Legislature poised to rework the Baker Act

first_img May 1, 2004 Associate Editor Regular News Legislature poised to rework the Baker Act Legislature poised to rework the Baker Act Jan Pudlow Associate Editor A tense 13-hour standoff between a sheriff’s deputy and a schizophrenic man off of his medication ended both of their lives and inspired a major rewrite of the Baker Act that calls for judges to order involuntary outpatient treatment.In the works for three years since that 1998 deadly drama, CS/SB 700 is primed for passage this year, touted as a way to prevent tragedies and save lives. But others warn that if the proposed legislation is not adequately funded, it will overburden the courts and create chaos in the delivery of mental health services that are already grossly underfunded.“Untreated mental illness is not just a humanitarian issue, but it’s also a public safety issue,” said Seminole County Sheriff Don Eslinger, legislative chair of the Florida Sheriffs Association. “We are one of nine states that does not have the ability to order outpatient treatment. We believe that medication noncompliance is a major issue that can be rectified simply by having service providers and the judiciary ensure that this is followed through.”The sheriffs also believe this year looks encouraging for their bill to pass at last.“We have a great deal of support,” Eslinger said. “The governor acknowledged in our meeting it was one of his priorities, and he totally supports this legislation. I talked to the lt. governor, and I understand leadership in both the House and Senate are very interested in this.”On April 13, the bill passed out of the Senate Appropriations Subcommittee on Article V Implementation & Judiciary, without much debate on its cost and impact on the court system. Yet, the committee’s 30-page staff analysis detailed dozens of concerns, including substantial court workload costs, potential equal protection issues because it only applies to counties where there are existing outpatient services, confusion on how noncompliance will be enforced, and possible conflicts of interest between those who make determinations for continued treatment and may have financial investments in treatment facilities.“Do we have the money to fund this?” asked Sen. Steve Wise, R-Jacksonville.Sen. Rod Smith, D-Gainesville, chair, responded that Wise’s question is “at the heart of the matter,” and he hopes there will be a “full and frank discussion” on the Senate floor.In the meantime, Smith said with a shrug: “I can’t answer the question, nor is it answerable. Will there be Art. V dollars directly sufficient to fund this? No.”Stay tuned, Smith said, on whether a combination of dollars from the criminal justice budget will be enough.A week later, April 20, the bill passed without debate 16-to-1 at the full Senate Appropriations Committee, with Sen. Alex Villalobos, R-Miami, casting the lone dissenting vote after withdrawing seven amendments.No one was called to testify, despite several witnesses waiting to do so, including expectations to hear from the Department of Children and Families on fiscal impact.At the earlier subcommittee meeting, nay-sayers acknowledged the bill was picking up steam to become law.“I will go on record to say we don’t like the bill. But because this bill is going to pass, what we are saying if you have got to do this, as a matter of public policy, then please fund it,” said Aleisa McKinlay, of the Advocacy Center for Persons With Disabilities, Inc.“We’re already 47th out of 50 states in terms of per-capita spending on mental health services. So, if you bring more people into the system and expect them to be served within current resources, it is not realistic.”Sheriff Eslinger countered that the criteria for assisted outpatient treatment “is so narrow in scope that our analysis of the 90-some thousand Baker Acts.. . this would only affect less than 1,000 individuals.“We’re not talking about bringing anybody new into the Baker Act system. What this focuses on is the recidivist people going in and out of both the criminal justice system, as well as the mental health system,” he said.Of the revolving-door problem, Eslinger said, one person was Baker Acted 41 times, and 736 people in Florida have been Baker Acted seven or more times in one year.But McKinlay told the senators she did not buy the sheriff’s argument that the bill only targets people already receiving services.“The net cast by the plain language of the bill is broader by far,” she said. “It will affect at least as many people not currently served in the public mental health system, as people who are.”Sixth Judicial Circuit Public Defender Bob Dillinger testified that carrying out the proposed bill would have “a significant fiscal impact,” because there will be more Baker Act cases for public defenders to handle, and they are on the case until treatment is completed.Relying on current numbers is problematic, he said, because referrals often aren’t made because programs don’t exist.“We have many people referred for Baker Act and meet Baker Act criteria who are just put back into the community,” Dillinger said. “We believe there will be more referrals when people realize there are alternatives to being locked up in long-term placement, and they can get treatment in the community. There are a lot of people who need these services.”Robert Trammell, general counsel for the Florida Public Defender Association, estimated the fiscal impact on public defenders will be $2 million a year.“This is a substantial departure from doing business as usual,” Trammell said. “Your own fiscal determination is that it is going to cost a whole lot of money.”The roles of public defenders and state attorneys “will substantially increase in this area,” Trammell said. One change he would like to see is to boost the criteria from one suicide attempt to two.“Our people think there are many, many people who make one suicide attempt who are never in the system again.. . . We simply can’t absorb this workload.”A judicial impact statement supplied by the Office of the State Courts Administrator forewarned: “Additional judicial resources will need to be allocated to Baker Act matters. The expedited hearing requirements and liberty interests of these cases will require priority attention from the courts, thereby backlogging and delaying civil cases that impact on Florida families and businesses.”Referring to the public defenders’ estimate that they would file approximately 2,000 appeals in the first year following implementation of similar involuntary placement legislation, OSCA estimates “the equivalent of six full-time district court of appeal judges, plus associated staff support and expenses” would be required to implement the bill at the district court level during fiscal year 2004-05, at a cost of $2.5 million.In addition, according to OSCA, it would require the equivalent of two to three full-time circuit judges, “conservatively estimated to range from $622,760 to $934,140.”But Sen. Durell Peaden, R-Crestview, a physician and sponsor of the bill, argues the Baker Act rewrite will actually save money in the long run.“We are trying to make sure those people with the proper diagnosis are treated the proper way to keep the prisons and jails empty. And to make sure we salvage those hundreds of millions of dollars in expenditures for folks who are not complying and don’t stay on their medications,” Peaden said.“Certainly, it will keep them out of acute care hospitals, mental hospitals, and keep them out of jails. I think it will be a big step, if we can get the governor to sign off on it.”Peaden, Eslinger and Sen. Skip Campbell, D-Tamarac, found encouragement in statistics from New York that enacted involuntary out-patient treatment (along with 40 other states) dubbed Kendra’s Law.Calling it a good bill that will eventually save the state money, Campbell ticked off these numbers from New York: reduced hospitalization by 63 percent, 55 percent fewer people experiencing homelessness, 75 percent fewer re-arrested, 69 fewer incarcerated.But the Senate committee’s staff analysis had this to say: “The New York City study found no statistically significant differences. . . between the involuntary outpatient treatment group and those who receive intensive services but without a commitment order.”last_img

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