM, RECOGNIZING THAT WE ARE
NOT POLICY-MAKERS, YET WE HAVE A
FUNDAMENTAL OBLIGATION TO BE
ABLE TO RESOLVE ISSUES THAT
RELATE TO THAT AREA.
IN THE LATE SUMMER, AS THE
UNFORTUNATE WOULD HAVE IT, THE
LATE SUMMER AND IN THE EARLY
FALL, WE BEGAN TO REACH A CRISIS
IN THE STATE OF FLORIDA.
HEADLINES, I AM SURE ALL OF YOU
SAW AROUND THE STATE, CRIED OUT
FOR SOME TYPE OF ATTENTION.
THEN IN THE FALL OF 2006, WE HAD
GREAT LEADERSHIP CUMMINS TO THE
EXECUTIVE BRANCH, COMMEND TO THE
LEGISLATIVE BRANCH AND BY THE
LATE FALL OF 2006 WE BEGAN
FORMULATING A SUBCOMMITTEE TO
BEGIN ANALYZING HOW WE MAY HELP
RESOLVE ISSUES OF THOSE
INTERACTING WITH THE COURT
SYSTEM WITH MENTAL HEALTH
ISSUES.
WITH THE SUPPORT OF THE
INITIALLY OF THE FLORIDA BAR
THROUGH GRANTS FROM THE FLORIDA
BAR FOUNDATION WE WERE ABLE TO
PLACE A JUDGE ON THIS ISSUE ON A
FULL-TIME BASIS.
THEN WITH THE HELP OF THE
LEGISLATIVE BRANCH, THE
APPROPRIATED FUNDS SO WE COULD
CONTINUE TO WORK IN THAT AREA.
THERE ARE SO MANY PEOPLE, SO
MANY PEOPLE WE NEED TO THANK
TODAY AND I WOULD SPEND ALL OF
OUR TIME DOING THAT BUT THOSE OF
YOU WHO HAVE WORKED ON THIS,
BELIEVE ME THE PEOPLE OF FLORIDA
THANK YOU FOR WHAT YOU HAVE
DONE.
I AM PROUD TO BE A FLORIDIAN
TODAY BECAUSE THESE OTHER KINDS
OF THINGS THAT WE OUGHT TO BE
ABOUT.
WE OUGHT TO BE ABOUT
COOPERATION, WE OUGHT TO BE
ABOUT COLLABORATION AND WE OUGHT
TO BE ABOUT THE BUSINESS OF THE
COMMON GOOD AND WORKING
TOGETHER.
ZOE IN THE JUDICIAL BRANCH ARE
CONSTANTLY WILLING TO REACH OUT
WHEN THERE ARE LEADERSHIP
POSITIONS FILLED BY THOSE SUCH
AS GOVERNOR CHRIS AND THE
INDIVIDUALS IN HIS LEADERSHIP
TEAM.
THESE ARE THE KINDS OF THINGS
THAT CAN HAPPEN AND WE MAY
REALIZE.
I WOULD CAUTION, CERTAINLY ALL
OF YOU I HOPE UNDERSTAND WE ARE
IN A TIME OF GREAT BUDGET AREAS.
AND AS WE FINISH THE LAST
LEGISLATIVE SESSION WE BEGAN
LOOKING AT WHERE CUTS WERE GOING
TO BE.
TODAY I HOPE WE ARE GOING TO
DISCUSS PLANS AND PROGRAMS AND
IDEAS THAT MAY BE IMPLEMENTED
WITHOUT CREATING UNREALISTIC
EXPECTATIONS.
THIS IS A BOLD ATTEMPT TO
ADDRESS THE ISSUES THAT FOR SO
LONG HAVE NOT BEEN ADDRESSED.
SO I WOULD LIKE TO TAKE THE
OPPORTUNITY TO OF KNOWLEDGE A
FEW OF THOSE, WHO HAVE WORKED SO
HARD WITH REGARD TO THIS.
AND OUR STATE COURT
ADMINISTRATOR, LISA GOODYEAR IS
HERE WITH US TODAY.
OUR DEPUTY, LYNN, ROSE PATTERSON
WHO IS CHIEF OF THE OFFICE OF
IMPROVEMENT AND SHE HAS BEEN
DEDICATING HERSELF TO CHILDREN
AND FAMILIES FOR A LIFETIME.
DANA GELLING, THE SENIOR
ATTORNEY IN THE OFFICE OF COURT
IMPROVEMENT AND LINDA MCNEIL WHO
HAS OPERATED STAFF FOR THIS
GROUP AND WORKED SO DILIGENTLY
TO HELP BRING THIS PROJECT
TOGETHER.
I WOULD ALSO LIKE TO RECOGNIZE
THOSE WHO HAVE COME FROM OUR
CHIEF JUSTICE, WHO HAVE COME TO
TALLAHASSEE TODAY AND INDICATED
THAT THEY WOULD BE PRESENT.
I DID NOT SEE, IT IS THE CHIEF
JUDGE FRANCIS, CHIEF JUDGE OF
VERNON DOUGLAS, DAN MERIT, DAVID
WALSH, A JUDGE WALSH, THANK YOU
FOR BEING HERE SIR.
JUDGE WALSH IS THE CHIEF JUDGE
OF THE SEVENTH JUDICIAL SERVICE.
THANK YOU FOR BEING HERE FROM
FALLUJAH COUNTY.
I DID SEE REPRESENTATIVE FROM
THE KEYS, JUDGE WAYNE MILLER WHO
IS VERY HELPFUL IN OUR SYSTEM.
THE RECENTLY ELECTED JUDGE
VICTOR TOBIN, FROM FORT
LAUDERDALE AND JUDGE WILLIAM
ROBEY, THE CHIEF JUDGE IN THE
19TH JUDICIAL CIRCUIT ALONG WITH
THE CUZ.
WE THANK YOU ALL OF YOU FOR
BEING HERE.
TODAY'S PROGRAM I HOPE WILL BE
INVIGORATING.
I HOPE IT WILL UNTIES YOUR IDEAS
AND I HOPE THAT IT WILL HELP YOU
DEDICATE YOURSELF TO RESOLVING
SOME ISSUES AND WITH THAT
PROCEDURAL INTRODUCTION, IT IS
NOW MY HONOR TO INTRODUCE TO YOU
THE GOVERNOR OF THE GREAT STATE
OF FLORIDA, THE LEADER OF THIS
EFFORT, THE HONORABLE GOVERNOR
OF FLORIDA, CHARLIE CRIST.
[APPLAUSE]
pp>> IT IS A TALL ORDER TO FOLLOW
THE CHIEF AT HIS PODIUM AND I
JUST WANT TO THANK HIM
PERSONALLY BEFORE I GIVE A FEW
REMARKS AND ALL THE JUSTICES.
IT IS AN HONOR TO BE IN YOUR
PRESENCE.
THANK YOU FOR YOUR WORK YOUR DO
FOR THE WORK OF, THE WISDOM YOU
PRESERVE AND THE KINDEST YOU
EXTEND.
BUT I HAD THE OCCASION TO HAVE
DINNER AT THE CHIEF'S HOUSE NOT
LONG AGO AND WITH HIS WIFE AND
BEAUTIFUL DAUGHTER AND WE HAD A
WONDERFUL EVENING.
EVER SINCE I'VE BEEN TRYING TO
GET BACK TOGETHER IN ORDER TO
WATCH A FOOTBALL GAME AND IT HAS
NOT HAPPENED YET NOTE IT GIVES
YOU A SENSE OF HOW BUSY WE ARE
AND MORE SO HOW BUSY HE IS AND
HOW DEDICATED HE IS TO FLORIDA.
THIS IS AN IMPORTANT ISSUE.
ALL OF YOU IN THIS ROOM REALIZE,
IT IS IMPORTANT TO UNDERSTAND BY
THE GRACE OF GOD THERE GO ON.
AND WHEN YOU DEDICATE YOURSELF
AND YOUR ENERGY -- SENATOR IT IS
GOOD TO SEE YOU -- TO IMPROVING
THE LIVES OF OTHERS, IT MAKES AN
ENORMOUS DIFFERENCE AND IT IS,
IT CAN NEVER BE UNDERESTIMATED
THE POWER OF ONE.
AND THE POWER THAT YOU HAVE JUST
ARE WORKING TOGETHER THROUGH
COOPERATION AS THE CHIEF JUSTICE
TOLD US TO MAKE A DIFFERENCE IN
THE LIVES OF OTHERS IN YOUR
COMPASSION, YOUR HEART, YOUR
DESIRE, YOUR LABOR MAKE ALL THE
DIFFERENCE IN THE WORLD AND THE
WILLING HEART THAT YOU HAVE
MAKES THE DIFFERENCE IN THEIR
LIVES FIRST AND FOREMOST.
AND WE HAVE GREAT SECRETARIES
HERE AND I AM VERY PROUD OF
THEM.
THANK YOU FOR ACCEPTING THE
APPOINTMENT, BUT WHETHER IN LAW
ENFORCEMENT, WHETHER IN HELPING
ON THE FRONT END RATHER THAN THE
BACK END, WE WANT TO DO
EVERYTHING WE CAN ACHIEVE FROM
THE ADMINISTRATION'S POINT OF
THE FEW TO BE SIGNIFICANT A
PARTNER AS YOU WILL AND GENERAL
BUTTERWORTH, I -- GENERAL
SECRETARY BUTTERWORTH, IS A DEAR
FRIEND AND HIS COMMITMENT AND
HIS HEART FOR CHILDREN IS TRULY
HEARTFELT.
HE IS A PREDECESSOR OF MINE AS
ATTORNEY GENERAL, A GREAT MAN
WHO HAS GIVEN OF HIS TIME AND
HIS WISDOM AND HIS ENERGY.
HE HAS BOUNDLESS ENERGY AND I
LOVE YOU FOR A GENERAL, BUT BY
WORKING TOGETHER-MACKY HAPPENS
TO BE A DEMOCRAT.
AND I HAPPEN TO BE REPUBLICAN,
BUT HERE IS THE TRUTH.
WE ARE ALL FLORIDIANS.
THAT IS THE TITLE WE ALL SHARE.
THAT IS WHAT WE ALL NEED TO BEAR
IN MIND AND WORK TOGETHER TO DO
WHAT IS RIGHT.
AND WHAT WE ARE HERE ABOUT TODAY
COULD NOT BE MORE RIGHT.
IT IS INCREDIBLY IMPORTANT WE
FOCUS ON OTHERS, THAT WE DO UNTO
OTHERS AND THAT WE ALWAYS HELP
THEM.
I HAVE HAD ALL THESE PREPARED
COMMENTS.
THERE IS PROBABLY SOMETHING IN
HERE IMPORTANT THAT I AM
SUPPOSED TO CONCLUDE THAT WILL
GO OUT IN THE PRESS RELEASE.
I HAVE ALREADY SAID IT, BUT I
HAVE LEARNED THAT IF YOU SAY IT
EL LITTLE BIT LESS IT GOES A LOT
LONGER WAY.
I BELIEVE IN LET MY PEOPLE GO SO
I WILL NOW SIT DOWN AND, BY
THANK YOU FROM THE BOTTOM OF MY
HEART FOR WHAT YOU ARE DOING,
THANK YOU FOR YOUR DEDICATION
AND THANK YOU FOR YOUR
COMPASSION FIRST AND FOREMOST.
GOD BLESS YOU AND GOD BLESS
FLORIDA.
[APPLAUSE]
pp>> THE CHIEF SAID THAT THE
WHITE-HAIRED GUYS GO FIRST.
WELCOME EVERYBODY IN GOVERNOR,
THANK YOU FOR THOSE VERY NICE
COMMENTS.
THE CHIEF STATED THAT WE HAD A
PROBLEM IN OUR SYSTEM IN THE
MENTAL HEALTH SYSTEM, AND IT WAS
COMING TO CLOSURE, IT WAS COMING
TO CLOSURE WITH UNFORTUNATELY
D.C. OF BEING INVOLVED IN MANY
LAWSUITS.
DE CF SECRETARY HELD IN CONTEMPT
, NOT HER FAULT.
GOVERNOR CRIST GAVE ME A CALL
AND WE MET IN TALLAHASSEE.
ANDY STATED, I WOULD LIKE YOU TO
BECOME PART OF THE
ADMINISTRATION.
I SAID, I APPRECIATE THAT.
WHAT YOU HAVE IN MIND?
WE TALKED ABOUT THE DEPARTMENT
OF CHILDREN AND FAMILIES.
THANK YOU GOVERNOR.
pp>> YOU SAID NO REPUBLICAN WOULD
TAKE IT, THAT IS WHAT YOU TOLD
ME.
DCF AND JUVENILE JUSTICE.
pp>> ALL KIDDING ASIDE, THE
GOVERNOR DID SAY THE FIRST THING
HE WANTED DONE WAS TO RESOLVE
THIS ISSUE OF HAVING ALMOST
RENDERED PEOPLE IN A STATE
SYSTEM IN THE COUNTY SYSTEM, WHO
HAVE ALREADY PROCEEDED TO TRIAL
AND GETTING WORSE AND WORSE.
HE WANTED TO MAKE SURE THAT NO
STATE AGENCY SUED ANOTHER STATE
AGENCY OR GOT INVOLVED IN
LAWSUITS WITH OTHER AGENCIES AND
THAT WAS THE KEY THING, WHICH
REALLY WENT A LONG WAY WITH ME.
A GOVERNMENT THAT WOULD
COOPERATE WITH EACH OTHER AND
THE GOVERNOR'S COMMITMENT TO
CHILDREN OF THE STATE AND THE
PEOPLE WHO HAVE MENTAL ILLNESS
AND OTHER ISSUES SUCH AS STRONG
COMMITMENT, I KNEW THIS WAS WET
WHEN IT TO SERVE WITH AND WHERE
I WANTED TO SERVE.
I WANT TO THANK THE JUDGES AND
PUBLIC DEFENDERS, THE STATE
ATTORNEYS, THE SHERIFFS TO ALL
CAME TOGETHER IN ORDER TO HELP
US COME OUT FROM UNDER THIS
PARTICULAR ISSUE.
FOR THIS ISSUE ONLY GOES TO THE
POINT OF WHAT HAPPENS AT THE END
, AT THE VERY COSTLY
EXPENSIVE AND AND IT IS
WONDERFUL THAT THE CHIEF JUSTICE
WAS ABLE TO GET A JUDGE TO COME
FULL TIME HERE WITH THE COURTS
TO ADDRESS THIS ISSUE BECAUSE
TODAY, AND WHEN WE HAD TO APPEAR
BEFORE THE LEGISLATURE AND ASK
FOR THAT $90 MILLION WHICH WILL
SOON BE $50 MILLION, MY COMMENT
WAS IN MY 35 YEARS IN
GOVERNMENT, THESE ARE THE COPPS
ALERT WORST HOURS THAT I AM
ASKING FOR.
WHAT WE ARE PAYING FOR NOW IS
1700 BED AT A COST OF
$250 MILLION, A QUARTER OF A
BILLION DOLLARS.
IN A REPORT THAT YOU HAVE THERE
IN FRONT OF YOU IT WILL SHOW
THAT IN THE NEXT FEW YEARS THAT
COST, BY ADDING MORE PEOPLE INTO
THAT SYSTEM, WILL BE A HALF A
BILLION DOLLARS.
IF WE CAN WORK OUT TOGETHER THE
EXECUTIVE BRANCH, JUDICIAL AND
LEGISLATIVE BRANCH WORKING
TOGETHER, WORKING ON THE FRONT
END, WE WILL NOT HAVE TO USE
THOSE USELESS DOLLARS, BUT SO
MANY DOLLARS FOR SUCH AN ISSUE
THAT WE REALLY SHOULD HAVE
ADDRESSED EARLY ON.
AGAIN, JUDGE LOUIS THANK YOU FOR
PUTTING THIS TOGETHER EVERYBODY
HERE IN THE WORLD, IT IS
FANTASTIC.
[APPLAUSE]
I WOULD ALSO LIKE TO WELCOME --
I AM SORRY I OVERLOOKED THE
CHIEF JUDGE ROBERT MOORE'S FROM
THE SIXTH JUDICIAL CIRCUIT IS
WITH US TODAY, AND CHIEF JUDGE
RICK SMITH FROM THE EIGHTH
JUDICIAL CIRCUIT IS WITH US
TODAY IN CHIEF JUDGE BILL
POLYMER FROM THE FIFTH DISTRICT
COURT OF APPEAL IS ALSO WITH US.
DR. CRFA AGWUNOBI.
pp>> THANK YOU, I AM A SECRETARY
FOR THE AGENCY OF HEALTH CARE
ADMINISTRATION AND IT IS AN
HONOR TO BE HERE.
I WANT TO THANK OUR LEADER,
GOVERNOR CRIST.
I WILL JUST CALL HIM OUR LEADER
AND I WANT TO THANK HIM FOR
APPOINTING ME BECAUSE I AM
HONORED TO BE IN THIS ROLE.
BUT ALSO FOR COMMUNICATING
CLEARLY TO ALL OF THE AGENCY
HEADS AND OTHERS IN THE
EXECUTIVE BRANCH THAT WE HAVE TO
COLLABORATE.
IT IS ABOUT THE PEOPLE OF
FLORIDA AND ABOUT THE SERVICES
AND WE HAVE TO WORK TOGETHER.
WE HAVE ADOPTED AN EMBRACE THAT
SPIRIT AND I WANT TO THANK YOU.
ALSO CHIEF JUSTICE AND EVERYONE
THAT IS MADE THIS POSSIBLE.
YOU KNOW, WALLS ARE ESSENTIAL
FOR SECURITY, ESSENTIAL FOR
SAFETY, ESSENTIAL FOR PRIVACY,
BUT FOR HEALTHCARE, WHAT IS
ESSENTIAL IS MERGING WHAT
HAPPENS ON EITHER SIDE OF WALLS,
AND THAT IS HOW HEALTHCARE WORKS
REALLY WELL.
THAT IS WHAT THIS IS REALLY
ABOUT AT ITS CORE.
I THINK THE BEST PARALLEL IN
TERMS OF PHYSICAL HEALTH IS,
TAKE HOSPITALS FOR EXAMPLE, IF
YOU HAVE SOMEONE WHO IS REALLY
SICK IN THE HOSPITAL AND IT GETS
TO THE POINT WE CAN SEND THEM
HOME BUT THEY ARE NOT TOTALLY
WELL, IF YOU DON'T SEND THEM
INTO A SUPPORTIVE COMMUNITY WITH
A WELL MANAGED, WELL SUPPORTED
SERVICES TO SUPPORT THEM, THEY
GET READMITTED TO THE HOSPITAL
AND IN FACT WE CONSIDER
READMISSION RATES TO HOSPITALS
WITHIN A CERTAIN PERIOD OF TIME
AS BEING A SIGN OF BAD QUALITY.
YOU SEND THEM OUT AND HAVE TO
READMIT THEM.
AND MENTAL HEALTH, IN THE
CORRECTIONAL SYSTEM, SOMEONE IS
SENT OUT, DISCHARGE OR DISCHARGE
FROM THE CORRECTIONAL SYSTEM AND
STILL HAVE MENTAL HEALTH
PROBLEMS, WHAT HAPPENS?
THEY END UP BEING READMITTED
QUITE SOON BECAUSE OF SOMETHING
THAT HAPPENED AS A RESULT OF
THEIR MENTAL HEALTH PROBLEM.
THE ADDITIONAL PROBLEM WITH THAT
OF COURSE IS THAT BECAUSE OF THE
NATURE OF THEIR ILLNESS, AND
MANY OF THESE PEOPLE CANNOT SEEK
SERVICES WHEN THEY ARE NOT
ACTUALLY BEING GIVEN THEM IN A
DIRECT FASHION.
SO, THIS INITIATIVE IS VERY
IMPORTANT I THINK FOR THE PEOPLE
OF FLORIDA.
IT IS REALLY IN MY MIND ABOUT
DISEASE MANAGEMENT IN CASE
MANAGEMENT.
THAT IS REALLY WHAT IT IS.
CASE MANAGING THESE PEOPLE AND
MANAGING THEIR ILLNESS
STYLISTICALLY AND THAT IS
SOMETHING THAT IS IMPORTANT FOR
US TO DO.
IT IS THE POWER AGENCY'S MISSION
TO INSURE ACCESS TO AFFORDABLE,
QUALITY HEALTHCARE FOR ALL
FLORIDIANS.
WE THINK THIS IS RIGHT THERE IN
THE BULLSEYE OF THAT.
AND WE BELIEVE WE ARE ALREADY
RESPONSIBLE FOR THESE
INDIVIDUALS, MANY OF THESE
INDIVIDUALS WHEN THEY COME OUT.
WE ARE RESPONSIBLE FOR THEM, SO
WE CAN'T DO ANYTHING BUT A
FLAWED PEOPLE THAT SAY, WELL
LET'S TRY AND BE RESPONSIBLE FOR
THEM BUT DO IT IN THE MOST
EFFICIENT MANNER POSSIBLE SO I
WANT TO THANK THOSE WHO HAVE
LEAD.
WE HAVE FOLLOWED THE LEADERS IN
THIS AND I WANT TO THANK
EVERYONE FOR BEING HERE AND
ALANAS FOR -- TO BE A PART OF
THIS.
THANK YOU.
[APPLAUSE]
pp>> GOOD AFTERNOON, I AM THE
SECRETARY OF THE DEPARTMENT OF
CRIMINAL JUSTICE.
AND FOR ABOUT 28 YEARS, I'VE
SERVED HERE IN THE CITY OF
TALLAHASSEE AS THE POLICE CHIEF.
ONE OF THE THINGS WE HAVE
GRAPPLED WITH IN LAW ENFORCEMENT
FOR WHAT SEEMS LIKE A LIFETIME
HAS BEEN THE ISSUE OF MENTAL
HEALTH.
I SAW AT LEAST ONE SHERIFF IN
THE ROOM WHEN I CAME IN, AND I
SHARE THE LIMITATIONS OF
SHERIFFS ALL OVER OUR STATE WITH
RESPECT TO THE PSYCHOTROPIC
DRUGS THAT THEY ARE DISPENSING
AT ALARMING RATES AND THE
CARNAGE THAT TAKES PLACE ACROSS
OUR COMMUNITIES AS A RESULT OF
THE MENTALLY ILL AND OUR LACK OF
CAPACITY, SO I TO ADD MY VOICE
TO THANK OUR GOVERNOR AND CHIEF
JUSTICE LEWIS, AND CHIEF LEIFMAN
FOR TAKING ON THIS INITIATIVE IN
TERMS OF TRANSFORMING THE MENTAL
HEALTH ISSUES FOR THE STATE OF
FLORIDA.
LIKE SO MANY ISSUES, THE STATE
OF FLORIDA IS STEPPING OUT IN
LEADING THE WAY, PARTICULARLY
LEADING THE WAY WITH RESPECT TO
MENTAL HEALTH ISSUES AND
JUVENILE ISSUES.
I HOPE THAT MANY OF YOU KNOW AND
REALIZE THAT THE WORK OF THIS
COMMITTEE, THIS COUNCIL, IS NOT
OVER, THAT THERE IS A HUGE PIECE
OF THIS COMPONENT THAT WILL BE
ADDRESSED HOPEFULLY IN THE
SECOND ROUND AND THAT IS THE
JUVENILE COMPONENT OF MENTAL
HEALTH.
YOU SHOULD KNOW THAT,
UNFORTUNATELY, SOME 65% OF THE
YOUTH TO COME INTO JUVENILE
JUSTICE SUFFER FROM SOME DEGREE
OF MENTAL ILLNESS, AND THAT IS
THE REALITY THAT WE MUST
ADDRESS.
WE MUST ADDRESS THAT UP FRONT
AND PREVENT THOSE KIDS FROM
GOING DEEPER INTO OUR CRIMINAL
JUSTICE SYSTEM.
SO IT IS THAT FROM THAT
PERSPECTIVE RYE RICE HERE THIS
AFTERNOON TO ADD MY VOICE TO
THIS INITIATIVE AND TO THANK YOU
THOSE WHO HAVE PUT YOUR HANDS TO
MAKING THIS DOCUMENT LIVED AND
THE RECOMMENDATIONS I KNOW WILL
COME FORTH AND MAKE A DIFFERENCE
IN THE GREAT STATE OF FLORIDA.
THANK YOU.
[APPLAUSE]
pp>> GOOD AFTERNOON, I AM JIM
MCDONOUGH.
LIKE OTHERS BEFORE YOU, I AM
HONORED TO BE HERE IN SUPPORT OF
THIS GREAT EFFORT.
I AM COGNIZANT THAT THE STAR OF
OUR SHOW IS ABOUT TO COME ON AND
BRIEF US ON HIS EXCELLENT REFORM
SO I WILL BE BRIEF AND THEN I
WILL BE GONE, BACK TO MY SEAT.
BUT I DON'T WANT TO SIT DOWN
WITHOUT ACKNOWLEDGING THE
SIGNIFICANCE OF WHAT IS
HAPPENING HERE.
FIRST OF ALL, THE LEADERSHIP HAS
BEEN ACKNOWLEDGED BY WANTED TO
TELL CHIEF JUSTICE LEWIS I
ADMIRE HIM GREATLY, I TRULY DO
FOR WHAT YOU ARE DOING AND
GOVERNOR BULL -- CRIST IT IS AN
HONOR TO SERVE WITH YOU.
STRIKE THAT.
, I APOLOGIZE GOVERNOR CHRIS.
IT IS AN HONOR TO SERVE WITH YOU
AND I AM PLEASED TO BE HERE.
BUT AS I LOOK AROUND THE ROOM, I
SEE SO MANY OTHERS THAT HAVE
BEEN HERE.
WHAT YOU HAVE REALLY IS A
COMBINATION OF MANY BRANCHES --
BRANCHES OF GOVERNMENT.
pp>> SENATOR WISE YOU ARE HERE
TODAY AND I ADMIRE YOU AS WELL
FOR YOUR SUPPORT AND I NOTE YOU
REPRESENT THE LEGISLATIVE
SUPPORT.
PEOPLE LIKE JUDGE MAY, DAVE
MILLER, THE HEALTH CORP. IT IS
YOUR EFFORTS THAT HAVE CARRIED
ON THIS CALL.
AS I LOOK AROUND AND I SEE THE
MENTAL HEALTH ADVOCACY GROUPS IN
THE ROOM, TRULY WHAT WE ARE
DOING HERE IS SIGNIFICANT.
I ONLY HAVE THIS TO ADD TO IT.
IN 1970, 75 I REMEMBER THE GREAT
THEORY THAT LEAD TO THE
EVACUATION OF MENTAL
INSTITUTIONS AROUND THE COUNTRY.
THE THEORY WAS THAT WE WOULD
TAKE THEM OUT OF THE MENTAL
INSTITUTIONS, THEY WOULD RETURN
TO COMMITTEE AND FAMILY.
OF THE FAMILY WOULD TAKE CARE OF
THEM AND ALWAYS GET BETTER.
IN THOSE YEARS THERE WERE FIVE
AND A THOUSAND MENTALLY ILL IN
VARIOUS INSTITUTIONS IN THE
COUNTRY.
TODAY THERE ARE 5,000.
THERE ARE IN FACT FIVE AND A
THOUSAND IN OUR PRISONS OF THE
MENTALLY ILL AROUND THE COUNTRY,
SO IN SOME WAY THERE IS BEEN A
MASSIVE DISPLACEMENT AND THE
THEORY DID NOT WORK.
I AM THE MAN THAT DEALS WITH IT
ON THE TAIL END OF THE PROBLEM.
I HAVE TODAY IN MY PRESENCE IN
THE STATE OF FLORIDA, 17,000
MENTALLY ILL.
IT IS THE FASTEST-GROWING
SEGMENT OF THE POPULATION.
OUT IN A FEW YEARS THAT NUMBER
WILL BE UP TO 35,000 MENTALLY
ILL.
FOR THOSE OF YOU IN THE AUDIENCE
WHO HAVE SEEN UP CLOSE THE
IMPACT OF MENTAL ILLNESS, THE
LAST THING YOU'D WANT FOR A
LOVED ONE WOULD BE FOR THEM TO
RECEIVE THEIR TREATMENT IN A
PRISON SYSTEM.
THAT IS NOT TO SAY THOSE INSIDE
THE PRISON HAVE NOT COMMITTED
HEINOUS CRIMES IN NEED TO BE IN
PRISON, BUT I DO WONDER HOW THE
RELATIONSHIP OF THEIR OWN
ACTIONS AND MENTAL ILLNESS RED,
LES LEAD TO THEIR BEING THERE.
PERHAPS I CAN BEST CAPTURE THIS
BY POINTING OUT THAT ALTHOUGH
ACROSS-THE-BOARD 17% OF MY
POPULATION OF MENTALLY ILL, FOR
THE WOMEN, AND THIS IS ALMOST
INEXPLICABLE, IT IS 50%.
WHAT HAPPENS TO THOSE WOMEN IN
THE YOUNG LIFE THAT LEADS THEM
AT SUCH PROPORTIONS INTO A
CRIMINAL INCARCERATION OUTCOME?
IT IS FOR THAT REASON THAT I
ADMIRE THE LEADERSHIP IN THIS
ROOM TODAY, TAKING THIS ONE ON
AND I THANK YOU FOR THE
OPPORTUNITY TO BE HERE CHIEF
JUSTICE.
[APPLAUSE]
pp>> AND NOW LADIES AND GENTLEMAN,
THE YOUNG MAN, THE JUDGE FROM
MIAMI-DADE COUNTY FLORIDA THAT
IS TAKEN THE BULL BY THE HORNS,
THE GOVERNOR DOES HAVE A FEW
THINGS ON HIS PLATE THESE DAYS.
THANK YOU GOVERNOR FOR BEING
HERE.
WE REALLY APPRECIATE IT.
JUDGE LEIFMAN WILL GIVE YOU A
HISTORICAL PERSPECTIVE OF WHERE
WE ARE GOING AND TAKE OVER THE
PROCEEDINGS AT THIS POINT.
OF JUDGE LEIFMAN, THANK YOU VERY
MUCH.
pp>> GOOD AFTERNOON.
IT SURELY HAS BEEN A REMARKABLE
SIX MONTHS.
I HAVE HAD THE OPPORTUNITY TO
WORK WITH SOME OF THE MOST
DEDICATED, KNOWLEDGEABLE PEOPLE
FROM EVERY BRANCH OF GOVERNMENT
IN OUR STATE.
TOGETHER WE HAVE STUDIED THIS
PROBLEM, WE HAVE ANALYZED THE
DATA, WE HAVE LOOKED AT MENTAL
HEALTH SYSTEMS FROM AROUND THE
WORLD, FROM AROUND THE UNITED
STATES AND WE BELIEVE WE HAVE
DEVELOPED A REDESIGNED
MENTAL-HEALTH SYSTEM FOR FLORIDA
THAT WILL IMPROVE PUBLIC SAFETY,
SAVE TAXPAYER DOLLARS TO SPEND
MORE EFFICIENTLY, TO GIVE CALLUS
NUMBERS OF FLORIDIANS WITH
MENTAL ILLNESS TRUE OPPORTUNITY
FOR RECOVERY AND HOPE.
NONE OF THIS WOULD HAVE BEEN
POSSIBLE WITHOUT ALL OF THE
WONDERFUL PEOPLE IN THE ROOM
TODAY.
OUR FIRST NEED TO THANK OUR
CHIEF JUSTICE FOR HIS FORESIGHT
AND LEADERSHIP IN BRINGING
TOGETHER THE BRANCHES OF
GOVERNMENT TO ADDRESS THESE
ISSUES OF SUCH CRITICAL
IMPORTANCE.
I WOULD ALSO LIKE TO THANK THE
OTHER JUSTICES THAT ARE HERE
TODAY FOR THEIR SHOW OF SUPPORT
AND FOR EVERYTHING YOU HAVE DONE
TO GET US HERE TO THIS POINT.
ALTHOUGH HE IS GONE, I STILL
LIKE TO THANK THE GOVERNOR FOR
BEING HERE TODAY AND RECOGNIZING
THE IMPORTANCE OF ADDRESSING
THIS VERY DIFFICULT AND CRITICAL
ISSUE.
HIS PRESENCE MEANS A GREAT DEAL
TO US AND I CANNOT GO FURTHER
WITHOUT PERSONALLY THINKING
SECRETARIES BUTTERWORTH, IN
AGWUNOBI, BOB DINA AND MCKEEL
FOR THEIR COMMITMENT AND TO
DEDICATE TIME STAFF AND
RESOURCES TO HELP TRANSFORM OUR
MENTAL HEALTH SYSTEM.
I WANT TO HAVE YOU PLEASE THANK
YOUR STAFF WHO WENT BEYOND THE
CALL OF DUTY ON THIS ISSUE IN
COOPERATED WITH US AT AN
UNPRECEDENTED LEVEL.
THANK YOU.
I WOULD LIKE TO THANK OUR
LEGISLATIVE LEADERS, SENATOR
WISE AND FOR ALL THE STAFF HERE
TODAY WHO HAVE SUPPORTED THIS
EFFORT AND ARE WORKING WITH US
TOWARDS IMPROVING OUR SYSTEM.
I ALSO NEED TO THANK JUDGE
CLARK, THE CHAIR OF OUR
FAMILIES, CHILDREN IN COURT
COMMITTEE FOR HER VALUABLE
LEADERSHIP AND THE MEMBERS OF
OUR MENTAL HEALTH SUBCOMMITTEE,
WHO HAVE WORKED TIRELESSLY AND
UNSELFISHLY ON THIS EFFORT.
I PARTICULARLY NEED TO THANK OUR
COCHAIRS FOR SITTING IN THE
FRONT ROW, IF THEY WOULD STAND
AND BE RECOGNIZED, MICHELLE
SAUNDERS WAS SPINNER AD HOC
COCHAIR OF ONE OF OUR CHAIRS.
PLEASE STAND AND BE RECOGNIZED.
[APPLAUSE]
I WOULD LIKE TO ALSO THANK THE
DEAN, THE FACULTY AND STAFF OF
THE FLORIDA MENTAL HEALTH
INSTITUTE AT THE UNIVERSITY OF
SOUTH FLORIDA WHO HAVE PROVIDED
US WITH THEM VALUABLE RESOURCES,
INFORMATION AND KNOWLEDGE AND I
ESPECIALLY NEED TO THANK MIKE
THOMPSON, BOB KREIN AND THE JED
FOUNDATION AS WELL AS THE HILTON
FOUNDATION FOR THEIR PHENOMENAL
TECHNICAL ASSISTANCE AND
RESOURCES TO MAKE THIS A
REALITY.
I WOULD LIKE TO THINK OF THE
OFFICE STAFF AS WELL HELPED
FACILITATE ALL OF THIS AND
SPECIAL THANKS TO TIM COFFEE WHO
WORKS ON OUR STAFF IN THE COURT
IN MIAMI WHO HAS THE MOST
DIFFICULT TASK OF BRINGING
TOGETHER ALL THE INFORMATION AND
MAKING IT FLOW INTO ONE COHESIVE
REPORT.
THANK YOU VERY MUCH.
WHEN I BECAME A JUDGE, I HAD
ABSOLUTELY NO IDEA OF, I WAS
BECOMING A GATEKEEPER TO THE
LARGEST PSYCHIATRIC FACILITY IN
FLORIDA, THAT BEING THE
MIAMI-DADE COUNTY JAIL.
EVERY DAY OUR COURTS, OUR JAILS
AND LAW-ENFORCEMENT ARE WITNESS
TO WHAT WE SEE AS A PARADE OF
MISSOURI BROUGHT ON BY ENTREATED
MENTAL ILLNESS.
BEFORE I GO FURTHER ON THE
PRESENTATION OF A LIKE TO BEGIN
WITH A SHORT VIDEO THAT WAS
PRODUCED BY CBS FORM IME, CHIEF
INVESTIGATIVE REPORTER
MICHELE -- THE HIGHLIGHTS THE
CRISIS WE HAVE IN OUR JAILS AND
PRISONS.
pp>> NOW, OF LIFE, THIS IS CBS
NEWS AT 11.
pp>> TONIGHT CBS BOORTZ TAKES YOU
TO A PLACE WHERE TO REVEAL WHAT
IS HAPPENING IN OUR JAILS, THE
INMATES, THE FORGOTTEN.
pp>> THE PEOPLE WHO SPEND THEIR
DAYS AND NIGHTS IN THESE JAILS
STILL SUFFER FROM MENTAL
ILLNESS.
THEY ARE ACCUSED CRIMINALS NOT
GUILTY IN THE EYES OF THE
LABERGE FORCED TO LIVE IN
CONDITIONS YOU CANNOT IMAGINE.
pp>> MICHELLE GIL LAND HAS BEEN
GIVEN ACCESS TO REVEAL WHAT IS
GOING ON.
MICHELLE JOINS US NOW AND I WAS
SHOCKED TO SAY THE LEAST WHEN I
SAW THIS.
pp>> IT THINK CERTAINLY THIS TIME
FOR THE PUBLIC TO SEE WHAT IS
GOING ON.
THE PICTURES YOU ARE ABOUT TO
SEE OUR AND THE HAUNTING AND
MOST DISTURBING.
HUNDREDS OF MEN WITH MENTAL
ILLNESSES, MANY CRANDON THE TINY
CELLS, SOME ARRESTED FOR MINOR
CRIMES THAT ADVOCATES SAY WOULD
HAVE THE AVERAGE PERSON OUT OF
JAIL AND JUST HOURS BUT
INCREDIBLY THERE IS NO PLACE TO
SEND THEM.
TONIGHT WE WILL TAKE YOU INSIDE
A WORLD RARELY EXPOSED, THE
FORGOTTEN FOR.
pp>> INSIDERS CALL THIS THE
FORGOTTEN FLOOR, BUT IT SEEMS
UNIMAGINABLE THAT THE HER IN
THIS, HORRIFYING CONDITIONS OF A
JAIL SPILLING OVER WITH INMATES
SUFFERING FROM MENTAL ILLNESSES
COULD BE ERASED FROM ANY MIND.
AS FRIGID AIR IS PUMPED INTO
CELLS, SOME BEG FOR HELP FOR THE
BAREST OF NECESSITIES, WATER.
THE FAUCETS ARE DRY.
pp>> THE WATER IS NOT WORKING.
STEVE WE WILL GET YOU WATER.
THE FAUCETS ARE NOT WORKING.
DOES THE THESE CELLS WERE
DESIGNED FOR ONE PURPOSE, WITH
ONLY A SINGLE STEEL SHELF FOR A
BED.
pp>> IN THIS ONE THERE THREE
INMATES IN A CELL DOES THE YET
TOO, THREE, SOMETIMES EVEN FIVE
MEN DIAGNOSED WITH MENTAL
ILLNESSES IN THOSE CASES
ARRESTED FOR LOW-LEVEL FELONY
CRIMES, IN SOME CASES
MISDEMEANORS, ARE LOCKED UP FOR
DAYS, WEEKS, MONTHS.
pp>> HOW MANY ARE LIVING -- WHAT
YOU WANT THE PUBLIC TO KNOW?
pp>> I WANT THE PUBLIC TO KNOW THE
PEOPLE IN HERE, THERE'D
URINATING ON THE FLOOR.
THERE ON THE FLOOR.
pp>> HOW MANY PEOPLE ARE IN
YOURSELF?
pp>> THERE ARE FOUR PEOPLE.
pp>> THEIR ONLY ALLOWED OUT OF
THEIR CELL FOR 50 MINUTES, TWO
TIMES A WEEK.
pp>> OTHER THAN A HALF AN HOUR.
THIS IS THAT?
pp>> THE LIGHTS ARE RON 24/7, THE
CONDITIONS DO NOT CHANGE.
pp>> A GELLING PERSPECTIVE FROM
THE JAILS CHIEF PSYCHIATRIST.
pp>> YOU WOULD THINK THAT IN 2006,
WE WOULD TREAT PEOPLE WITH
CHRONIC MENTAL ILLNESS IN A MUCH
BETTER, MORE HUMANE MANNER BUT
UNFORTUNATELY WE ARE REVERTING
BACK TO HOW IT WAS IN THE 16 AND
1700'S, WHICH IS TERRIBLE, IT IS
MORALLY AND COMPREHENSIVE.
pp>> SENT THE MEN OUT RAID --.
pp>> THIS IS LIKE THE SECRET.
pp>> IT IS A SAD SECRET.
pp>> WHAT MUST IF YOU DON'T KNOW
IS THAT THE MIAMI-DADE JAIL NOW
SERVES AS THE LARGEST
PSYCHIATRIC FACILITY IN THE
STATE OF FLORIDA.
THREE OF NINE INMATES SUFFERING
FROM MENTAL ILLNESSES AND
ACCORDING TO -- IN DESPERATE
NEED OF TREATMENT.
NOT THIS TYPE OF CONFINEMENT
DESIGNED TO PUNISH PEOPLE.
pp>> FIVE TIMES AS MANY PEOPLE IN
OUR JAILS, FIVE TIMES WITH
MENTAL UNLESS.
AN ELDERLY MAN EMERGED FROM
DARKNESS.
pp>> ONE ON THE FLOOR UNDERNEATH
AND WARNER TWO STANDING AROUND
WAITING FOR THEIR TURN TO SLEEP.
pp>> THE CRISIS HAS UNFOLDED
ACROSS THE STATE.
IN OTHER FLOORED IT DEALS WILL
THEY STRIVE TO COMPLY WITH THE
NATIONAL STANDARDS, FRUSTRATION
OVER THE VIRTUAL ABANDONMENT OF
MENTALLY ILL LEFT BY THE STATE
TO LANGUISH IN JAIL CELLS FOR
MONTHS.
COLONEL DAVID PARIS.
pp>> CAN YOU IMAGINE THE CHAOS
THAT WOULD RESOLVE IF I SAID,
SURRY WE DON'T HAVE ANY MORE
ROOM?
>> PARIS, FROM HILLSBOROUGH
COUNTY SAYS LOCAL AUTHORITIES
HAD NO CHOICE BUT TO SUE THE
STATE OF FLORIDA TO FORCE THE
DEPARTMENT OF CHILDREN AND
FAMILIES TO COMPLY WITH THEIR
LEGAL MANDATE TO TRANSFER
MENTALLY ILL INMATES TO A
FACILITY WITHIN 15 DAYS.
pp>> J-LO SHOULD NOT BE BE THE
FACT OF MENTAL HEALTH FACILITY
FOR THE COUNTY, BUT THAT IS WHAT
THEY ARE.
pp>> HOW OLD WERE YOU?
21?
AND YOU HAVE BEEN HERE EIGHT
MONTHS.
THE WEIGHT OF INCARCERATING AND
CARING FOR MENTALLY ILL INMATES
HAS EVERYONE PAYING THE PRICE,
AN UNACCEPTABLE ONE ACCORDING TO
MAJOR CURVE FROM THERE.
pp>> THESE PEOPLE YOU SAW, THEY
NEED TO BE IN A TREATMENT
FACILITY, NOT OUR RESPONSIBILITY
pp>> AND THEIR ALLIES THE DANGER.
WAS CARING FOR HIS SON AT HOME
WHO'S SUFFERED FROM
SCHIZOPHRENIA BUT FUNCTIONED
WELL FOR DECADES UNTIL HIS
MEDICINE WAS CHANGE.
ACCORDING TO POLICE RECORDS, HIS
FATHER CALLED POLICE AND URGE
THEM TO ARREST HIS SON HOPING
FOR TREATMENT.
pp>> HE WAS UNDER THE FALSE IDEA
THAT IF HE GOT ARRESTED, HE
WOULD GET TREATMENT.
pp>> HE ENDED UP LOCKED UP IN A
CELL IN THE MIAMI-DADE PRETRIAL
CENTER FOR SEVERAL MONTHS.
ACCORDING TO AUTHORITIES, HE
JUMPED FROM HIS TOP BUNK BED,
BREAKING HIS NECK.
HE IS NOW A QUADRIPLEGIC WHO
NEEDS HOSPITALIZATION.
pp>> WE MET UP WITH HIS FATHER WHO
HAD JUST LEFT HIS HOSPITAL BED.
[INAUDIBLE]
pp>> NOTHING HAS CHANGED.
DO I THINK SOMETHING HAS
CHANGED?
I DON'T KNOW.
IT IS TIME.
IT IS TIME THAT SOMETHING
CHANGED.
BUT I DON'T KNOW IF IT EVER WILL
pp>> IT IS PRETTY SOBERING.
FROM THE TIME OUR COUNTRY WAS
FOUNDED UNTIL THE EARLY 1800'S,
WE DID NOT KNOW WHAT TO DO WITH
PEOPLE WITH MENTAL ILLNESSES.
THEY WERE REFERRED TO AS
LUNATICS.
FAMILIES WOULD TAKE THEM TO THE
LOCAL JAIL NOTE IT WAS NOT UNTIL
THE EARLY 1800'S WHEN IT
WONDERFUL NONE BY THE NAME OF
DOROTHEA DIX WAS VISITING A
BOSTON JILL AND CAME ACROSS
SEVERAL MEN WHO WERE FREEZING TO
DEATH IN THE GEO.
SHE WENT TO SEE THE JAILER AND
ASKED HIM WHO THESE PEOPLE WERE.
HE SAID THEY ARE JUST A BUNCH OF
LUNATICS, THEY WERE DROPPED OFF
BY FAMILY.
THIS ONE WOMAN, THIS ONE PERSON
WAS SO OUT GREAT SHE STARTED AN
ENTIRE MOVEMENT KNOWN AS MORAL
TREATMENT, TO TAKE PEOPLE FROM
THIS CONFINEMENT AND PUT THEM IN
A HOSPITAL SETTING,
UNDERSTANDING IN THE 1800'S WE
HAD NO PSYCHIATRIST, NO
MEDICATION, NO TREATMENT AND THE
IDEA WAS TO PUT PEOPLE AND
FACILITIES HOUSING NO MORE THAN
120 PEOPLE TO ALLOW THEM DIGNITY
AND HUMANITY.
AND FLORIDA WHAT WE DID UNTIL
THE LATE 1800'S AS WE TOOK
PEOPLE WITH SERIOUS MENTAL ALICE
AND SHIP THEM TO GEORGIA AND
SOUTH CAROLINA CREEK OF WE PAY
THE STATES TO RUN AND $50 PER
PERSON PER YEAR TO HOUSE OF
INDIVIDUALS WITH SERIOUS MENTAL
ILLNESSES.
IT WAS NOT UNTIL 1876 AT THE OLD
CHATTAHOOCHEE'S CIVIL WAR
ARSENAL WE OPENED OUR FIRST
PSYCHIATRIC FACILITY.
DOROTHY A DIGS MOVEMENT BY 1900,
EVERY STATE IN THE COUNTRY HAD A
HOSPITAL SYSTEM AND
UNFORTUNATELY, MANY OF THESE
FACILITIES BECAME NOTHING LESS
THAN HOUSES OF FOUR.
OF THE ECONOMY STILL FORCE THEM
TO SHUT DOWN 125 FACILITIES AND
GREW THEM 2000'S AND IN ILLINOIS
THEY HAPPEN, THE LARGEST
FACILITY IN OHIO WAS ABOUT
10,000 PEOPLE WITH SERIOUS
MENTAL ILLNESSES WERE HOUSED AND
BECAUSE THERE WAS NO TREATMENT
THERE WAS EXPERIMENTATION.
THEY FOUND PEOPLE WITH MENTAL
ILLNESS, MANY HAD SLIGHTLY
ELEVATED BLOOD SUGAR LEVELS, SO
THEY STARTED GIVING INSULIN
SHOCK THERAPY TO PEOPLE WITH
MENTAL ILLNESSES AND THEY KILLED
MANY.
WHEN THAT DID NOT WORK THEY
TRIED ELECTRIC SHOCK THERAPY,
AND THEY KILLED MORE.
WHEN THAT FAILED THEY STARTED
USING LOBOTOMIES TO CONTROL THE
POPULATION.
BY THE 1950'S, 1960'S WE STARTED
TO GET MORE SOPHISTICATED.
FACILITIES STARTED TO GET OLD,
AND MEDICATION CANNOT AND WE
REALIZED WE DID NOT NEED TO KEEP
PEOPLE IN THIS KIND OF
CONFINEMENT FOR THE ENTIRE
LIVES.
IN 1963 CONGRESS PASSED A
WONDERFUL BILL CALLED THE
COMMITMENTS OF HEALTH CENTER ACT
AND THE IDEA WAS TO CLOSE DOWN
HOSPITALS, COMBINE TREATMENT
MEDICATIONS IN RETURN PEOPLE TO
THE COMMUNITY SO THEY COULD LIVE
IN THE LIFE OF RECOVERY.
IN 1963, IN WHAT WAS GOING TO BE
HIS LAST PUBLIC BILL SIGNING,
PRESIDENT KENNEDY SIGNED A
3 BILLION-DOLLAR AUTHORIZATION
TO FUND THE SYSTEM.
UNFORTUNATELY DUE TO THE TRAGIC
ASSASSINATION OF THE PRESIDENT
AND THE ESCALATION OF THE
VIETNAM WAR, NOT 1 PENNY OF THE
$3 BILLION WAS APPROPRIATED TO
CREATE THIS MENTAL-HEALTH
SYSTEM.
AT THE SAME TIME A FLURRY OF
LAWSUITS WERE FILED IN FEDERAL
COURTS BECAUSE OF THE CONDITIONS
PEOPLE WERE LANGUISHING UNDER.
IN THE FIRST CASE IN 1971 CAME
OUT OF ALABAMA.
WHAT HAPPENED, IT HAD LITTLE TO
DO WITH THE PLIGHT OF MENTAL
ENOUGH.
IT HAD TO DO WITH THE CIGARETTE
TAX OF ALABAMAN.
ALABAMAN CUT THESE THE RED, TAX
USED TO FUND THEIR STATE MENTAL
HOSPITAL AND THEY LAID OFF HALF
THE EMPLOYEES FROM THE FACILITY.
AND INTEND TO TRY TO GET THEIR
JOBS THAT THESE EMPLOYEES FILED
A LAWSUIT TO GO TO COURT TO
FORCE THE STATE OF ALABAMA TO
GIVE THEM THEIR JOBS BACK AND
THEY REALIZE THEY NEEDED MORE TO
GET INTO FEDERAL COURT SO
ALMOST, BY THE WAY, THEY FOUND A
RELATIVE OF ONE OF THE
EMPLOYEES, HIS NAME WAS WYATT, A
PATIENT IN THE FACILITY.
THEY ADDED HIM TO THE LAWSUIT
AND THEY MENTIONED THE
CONDITIONS WERE NOT SO GREAT
EITHER.
THE FEDERAL JUDGE CAME OUT WITH
A REMARKABLE -- AND THE FIRST
THING YOU SAID TO THEM WAS, I AM
REALLY SORRY LESTER JOBS BUT I
HAVE NO JURISDICTION TO DO
ANYTHING ABOUT THAT.
HOWEVER HE SAYS I AM HORRIFIED
AT THE CONDITIONS OF THE PEOPLE
IN THIS FACILITY AND I'M GOING
TO ORDER THE STATE OF ALABAMA TO
SIGNIFICANTLY IMPROVE CONDITIONS
OF THIS FACILITY.
HE GUNS ON TO LIST 80 SPECIFIC
CONDITIONS ALABAMA MUST MEET IN
ORDER TO RUN THEIR FACILITY
PROPERLY AND HE WANTS THEM,
SECONDARILY THAT IF THEY FAIL TO
COMPLY WITH THE 80 CONDITIONS HE
HAS ORDERED, HE WILL IN FACT
SHUT DOWN THE HOSPITAL AND THEY
WILL BE RESPONSIBLE FOR
PROVIDING CARE IN THE COMMUNITY
PART OF HE WENT SO FAR TO TELL
ALABAMA WHAT THE WATER
TEMPERATURE NEEDED TO BE FOR THE
DISHWASHERS BECAUSE WE FOUND OUT
IS THEY WERE NOT CLEANING
UTENSILS AND PEOPLE WERE GETTING
PHYSICALLY ILL.
ALABAMAN BEGAN TO TRY TO MEET
CONDITIONS AND SPEND A LOT OF
MONEY THEY PROBABLY DID NOT
HAVE.
OF THEY GOT THEIR HALFWAY AND
RAN OUT OF MONEY.
TRUE TO HIS WORD, HE CLOSED DOWN
HOSPITAL.
IN THE CASE WENT ON TO THE
UNITED STATES SUPREME COURT, IT
WAS CONFIRMED IN A SHOCK WAVE
WENT TO THIS COUNTRY.
AS PREDICTED BY ONE OF THE
LEADING EXPERTS IN 1972 BEGAN
THE CRIMINALIZATION OF MENTAL
ILLNESS BECAUSE WHAT HAPPENED
WAS, THE STATE'S LOOKED AROUND
AND THEY SAW THIS WAS NOW THE
LAW OF THE LAND AND THEY WOULD
MEET ALL THE CONDITIONS LAID OUT
IN THE OPINION AND THE CHOICE
WAS TO PAY FOR THE CHANGES OR
RELEASE THE POPULATION AND THEY
CHOSE TO RELEASE THE POPULATION.
THERE IS NO NATIONAL NETWORK OF
COMMUNITY FACILITIES TO ABSORB
THE POPULATION THAT WAS ABOUT TO
BE RELEASED.
OF THE IMPACT WAS STAGGERING.
IN 1955 THERE WERE 560,000
PEOPLE IN STATE HOSPITALS, TODAY
THERE ARE LESS THAN 40,000.
LAST YEAR ACCORDING TO THE
JUSTICE DEPARTMENT 1.1 MILLION
PEOPLE WITH SERIOUS MENTAL
ILLNESSES WERE ARRESTED.
WE HAVE THREE TO 40,000, REALLY
CLOSER TO 500,000 ANOTHER HALF A
MILLION ON PROBATION.
SINCE 1955 THE NUMBER OF
PSYCHIATRIC HOSPITAL BEDS
NATIONWIDE HAS DECREASED BY MORE
THAN 90%, WHILE THE NUMBER OF
PEOPLE WITH MENTAL ILLNESS
INCARCERATED HAS GROWN BY MORE
THAN 400%.
IN FLORIDA WE HAVE ROUGHLY
125,000 PEOPLE WITH SERIOUS
MENTAL ILLNESSES REQUIRING
IMMEDIATE TREATMENT, ARE
ARRESTED AND BOOKED EVERY YEAR
AND ARE JILLS.
ON ANY GIVEN DAY THERE ARE
16,000 PRISON INMATES, A LOCAL
JAIL DETAINEES AND 40,000
INDIVIDUALS WITH SERIOUS MENTAL
ILLNESS UNDER CORRECTIONAL
SUPERVISION.
DETAILS ARE THE LARGEST
PSYCHIATRIC FACILITY IN OUR
STATE.
SINCE 1998 THE TOTAL NUMBER OF
CIVIL MENTAL-HEALTH BEDS IN
FLORIDA HAS DECREASED BY 43%
FROM 1800 TO ABOUT 1,000.
DURING THE SAME PERIOD, THE
TOTAL NUMBER OF RANCIC MENTAL
HEALTH BEDS AND FLORIDA HAS
INCREASED BY 73.
IT IS AMAZING TO LOOK AT THE
NUMBERS.
ALMOST AS MANY BEDS AS WE HAVE
CLOSED IN THE CIVIL, WE HAVE HAD
TO OPEN ON THE FORENSIC SIDE.
AND SO, THEY ARE TOO HORRIBLE
IRONY IS THAT HAVE OCCURRED
HERE.
WHAT IS THAT WE WILL NEVER BE
INSTITUTIONALIZED.
WEED FRANCE INSTITUTIONALIZE, WE
TRANSFER PEOPLE FROM THESE
HORRIBLE HOSPITAL TO THAT
HORRIBLE TALES.
THIS TIME GIVING THEM CRIMINAL
RECORDS, MAKING IT MORE
DIFFICULT TO GET INTO RECOVERY
BECAUSE THEY CAN'T GET
EMPLOYMENT AND HOUSING.
THE MORE CRUEL IRONY IS THAT WE
HAVE COME FULL CIRCLE.
WE HAVE GOT 200 YEARS IN THIS
COUNTRY IN JAILS AND PRISONS ARE
ONCE AGAIN THE PRIMARY PLACE
WHERE PEOPLE WITH MENTAL
ILLNESSES.
IT IS PROBABLY THE ONLY AREA OF
CIVIL RIGHTS IN THIS COUNTRY WE
HAVE GONE BACKWARDS ON.
THE CONSEQUENCES HAVE BEEN HUGE.
WE HAVE SEEN HOMELESSNESS, 25%
OF THE HOMELESS LESS HAVE MENTAL
ILLNESS AND OVER 50% HAVE BEEN
IN JAILS AND PRISONS.
WE HAVE SEEN INJURIES INCREASE,
WE HAVE SEEN POLICE SHOOTINGS
INCREASE, WE HAVE WASTED
CRITICAL TAX DOLLARS AND IN
EFFECT MADE MENTAL ILLNESS A
CRIME IN THIS COUNTRY.
IN FACT IN FLORIDA THE POLICE
INITIATE MORE IN VOLUNTARY
EXAMINATIONS UNDER OUR SPEAKER
AT THE LAW THEN THEY HANDLE, THE
TOTAL NUMBER OF ARRESTS FOR
ROBBERY, MURDER AND GRAND THEFT
AUTO COMBINED.
AND IF WHAT YOU SAW FROM THE
VIDEO WAS NOT DISTURBING ENOUGH,
JUST CONSIDER THE FISCAL IMPACT
THAT THE SYSTEM IS HAVING ON OUR
STATE BUDGET AND THE PROJECTED
IMPACT IT WILL HAVE OVER THE
NEXT NINE YEARS.
INDIVIDUALS ORDERED INDIFFERENCE
ENTREATMENT ARE NOW THE
FASTEST-GROWING SEGMENT OF THE
PUBLICLY FUNDED MENTAL HEALTH
MARKETPLACE IN FLORIDA.
BETWEEN 1999 AND 2007 FORENSIC
COMMITMENTS INCREASED 72%
INCLUDING AN UNPRECEDENTED 16%
INCREASE BETWEEN 05 AND 06.
BASED ON RECENT TRENDS, IF THE
SYSTEM DOES NOT CHANGE, THE
NUMBER OF RANCIC AMENDMENTS IS
PROJECTED TO INCREASE BY ROUGHLY
1100 EMISSIONS OVER THE NEXT
EIGHT YEARS, SO BY 2015 THERE
WILL BE OVER 2500 PEOPLE IN THE
FORENSICS IS THEM.
LET ME PUT THAT IN SOME
PERSPECTIVE FOR YOU.
THE STATE OF FLORIDA IS
CURRENTLY SPENDING, AS SECRETARY
BUTTERWORTH MENTIONED, ABOUT A
QUARTER OF A BILLION DOLLARS TWO
TREAT 1700 PEOPLE, AND IT IS NOT
TREATMENT SO THEY CAN GO BACK
INTO THE COMMUNITY UNDERSTAND.
THIS IS FORENSIC COMMITMENTS
THAT WE CAN RESTORE THEIR
COMPETENCY AND TRY THEM AND MOST
LIKELY PUT THEM IN PRISON.
IF THIS NUMBER DOUBLES, AS WE
PROJECT IT WILL, IN THIS PERIOD
OF TIME, THE COST WILL GO TO
APPROXIMATELY -1/2 BILLION
DOLLARS.
AND THAT IS THE LOW NUMBER.
BETWEEN 1995 AND 2007, THE
PERCENTAGE OF INMATES IN THE
PRISONS HAS ALMOST DOUBLED.
OVER THE PAST NINE YEARS THE
POPULATION OF INMATES WITH
SERIOUS MENTAL MS HAS GONE FROM
8,000 TO 17,000 INDIVIDUALS.
BASED ON RECENT TRENDS, IT'S THE
SYSTEM DOES NOT CHANGE, FLORIDA
CAN EXPECT THE NUMBER OF PRISON
INMATES WITH MENTAL ILLNESS TO
NEARLY DOUBLE IN THE NEXT NINE
YEARS TO OVER 32,000 INDIVIDUALS
A POPULATION THE SIZE WILL BE
ENOUGH TO FILL THE LARGEST
EXISTING CORRECTIONAL
INSTITUTION.,,``%%
>> THAT NEEDS TO BE BROACHED.
ROUGHLY 150,000 CHILDREN IN
ADOLESCENCE ARE REFERRED TO THE
DEPARTMENT OF JUVENILE JUSTICE
EVERY YEAR.
ABOUT 65% OR ALMOST 100,000 OF
THEM HAVE AT LEAST ONE SERIOUS
MENTAL ILLNESS.
THE MAJORITY ARE ALSO DIAGNOSE
WITH THE A CO-OCCURRING
SUBSTANCE DISORDER.
THE BOTTOM LINE IS IF WE DO
NOTHING TO CHANGE OR REDESIGN
OUR MENTAL HEALTH SYSTEM, THE
STATE WILL BE LOOKING AT
HUNDREDS OF MILLIONS IF NOT
BILLIONS OF DOLLARS OVER THE
NEXT NINE YEARS TO DEAL WITH THE
INCREASES OF THIS POPULATION IN
BOTH THE JUVENILE JUSTICE
SYSTEM, THE FORENSIC SYSTEM, AND
THE CORRECTIONAL SYSTEM.
SO HOW DO YOU FIX IT?
WELL, AFTER I WAS ASKED TO HELP
WITH THIS EFFORT, I WENT TO
SECRETARY BUTTERWORTH, AND I
ASKED HIM IF HE HAD ANY
EXPECTATIONS OR IDEAS ON HOW HE
WOULD LIKE US TO PROCEED WITH
THIS EFFORT.
IN QUOTING HIM HE SAID, JUST FIX
THE DAMN THING.
[LAUGHTER]
>> MR. SECRETARY, WE TRULY
BELIEVE WE'VE COME UP WITH A
PLAN THAT WILL DO EXACTLY THAT.
WE DID A LOT OF RESEARCH TO GET
TO THIS POINT, AND THE
CONDITIONS IN WHICH WE MET WERE
PHENOMENAL BECAUSE WE WERE
REALLY ABLE TO DEVELOP IDEAS
BASED UPON SCIENCE AND RESEARCH
AND DATA.
AND ONE OF THE FIRST THINGS THAT
WE REALIZED IS THAT WE CAN'T
JUST LOOK AT THE MENTAL HEALTH
POPULATION AS A WHOLE AND THINK
YOU CAN FIX THE WHOLE THING.
MOST PEOPLE WITH MENTAL
ILLNESSES ARE DOING OKAY OUT IN
THE COMMUNITY.
IT IS A MUCH SMALLER POPULATION,
THOSE THAT HAVE A MORE SERIOUS
ACUTE ILLNESS THAT CONTINUE TO
RECYCLE THROUGH OUR CRIMINAL
JUSTICE SYSTEM.
AS DR. AGWUNOBI POINTED OUT F WE
START TO LOOK AT THIS AS AN
ILLNESS AND A MEDICAL ISSUE, IT
MAKES SO MUCH MORE SENSE.
WHAT WE REALIZE AFTER LOOKING AT
THE DATA IS WHEN WE CLOSE THE
HOSPITALS, WHEN WE DEVELOPED OUR
MENTAL HEALTH SYSTEMS, WE DIDN'T
HAVE ANY RESEARCH OR DATA TO
KNOW HOW TO DEAL WITH THE MOST
ACUTELY ILL INDIVIDUALS, SO WE
CREATED A SYSTEM THAT ONE SHOE
FIT ALL.
AND FOR THE MAJORITY OF PEOPLE
THAT WEREN'T THAT ACUTE, THEY
WERE ABLE TO SURVIVE IN THE
SYSTEM.
BUT FOR THOSE THAT HAD THE
HIGHER ACUITY LEVEL, THERE WAS
NO COMPETENT MENTAL HEALTH
SYSTEM TO CARE FOR THEIR DEGREE
OF ILLNESS.
THINK OF SOMEONE WHO HAS EARLY
STAGES OF CANCER.
THEY GO TO THE DOCTOR, THEY'RE
DIAGNOSE NOTICED, THEY'RE IN
RECOVERY, THEY'RE MONITORED, AND
THEY LIVE A GOOD, HEALTHY LIFE.
SIMILARLY, MOST PEOPLE WITH
MENTAL ILLNESS DO THAT, BUT
THAT'S WHERE THE SIMILARITY
CHANGES.
BECAUSE IF YOU HAVE A HIGHER
LEVEL OF CANCER TODAY, YOU CAN
GO TO A HOSPITAL, YOU CAN GET
GREATER AMOUNTS OF TREATMENT,
AND YOU CAN THEN LIVE WITH YOUR
ILLNESS IN MOST CASES.
BUT FOR PEOPLE WITH A HIGHER
DEGREE OF SERIOUS MENTAL
ILLNESS, THERE IS NO SYSTEM OF
CARE FOR THEM IN OUR COMMUNITY,
ANYWHERE IN THE UNITED STATES.
THIS IS NOT A FLORIDA PROBLEM,
THIS IS A NATIONAL PROBLEM
BECAUSE WE ALL SET UP SIMILAR
SYSTEMS AT THE SAME TIME WITH
THE SAME IDEAS.
AND SO WHAT WE REALIZE WE NEED
TO DO IS TO CREATE A SYSTEM OF
CARE FOR THIS VERY ACUTE
POPULATION SO WE DON'T SEE THEM
RECYCLE BACK AND FORTH THROUGH
THESE VERY EXPENSIVE DEEP END
SYSTEMS.
WELL, HOW DO YOU PAY FOR IT, AND
HOW DO YOU SUSTAIN IT?
PARTICULARLY AT A TIME WHEN OUR
BUDGET IS IN SUCH SERIOUS,
SERIOUS NEED?
AND WE'VE APPROACHED THAT AS
WELL.
SECRETARY BUTTERWORTH MENTIONED
HOW HE HAD TO GO TO THE
LEGISLATURE AND GET ABOUT $50
MILLION IN RECURRING DOLLARS TO
FUND 300 PEOPLE.
WHAT WE REALIZE WE NEED TO DO IS
OUR PLAN WILL FIRST START OFF BY
FOCUSING ON THOSE 300 BEDS
BECAUSE ONE OF THE VERY SMART
THINGS THAT THE DEPARTMENT DID
WHEN THEY SECURED THOSE BEDS IS
THEY WERE ABLE TO PUT A CLAUSE
IN THE CONTRACT SO THEY COULD
ACTUALLY CANCEL THAT CONTRACT
WITH A 30-DAY NOTICE.
WE WILL NEED SOME UP-FRONT
DOLLARS TO GET THIS STARTED,
OBVIOUSLY.
OUR GOAL WILL BE TO REMOVE 300
PEOPLE OUT OF THE FORENSIC
SYSTEM FREEING UP $48 MILLION IN
REAL DOLLARS THAT COULD BE FRONT
ENDED SO THAT WE COULD PUT UP A
WALL TO PROVIDE AND CREATE THE
KIND OF COMPETENT SYSTEM THAT WE
NEED SO THAT PEOPLE DON'T GO
BACK INTO THE SYSTEM.
AND THE REPORT DOES A VERY GOOD
JOB ADDRESSING WHAT THAT SYSTEM
SHOULD LOOK LIKE.
ONE OF THE OTHER THINGS WE FOUND
WAS VERY INTERESTING, IS THAT
THERE'S A HUGE GAP BETWEEN THE
SCIENCE AND MEDICINE OF MENTAL
ILLNESS AND WHAT'S ACTUALLY
BEING PROVIDED IN THE COMMUNITY.
WE ALSO FOUND THERE WAS A HUGE
GAP BETWEEN THE JUSTICE SYSTEM
AND THE PROVIDERS AND WHAT THE
BEST PRACTICES ARE ON HOW WE
DIVERT AND COORDINATE AND
COLLABORATE WITH PEOPLE WITH
MENTAL ILLNESSES THROUGH THE
DIFFERENT SYSTEMS.
SO WE CREATE WHAT THAT SYSTEM
SHOULD LOOK LIKE.
AND TO SCENE IT -- SUSTAIN IT,
WE'VE COME UP WITH A NOVEL IDEA
THAT HAS NEVER BEEN TRIED
ANYWHERE IN THE UNITED STATES.
WORKING WITH DR. AGWUNOBI AND
HIS TEAM, WE'VE COME UP WITH A
VERY INTERESTING IDEA TO CREATE
WHAT WE CALL AN INTEGRATED
SPECIALTY CARE NETWORK.
USING MEDICAID AND USING A
DECIDE MODEL, WE WILL BE ABLE TO
HAVE MUCH MORE RESOURCES THAN
ACTUALLY EXIST TODAY TO HELP US
SUSTAIN THIS NEW COMPETENT
SYSTEM OF CARE, BUT THE IDEA
ISN'T TO JUST TRY TO TAKE WHAT
LIMITED DOLLARS THERE ARE AND
PUT THEM IN THE EXISTING SYSTEM.
THE SYSTEM HAS TO BE FORCE TODAY
CHANGE, AND THE WAY WE ENFORCE
THAT IS WE CREATE THIS WONDERFUL
LEADERSHIP COUNCIL WHERE THEY
WILL ACTUALLY GO INTO
COMMUNITIES AND CERTIFY THE
COMMUNITY AND THE PROVIDERS TO
MAKE SURE THAT THEY WILL BE
USING BEST PRACTICES.
AND THEY WILL NOT BECOME
ELIGIBLE FOR THIS NEW MEDICAID
MONEY UNLESS AND UNTIL THEY ARE
CERTIFIED.
WE KNOW, AS I MENTIONED, THAT
THERE'S THIS HUGE GAP, AND ONE
OF THE ISSUES ACTUALLY ANSWERS
SECRETARY McDONOUGH'S COMMENT
ABOUT WOMEN.
ALMOST 100% OF WOMEN IN JAIL
TODAY WITH SERIOUS MENTAL
ILLNESSES WERE SEXUALLY ABUSED
AS CHILDREN.
ALMOST 100%, AND IT'S BASED ON
SOME WONDERFUL NATIONAL STUDIES
THAT HAVE COME OUT.
WHAT HAPPENS IS IT MANIFESTS
ITSELF IN A SKIT SEW EFFECTIVE
DISORDER.
THEY CONTINUE TO RECYCLE THROUGH
OUR CRIMINAL JUSTICE SYSTEM
WHICH EXPLAINS WHY WOMEN HAVE A
MUCH HIGHER LEVEL OF MENTAL
ILLNESS IN JAIL.
BUT TRAUMA TREATMENT IS NOT
AVAILABLE TO THEM.
THIS IS SIMILAR TO POST
TRAUMATIC STRESS AND IN A
SIMILAR TYPE OF TREATMENT NEEDS
TO BE AVAILABLE.
THIS WILL BE ENFORCED THROUGH
OUR BEST PRACTICES AND OUR
SYSTEM OF COMPETENT CARE.
THE OTHER ISSUE THAT NEEDS TO BE
ADDRESSED, THERE'S SOME NEW
RESEARCH THAT ALSO INDICATES
PEOPLE WHO HAVE BEEN IN CRIMINAL
JUSTICE SETTINGS LORM TERM --
LONG TERM DEVELOP WHAT THEY CALL
A SNITCH DISORDER MEANING THEIR
BEHAVIOR IS MODIFIED IN JAIL TO
KEEP THEIR MOUTH SHUT.
WHEN THEY DO SPEAK, THEY OFTEN
GET HURT IN PRISON.
SO WHEN WE GET THEM AND THEY GO
TO GROUP THERAPY, THEY WON'T
TALK, AND THEY IMMEDIATELY GET
LABELED AS BEING RESISTANT, SO
WE SEND THEM BACK TO JAIL.
THERE'S A WHOLE NEW LEVEL OF
CARE THAT'S BEEN DEVELOPED TO
DEAL WITH THIS ISSUE, AND SO
WHEN WE DEAL WITH OUR COMPETENT
SYSTEM, THAT WILL BE ANOTHER
LEVEL OF CARE THAT WILL HAVE TO
BE PROVIDED BY THE PROVIDERS.
WE ALSO WORK AND ENCOURAGE A
PARTNERSHIP BETWEEN THE
DEPARTMENT OF CHILDREN AND
FAMILIES AND ACA.
ONE OF THE OTHER FINDINGS THAT
WE FOUND IS THAT RIGHT NOW
MEDICAID HAS ACTUALLY BECOME THE
LARGEST MENTAL HEALTH PROVIDER
IN THE STATE OF FLORIDA,
ACTUALLY MORE THAN DCS.
AND THEY SPEND THEIR MONEY THIS
WAY, AND DCS SPENDS IT THIS WAY.
THERE'S BEEN LITTLE
COLLABORATION, AND THERE ARE
WAYS TO BLEND THESE DOLLARS FOR
EFFICIENTLY TO MAKE SURE THE
PEOPLE THAT DO QUALIFY FOR THE
BENEFITS AND THOSE THAT DON'T
CAN USE THE STATE MONEY.
AND THROUGH OUR DISCUSSIONS
WE'RE COMING UP WITH A WONDERFUL
PARTNERSHIP PLAN, THE JET
FOUNDATION HAS ACTUALLY OFFERED
TO HELP FUND THE INFRASTRUCTURE
OF THIS PLAN, AND WE THINK IT'LL
BE A CRITICAL POINT TO SAVE A
LOT OF RESOURCES AND MORE
EFFECTIVELY SPEND OUR DOLLARS.
WE TOOK A HARD LOOK AT OUR
JUVENILE JUSTICE SYSTEM AND
JUDGE CLARK'S GOING TO HAVE AN
OPPORTUNITY TO TALK MORE ABOUT
THAT AFTER OUR BREAK.
BUT THERE ARE A LOT OF ISSUES
THAT REALLY NEED TO BE ADDRESSED
THERE AS WELL.
ONE OF THE NEW AREAS OF SCIENCE
THAT WE LOOKED AT WAS SOMETHING
CALLED AN ATTACHMENT DISORDER.
WHAT WE NOW KNOW BY LOOKING AT
MRIs OF 3-YEAR-OLDS, THAT IF A
CHILD ISN'T HELD AND NURTURED,
THEY DON'T DEVELOP NEUROONS IN
THE BRAIN.
AND WITHOUT THAT, THEY LACK THE
ABILITY TO HAVE SYMPATHY,
EMPATHY, AND RELATIONSHIPS.
AND THESE ARE THE CHILDREN THAT
ARE GOING TO GROW UP IN THE
JUVENILE JUSTICE SYSTEM WHO ARE
GOING TO CAUSE THE PROBLEMS IN
SCHOOL, WHO ARE GOING TO GROW
INTO ADULTS AND END UP IN JAIL
AND PRISON.
THERE ARE NEW SCREENING TOOLS
AVAILABLE WHICH AREN'T BEING
USED WHICH WE RECOMMEND BE USED
TO MAKE SURE THAT THESE CHILDREN
ARE CARED FOR SO THEY DON'T E7BD
UP IN THE SYSTEM.
WE ALSO PUT TOGETHER WHAT WE
BELIEVE WOULD BE A COMPETENT
MENTAL HEALTH SYSTEM FOR JEWELS
TO MAKE SURE THAT THEY ARE BEING
TREATED APPROPRIATELY.
WE ALSO DEAL WITH PSYCHOTROPIC
ISSUES, WE CAN TALK ABOUT THAT
THE NEXT HALF OF THE SESSION AS
WELL, BUT WE FEEL THAT WE HAVE
REALLY TOUCHED UPON SOME OF THE
MAIN ISSUES THAT WE NEED TO
TRANSFORM OUR SYSTEM SO THAT WE
CAN KEEP PEOPLE FROM RECYCLING
IN THE CRIMINAL JUSTICE SYSTEM
AND THE JUVENILE JUSTICE SYSTEM.
WE KNOW WE HAVE MANY OUTSTANDING
CHALLENGES.
HOWEVER, WE DO ALSO KNOW THAT IF
WE DO NOTHING AND LEAVE THE
SYSTEM AS IT IS TODAY, THE STATE
WILL BE FORCED TO SPEND HUNDREDS
OF MILLIONS OF DOLLARS ON A
SYSTEM THAT ONLY PERPETUATES THE
RECYCLING THROUGH THESE CRIMINAL
JUSTICE, DEEP-END SYSTEMS.
WE REALLY BELIEVE THAT IF WE ARE
ABLE TO IMPLEMENT MANY OF THESE
RECOMMENDATIONS, WE WILL FINALLY
ACCOMPLISH WHAT THE SUPREME
COURT SET OUT TO DO 40 YEARS
AGO, TRUE
DEINSTITUTIONALIZATION.
THANK YOU VERY MUCH.
[APPLAUSE]
THEREBY,,``%%
[APPLAUSE]
>> FROM THE OVERVIEW YOU'LL HAVE
AN OPPORTUNITY LATER ALSO, BUT
IF THERE ARE ANY QUESTIONS YOU'D
LIKE TO PRESENT TO JUDGE LEIFMAN
OR ANY OF THE SECRETARIES WITH
REGARD TO WHAT YOU'VE HEARD AS
AN OVERVIEW, WE HAVE A COUPLE OF
MINUTES THAT WE COULD GO AHEAD
AND TAKE CARE OF THAT AT THIS
POINT.
>> I HAVE A QUESTION.
>> YES, SIR.
>> WHAT, YOU HAD THE VIDEO OF
THE MIAMI-DADE JAIL.
>> IT WAS ALSO HILLSBOROUGH.
>> AND HILLSBOROUGH.
WHAT IS THE PART OF YOUR PLAN
THAT WILL AFFECT THE LOCAL
JAILS?
AND WHAT PERCENTAGE OF THE
DOLLARS IN THIS PLAN ARE STATE
DOLLARS AND WHAT PERCENTAGE ARE
LOCAL DOLLARS?
>> I DON'T KNOW IF I CAN TELL
YOU THE PERCENTAGE YET OF
FEDERAL AND STATE DOLLARS, BUT
WHAT I CAN TELL YOU IS THE WAY
FLORIDA MEDICAID WORK IS THE
THAT 40% OF GENERAL REVENUE IS
USED VERSUS 60% OF FEDERAL
MONEY.
OUR PLAN ACTUALLY CREATED A
THREE-THAT TIERED SYSTEM.
AND WE CAT EYES PEOPLE --
CATEGORIZE PEOPLE BASED ON THEIR
RISK OF CRIMINAL JUSTICE.
TIER ONE MAY BE THOSE IN THE
SYSTEM, TIER TWO ARE THOSE AT
RISK BASED ON PRIOR ARRESTS, AND
TIER THREE, WHICH IS THE LARGEST
POPULATION OF PEOPLE WITH MENTAL
ILLNESSES, WHICH STAY IN THE
SYSTEM THEY'RE IN.
WE WOULD MAKE THIS NEW MEDICAID
PLAN AVAILABLE FOR BOTH THOSE
WHO ARE AT RISK AND THOSE THAT
ARE ALREADY IN.
THAT ALLOWS US TO USE FEDERAL
MONEY IN MANY WAYS VERSUS
GENERAL REVENUE MONEY TO GET
THEM SERVICES.
AND WE DIDN'T WANT TO CREATE A
SYSTEM WHERE YOU'D HAVE TO GET
ARRESTED TO GET THOSE SERVICES,
SO THAT'S WHY WE SET IT UP AS
BOTH AT RISK AND INVOLVED.
AND THIS WOULD APPLY FOR BOTH
CHILDREN AND ADULTS.
THE EMOTIONALLY-DISTURBED
CHILDRENS AND INDIVIDUALS
INDIVIDUALS WITH SERIOUS MENTAL
ILLNESSES, ADULTS WHAT WE DO
THROUGH OUR PLAN IS WORKING
THROUGH WHAT WAS CALLED THE
REINVESTMENT GRANT LAST YEAR
WHERE COMMUNITIES ARE GETTING
TOGETHER TO PUT UP COLLABORATIVE
EFFORTS, WE WILL WORK WITH THE
COMMUNITY TO DEVELOP A MENTAL
HEALTH COURSE, A DIVERSION
PROGRAM WHERE THEY WOULD HAVE
ACCESS TO COMPETENT MENTAL
HEALTH SYSTEM WHICH WOULD BE
RECEIVING MEDICAID DOLLARS AT A
MUCH HIGHER RATE THAN IS
AVAILABLE TODAY SO THAT IT WILL
PAY FOR THE SYSTEM.
THERE IS HUGE INTE GRADUATION
BETWEEN THE COURT SYSTEMS AROUND
THE STATE AND THE MENTAL HEALTH
SYSTEMS, AND THE WAY WE GET THEM
TO MOVE FORWARD IS WE KIND OF
DANGLE THE MONEY OVER THEIR HEAD
AND SAY IF YOU AGREE TO DO IT
THE RIGHT WAY BASED UPON WHAT WE
KNOW ARE THE BEST PRACTICES, YOU
BECOME ELIGIBLE FOR THIS
MEDICAID PLAN.
RIGHT NOW IT'S ABOUT $31 A MONTH
UNDER MANAGED CARE WOULD BE
SIGNIFICANTLY HIGHER FOR THIS
VERY ACUTE POPULATION.
I CAN'T BELIEVE WE ANSWERED ALL
YOUR QUESTIONS.
ALL RIGHT.
ANY OTHER QUESTIONS?
YES, SIR.
THERE'S A MICROPHONE, IF YOU
WANT TO STEP FORWARD AT THE VERY
FRONT.
YOU COULD JUST TELL US YOUR
NAME.
THANK YOU.
>> I'M FROM TAMPA, FLORIDA, AND
MY QUESTION IS WITH YOUR TIER
TWO THAT YOU DESCRIBE, THE AT
RISK, ARE YOU RECOMMENDING
CRITERIA TO IDENTIFY THOSE?
I CAN SEE HOW WE IDENTIFY TIER
ONE --
>> THEY'RE ALREADY IN.
WE WILL COME UP, THE NEXT PHASE
THAT WE HAVE TO DO IS WE'RE
PUTTING AN IMPLEMENTATION GROUP
TOGETHER TO COME UP WITH SOME OF
THE DETAIL AND LANGUAGE OF THIS.
BUT THEY'RE USUALLY FAIRLY
OBVIOUS.
IT'S A LOT OF HOMELESS
INDIVIDUALS, IT'S INDIVIDUALS
THAT HAVE PRIOR CONTACT WITH THE
CRIMINAL JUSTICE SYSTEM.
ONE OF THE MOST INTERESTING
PIECES OF DATA WE LOOKED AT
THROUGH THE MEANT 58 HEALTH
INSTITUTE IS THAT MOST PEOPLE IN
THE CIVIL MENTAL HEALTH SYSTEM
DON'T CROSS OVER INTO THE
CRIMINAL JUSTICE SYSTEM.
AND WE BELIEVE IT'S BECAUSE OF
THE ACUITY LEVEL, AND THE SYSTEM
WAS NEVER DEVELOPED TO LOOK AT
THE DIFFERENCES.
SO WE HELP DISTINGUISH BETWEEN
THE ACUITY LEVELS USING A
DISEASE MODEL AND BRINGING MORE
DOLLARS IN TREATMENT FOR THE
HIGHER LEVEL OF INDIVIDUAL.
AND I ALSO DIDN'T GET A CHANCE
TO MENTION THAT WE ARE SERIOUSLY
UPGRADING AND REVAMPING THE
JUDICIAL EDUCATION SYSTEM AS
WELL SO THAT WE CAN DO A MUCH
BETTER JOB OF TEACHING JUDGES
THROUGHOUT THE STATE ABOUT THIS
ILLNESS, HOW IT MANIFESTS
ITSELF, WHAT OPTIONS ARE
AVAILABLE IN THE COMMUNITY, AND
WE'RE ALREADY PUTTING TOGETHER A
PLAN THAT WE WILL BE
IMPLEMENTING OVER THE NEXT YEAR.
WE WILL DO THIS, WE SUGGEST
DOING THIS PLAN OVER A SIX-YEAR
PERIOD.
IT'S GOING TO TAKE A WHILE.
YOU CAN'T JUST FLIP A SWITCH AND
HAVE A COMPETENT MENTAL HEALTH
SYSTEM.
AND WE WILL TARGET BEGINNING
WITH THREE COUNTIES THAT ARE
OVERUTILIZING THE FORENSIC
MENTAL HEALTH SYSTEM SO WE CAN
DRAW DOWN ON THOSE 300 BEDS SO
WE CAN LET THE DEPARTMENT CANCEL
THOSE CONTRACTS AND GET THE $48
MILLION TO THE FRONT END AS
QUICKLY AS POSSIBLE SO WE CAN
BUILD THIS SYSTEM.
AND THEN WE WILL GROW THE
MEDICAID PLAN OVER A SIX-YEAR
PERIOD.
WE INITIALLY SEE ABOUT A
THOUSAND PEOPLE IN THE FIRST
YEAR OR TWO, SO IT'LL GIVE THE
DEPARTMENTS TIME TO SET UP A
SYSTEM.
THEY HAVE TO GO THROUGH AN
AMENDMENT PROCESS WITH THE
FEDERAL GOVERNMENT WHICH WE
BELIEVE WILL TAKE ABOUT SIX
MONTHS.
AND WE WERE VERY LUCKY.
I MEAN, ONLY THIS YEAR AS OF
JANUARY 1ST THE FEDERAL
GOVERNMENT ALLOWED THIS TYPE OF
MEDICAID PROGRAM TO BE PUT
TOGETHER, AND IT HASN'T BEEN
DONE ANYWHERE ELSE IN THE U.S.
AND THE NOVEL PART IS THAT WE
WILL BE, YOU KNOW, CARVING OUT
THIS AREA FOR THOSE WITH
CRIMINAL JUSTICE INVOLVED AND
THOSE AT RISK IN CRIMINAL
JUSTICE.
JUSTICE?
>> JUDGE LEIFMAN, AS YOU KNOW
WE'RE VERY PROUD HERE IN FLORIDA
OF OUR DRUG COURT SYSTEM.
AND WE'VE REALLY SEEN ANOTHER
THING THAT WE CAN BE VERY PROUD
OF, OUR TRIAL COURT JUDGES AND
YOU, OF COURSE R A PRIME EXAMPLE
OF THIS.
THIS HAS BUBBLED UP REALLY FOR
THE SAME REASON THAT THE DRUG
COURTS CAME INTO EXISTENCE.
AND THAT IS THAT AROUND THE
STATE OF FLORIDA TRIAL JUDGES
SUCH AS YOU SAW EVERY DAY IN
THEIR COURTROOMS AT ARRAIGNMENTS
OR WHATEVER THAT SIGNIFICANT
NUMBERS OF THESE PEOPLE THAT
WERE BEFORE THEM IN THE CRIMINAL
JUSTICE SYSTEM REALLY HAD
ANOTHER ISSUE, REALLY, ANOTHER
PROBLEM THAT WAS BRINGING THEM
IN THERE.
IN THIS CASE THE MENTAL HEALTH
ISSUE.
AND I THINK THAT WE'VE BEEN
TREMENDOUSLY SUCCESSFUL WITH OUR
DRUG COURTS, AND THEY'VE SERVED
AS A MODEL FOR THE COURTS AROUND
THE COUNTRY.
HOW MUCH IS A VALID ANALOGY
HERE?
YOU'VE LOOKED AT THIS VERY
CLOSELY, AND HOW MUCH IS THERE A
VALID ANALOGY O OTHER THAN THE
INITIAL DISCOVERY THAT, WAIT A
MINUTE HERE, YOU KNOW, WE HAVE
PEOPLE THAT REALLY HAVE A MENTAL
HEALTH ISSUE AS OPPOSED TO A
CRIMINAL JUSTICE ISSUE, AND
WE'VE GOT TO ADDRESS IT AS SUCH?
SO COMPARE THE TWO, IF YOU CAN,
AND GIVE US -- BECAUSE I KNOW A
LOT OF PEOPLE OUT THERE MAY JUST
THINK, OH, WELL, WE CAN JUST DO
IT, YOU KNOW, LIKE THE DRUG
COURTS AND HAVE PEOPLE PAY, YOU
KNOW, FOR THEIR COUNSELING FOR
DRUGS OR WHATEVER AND, YOU KNOW,
THAT THIS IS GOING TO -- HOW
MUCH OF A VALID ANALOGY IS
THERE, AND HOW MUCH OF A VALID
ANALOGY IS THERE NOT THERE?
>> IT'S A SUPERB QUESTION, AND
THERE'S RESEARCH GOING ON
NATIONALLY TO TRY TO ANSWER THAT
QUESTION ON A BEST PRACTICE
LEVEL.
BUT THERE ARE SOME
DISTINGUISHING ISSUES THAT WE
HAVE TO BE CAREFUL OF.
UNDER THERAPEUTIC JUS PREENS, WE
CAN PIT THEM IN -- PUT SOMEONE
IN JAIL AN EXTRA COUPLE OF WEEKS
TO GET THEM OFF DRUGS.
WHAT WE'LL DO WITH MENTAL
ILLNESS IS EXACERBATE THE
ILLNESS.
YOU DON'T WANT TO SEND A MESSAGE
TO THE COMMUNITY THAT YOU NEED
TO GET ARRESTED TO GET OTHER
KIND OF SERVICES.
SO WE'VE TRY TODAY FORCE THE
CIVIL SYSTEMS IN THE COMMUNITY
TO DO A BETTER, MORE COMPETENT
JOB SO THEY DON'T COME TO US TO
BEGIN WITH.
THE GROWTH NUMBERS, IT'S
EXPLODING.
ALSO, UNLIKE SUBSTANCE ABUSE,
SOMETIMES, OFTENTIMES AFTER A
YEAR OR TWO OF REALLY GOOD
THERAPEUTIC JURISPRUDENCE,
THEY'RE IN RECOVERY AND OFF
DRUGS.
MENTAL ILLNESS IS A CHRONIC
ILLNESS WHICH WE HAVE NO CURE
FOR, AND WE HAVE TO BE CAREFUL.
WE DON'T WANT THE COURT IN A
POSITION MONITORING THEM FOR
THEIR WHOLE LIVES.
SO WE TRY HARD TO MAKE SURE THE
CIVIL SYSTEM DOES THAT BETTER
JOB AND KEEPS THEM OUT OF OUR
SYSTEM.
AND THERE ARE DIFFERENT MODELS.
OTHER COMMUNITIES ARE USING
DIVERSION PROGRAMS, AND I THINK
IT'S GOING TO BE UP TO THE
INDIVIDUAL CIRCUITS TO DECIDE
WHAT WORKS BEST FOR THEM.
AND WE GIVE THEM GUIDANCE ON
BOTH WAYS USING BEST PRACTICES
BOTH WAYS.
AND I THINK WE ALSO, THE JURY'S
STILL OUT A LITTLE BIT ON HOW IT
WORKS BEST.
NOW, ONE AREA THAT DRUG COURTS
PROBABLY COULD IMPROVE ON IS
THOSE INDIVIDUALS THAT HAVE A
CO-OCCURRING DISORDER MEANING
THEY HAVE A MENTAL ILLNESS AND A
SUBSTANCE ABUSE PROBLEM, AND
TREATMENT HAS TO BE INTEGRATED.
YOU CAN'T JUST OFFER ONE AND NOT
THE OTHER TO MAKE SURE THEY GO
IN RECOVERY.
FROM THE STATISTICS ABOUT 5-6%
OF THE PEOPLE IN DRUG COURT
PROBABLY MEET THAT DUAL
CRITERIA, AND TREATMENTS NEED TO
BE INDICATED TO COVER THOSE
INDIVIDUALS.
THANK YOU.
YES, SIR.
>> IN TERMS OF DEDICATING
DOLLARS, OBVIOUSLY, THE FEDERAL
GOVERNMENT -- [INAUDIBLE]
>> THERE IS SOME FLEXIBILITY
UNDER THE AMENDED PLAN ON WHO
CAN BECOME ELIGIBLE NOW UNDER
THIS NEW PLAN.
I, YOU KNOW, ALL WE'LL BE DOING
IS PUTTING PEOPLE WHO ALREADY
QUALIFY FOR THE MEDICAID BENEFIT
INTO THE SYSTEM AND DOING A
BETTER JOB ACCESSING THE SYSTEM.
ONE OF THE OTHER AREAS THAT
WE'VE LOOKED AT, AND I'M SO
THRILLED THAT THE SHERIFFS ARE
REPRESENTED HERE AND WE'RE
WORKING WITH THEM.
UNFORTUNATELY, IN ALL THE
DIFFERENT JAILS AROUND THE
STATE, WE USE DIFFERENT
SCREENING AND ASSESSMENT TOOLS.
AND THAT'S GOING TO HAVE TO BE
IMPROVED.
EVERYBODY'S GOING TO HAVE TO
COME UP WITH A MORE UNIFORM TOOL
SO THAT WE CAN, A, DO A BETTER
JOB IDENTIFYING THOSE
INDIVIDUALS TO FIGURE OUT, A,
WHO WILL MEET FROM A MEDICAL
POINT OF VIEW THE CRITERIA FOR
MEDICAID, AND TO MAKE SURE THAT
THEY GET THEIR BENEFITS.
WE HAVE A PLAN IN HERE THAT
WORKS WITH THE FEDERAL
GOVERNMENT.
WE JUST ALSO THANKS TO THE
COUNSEL STATE GOVERNMENT ARE
GOING TO BE GIVEN A STATEWIDE
GRANT TO WORK ON IMPROVING HOW
WE ACCESS MEDICAID, SO WE WILL
MERGE ALL THIS TOGETHER, AND WE
LOOK TO THE COUNTIES TO PUT
PEOPLE IN THE JAILS AND IN THE
PRISON TO START THE BENEFIT
PROCESS BEFORE THEY COME OUT.
AND THERE'S SOME WONDERFUL
STRATEGIES THAT WE'VE BEEN USING
IN MIAMI-DADE WHERE WE'RE ABLE
TO GET PEOPLE ON BENEFITS WITHIN
21 DAYS RIGHT NOW.
SO WE PUT THOSE MODELS IN HERE,
AND WE'LL WORK WITH THE
SOWNTIES.
THE TECHNICAL ASSISTANCE CENTER
IS WORKING WITH US ON THIS TO GO
TO THE COMMUNITIES AND TEACH THE
COMMUNITIES ON HOW TO USE THESE
DIFFERENT TOOLS.
YES, SIR?
>> [INAUDIBLE] PEOPLE ARE BEING
RELEASED FROM -- WE HAVE
PROBLEMS BUT ALSO THOSE WHO HAVE
QUOTE OCCURRING PROBLEMS WITH
SEXUAL MOLESTATION CASES, THEY
CAN'T LIVE IN CERTAIN AREAS.
>> HOUSING IS A CRITICAL ISSUE,
AND WHAT WE DO IS WHEN WE CREATE
THIS INTEGRATED SPECIALTY
NETWORK, THE PROVIDERS WILL BE
PART OF THIS HOUSING SOLUTION.
AND WITH THE MORE DOLLARS FROM
MEDICAID AND SOCIAL SECURITY AND
GETTING ALL THEIR FEDERAL
BENEFITS UP FRONT, WE HOPE WE
CAN DO A BETTER JOB, AND WE PLAN
ON WORKING WITH THE LEGISLATURE
TO ADDRESS THIS AS WELL.
BUT ONE OF THE MODEL THAT IS WE
RECOMMEND IN HERE AND THAT WE'VE
BEEN VERY SUCCESS.
IN -- SUCCESSFUL IN MIAMI-DADE
IS GETTING GAP MONEY.
IF YOU QUALIFY FOR FEDERAL
BENEFITS, IT TAKES ALMOST SIX
MONTHS TO GET YOUR CHECK.
AND WHEN YOU DO RECEIVE YOUR
CHECK, IT'S RETROACTIVE.
SO THEY'RE SENDING A $4800 CHECK
TO SOMEONE WITH A RECURRING
COCAINE PROBLEM.
AND IF THEY CAN FIND 'EM, IT
LASTS ABOUT THREE DAYS, AND IT'S
GONE.
WE'VE BEEN DOING, WE HAVE GAP
FUNDING.
WE HAVE THE MONEY.
WE SIGN A CONTRACT WITH THE
CONSUMER, SOCIAL SECURITY, AND
THE COULD BETY -- COUNTY, AND WE
PROVIDE THEM WITH THEIR HOUSING
RIGHT AWAY, LINE UM ALL THEIR --
UP ALL THEIR MEN FITS, AND WHEN
THEIR CHECK COMES IN, INSTEAD OF
GOING BACK TO THE CONSUMER, IT
COMES BACK TO US, WE LEVERAGE
FEDERAL MONEY, AND BY THAT POINT
THEY'RE ALREADY IN A SYSTEM OF
CARE FOR SIX MONTHS, AND THEY'RE
DOING MUCH BETTER.
THAT'S HOW WE KIND OF BLEND ALL
THAT TOGETHER.
AND AGAIN, THESE NETWORKS WILL
HAVE TO BE CERTIFIED AND HOUSING
WILL HAVE TO BE A COMPONENT OF
DOING THIS PLAN.
AND WE THINK WHAT WILL HAPPEN IS
WE START TO SPEND LESS DOLLARS,
WE CAN START TO MOVE MORE
COLLARS TO THE FRONT-END CIVIL
SYSTEM BECAUSE THAT SYSTEM IS
STILL HORRIBLY, INADEQUATELY
UNDERSOURCES AT THIS POINT AS
WELL.
OKAY.
>> YEAH.
WE HAVE COFFEE AND SOFT DRINKS,
SO WHY DON'T WE TAKE OUR LITTLE
BREAK NOW.
MAYBE NOT TAKE THE FULL HALF
HOUR, BUT LET'S TAKE A 15-20
MINNESOTAER.
COME BACK IN AND WE CAN ROLL
BACK THROUGH THIS.
THE INDIVIDUAL PARTS BY THE
DIFFERENT SUBCOMMITTEES.
PLEASE HELP YOURSELF AND JOIN US
FOR COFFEE AND A SOFT DRINK.,,,,,,,,,,,,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS]``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
[INAUDIBLE CONVERSATIONS],,``%%
>> IF I COULD HAVE YOUR
ATTENTION, PLEADS, WE NEED TO
BEGIN ROLLING OUT THE DETAILS.
TO SPEAK TO US WITH REGARD TO
TRANSFORMING SOLUTIONS EACH TIME
THAT THERE'S A SHIFT IN THE
FRONT OFFICE, WE NEED TO SPEAK
TO FOLKS WHO UNDERTAKE
LEADERSHIP ROLES AND WHAT GOES
ON WITHIN THE COURT SYSTEM.
AND THERE'S A CIRCUIT JUDGE HERE
IN LEON COUNTY THAT JUST STEPS
UP.
JUST STEPS UP AND KEEPS STEPPING
UP.
AND I ASKED HER IF SHE'D MEET
WITH ME AND TALK ABOUT
UNDERTAKING A PROJECT, AND I
THINK WHEN SHE WALKED IN SHE WAS
FIGURING OUT A WAY TO TELL ME
HER PLATE WAS REALLY FULL.
BUT BY THE TIME WE HELD HANDS
AND WE SHED A FEW TEARS ABOUT A
COMMITMENT, THIS IS A GREAT
JUDGE, A GREAT WOMAN.
LET ME INTRODUCE TO YOU THE
CIRCUIT JUDGE NICKY ANN CLARK
FROM HERE IN LEON COUNTY.
JUDGE CLARK?
[APPLAUSE]
>> CHIEF JUSTICE, JUSTICE
PARIENTE, JUSTICE QUINCE,
JUSTICE ANSTEAD, FRIENDS,
COLLEAGUES, THANK YOU VERY MUCH.
I'M SO EXCITED TO BE A PART OF
THIS, AND CHIEF JUSTICE LEWIS
WAS RIGHT.
WHEN HE FIRST ASKED ME TO CHAIR
THIS COMMITTEE, MY FIRST THOUGHT
WAS WHAT AN INCREDIBLE
COMPLIMENT THAT HE'S GOT SUCH
CONFIDENCE, MY SECOND THOUGHT
WAS I JUST CAN'T DO THIS.
THE CHALLENGE MIGHT JUST BE TOO
BIG.
I WENT AND MET WITH HIM, AND
HE'S ABSOLUTELY RIGHT, I FULLY
INTENDED TO TELL HIM THANKSBUT
NO THANKS.
AND BY THE TIME WE GOT DONE
TALKING I WAS SO CONVINCED THAT
THIS WAS NOT GOING TO BE A
COMMITTEE THAT WROTE A REPORT
THAT SAT ON A SHELF.
I WAS PERSUADED THAT THIS WAS
GOING TO MAKE A DIFFERENCE, THAT
WE HAD GOOD PEOPLE ON OUR
COMMITTEE, WE HAD WONDERFUL
PEOPLE ON OUR SUBCOMMITTEE, WE
HAD THE 100% BACKING OF A VERY
DEDICATED CHIEF JUSTICE, SO I'M
SO GLAD THAT YOU ASKED ME, AND
I'M SO GLAD I SAID THANK YOU.
I WANT TO FIRST THANK JUSTICE
LEWIS FOR HIS INCREDIBLE
FORESIGHT AND HIS ENERGETIC
LEADERSHIP IN RECOGNIZING,,,,,,``%%
UNDER JUDGE LEIFMAN SALIDA
MACKY IS UNABLE TO BRING
TOGETHER ALL THE BRANCHES OF
GOVERNMENT AND FOR THE CERTAIN
TIME IN MY MEMORY WE HAVE GOT
ALL THREE BRANCHES OF GOVERNMENT
TO CONSIDER THIS A CRITICAL
ISSUE.
WITH THAT KIND OF SUPPORT THERE
IS NO DOUBT THAT WE WILL MAKE
SOME CHANGES THAT WE HAVE BEEN
MEETING TO MAKE IN THE STATE FOR
A WHILE.
THE SUPREME COURT COMMITTEE OF
FAMILIES AND CHILDREN IN THE
COURT IS VERY PLEASED TO RECEIVE
THE RECOMMENDATIONS HERE TODAY.
THE REPORT IS EXTRAORDINARY, IT
IS COMPREHENSIVE, IT IS BOLD,
AND IT IS EXACTLY WHAT FLORIDIAN
NEEDS.
THE PERSPECTIVE I WANT TO SHARE
THIS AFTERNOON IS THAT OF A
CIRCUIT JUDGE WHO PRESIDES OVER
FAMILY MATTERS.
AND IF UNIFIED FAMILY COURT IN
TALLAHASSEE WHICH MEANS I'VE
PRESIDE OVER CASES A INVOLVING
FAMILIES AND CHILDREN AND
FAMILIES THAT ARE QUITE FRANKLY
IN CRISIS.
AS A UNIFIED FAMILY COURT JUDGE,
SAYING DEPENDENCY CASES AS WELL
AS DELINQUENCY CASES, I GET TO
SEE ON A DAILY BASIS, SOMETIMES
OVERWHELMINGLY, BUT ON A DAILY
BASIS FIRSTHAND HOW UNTREATED
MENTAL ILLNESSES OF FACT
FLORIDA'S FAMILIES.
I SEE ON A DAILY BASIS HOW MANY
OF FLORIDA'S FAMILIES FROM ALL
WALKS OF LIFE, STRUGGLE FOR
NORMALCY, STRUGGLED WITH THE
GENERATIONAL MENTAL HEALTH
ISSUES.
I SEE HOW THESE ISSUES AFFECT
THE FORMATIVE YEARS OF A CHILD'S
LIFE AND HOW GROWING UP IN A
FAMILY THAT HAS UNTRADED MENTAL
HEALTH ISSUES SETS THE
PERSPECTIVE FROM WHICH THESE
CHILDREN WILL SEE THE REST OF
THE WORLD FOR THE REST OF THEIR
LIVES.
WHERE IS THAT I'M SUPPOSED TO
PUT A CHILD WHO HAS GOT PTSD,
BECAUSE HE OR SHE WAS MOLESTED
BY STEPPARENT?
WHAT RESOURCES THE WE HAVE THAT,
AS A JUDGE, I CAN ADEQUATELY
TREAT OR SEND FOR TREATMENT A
CHILD WHO SUFFERS FROM EMOTIONAL
DISTURBANCE?
PERHAPS SHE IS ONLY SEEN HER
PARENTS FOUR TIMES AND THEY ARE
UNFIT AND HAVE BEEN FOR MOST OF
THEIR LIVES.
AND PERHAPS SHE HAS BEEN SHUNTED
FROM FOSTER HOME TO FOSTER HOME
UP TO A DOZEN TIMES.
WHERE DO I SEND A 14-YEAR-OLD
BIPOLAR PREGNANT GIRL, WHO IS
ABUSING THE MEDICATIONS SHE IS
ON?
AND WHAT DO I DO WITH THAT
CHILD?
WE NEED ANSWERS TO ALL THESE
QUESTIONS.
AND WHAT HAPPENS TO THE
18-YEAR-OLD WHO HAS BEEN IN
THERAPEUTIC FOSTER CARE AND IT
AGES OUT?
TO SIMPLY TELL THEM GOOD-BYE,
LEAVE FROM THE COURTROOM, GO
FIND HOMELESS MILTER?
THOSE ANSWERS ARE NOT ACCEPTABLE
ONE OF THE ISSUES THAT THE FULL
COMMITTEE IS LOOKING AT IN
ADDITION TO THE MENTAL HEALTH
ISSUES IS THE AGING OUT ISSUE
AND THAT IS -- COMMINATE
18-YEAR-OLD DO YOU KNOW
PERSONALLY THAT CAN FIGURE OUT
THE ADULT SYSTEM AND ALL THE
INTRICACIES AND FAULT WITH BEING
AN ADULT?
I DON'T KNOW MANY.
AND THOSE WHO ARE ALSO SUFFERING
FROM MENTAL HEALTH ISSUES.
YOU SEND THEM OUT INTO THE WORLD
WITH NO BACKUP, WITH NO SYSTEM,
WITH NO HELP.
THAT IS NOT WORKING.
WE HAVE GOT TO GET A HANDLE ON
THIS SYSTEM.
AND I WANT TO SHARE WITH YOU
SOME NUMBERS YOU DID NOT HEAR
THIS MORNING, AN ESTIMATED 40%
OF CHILDREN IN FOSTER CARE IN
FLORIDA HAVE A SERIOUS EMOTIONAL
DISTURBANCE.
MORE DISTURBINGLY, SUICIDE IS
THE THIRD LEADING CAUSE OF DEATH
IN YOUNG PEOPLE BETWEEN THE AGES
OF 15 AND 24.
MORT TEENAGERS AND YOUNG ADULTS
DIE FROM SUICIDE THAN FROM
CANCER, HEART DISEASE, AIDS,
BIRTH DEFECTS, AND AMMONIA,
CHRONIC LUNG DISEASE, ALL THOSE
COMBINED.
THAT IS UNACCEPTABLE AND MORE
IMPORTANTLY, THAT IS PREVENTABLE
JUDGE LEAFIER -- LEIFMAN TALKED
ABOUT THIS AND THE FIGURES I
COME UP WITH BASED ON NATIONAL
FIGURES AND STATE FIGURES IS
THAT AT LEAST 80% OF THE GIRLS
IN THE DELINQUENCY CENTER HAVE
BEEN SEXUALLY MOLESTED.
DON'T THINK IT IS JUST GIRLS
THERE SEXUALLY MOLESTED.
WE DON'T HAVE THE NUMBERS YET
FOR THE BOYS BUT THE NUMBERS ARE
NEARLY AS HIGH AS FAR AS A
BEACON TELL.
THAT IS MOST OF THE GIRLS IN THE
SYSTEM AND MANY, MANY OF THE
BOYS.
FOR THESE CHILDREN BEGAN TO ACT
OUT, THEY ARE BEGGING FOR HELP.
THERE BEGGING FOR US TO DO
SOMETHING FOR THEM.
WE DON'T PROVIDE THE COUNSELING
THAT THESE CHILDREN NEED WHEN
THEY ARE BEGGING FOR IT, WHO IS
IT THE THINK IS GOING TO BECOME
THE MOLESTERS AND THE CHILD
ABUSERS?
WE ALL KNOW.
I HAVE BEEN ON THE BENCH NOW FOR
OVER 14 YEARS, AND THAT HAS
GIVEN ME, I'M NOT SURE IF I WANT
TO SAY OPPORTUNITY BUT I'VE BEEN
ON THE BENCH LONG ENOUGH TO BE
ABLE TO SEE SEE THE REPUTES
FAMILY CYCLES OF DEVASTATION AND
DESPAIR.
I HAD A CASE INVOLVING AN ABUSED
TEENAGER, THE CHILD WAS ALSO
CHARGED WITH A CRIMINAL OFFENSE.
THIS GROW, BOTH HER PARENTS HAD
BEEN IMPRISONED DURING HER
FORMATIVE YEARS.
AS I REVIEWED THE CASE, I GOT
THIS REALLY STRANGE SENSE OF
DEJA VU AND AS I REVIEWED THE
CASE, I REALIZED WHY IT SOUNDED
SO FAMILIAR TO ME.
12 YEARS AGO, THE MOTHER OF THIS
CHILD WAS IN MY COURT AS A
JUVENILE.
AS A JUVENILE, FACING SIMILAR
DELINQUENCY CHARGES.
A FEW YEARS LATER I SAW HER IN
ADULT COURT.
SHE WAS CHARGED WITH ROBBERY AND
VERY SERIOUS FELONY CHARGES.
WE TRIED AND TRIED TO GITTER THE
HELP SHE NEEDED.
WE TRIED AND TRIED TO WORK WITH
HER.
SHE ENDED UP IN PRISON.
DURING HER YEARS OF CRIME
SPREES, SHE OF COURSE THE GENA
FAMILY.
SHE IS OUT OF PRISON NOW BUT SHE
STILL STRUGGLES WITH MENTAL
HEALTH ISSUES.
SHE STILL STRUGGLES WITH
SUBSTANCE-ABUSE ISSUES, AND THE
WEEK WHEN I SAW HER IN
DEPENDENCY COURT, THIS TIME IT
WAS ON CHILD ABUSE CHARGES AND
CYNTHIA HAD, AND HER DAUGHTER IS
STRUGGLING WITH, SUBSTANCE-ABUSE
ISSUES AND MENTAL HEALTH ISSUES.
CYNTHIA HAD HER NOW TEENAGED
DAUGHTER IS DEALING WITH THE
TRAUMA OF HAVING BEEN SEXUALLY
ABUSED AS A YOUNG GIRL.
AND HER MOTHER ASKED, WITH THIS
GIRL END UP IN PRISON BECAUSE WE
DON'T HAVE THE RESOURCES, THE
CREATIVITY TO PROVIDE NECESSARY
MENTAL HEALTH TREATMENT FOR HER
TODAY?
WE HAVE HEARD LOTS OF STAFF
TODAY, WE HAVE HEARD LOTS OF
NUMBERS ABOUT PROBLEMS
ASSOCIATED WITH MENTAL HEALTH
ISSUES IN ADULTS AND CHILDREN.
AND I WANT TO REMIND ALL OF DO
YOU THAT NONE OF THESE
STATISTICS EXIST IN A VACUUM.
THESE ARE HUMAN BEINGS, THESE
ARE REAL PEOPLE.
EACH OF THOSE STATISTICS IS A
PERSON.
EACH ONE OF THE SCORES OF
THOUSANDS OF PEOPLE THAT WE HAVE
HEARD ABOUT TODAY IS SOMEBODY'S
SON OR DAUGHTER.
IT IS SOMEBODY'S MOTHER OR
FATHER.
NONE OF THESE STEPS MEAN
ANYTHING WITHOUT THE RECOGNITION
THAT EACH FAILURE HAUNTS A
FAMILY FOR GENERATIONS TO COME.
IS IT MORE COST-EFFECTIVE TO
DEAL WITH THESE ISSUES AT A TIME
WHEN SERIOUS MENTAL HEALTH
ISSUES CAN BE A BURDEN?
EVE BAGGED THIS BRITO IS A MORE
COST-EFFECTIVE TO BREAK THAT
VICIOUS CYCLE OF INAPPROPRIATE
BEHAVIOR, LEADING TO MORE
INAPPROPRIATE BEHAVIOR?
YOU BET IT IS.
THIS IS AN IMPORTANT PROCESS
WERE WORKING ON.
IT IS REAL BLAZING WORK THAT
WILL CHART A COURSE QUITE
FRANKLY FOR THE ENTIRE NATION.
WE HAVE A CHANCE TO BE LEADERS
IN THIS NATIONAL EFFORT, AND I
AM SO PROUD TO BE PART OF THAT
EFFORT.
IN THE FINAL ANALYSIS, ALL OF
THE ISSUES ADDRESSED IN THIS
CRITICAL REPORT GO BACK TO OUR
NEED TO SUPPORT CHILDREN AND
FAMILIES.
EVERY ONE OF THE STEPS YOU HEARD
ABOUT SOME OF THE MENTALLY ILL
IN JAIL BEGAN AS SOMEBODY'S
CHILD.
AS CHAIR OF THE COMMITTEE, THAT
SHE JUSTICE LEWIS SET UP, I URGE
SUPPORT FOR THE INNOVATIVE AN
INCREDIBLE IDEAS THAT HAVE BEEN
PRESENTED HERE TODAY AND I SO
LOOK FORWARD TO THE INPUT FROM
EVERYBODY INVOLVED, I LOOK
FORWARD TO WORKING WITH YOU IN
CHIEF JUSTICE LEWIS, THANK YOU
AGAIN FOR THE OPPORTUNITY TO BE
PART OF THE EFFORT.
I STAND READY TO OFFER MY
SERVICES IN THIS CONTINUING
EFFORT AND, AS WE CONTINUE
PROCESS THAT HAS BEGUN, WE WILL
HAVE OUR REPORT.
OUR COMMITTEE IS THROUGH
JUNE 08, AND HAVING ACCEPTED
THIS REPORT WILL CONTINUE TO
WORK.
WE WANT TO CONTINUE TO
INCORPORATE ISSUES AFFECTING
CHILDREN AND FAMILIES AND I WILL
BE GLAD TO SHARE THAT REPORT
WITH ANYBODY WHO WANTS TO.
THANK YOU.
[APPLAUSE]
pp>> WHAT WE LIKE TO DO NOW, I
WILL CALL IN THE COCHAIRS OF THE
WORK GROUP SO THEY CAN GET INTO
MORE DETAIL OF SOME OF THE
PROPOSALS.
I WILL START WITH
DR. CONSTANTINE AND DR. TANDON
TO COCHAIRS THE BEST PRACTICES
WORK GROUP.
pp>> I WAS SITTING BACK RESTING.
I WAS THE LAST ONE ON THE
AGENDA, ALL OF A SUDDEN I GOT TO
BE FIRST.
NO PROBLEM.
AS STEVE SAID, ARE WORKING
GROUP, STANDARDS AND HAVE
ABEYANCE BASE PRACTICES.
WE ADDRESSED THREE BASIC
QUESTIONS.
THE FIRST IS WHAT KINDS OF
SERVICES AND SYSTEMS ARE
NECESSARY TO TRANSFORM FLORIDA'S
MENTAL HEALTH SYSTEM IN A WAY
THAT WOULD PREVENT PEOPLE WITH
SERIOUS MENTAL ILLNESS FROM
GETTING INVOLVED IN THE CRIMINAL
JUSTICE SYSTEM.
WHAT SHOULD THE SERVICES LOOK
LIKE, WHAT SHOULD THE SYSTEM
LOOK LIKE?
WHAT DO WE NEED TO DO TO MAKE
THAT HAPPEN?
QUITTOR THE THREE OR FOUR
CRITICAL STEPS THAT HAVE TO BE
TAKEN IF WE ARE GOING TO MAKE
PROGRESS?
AND THEN THE LAST IS, HOW WILL
WE FINANCE IT?
LET ME START WITH THESE SERVICES
AND SERVICES TUMS.
WORKGROUP FOUND LOTS OF
LITERATURE AND ACTUALLY GOOD BIT
OF RESEARCH INDICATING WE REALLY
DO KNOW SOMETHING ABOUT DEALING
WITH PEOPLE WITH SERIOUS MENTAL
ILLNESS IN THE CRIMINAL JUSTICE
SYSTEM.
THERE IS LOTS OF STUFF WRITTEN,
LOTS OF RESEARCH ABOUT DIVERTING
PEOPLE WITH INITIAL, THAT HAVE
INITIAL CONTACT WITH LAW
ENFORCEMENT, AVERTING THEM ONCE
THEY ARE IN JAIL, ABOUT
PROVIDING APPROPRIATE SERVICES
FOR WHEN THEY ARE RELEASED FROM
THE JAIL, ABOUT PROVIDING
REENTRY SERVICES WHEN THEIR
RELEASE FROM PRISON.
WE KNOW HOW TO IMPLEMENT THESE
THINGS.
THE INFORMATION IS OUT THERE.
AND IT CAN BE DONE.
WHEN THE QUESTIONS THAT CAME UP
IN THE WORK GROUP WAS, WHAT
SUPPOSE WE GET SOME RESOURCES
AND WE GET SOME ENERGY AND WE
IMPLEMENT THESE NEW DIVERSION
SERVICES AND REENTRY SERVICES.
WHAT ARE WE DIVERTING THEM TO?
WHAT ARE THEY RE-ENTERING?
THE TRUTH OF THE MATTER IS,
THERE ARE HUGE HOLES IN
FLORIDA'S PUBLIC SUPPORTED
MENTAL HEALTH SYSTEM AND SO THE
SECOND THING WE ADDRESSED WAS
NOT JUST HOW TO DIVERT PEOPLE
BUT WHAT HAS TO BE DONE AS FAR
AS COMMUNITIES TO BE ABLE TO
PROVIDE THE SERVICES AND SUPPORT
THAT ARE NECESSARY TO TAKE CARE
OF THEM AND PREVENT THEM FROM
CONTINUING TO RECYCLED BACK INTO
THE CRIMINAL JUSTICE SYSTEM.
WE CAME UP WITH, WE COULD COME
UP WITH A BOOK WORTH OF THINGS
WE NEED TO DO BUT THE PRIORITIES
WHICH SAID WERE FIRST OF ALL, WE
THOUGHT EVERYONE COMMUNITY NEEDS
AND ENHANCED IN CENTRALIZED
ACUTE CARE SYSTEM.
THERE IS SUCH A MODEL IN PLACE
IN TWO OR THREE PLACES IN THE
STATE.
APPROVES BE EFFECTIVE AND
EFFICIENT.
IN ADDITION WE THINK THE ACUTE
CARE SYSTEM WITH WHICH IN THE
'70S KIND OF MOSTLY GAVE UP
HOSPITAL CARE AND CONVERTED TO A
CRISIS STABILIZATION CARE, WE
NEED TO TAKE THE NEXT THAT'S
INTO CRISIS INTERVENTION WORK ON
AN AMBULATORY BASIS, NOT A
FACILITY BASED APPROACH TO IT.
SECOND IS, THE SECOND PARTY, FOR
SERVICES SPECIALIZED FRIENDS A
CASE MANAGEMENT, SUPPORTED
HOUSING, CONSUMER FAMILY
EDUCATION TO THE EXTENT WE CAN
GIVE CONSUMERS AND FAMILIES
INVOLVED IN WORKING ON THE SAME
WAVELENGTH AS THE REST OF US, WE
CAN BE SUCCESSFUL.
AND IN THE LAST THING IS
MEDICATION MANAGEMENT.
DR. LEIFMAN MENTIONED THE
IMPORTANCE OF MEDICATION IS NOT
AS THE ONLY THING TO BE DONE IN
TERMS OF SERVICE DELIVERY BUT AS
A CRITICAL COMPONENT OF THAT.
AND WERE ALREADY INVOLVED IN THE
INSTITUTE IN A PROGRAM CALLED
THE MEDICAID BEHAVIORAL HEALTH
PHARMACY MANAGEMENT PROGRAM
DESIGNED TO IMPROVE THE QUALITY
OF BEHAVIORAL HEALTH SERVICES, A
PART OF THE REPORT INCLUDED IN
OUR REPORT SIMPLY A STATEMENT
THAT PROGRAM WOULD FOCUS THE
SPECIAL ATTENTION ON CONSUMERS
WITH SERIOUS MENTAL ILLNESS IN
THE CRIMINAL JUSTICE SYSTEM.
THE THIRD THING THAT IS NEEDED
IN TERMS OF SERVICE AND SYSTEMS
IS A PROVIDER NETWORK END -- I
NEED TO DR..
JUDGE LEIFMAN MENTION THE
INTEGRATED PROVIDER NETWORK.
WHAT WE ARE TALKING ABOUT IS A
GROUP OF PROVIDERS IN EACH
COMMUNITY THAT ARE CAPABLE OF
PROVIDING EVIDENCE BASED
SERVICES THAT COMMUNICATE WITH
EACH OTHER ON A DAILY BASIS
ABOUT THESE HIGH KNEED
INDIVIDUALS, A PROVIDER NETWORK
THAT IS LINKED ON A DAY-TO-DAY
BASIS WITH THE LAW ENFORCEMENT
SYSTEM IN THE CRIMINAL JUSTICE
SYSTEM.
THAT SYSTEM MUST BE TIGHTLY
MANAGED, MUST OPERATE IN
PERFORMANCE WITH STANDARDS, IT
IS GOING TO TAKE LOTS OF TIME
AND EFFORT TO BRING THE SYSTEMS
UP AND OUR WORK GROUP PROPOSED
THAT SORT OF MENTAL HEALTH
INSTITUTE WOULD BE INVOLVED IN
HELPING FLORIDA'S COMMUNITIES DO
THAT.
WE PROPOSE THAT BECAUSE IN THE
LAST LEGISLATIVE SESSION, THE
LEGISLATOR PASSED HOUSE BILL
1447 WHICH CREATED TECHNICAL
ASSISTANCE FUNCTION FOR
CRIMINAL-JUSTICE MENTAL-HEALTH
IN THE MENTAL HEALTH INSTITUTE
SO IT SEEMED LIKE A LOGICAL
EXTENSION OF THAT.
DATA SERVICES AND SYSTEMS.
THE SECOND IS, WHAT DO WE NEED
TO MAKE IT HAPPEN?
A COUPLE OF THINGS THAT THE WORK
GROUP THOUGHT WERE CRITICAL.
THE FIRST IS LEADERSHIP AT THE
STATE LEVEL AND IF LEADERSHIP
THEN PASSED ACROSS
JURISDICTIONAL BECAUSE WHAT
NEEDS TO BE DONE DOES NOT FALL
WITHIN THE PURVIEW OF ANY SINGLE
STATE AGENCY, AS YOU CAN TELL BY
THE PRESENTATIONS.
THERE A LOT OF DIFFERENT AGENTS
IN THE MALL THAT THE STATE
LEVEL, ALSO SEVERAL THAT THE
LOCAL LEVEL.
AT THE STATE LEVEL, THE REPORT
PROPOSES A BOARD THAT
ESSENTIALLY WILL GIVE SOME
MOMENTUM AND SOME CLOUT TO THESE
DIVERSE AND THIS ABILITY AND
REPRESENTS INTEREST IN THE
EXECUTIVE BRANCH AND IN THE
LEGISLATIVE BRANCH.
THE STAFFING OF THAT LEADERSHIP
FUNCTION AS PROPOSED, WILL FALL
BOTH TO THE TWO MAJOR AGENCIES,
DCF AND -- AND THE TECHNICAL
ASSISTANCE CENTER TO WORK WITH
COMMUNITIES TO HELP THEM BRING
UP THE APPROPRIATE KINDS OF
SERVICES TO CONSULT WITH THEM,
TO REVIEW WHAT THEY ARE DOING,
TO IDENTIFY PROBLEMS AND HELPED
FIX THOSE PROBLEMS.
THE SECOND THING WE NEED IS A
STRATEGY.
WE HAVE A GREAT FLYNN BUT IF YOU
DON'T HAVE A CONCRETE IDEA OF
HOW YOU'LL GET THERE, YOU'LL
PROBABLY NOT GET VERY FAR.
AGAIN, JUDGE LEIFMAN MENTIONS
BRIEFLY THIS STRATEGY.
THIS THING NEEDS TO HAPPEN OVER
A PROLONGED PERIOD OF TIME.
WE PROPOSED SIX YEARS, STARTED
OUT WITH THREE AREAS, THE STATE
IS DIVIDED INTO 11 AREAS UNDER
THE AUSPICE TEAM AT LEAST AND IT
WAS THOSE AREAS WE CHOSE TO
FOCUS ON SO TO START WITH THREE,
GIVE THOSE THREE AREAS TWO YEARS
TO FULLY IMPLEMENT, THEN GO TO
FOR MORE AND THEN GO TO FOR MORE
THAT WILL ALLOW A KIND OF FOCUS
THAT IS NEEDED TO REALLY PULL
THIS KIND OF THING OFF.
THE OTHER FOCUS WE EMPHASIZE IS,
YOU CAN'T WORK WITH EVERY
CONSUMER THAT NEED SERVICE AND
EXPECT TO GET ANYTHING
ACCOMPLISHED.
AND SO IN ADDITION TO FOCUSING
ON SPECIFIC AREAS FIRST AND THEN
SECOND AND THEN THIRD, WE ARE
PROPOSING TO FOCUS ON CONSUMERS
THAT ARE INVOLVED IN THE
CRIMINAL JUSTICE SYSTEM WITH
SERIOUS MENTAL ALICE AND THOSE
BASED ON THE DATA WE HAVE, WHO
ARE AT SERIOUS RISK OF BEING
INVOLVED, FOCUS ON THEM BECAUSE
WE HAVE TO IN THE EARLY YEARS OF
THIS IMPLEMENTATION PRODUCE SOME
IMPACT.
THE THIRD ISSUE IS, HOW WILL WE
FINANCE THIS THING?
THERE IS LOTS OF MONEY LYING
AROUND THESE DAYS TO SUPPORT AND
ENHANCE MENTAL HEALTH SERVICES.
IT HAS ALWAYS BEEN A HIGH
PRIORITY IN THE STATE SYSTEM.
BUT, JUST A FEW IDEAS IN CASE
THAT HISTORY DOES NOT HOLD TRUE.
FIRST IS THE NEW RESOURCES THAT
ARE NEEDED, THE EXISTING SYSTEM
IS POORLY FUNDED BY ANY
STANDARD, BY ANYBODY'S JUDGMENT.
WE ARE RANKED IN THE MID TO HIGH
40'S DEPENDING ON WHICH FEDERAL
ORGANIZATION LOOKS AT US IN
TERMS OF FUNDING.
SO HOW DO WE DEAL WITH THE
RESOURCE ISSUE GIVEN THE OBVIOUS
SHORTAGE OF FUNDS?
THE FIRST IS A PHASE IN.
YOU WILL NEED NEW RESOURCES.
IF YOU FACE THE NEED FOR THOSE
IN OVER SIX YEARS, THEN YOU NEED
LESS IN A GIVEN YEAR AND
HOPEFULLY IN SOME OF THE OUT
YEARS THINGS WILL LOOK BETTER
THAN THEY LOOK NOW.
SECOND IS WE HAVE TO MAXIMIZE
THE USE OF FEDERAL MONEY.
HAS JUDGE LEIFMAN HARDEES SAID,
TO THE EXTENT WE CAN GET AS MANY
PEOPLE AS POSSIBLE ENROLLED IN
MEDICAID, THE FEDERAL GOVERNMENT
PAYS FOR 60% OF THE COST AND
SERVICES.
THE THIRD IS THAT WE RECOMMEND
THE CONSUMERS THAT WE ARE GOING
TO FOCUS ON IN THIS FIRST MAC OF
SIX YEARS, NEED TO BE REMOVED
FROM ANY, LEAST INITIALLY FROM
MANY MANAGED CARE PLAN.
AEGIS SEEMS TO WAS THAT THE
NEEDS OF THESE PEOPLE AND THE
COST OF THE PEOPLE INVOLVED IS
SUCH THAT IT REALLY DOES NOT
MAKE ANY SENSE TO TRY TO BLEND
THEM INTO SOME FOR MEMBER FOR
MONTH HEBETATION POOL AND SAY,
WE WILL TAKE CARE OF THEM AND
AVERAGE ABOUT OVER THE OTHER
10,000 PEOPLE THAT MAYBE DON'T
NEED AS MANY SERVICES.
THE TRUTH IS, THERE NEEDS TO BE
A PROVIDER NETWORK THAT KNOWS
WHAT'S GOING ON WITH THESE
CONSUMERS ON A DAY-TO-DAY BASIS,
RESPONDING TO THEIR NEEDS AND
RESPOND TO THEIR ONCE.
THE WORK GROUP ESSENTIALLY
CONCLUDED THAT THIS COULD BE
DONE TRANSFORMATION IS POSSIBLE.
WHAT IT WILL TAKE IS SUSTAINED
LEADERSHIP.
IT WILL TAKE SOME ADDITIONAL
FUNDING IN THE EARLY YEARS TO
GET IT STARTED.
WE FIRMLY BELIEVE IF WE MANAGE
THIS THING TIGHTLY, AND WE FOCUS
ON SPECIFIC TYPES OF CONSUMERS
IN SPECIFIC AREAS, WE CAN REDUCE
THE NUMBER OF PEOPLE GOING INTO
FORENSIC HOSPITALS, THE NUMBER
OF PEOPLE GOING INTO PRISONS
WITH SERIOUS MENTAL ILLNESS AND
THE NUMBER OF PEOPLE GOING TO
JAIL.
THE THE EXTENT WE CAN DO THAT,
WE CAN BACK ON THESE
COMMUNITY-BASED SERVICES WITH
SAVINGS IN THE INSTITUTIONAL
SYSTEM.
THANK YOU VERY MUCH.
[APPLAUSE]
pp>> IT HELPS IF YOU READ THE
AGENDA.
I AM GOING TO ASK JOHN PETRILA,
WHO IS THE MY COCHAIR AND POLICY
LEGISLATION AND FINANCE WORK
GROUP TO GIVE A PRESENTATION.
THANK YOU.
pp>> THANK YOU JUDGE LEIFMAN,
CHIEF JUSTICE LEWIS, THANK YOU
VERY MUCH FOR HAVING US HERE.
THERE IS ONE FIGURE THAT HAS
BEEN TALKED ABOUT A LOT BUT LET
ME REFERENCES TO MAKE A
COMPARISON TO WHERE THE PUBLIC
MENTAL HEALTH SYSTEM WAS 30
YEARS AGO.
THAT IS THIS NUMBER, WE SPEND
$250 MILLION IN FLORIDA FOR 1700
PEOPLE FOR INCOMPETENT TO STAND
TRIAL AND LAST YEAR THE REAL
INVESTMENT BILL WHICH THE
LEGISLATURE PASSED WHICH IS A
TERRIFIC PIECE OF LEGISLATION,
WERE 125,000 PEOPLE WITH ALS ARE
ARRESTED EACH YEAR, SO THOSE TWO
STATEMENTS I THINK ILLUSTRATE
WHAT IS REALLY AT STAKE HERE,
WHICH IS THAT THIS IS A SYSTEM
THAT IS SERIOUSLY OUT OF WHACK.
DO DRAUT DE HISTORIC ANALOGY,
THE PUBLIC SYSTEM FACE THE SAME
DILEMMA OF.
THE SYSTEM IN PUBLIC PSYCHIATRIC
HOSPITALS AND SPEND RELATIVELY
LITTLE MONEY WHERE IT WAS MOST
NEEDED, IN THE COMMUNITY.
THE CENTRAL POLICY CHALLENGE
THAT FACED THE PUBLIC MENTAL
HEALTH SYSTEM IN EVERY STATE
THEN WAS WHETHER THAT MONEY
COULD BE REINVESTED IN A STATE
HOSPITAL OR DOWNSIZED AND MANY
STATES ) THOUGH THE CENTRAL FACT
IS THAT IN EVERY STATE, THAT
POLICY CHALLENGE WAS FAILED.
THERE IS NOT A SINGLE STATE
WHERE ONE CAN LOOK AT A
SUCCESSFUL PATTERN OF
REINVESTING THE MONEY THAT WAS
SPENT ON THE DEEPEST END OF THE
PSYCHIATRIC SYSTEM, WHEN THAT
MONEY WAS IN FACT REINVESTED IN
ANY SIGNIFICANT WAY IN FRONT AND
SERVICES.
THE RESULT OF THAT IS THE THING,
THE RESULT HAS BEEN FELT IN
EVERY PART OF OUR SOCIETY
INCLUDING THE ISSUES WE FACE
TODAY WHERE WE HAVE A SIMILAR
POLICY CHALLENGE WITH I THINK IN
SOME WAYS EVEN WORSE FISCAL
ENVIRONMENT SO THE QUESTION IS,
AND WHETHER THIS POLICY WILL BE
SUCCESSFULLY MET WILL LARGELY
DEFINED THE STATE OF OUR
COMMUNITIES OVER THE NEXT 15 OR
20 YEARS, WHAT HAPPENS IN EVERY
COURT SYSTEM IN THE UNITED
STATES, WHAT HAPPENS IN OUR
JAILS AND PRISONS AND IS JUDGE
CLARK SAID, WE ARE NOW IN THE
SECOND THE THIRD GENERATION OF
ESSENTIALLY THROWING FAMILIES
AWAY BY OUR UNWILLINGNESS TO
MAKE INVESTMENTS AT THE FRONT
END OF THE SYSTEM.
SO WHEN WE TALK COSTS, JUDGE
CLARK REMINDS US THIS HAS THE
HUMAN COSTIN THAT GOES FROM
GENERATION TO GENERATION WHERE
WE HAVE EFFECTIVELY CREATED AN
ONGOING UNDERCLASS OF PEOPLE
WHOSE CHILDREN AND UP AND
SIMILAR OR WORSE STRAITS THAN
THEIR PARENTS, SO IT IS A
SIMILAR CHALLENGE TO THE CENTRAL
CHALLENGE OF PUBLIC MENTAL
HEALTH SYSTEM IN WHICH THE
HEALTH SYSTEM IN EVERY PART OF
THIS COUNTRY FILLS.
I THINK THAT SHOWS THE
SIGNIFICANCE AND DIFFICULTY OF
MEETING THAT CHALLENGE.
AS A RESULT, AND AS EVERYONE
KNOWS, BUT I THINK IT IS WORTH
REPEATING, OUR COURTS AND JAILS
ARE THE NEW REVOLVING DOOR OF
THE 21ST CENTURY.
I SPENT YEARS REPRESENTING IN
DEFENDING STATE PSYCHIATRIC
HOSPITAL LITIGATION AND HAD
CONVERSATIONS REPEATEDLY WITH
HOSPITAL DIRECTORS TO TALK ABOUT
REVOLVING DOOR PATIENT'S.
THOSE CONVERSATIONS REALLY EXIST
ANYMORE.
WE SAY HOSPITAL DIRECTORS, BUT
JUDGES IN ANY DOCKET IN THE
UNITED STATES OR ANY SHERIFF IN
THE UNITED STATES, WHO TALK
ABOUT THE REVOLVING DOOR
DEFENDANTS TO SHOW UP OVER AND
OVER, WITH THE SAME SIGNIFICANCE
MENTAL DISORDER ISSUES THAT
PEOPLE FACE TO THE PUBLIC MENTAL
HEALTH SYSTEM BEFORE.
HAS JUDGE LEIFMAN SUGGESTED
EARLIER, RELATIVELY SPEAKING
HAVE INSTITUTIONALIZED OR SIMPLY
MOVED THE FORM FOR THE PROBLEM
TO A DIFFERENT PLACE.
ONE OF THE THINGS I THINK GIVES
HOPE IS THAT THE COURTS ARE
INVOLVED.
THIS IS THE SORT OF MEETING THAT
WOULD NOT HAVE BEEN IN THIS
ORDER PROJECT THAT WOULD NOT
HAVE BEEN THOUGHT OF TEN YEARS
AGO.
THE FACT THAT THE CHIEF JUSTICE
IS HERE AND OTHER JUSTICES ARE
HERE IS EXTRAORDINARY AND I
THINK IT IS FAIR TO SAY THAT IN
THE LAST DECADE, THE MOST
IMPORTANT INNOVATIONS IN PUBLIC
MENTAL HEALTH AND THE UNITED
STATES HAVE BEEN INITIATED BY
LAW ENFORCEMENT, NOT BY
MENTAL-HEALTH PRACTITIONERS OR
POLICY-MAKERS BUT BY LAW
ENFORCEMENT AND BY THE COURTS.
AND I THINK THAT IS THE CENTRAL
FACT OF LIFE WHICH ABOVE SHOWS
SORT OF THE FACT OF THE PROBLEM
HAS SHIFTED TO THE CRIMINAL
JUSTICE SYSTEM AND THE CIVIL
JUSTICE SYSTEM BUT ALSO THE FACT
THE COURTS HAVE COME OUT OF
THEIR TRADITIONAL ROLE AND AS I
RECALL LAST YEAR, THE CHIEF
JUSTICES AS A GROUP ENDORSED
THERAPEUTIC COURTS AND HAWKED
EXCLUSIVELY ABOUT THE NEW ROLE
THAT THE JUDGES ARE TAKING ON AS
COMMUNITY LEADERS AND INNOVATORS
I THINK WE SEE THAT REFLECTED
HERE TODAY.
THE QUESTION AS BOB CONSTANTINE
HAS SAID, MAKE THAT HAPPEN IN AN
ENVIRONMENT WHERE RESOURCES ARE
SIMPLY FLOWING IN EVERY SECTOR.
THERE'S A SECTION ON POLICY AND
FINANCE.
I THINK IT DOES DO A VERY GOOD
JOB OF ADDRESSING WHAT I THINK
ARE THE FIVE CORE ELEMENTS OF
MOVING THIS PROBLEM FOR WORD.
AND LET ME JUST BRIEFLY TOUCH ON
THOSE FIVE ELEMENTS.
THE FIRST IS LEADERSHIP AND
LATER MET IN A NUMBER OF WAYS
AND CLEARLY THE COURTS HAVE
ASSUMED THEIR ROLE IN THIS FAR
BEYOND WHAT I THINK PEOPLE WOULD
REASONABLY EXPECT OF COURTS AT
EVERY LEVEL, BUT THE REPORT ALSO
TALKS ABOUT THE NEED FOR COST
AGENCY, A LEADERSHIP END STATE
LOCAL PARTNERSHIP.
THIS IS NOT A PROBLEM THAT CAN
BE SOLVED BY ANY SINGLE AGENCY
IN ANY JURISDICTION OR BY ANY
PART OF GOVERNMENT WHETHER LOCAL
OR STATE ACTING ON THEIR OWN.
AND REPORT SETS UP A NUMBER OF
WAYS TO TRY AND ADDRESS THE
QUESTION.
THE SECOND ELEMENT IS TO TARGET
A POPULATION.
THE NUMBERS ARE SIMPLY TOO LARGE
TO THINK OF SOLVING THIS THE ONE
TIME AND THE REPORT LAYS OUT AND
TRIES TO SATISFY PEOPLE
ACCORDING TO THE MOST NEED AND
TO FOCUS RAM BUSMAN ON THE
PEOPLE MOST AT RISK BY THEIR
HISTORY FOR CONTINUING REPEATED
INVOLVEMENT IN CRIMINAL JUSTICE
SYSTEMS.
THERE ARE RELATIVELY SMALL
NUMBER OF PEOPLE WHO CYCLE OVER
AND OVER, AND HAVING SOME IMPACT
ON THOSE LIVES CAN HAVE AN
ENORMOUS IMPACT FAR BEYOND WHAT
THOSE SIMPLE NUMBERS WOULD
SUGGEST AND I THINK THE REPORT
DOES THAT AND FOR THOSE OF YOU
HAVE HAVE NOT MEMORIZE THE
REPORT, YOU CAN FIND THAT THIS
CUTS BEGINNING ON PAGE 39.
THE THIRD ESSENTIAL ELEMENT FOR
DEALING WITH THIS ISSUE AND
MOVING THIS FORWARD IS CREATIVE
FINANCING STRATEGIES.
MEDICAID AND RAND DOESN'T WANT
SAW THIS ON AT SOME BUT IT IS AN
ESSENTIAL ELEMENT.
AS BOB CONSTANTINE SAID MEDS,
THIS IS NOT A -- CLIMBER TO
CONSERVE.
CARE COMPANIES HAVE DONE
EVERYTHING IN THEIR POWER TO
SHIFT RESPONSIBILITY FOR THIS
POPULATION ELSEWHERE IN THIS
REPORT DEALS WITH THAT BY
ESSENTIALLY CREATING SORT OF
THEY WERE FIRST CARVE-OUT AND IT
IS A QUITE CREATIVE WAY TO
ADDRESS THAT AND OUR PROBLEM AND
WHAT ESSENTIALLY REINVEST THE
DEPARTMENT OF CHILDREN AND
FAMILIES WITH SOME AUTHORITY
OVER A SEGMENT OF THE MENTAL
HEALTH SYSTEM THAT THEY HAVE
LARGELY LOST OVER THE YEARS
BECAUSE OF THE SHIFT IN
FINANCING TO MEDICAID MANAGED
CARE.
FOR THOSE WHO WANT TO KNOW WHERE
THAT STARTS, IT IS ON PAGE 48.
THE FOURTH CRITICAL ELEMENT IS
TO ASSESS THE IMPACT AND
STRATEGIES WE ADOPT.
THIS AREA THERE IS A CONCERN,
ARE WE GOING TO THROW MORE MONEY
THE WAY?
AND SO, IT IS ESSENTIAL TO
ADDRESS WHETHER, UNDER THIS PLAN
OR UNDER THE REINVESTMENT THOUGH
WHETHER THESE INTERVENTIONS HAVE
IMPACT.
THIS IS ONE AREA WHERE I THINK
FLORIDA IS AHEAD OF MANY PLACES
BECAUSE OF THE DATA AVAILABLE
BOTH LOCAL AND STATE LEVEL, AND
THIS REPORT ALSO TALKS ABOUT THE
NEED TO INCREASE THE STATE
ANALYTIC CAPACITY SO WE CAN MAKE
JUDGMENTS ABOUT WHETHER THESE
INTERVENTIONS WORK AND THAT IS
ESSENTIAL TO HAVE CREDIBILITY IN
THE OUT YEARS, WHETHER THERE'S
FUNDING IN THE FIRST YOU ARE NOT
AND THAT IS DISCUSSED ON PAGE
56.
FINALLY, THE FIFTH I THINK THE
ESSENTIAL ELEMENTS IS THAT AS
JUDGE LEIFMAN TALKED ABOUT
EARLIER, THIS BE DONE IN
INCREMENTAL FASHION.
THERE'S NO MAGIC WAND.
IT IS TAKEN YEARS AND YEARS TO
GET TO THIS DAY.
SO IT WILL TAKE YEARS AND YEARS
TO REVERSE THE COURSE WE ARE ON,
AND SO THIS IS A PLAN THAT IS
DELIBERATELY INCREMENTAL AND
TALKS IN TERMS OF SIX YEARS BUT
IT IS CLEARLY TO THAT DO THAT
WILL TAKE LONGER TO TRANSFORM
WHAT IS EFFECTIVELY BEEN 30 OR
40 YEARS OF POLICY FAILURE.
THOSE ARE THE FIVE ESSENTIAL
ELEMENTS, ALL OF WHICH ARE
ADDRESSED IN THE POLICY PARK.
I REALLY DO THINK, PEOPLE, AS
ALL OF YOU HAVE BEEN PART OF AND
READ MANY REPORTS, YOU PROBABLY
CART THEM AROUND FROM OFFICE TO
OFFICE WHEN YOU SHIFT JOBS, BUT
THIS REALLY IS AN HISTORIC
OPPORTUNITY AND I THINK THE FACT
THAT THE COURTS ARE INVOLVED IS
ESSENTIAL AND NOT TO BE
DOWNPLAYED, THAT FUNDAMENTALLY
ALTERS THE CONVERSATION AT A
STATE LEVEL AND LOCAL LEVEL AND
DOES CREATE AN OPPORTUNITY THAT
IS IN A.
SO I THINK WHAT THIS PLAN LAYS
OUT, AND IT WILL BE EASY TO READ
THE PLAN, AND SAY THAT IS REALLY
STUPID OR THAT WON'T WORK BUT IF
ONE TAKES THE PLAN AS A HOLE IN
THE SPIRIT WITH WHICH IT IS
WRITTEN, IT CREATES A FRAMEWORK
FOR FUNDAMENTALLY MOVING THE
STATE IN A DIFFERENT DIRECTION
THAT OVER TIME WILL REVERSE ARE
HAVING TO SPEND ALL OF OUR MONEY
ON A HANDFUL OF PEOPLE IN THE
SYSTEM WHILE EXPLORING THE VAST
MAJORITY OF PEOPLE WHO ARE AT
THE FRONT END AND IN THE
COMMUNITY PART OF THE SYSTEM, SO
IT HAS BEEN A PRIVILEGE TO BE
PART OF THIS AND I APPRECIATE
YOUR TIME.
THANK YOU.
[APPLAUSE]
pp>> MAYBE I SHOULD FEEL A LITTLE
BACKGROUND ON HOW WE PROCEEDED
AND MAYBE I SHOULD HAVE DONE AND
OF THE BEGINNING OF A
CONVERSATION BUT I AM RUNNING
AROUND TO MUCH AND I APOLOGIZE.
WHEN WE FIRST PUT OUR
SUBCOMMITTEE TOGETHER ON MENTAL
HEALTH WE REALIZED THERE WERE SO
MANY SIGNIFICANT ISSUES THAT IN
AND OF ITSELF NEEDED TO BE
ADDRESSED, SO WHAT IN EFFECT WE
DID WAS WE BROKE DOWN THE
SUBCOMMITTEE INTO FOR WORK
GROUPS THAT FOR RESPONSIBLE FOR
DIFFERENT AREAS OF THE PROBLEM.
YOU HAVE ARE INCURRED FROM THE
EVIDENCE BASED PRACTICES FROM
DR. TENDON AND DR. CONSTANTINE
WHO LOOK TO THE BEST PRACTICES
NATIONALLY AND OTHER PROBLEMS
GOING ON AROUND THE WORLD AROUND
THE COUNTRY AND HOW TO AND
DEVELOP THOSE PRACTICES FOR THE
PROGRAMS.
YOU JUST HEARD FROM JOHN PETRILA
, WHO I CO-CHAIR THE
POLICY OF LEGISLATION IN
COMMON -- TO SEE HOW WE COULD
WORK THE PROGRAM IN A WAY THAT
WILL BE AFFORDABLE FOR THE STATE
OF FLORIDA AND WE THINK WE
ACCOMPLISH THAT WITHOUT HAVING
TO ASK FOR A HUGE AMOUNT OF
INVESTMENT AT THIS POINT SO WE
CAN -- THE THIRD AREA THAT WE
LOOKED AT WHAT WAS WE CALL THE
CRIMINAL JUSTICE WORKGROUP AND
THEIR RESPONSIBILITY WAS TO LOOK
HOW THIS WOULD INTERFACE AND
CORNETT WITH THE CRIMINAL
JUSTICE SYSTEM AND WE WERE
FORTUNATE THAT JUDGE SPEISER AND
HARRY SHORSTEIN FROM DUVAL
COUNTY COCHAIR THE SEVERED AND
THEY ALSO DID A WONDERFUL JOB
AND WE USE MICHELLE SAUNDERS FOR
PARTNERS IN CRISIS AS ARE AD HOC
COCHAIR TO HELP US WITH SOME OF
THE CIQ WORK SO I WOULD LIKE TO
COLIN JUDGE SPEISER AND JUDGE
SOARER -- SHORSTEIN.
pp>> THANK YOU VERY MUCH MR. G
JUSTICE, THE JUSTICES.
THE JUDICIAL CANONS OF ETHICS,
HIS JUDICIAL CODE OF CONDUCT
ENCOURAGES JUDGES TO -- THAT
APPLIES REALLY FROM THE TOP TO
THE BOTTOM, SO I HAVE TO SAY IT
SAYS A LOT AND SENDS A VERY
STRONG MESSAGE WHEN A CHIEF
JUSTICE REALIZING AS HE DID
APPROXIMATELY A YEAR-AND-A-HALF
AGO, AS A RESULT OF -PRESS, AS A
RESULT OF HIS AWARENESS OF THE
CORE PROCESSES, THE OVERWHELMING
CHALLENGES THAT ARE FACING THE
COURT THROUGH THE INFLUX OF A
TREMENDOUS NUMBER OF PEOPLE THAT
HAVE MENTAL HEALTH ISSUES, THAT
HE CALLED TOGETHER THIS
COMMITTEE AND CERTAINLY IT SENDS
A STRONG MESSAGE THAT HIGH AS
CHIEF JUSTICE OF THE FLORIDA
SUPREME COURT AND BRING INTO
EVERYBODY'S ATTENTION THAT WE
HAVE TO DO SOMETHING HERE.
I COMMEND THE CHIEF JUSTICE FOR
SAYING HE WAS GOING TO DO SO BUT
ACTUALLY DOING SO AND BY PUTTING
TOGETHER A COMMITTEE THAT
CONSIST NOTCHES JUDGES, BECAUSE
IF THIS WERE COMING FROM JUST
JUDGES, I WOULD BE COMING FROM A
NARROW POINT OF VIEW BUT THIS
COMMITTEE IS COMPRISED OF THE
HEAD THE FIVE DIFFERENT
AGENCIES, FROM INDIVIDUALS FROM
DIFFERENT ORGANIZATIONS,
PSYCHOLOGIST, CONSUMERS, SO
THERE IS A CROSS SECTOR IN THIS
COMMUNITY THAT IN THE STATE HAS
HAD AN OPPORTUNITY TO VOICE
THEIR THOUGHTS WITH RESPECT TO
WHAT WE NEED TO DO.
NOW WE HAVE HEARD THE CONCEPT OF
THE CRIMINALIZATION OF THE
MENTALLY ILL.
WHAT DOES THAT MEAN?
BASICALLY WHAT THAT MEANS IS
INDIVIDUALS IN THE STATE OF
PSYCHOSIS BECAUSE OF THEIR LACK
OF MEDICATION, LACK OF POLICY,
LACK OF COUNSELING, LACK OF
THERAPY, THEY COMMIT CRIMES THAT
THEY OTHERWISE WERE NOT
PREDISPOSED TO DO AN END UP IN
THE ZONE OF THE UN JUAN FULL
LESS AND THAT HAS BEEN A
TREMENDOUS PROBLEM.
IT IS BEEN A TREMENDOUS PROBLEM
FOR JUDGES THAT LABOR IN THE
FIELD OF TRYING TO ALLOW
JUSTICE, AND MANY PEOPLE ARE OF
THE MISPERCEPTION AND
MISCONCEPTION THAT JUSTICE JUST
MEANS PUNISHMENT.
JUSTICE HAS A DIFFERENT MEANING,
AT LEAST TO ME AND I'M SURE TO
OTHER TRIALED FOR JUSTICE AND
THAT IS JUSTICE MEANS OF
REACHING THE RIGHT RESULT AND
THE RIGHT RESULT IS NOT ALWAYS
PUNISHMENT.
THE RIGHT RESULT IS WHAT IS BEST
FOR SOCIETY AND WHAT IS BEST FOR
THE INDIVIDUAL STANDING IN FRONT
OF A JUDGE.
SO THE PROBLEM THAT WE REALLY
HAVE HAD IS NOT REALLY THE
PROBLEM OF INDIVIDUALS COMING
INTO THE SYSTEM WHO HAVE MENTAL
HEALTH ISSUES, BUT REALLY THE
PROBLEM HAS BEEN US.
HOW LIVING RESPONDING TO THEM?
HOW HAVE WE BEEN MAKING
RESOLUTION WITH RESPECT TO THEIR
NEEDS?
THAT IS THE REAL PROBLEM.
THE PROBLEM IS WITH US, NOT WITH
THE PEOPLE WHO HAVE MENTAL
HEALTH ISSUES.
SO, HAVING SAID THAT, WHAT I
HAVE TRIED TO DO IN BROWARD
COUNTY IS CONVINCE PEOPLE THAT
WE HAVE TO LOOK AT THE ROOT OF
THE PROBLEM, NOT THE
CONSEQUENCES OF A PROBLEM
BECAUSE WHEN WE SEE SOMEONE
STANDING IN FRONT OF US UNLESS
WE HAVE HAD THAT INSIDE THE
DELTON TO WAS TO BE SENSITIVE TO
THIS POPULATION, WE ARE JUST
LOOKING AT THE FACT THAT THIS
PERSON STANDING IN FRONT OF US
AS A JUDGE IN HE/SHE COMMITTED A
CRIME.
TO WE EVER STOP AND THINK AS TO
WHAT IS THE REASON WHY THIS
PERSON COMMITTED A CRIME?
WAS THIS PERSON PREDISPOSED TO
COMMIT A CRIME?
I WOULD SAY MANY INSTANCES NOT
SO THE PROBLEM IS WE HAVE TO
LOOK TO THE ROOT OF THE PROBLEM.
MY MANTRA IN MY LIFE, BOTH
PROFESSIONALLY AND PERSONALLY IS
THAT IT IS BETTER TO DO
SOMETHING PERFECTLY INTO NOTHING
FLAWLESSLY.
IT IS EASY TO SIT THERE AND ROLL
WITH THE DIES.
JUST GO ALONG AND NOT TAKE ANY
ACTION.
IT REQUIRES MORE TO PUT THAT
FOURTH STEP FORWARD NO MATTER
WHAT THE CONSEQUENCES ARE GOING
TO BE, SEE WHAT THE RESULTS ARE
AND IF THE RESULTS ARE OFTEN
MOM, FANTASTIC.
IF THEY ARE NOT, LET'S MODIFY
WHAT WE HAVE THEM BUT ELISE WE
ARE MAKING PROGRESS.
SO WHAT WE DID IN BROWARD COUNTY
WAS, WE DECIDED WE HAD TO PUT
TOGETHER A TASK FORCE AND A TASK
FORCE BASICALLY CAME AS A RESULT
OF MY DECISION TO BRING PEOPLE
TO THE TABLE YOU ALL HAVE MUTUAL
INTERESTS AND THAT IS IN THE
FIELD OF MENTAL HEALTH AND
CRIMINAL JUSTICE BUT NEVER HAD
AN OPPORTUNITY TO ENGAGE AND
INTERACT WITH ONE ANOTHER AND
HAVE A COMMON OPPORTUNITY TO
EXPRESS THEIR THOUGHTS.
ONE OF THE ADVANTAGES OF BEING A
JUDGE IS TO HAVE A LOT OF POWER,
AND POWER CORRUPT SAYS.
ON THE OTHER HAND IF YOU WILL
THAT POWER IN A WAY THAT IS
BENEFICIAL FOR SOCIETY IT IS
AMAZING WHAT THE POWER, THE
RESULTS OF THAT POWER CAN BRING
SO WHAT WE DID WAS WE PRODUCED A
TASK FORCE AND BELIEVE IT OR
NOT, WE HAVE HAD THIS TASK FORCE
FOR 14 YEARS.
IT IS BEEN COSTLY TO BUY LUNCH
EVERY MONTH BUT IT HAS BEEN
WORTHWHILE.
KNOW WE HAVE BEEN BEATING FOR 14
YEARS, ONCE A MONTH.
WE HAVE 30 TO 40 PEOPLE FROM ALL
DIFFERENT DISCIPLINES.
, PUBLIC AND PRIVATE PROVIDERS
OF MENTAL HEALTH SERVICES,
DEPARTMENT OF CHILDREN AND
FAMILY SERVICES, LOCAL AGENCIES
AND IT IS AMAZING WHAT WE HAVE
ACCOMPLISHED.
ONE OF THE THINGS WE ARE
PROMISED OF IT IS THE CREATION
OF THE MENTAL HEALTH BOARD, THE
FIRST IN THE NATION AND STARTED
ON A MISDEMEANOR LEVEL.
IT BECAME THE SECOND BIGGEST
ATTRACTION IN FLORIDA BEHIND
DISNEYWORLD.
WE HAD PEOPLE COMING TO SEE YOU
WHAT IS IT DOING, WHAT IS IT
ACCOMPLISHING?
IS IT REAL?
IS A VIABLE WITH IT TURNED OUT
IT WAS VERY SUCCESSFUL AND THEN
AFTER BEING IN OPERATION WHICH
HAS BEEN TENURES, WE DECIDE
THREE AND HALF YEARS AGO TO
CARRY ON TO THE FELONY LEVEL A
FELONY MENTAL HEALTH COURT.
AND THIS WHOLE PROCESS OF
DEALING WITH THE CRIMINAL
POPULATION THERE IS REALLY FOUR
AREAS WE NEED TO FOCUS ON AND
THAT IS PREVENTION, AND WE HAVE
HEARD FROM JUDGE LEIFMAN AND
JOHN PRISCILLA -- PETRILA AND
MR. CONSTANTINE ABOUT SOME OF
THE WAYS WITH RESPECT TO
PREVENTION.
PREVENTION IS TRYING TO PREVENT
PEOPLE FROM EVER GETTING
ARRESTED THEN GETTING INTO THE
CRIMINAL JUSTICE SYSTEM IN
ADDRESSING THEIR NEEDS SALLY
DULL BECOME A STATISTIC.
PREVENTION IS NOT ALWAYS GOING
TO WORK.
WE DO NOT LIVE IN AN IDEAL
WORLD, SO THE NEXT THING WE HAVE
TO FOCUS ON IS THE VERSION.
THE EVERSION IS THE OPTIMUM
RESULT, THAT IS THAT PEOPLE WHO
FOR WHATEVER REASON OF MENTAL
HEALTH ISSUES THAT UNFORTUNATELY
ARE GETTING ENTANGLED IN THE WEB
OF THE CRIMINAL JUSTICE SYSTEM,
HOW CAN MCKEE THEM OUT OF THE
SYSTEM BEFORE THEY GET ARRESTED?
SAID THE BEST RESULT, IF
PREVENTION DOES NOT WORK IS
DIVERSION AND WHAT WE TRY TO DO
IS COME UP WITH ALTERNATIVES TO
DIVERT PEOPLE WHO COME INTO
CONTACT WITH LAW ENFORCEMENT
OFFICERS FROM ENDING UP GETTING
ARRESTED IN COMING TO THIS
JUSTICE SYSTEM.
WE HAVE HAD THAT BIGGER ACTS LAW
IN EFFECT FOR A NUMBER OF YEARS
AND BASICALLY THE SPEAKER AT LAW
IS DESIGNED TO ADDRESS PEOPLE IN
CRISIS UNITS, DESIGNED TO
ADDRESS PEOPLE IN A STATE OF
CRISIS AND WE TRY TO ENCOURAGE
POLICE OFFICERS TO BRING
INDIVIDUALS THEY ENCOUNTER IN
THE STREET TO CRISIS UNITS OR
SPEAKER AT FACILITIES OF THEY
CAN BE STABILIZED AND HOPEFULLY
NOT HAVE TO END UP IN THE
CRIMINAL JUSTICE SYSTEM.
AS MANY OTHER IDEAS, IT IS MORE
THEORETICAL THAN REALISTIC
BECAUSE THE SPEAKER AT
FACILITIES ARE UNDERFUNDED, THEY
ARE VERY INCONVENIENT FOR THE
POLICE OFFICERS WITH RESPECT TO
HAVING TO BRING PEOPLE TO
SPEAKER ACT FACILITIES, IT IS
VERY FRUSTRATING, SAID THE
SPEAKER ACT PROCESS GENERALLY
WITH THE EXCEPTION OF TWO AREAS
IN THE STATE IN TAMPA AND
ORLANDO HAS NOT WORKED OUT WELL.
PEOPLE COME INTO THE FACILITIES,
ARE STABILIZED AND DISCHARGE AND
SAY HERE IS WHERE YOU ARE
SUPPOSED TO GO.
IF YOU HAVE MENTAL HEALTH ISSUES
AND ARE TOLD WHERE TO GO YOU
WILL NOT BEEN A POSITION TO GET
TO WHERE YOU NEED TO BE, SO
THERE IS A LOT OF ROOM, A LOT OF
IMPROVEMENTS NEEDED IN THE
SPEAKER ACT PROCESS.
BASICALLY WE ARE ASKING FOR A
PROCESS WHEREBY PEOPLE ARE
PHYSICALLY LINKED WITH THE
PROVIDER THAT IS A SUBJECT
MATTER THAT DISCHARGE PLANNING,
WE WANT TO MAKE IT EASIER TO
ENCOURAGE POLICE OFFICERS TO
BRING INDIVIDUALS TO SPEAKER AT
FACILITIES TO AND DOES NOT
CONSUME HOURS THEY WOULD OTHER
WISE -- ANOTHER THING THAT IS
THE POSITIVE IS THE CRISIS
INTERVENTION TEAM AND THAT IS A
CONCEPT IN THE STATE OF FLORIDA
BY PARTNERS IN A CRISIS WHERE BY
LAW ENFORCEMENT OFFICERS
COMPLETE A 40 HOUR COURSE FOR
THEIR SENSITIZED AND EDUCATED
AND IN LIGHT NOT HOW TO DEAL
WITH THE MENTALLY ILL THAT THEY
ENCOUNTER ON THE STREET.
THE MENTALLY ILL THE ENCOUNTER
INDUSTRY MAY BE SOMEONE WHO IS
NOT COMMITTING A CRIME, SOMEBODY
WHO IS ACTING OUT WITHOUT
NECESSARILY COMMITTING CRIME OR
SOMEONE WHO IS ACTUALLY
COMMITTING A CRIME BUT IS SO
POTENTIALLY DANGEROUS THAT
PERSON CAN COMMIT OTHER CRIMES
WHICH WE WOULD LIKE TO AVOID.
OF A PERSON WHO'S BEEN THROUGH
THE TRAINING PROCESS JUST LIKE
NEGOTIATORS, THEY ARE IN A
POSITION TO QUELL A DISTURBANCE,
THE PEOPLE DOWN, COLIN LOCAL
CRISIS UNITS IN TWO THINGS THAT
WILL ENABLE THIS PERSON TO AVOID
MORE SERIOUS CHARGES BEING
IMPOSED ON THAT PERSON.
ANOTHER THING WE RECOMMEND IN
OUR REPORT IS WHAT IS KNOWN AS
RUSS THAT HOUSES, BASICALLY THIS
POINT, POLICE OFFICERS HAVE TWO
CHOICES WHEN THEY ENCOUNTER
SOMEBODY ON THE STREET.
THEY CAN ARREST THEM OR BRING
THEM TO A BIG IRAQ FACILITY, BUT
THERE IS A ZONE BETWEEN THOSE
POLARIZED POSITIONS FOR PEOPLE
WHO DON'T NECESSARILY HAVE TO BE
ARRESTED BUT ON THE OTHER HAND
ARE IN SUCH PRICES FOR THE HAVE
TO BE BROUGHT TO THE BAKER AT
FACILITY AND THAT IS WHAT RES
THE HOUSES ARE FOR, DESIGN,
CONSUMER DRIVEN, CONSUMER
OPERATED AND STAFFED BY LOCAL
COMMUNITY HEALTH PROVIDERS TO
TRY AND CALM THAT PERSON DOWN,
SLING THAT PERSON BACK UP WITH
THE MEDICATION, I PSYCHOTROPIC
MEDICATION AND BRING THAT
INDIVIDUAL BACK TO HIS OR HER
GROUP, OR EVEN BACK TO THEIR
FAMILY HOME.
NOW, AS I INDICATED, OF THEIR
VERSION IS NOT ALWAYS GOING TO
WORK SO THE NEXT FUND WE HAVE IS
CALLED INTERVENTION WHICH IS
POSED LOOKING DIVERSION, BUT
INTERVENTION IS WHERE SOMEBODY
GETS ARRESTED AND THEN WE HAVE
TO DEAL WITH THAT AND NO MATTER
WHAT WE DO HERE TODAY AND WHAT
WE ACCOMPLISH THERE'LL ALWAYS BE
AN ELEMENT OF POPULATION THAT
HAS MENTAL HEALTH ISSUES THAT
WILL BE ARRESTED.
THESE ARE PRIMARILY BECAUSE OF
THE SERIOUSNESS OF THE CRIME OR
BECAUSE OF THE SERIOUSNESS OF
THE MENTAL HEALTH ISSUE, SO HOW
WE HANDLE PEOPLE WHO GET
ARRESTED THEM GET INTO THIS
SYSTEM, WHAT DO WE DO?
I SUGGESTED THE MENTAL HEALTH
COURTS ARE SOMETHING THAT HAVE
BEEN VERY SUCCESSFUL.
THERE HAS BEEN REFERENCE MADE TO
THE SUCCESS OF DRUG COURTS WITH
RESPECT TO ADDRESSING THE
POPULATION OF INDIVIDUALS THEY
GET ARRESTED FOR DRUG-RELATED
OFFENSES THAT ARE PURCHASERS ARE
POSSESSORS OR NOT PEOPLE WHO
TRAFFIC, THE ROADS HAVE BEEN
DOCUMENTED, IT IS A TREMENDOUS
SUCCESS.
MENTAL HEALTH COURTS ARE
ORIENTED TOWARDS BRINGING
TOGETHER PEOPLE FROM DIFFERENT
DISCIPLINES IN THE COURT SYSTEM
TO TRY AND ADDRESS THE PROBLEM.
IT IS WHAT WE CALL THERAPEUTIC
JURISPRUDENCE AND BASICALLY WHAT
WE TRIED TO DO IS DEAL WITH TWO
TYPES OF POPULATIONS.
PEOPLE WHO ARE MENTALLY ILL BUT
COMPETENCE AND PEOPLE WHO ARE
MENTALLY ILL AND IN COMPETENT.
THE STATE OF FLORIDA IS ONE OF A
HANDFUL OF STATES IN THIS
COUNTRY WHERE A JUDGE HAS AN
OPTION THAT SOMEBODY IS FOUND
INCOMPETENT AND MENTALLY ILL.
WE HAVE THE OPTION TO SEND THE
PERSON TO A FORENSIC HOSPITAL OR
DEAL WITH THE PERSON ON WHAT IS
KNOWN AS THE CONDITIONAL RELEASE
PLAN.
BEFORE SENT TO FORENSIC
HOSPITALS OF THEIR DANGER TO
THEMSELVES OR OTHERS.
IF THEY ARE NOT IN DANGER TO
THEMSELVES OR OTHERS, AND IT IS
CONFIDENT THEY CAN GET NECESSARY
TREATMENT THERE.
BEFORE WE HAVE THESE MENTAL
HEALTH COURTS, AS FAR AS JUDGES
WERE CONCERNED WITH THE DUMPING
GROUND, GOODBYE, GOOD LUCK, IF I
DON'T SEE IT FOR FIVE YEARS,
THAT IS GREAT.
THAT IS NOT WHAT WE WANT TO BE.
WITH THE ADVENT OF THIS MENTAL
HEALTH COURT WE HAVE BEEN VERY
SUCCESSFUL IN LINKING UP PEOPLE
WHO GET ARRESTED INTO THE
CRIMINAL JUSTICE SYSTEM THAT ARE
CHARGED WITH RATHER INNOCUOUS
THIRD DEGREE FELONIES THAT WE
FEEL ARE WORTH THEIR RISK TO GO
OUT INTO THE COMMUNITY AND GET
THE TREATMENT THEY NEED EITHER
AS AN INPATIENT OR OUTPATIENT
AND THAT HAS WORKED WELL.
AND THE REASON WHY IT IS WORKED
WELL IS BECAUSE WE HAVE COURT
OVERSIGHT.
WE ARE TRYING TO BE PROACTIVE
RATHER THAN RESPONSIVE TO THEIR
NEEDS.
WE LINK THEM UP WITH A CASE
MANAGER, WE LINK THEM UP WITH
PSYCHOTROPIC MEDICATION, BUT
THOSE PEOPLE WHOSE FAMILIES ARE
NO LONGER IN A POSITION TO
HANDLE THEM OR FOR THOSE PEOPLE
WHO ARE HOMELESS, AND NEEDY
PLAYS, WE PROVIDE THEM WITH
RESIDENTIAL PLACEMENT.
I HAVE TO SAY THE DEPARTMENT OF
CHILDREN AND FAMILY SERVICES
STEPPED UP TO THE PLATE.
WHEN THE DEMAND IS THERE, THE
SUPPLY WILL COME.
SET WE HAVE CREATED A NUMBER OF
AVAILABLE RESIDENTIAL FACILITIES
FOR PEOPLE IN BROWARD COUNTY TO
COME FOR MENTAL HEALTH FOR THE
DON'T NEED TO BE SENT TO A
FORENSIC HOSPITAL.
ANOTHER IMPORTANT ASPECT OF
CONDITIONAL RELEASE IS TO HAVE
COMPENSATE RESTORATION.
WE WANT TO USE WHENEVER EFFORTS
WE CAN TO TRY TO RESTORE THESE
PEOPLE, THIS POPULATION'S
CONFIDENCE THESE SO THEIR CASES
CAN BE RESOLVED.
THEY CAN GO TO TRIAL, THEY CAN
RESOLVE THE CASE THAT WE WANT
THE CASE IS RESOLVED.
NOT EVERYBODY WHO IS INCOMPETENT
CAN GET THEIR COMPETENCY
RESTORED BUT WE WANT TO MAKE
THAT EFFORT.
THE BOTTOM LINE, TO THIS
CONDITIONAL RELEASE PROGRAM THAT
COMES TO THE MENTAL HEALTH CORD
IS A VIABLE OPTION THAT IS
WORKING WELL WITH RESPECT TO
INDIVIDUALS THAT ARE INCOMPETENT
ORMAN TILLIE EL.
THE OTHER POPULATION WE DEAL
WITH OUR PEOPLE BETTER
COMPETENTLY -- I'M A FIRM
BELIEVER AS WELL THAT INNOVATION
AND INGENUITY CAN HELP
DRAMATICALLY ESPECIALLY WHEN YOU
ARE A JUDGE.
WE ARE FROM A COUPLE OF PILOT
PROGRAMS IN BROWARD COUNTY.
FELL IN THE MENTAL HEALTH
PROBATION WHICH IS WORKED WELL
FOR PEOPLE THAT ARE COMPETENT
BUT MENTALLY ILL, WE LIKE THEM
UP WITH PROBATION OFFICERS THAT
WE HAVE TRAINED IN CONJUNCTION
WITH THEIR COMMUNITY CASE
MANAGERS AND IT HAS WORKED VERY
WELL.
WILL ASSESS CONFERENCES ONCE A
MONTH SO THAT WE CAN ADDRESS THE
PROBLEM, ADDRESS THEIR NEEDS.
THE PROBATION OFFICERS ARE NOT
THERE TO VIOLATE THEM BUT TO
WORK WITH THEM AND IT HAS WORKED
WELL.
ANOTHER THING WE HAVE IN OUR
FLORIDA STATUTE THAT I SUGGEST
WE CONTINUE TO BE THERE IS WHAT
IS KNOWN AS DEPARTURES, THE ONLY
WAY SOMEONE CHARGED WITH A CRIME
IS MANDATORY OBLIGATED TO BE
SENTENCED TO PRISON CAN AVOID
PRISON IS THAT THAT PERSON CAN
ESTABLISH THAT AT THE TIME THEY
COMMITTED THE CRIME, EVEN THOUGH
THEY WERE CONFIDENT THEY HAVE
MENTAL HEALTH ISSUES, AND WHAT
THE JUDGE HAS THE AUTHORITY TO
DO IN THAT INSTANCE IF I JUDGE
IS SATISFIED BASED UPON
PSYCHOLOGICAL TESTIMONY THE
INDIVIDUAL IS AMENABLE TO
TREATMENT, THAT THE INDIVIDUAL,
THE LIKELIHOOD OF SUCCESS OF
TREATMENT IS POSITIVE AND THE
RESULTS APPEAR TO BE THERE, WE'D
HAVE A RIGHT TO DEPART AND AVOID
THAT PERSON BEING SENTENCED TO
PRISON AND PLEASED THAT PERSON
ON FAMILY MENTAL HEALTH
PERVASION.
EVERY TIME I -- I KEEP MY
FINGERS CROSSED BECAUSE I DON'T
WANT TO SEE THAT PERSON ON THE
FRONT PAGE OF THE PAPER, BUT IT
HAS WORKED VERY WELL.
WIN USED WISELY AND CENTRALIZE
IN FRONT OF ONE JUDGE, WHO HAS
AN OPPORTUNITY TO SEE THE RANGE
OF CASES WHERE PEOPLE SIG DELMAR
DEPARTURES IS WORKED OUT WELL.
ANOTHER AREA THAT WE NEED TO
FOCUS ON WHICH IS OF TREMENDOUS
CONCERN, I SUGGEST YOU IS PEOPLE
WHO ARE INSTITUTIONALIZED IN
PRISON.
THAT IS THE NUMBER OF PEOPLE ARE
GOING TO HAVE TO BE SENT TO
PRISON THAT ARE COMPETENT BUT
MENTALLY ILL.
WHAT DO WE DO WITH THIS
POPULATION?
WE KNOW PEOPLE THAT COME OUT OF
PRISON HAVE A HIGH RECIDIVISM
RATE.
BUT PEOPLE WHO, THE PRISON THAT
ARE MENTALLY ILL HAVE AN EVEN
HIGHER RECIDIVISM RATE SO ONE OF
THE THINGS WE DISCUSSED IN OUR
PROPOSAL HERE IS THE POSSIBILITY
THAT WHERE INDIVIDUALS ARE BEING
SENT TO PRISON BETTER DOCUMENTED
THROUGH PSYCHOLOGICAL TESTING TO
HAVE ANNEXES ONE DIAGNOSES, TO
BE SERIOUSLY MENTALLY ILL THAT
THEY BE OBLIGATED TO BE
SENTENCED TO A SPLIT-SECOND, NOT
JUST THE STRAIGHT PRISON
SENTENCE BUT THE SENTENCE TO BE
FOLLOWED BY FALLABLE BENTZEL
HEALTH PROBATION.
THE IDEA IS NOT TO CONTINUE TO
PUNISH THE PERSON BUT THE IDEA
IS SO WHEN THAT PERSON IS READY
TO BE RELEASED FROM PRISON AND
GETTING WHATEVER MENTAL-HEALTH
SERVICES THE PRISONS HAVE TO
OFFER, THAT PERSON BE LINKED UP
WITH THE MENTAL HEALTH COURT
JUDGE AND BY DOING SO, THAT
PERSON CAN BE LINKED WITH THE
COMMUNITY RESOURCES THAT WILL
MAKE SURE ONE'S THIS PERSON GETS
OUT OF PRISON HE OR SHE IS
GETTING THE TREATMENT THAT THEY
NEED.
THAT IS ABSOLUTELY IMPERATIVE
BECAUSE ONCE PEOPLE ARE RELEASED
FROM THE STRAIGHT PRESENT TIME
YOU CAN REST ASSURED THEY NEVER
FIND AND KILLING UP WITH THE
TREATMENT THEY NEED, SO JUST
LIKE WE HAVE, WITH RESPECT TO
SEXUAL PREDATORS, PEOPLE
SENTENCED TO PRISON FOR SEXUALLY
RELATED OFFENSES, PROBATION
FOLLOWING PRISON.
I SUGGEST THE SAME THING AND IT
SUGGESTS THAT THE A STRONG
CONSIDERATION BY THE LEGISLATURE
TO IMPOSE SPLIT SENTENCES FOR
PEOPLE WHO ARE CERTIFIED AS
BEING SERIOUSLY MENTALLY ILL AND
SENTENCED TO PRISON.
ANOTHER THING WE SUGGEST IN
THEIR REGARD IS THAT THERE BE A
PERSON WHO IS DESIGNATED AS A
COORDINATOR AND EVERY CIRCUIT BY
THE DEPARTMENT OF CHILDREN AND
FAMILY SERVICES TO BE THE
INDIVIDUAL WHO IS RESPONSIBLE TO
COORDINATE THIS LINKAGE BETWEEN
THE PERSON GETTING OUT OF THE
DEPARTMENT OF CORRECTIONS AFTER
SAID SERVING HIS/HER SENTENCE
AND THE MENTAL HEALTH COURT TO
MAKE SURE THIS PERSON GETS
MARRIED UP WITH THE RIGHT TYPE
OF SERVICES AND THE RIGHT TYPE
OF PROGRAMS TO INSURE THIS
PERSON GETS THE TREATMENT HERE
SHE NEEDS.
SAID THE BOTTOM LINE IS, WE ARE
VERY APPRECIATIVE OF THE
LEGISLATURE FOR WHAT THEY HAVE
DONE.
THEY GAVE US A CONSIDERABLE
AMOUNT OF MONEY WITH RESPECT TO
FRANCE'S BEDFORD COE THEY GIVE
US $4 MILLION WITH RESPECT TO
COMING UP WITH IDEAS FOR A GRANT
APPLICATION MADE BY THE COUNTY
TO HOPEFULLY ESTABLISH BEST
PRACTICES THAT CAN BE USED A
WIDE.
WE APPRECIATE THAT, WE KNOW
THERE IS ROOM FOR A MUCH MORE
NEED OF FUNDS AND HOPEFULLY WITH
THIS ADDITIONAL INFLUX WE CAN
ACCOMPLISH WHAT WE WANT.
THANK YOU.
[APPLAUSE]
pp>> DID YOU WANT TO ADD ANYTHING?
pp>> NEXT I WOULD LIKE TO CALL UP,
OFFERS COMPLEMENT JUDGE LEIFMAN
WHO DID A FABULOUS JOB LOOKING
AT OUR JUDICIAL EDUCATION
PROGRAM AND, THAT IS WHAT THEY
USUALLY DO NO THANK YOU VERY
MUCH.
pp>> GOOD AFTERNOON EVERYONE.
WE ARE HERE TODAY, I SERVE ON
THE SUBCOMMITTEE AS THE LIAISON
FROM THE TASK FORCE DREEBEN
PHASE TRE ACCORDS I COME FROM
THE SUBSTANCE ABUSE FIELD.
SO TOGETHER WE ARE COAPPEARING.
AND I WOULD SUGGEST TO YOU THAT
IS A WORD, EVEN THOUGH THIS IS
THE MENTAL HEALTH SUBSTANCE, WE
NEED TO USE IN OUR VOCABULARY.
I THINK WE RECOGNIZE IT, WAS A
JUST A PERCENTAGE OF OVERLAP ARE
GREAT.
AND I KNOW SECRETARY MCDONOUGH I
CAME FROM THE DRUG CONTROL, WENT
TO THE DEPARTMENT OF CORRECTIONS
IN CAME AND SAID HELD MENTAL
HEALTH, SO NOW WE ARE TALKING
ABOUT FOR DISORDERS IN THE FORM
OF CORRECTIONS WHICH IS A BREATH
OF FRESH AIR AND I THANK YOU FOR
YOUR LEADERSHIP.
ALSO DIRECTOR JANES WHO IS
SERVING IN TWO CAPACITIES AS THE
DIRECTOR OF DRUG CONTROL AND
DEPUTY SECRETARY OVER SUBSTANCE
ABUSE AND MENTAL HEALTH AT THE
DEPARTMENT OF CHILDREN AND
FAMILIES.
HE IS DOING A BANG OF JOB ON
CO-OCCURRING DISORDERS AND I
THANK YOU FOR YOUR LEADERSHIP
THERE AS WELL.
THANK YOU CHIEF JUSTICES AND
JUDGE LEIFMAN FOR YOUR
LEADERSHIP AND FOR ALLOWING US
TO SERVE.
I CAN TELL YOU IT TOOK US 18
YEARS IN THE DRUG COURT -- THIS
THAN IS GIVING ME A BAD HAIR DAY
BUT IT IS KEEPING A COOL NOAH
TICK IS 18 YEARS IN THE DRUG
COURT TO GET ONE PLENARY
SESSION, ALL OF THE JUDGE IS
LISTENING TO SOMETHING ABOUT
DRUG COURT.
IT IS TAKEN AS ONE YEAR TO GET
MENTAL-HEALTH ON PLENARIES THAT
THE COUNTY AND JUDGE CONFERENCES
IN 2008.
I THINK THAT IS A BIG
ACCOMPLISHMENT.
[APPLAUSE]
ALSO JUDGE LEIFMAN IS GOING TO
BE TEACHING AT THE NEW JUDGES
SCHOOL, SOMETHING WE HAVE YET TO
ACCOMPLISH THIS COMING JANUARY
AND I'M GOING TO LEAD JUDGE LOT
OF TALK ABOUT THE THREE DECORS
PLAN.
I WOULD SUGGEST THE ONLY OTHER
PERSON IN THE ROOM OTHER THAN ME
ON PAGE ONE OF TWO OF THE REPORT
IS A FULL PANOPLY OF WHAT WE ARE
PLANNING ON DOING AS WELL AS THE
APPENDICES SO I WILL NOT GO INTO
DETAIL BUT I WILL ALLOW JUDGE
LOT TO TALK ABOUT A DANCE
JUDICIAL STUDIES.
pp>> I AM GOING TO BE EXTREMELY
BRIEF.
THANK YOU VERY MUCH.
WE DO HAVE AN INTENSIVE THREE
DECORS PLAN FOR THE ADVANCED
YEARS OF COLLEGE.
THOSE OF YOU WHO HAVE BEEN
INVOLVED IN JUDICIAL EDUCATION
OF THE STATE OF FLORIDA HAS ONE
OF THE VESTS JUDICIAL EDUCATION
PROCESS IS IN THE ENTIRE
COUNTRY.
HAVING TAUGHT AT JUDGES'
CONFERENCE CIRCUIT JUDGES
CONFERENCE AND THE NATIONAL
JUDICIAL COLLEGE I'M HAPPY TO BE
PART OF PULLING TOGETHER THIS
PRESENTATION AND WHAT WE HAVE
DONE IN ONE YEAR, IN THE YEAR
2008 IS COVER EVERY TRAINING
AVAILABLE TO JUDGES IN THE
STATE.
AULETTA ONE TIME.
I REMEMBER WHEN I WAS FIRST
ELECTED 17 YEARS AGO, CHIEF
JUDGE REX SMITH WAS MY MENTOR.
ONE OF THE THINGS HE TOLD ME OR
INVITES ME TO DO WAS GET
INVOLVED IN JUDICIAL EDUCATION
AND WITH LEGISLATION AND SURE
ENOUGH THAT THIS TURNED OUT TO
BE AN IMPORTANT CORRECTION THAT
I'VE HAD THE OPPORTUNITY TO
PARTICIPATE IN AND WE ARE READY
TO CARRY FORWARD THE
RECOMMENDATIONS OF THIS ENTIRE
REPORT TO ALL OF THE JUDGES.
JUDGES WHO GET INVOLVED WITH
MENTAL ILLNESS, SUBSTANCE ABUSE,
MENTAL RETARDATION, ARE EITHER
UNINFORMED OR THEY ARE VERY
FRUSTRATED AND THAT WAS
INDICATED VERY CLEARLY BY THE
QUESTIONS THAT JUDGE CLARK ASKED
, BY THE QUESTIONS THAT
JUDGE LEIFMAN ASKED IN THE NEW
PRESENTATION EMBRY COE WHY ARE
WE ON FAULT IN A SYSTEM THAT IS
AS INEFFECTIVE AS WE HAVE IN THE
STATE OF FLORIDA, THAT IS
INEFFECTIVE AS WE HAVE IN THIS
ENTIRE COUNTRY AND WHY ARE WE,
AS THE LEADERS OF THESE
COMMUNITIES, NOT STEPPING UP,
STEPPING FORWARD AND SAYING IT
IS TIME TO ADDRESS THESE ISSUES?
WE ARE ADDRESSING -- THANK YOU
MR. G JUSTICE, THANK YOU MR.
SECRETARY AND OTHER JUSTICES.
I APPRECIATE YOU BEING HERE
BECAUSE YOU WERE HERE, IN YOUR
COMMITMENT TO SOLVING THE
PROBLEMS WE FACE IN THE
COMMITTEES, NOT IN JUST PASSING
THEM BY, NOT INCLUDING ONE MORE
REPORT ON THE SHELF BUNNING
GETTING WITH THE BUSINESS OF
GETTING THE JOB DONE.
THANK YOU.
[APPLAUSE]
pp>> IN CONCLUSION TO USE SOME OF
THE REAL HIGHLIGHTS, JUSTICE --
WE DON'T HAVE TO REINVENT THE
WHEEL.
THERE.
LEWICKE NEWSEUM FLOYD, TO HELP
US AND OUR JOBS FROM THE
NATIONAL JUDICIAL CALLUS, FROM
THE JUVENILE COURT JUDGES AND
THE NATIONAL DRUG COURT INTO TO.
WE HAVE OBSTACLES AND I WOULD
SUGGEST THE HARDEST OBSTACLE IS
THE CULTURE, THE CULTURE OF THE
COURT SYSTEM REALLY.
WE CAME UP AND WERE TRAINED AT
THE SYSTEM AND JUST LIKE THE
AGENCIES AND BRANCHES OF
GOVERNMENT ARE COLLABORATING WE
HAVE TO BE LESS ADVERSARIAL IN
SOME INSTANCES THAT ARE PART SO
WE CAN REACH A BETTER OUTCOME.
I WOULD SUGGEST WE HAVE
FRUSTRATING ISSUES WE NEED TO
DEAL WITH BOTH FROM THE
TREATMENT AND AND THE JUDICIAL
AND CORRECTIONS AND ALL OF US
WORKING TOGETHER NEED TO KNOW
MORE ABOUT HOW THE OTHER PART
OPERATES IN ORDER TO DO A BETTER
JOB.
WE BELIEVE OTHER KINDS OF
TRAINING, POSSIBLY A WEB BASED
TRAINING, AND OUR GOAL IS NOT TO
BE THE SPOTLIGHT BUT TO
INSTITUTI