House Community Budget Issue Requests - Tracking Id #296 Criminal Justice Behavioral Health Assessment & Holding Area
Requester:	Wil Trower		Organization:		North Broward Hospital District
Project Title:	Criminal Justice Behavioral Health Assessment & Holding Area		Date Submitted:		01/28/2000 3:17:38 PM
District Member:	Tracy Stafford		Service Area:		County
Counties Affected:	Broward
Recipient:	North Broward Hospital District		Contact:		Charlotte Mather
	303 SE 17th St.		Contact Phone:		(954) 355-5180
	Ft. Lauderdale 33316
Project Description:
The North Broward Hospital District is developing a newly designed Behavioral Health assessment and holding area within the first floor West Wing of Broward General Medical Center. This will allow behavioral health and criminal justice behavioral health patients to be safely escorted into a psychiatric assessment area within the hospital where they will be screened and evaluated (and processed for admission as appropriate) by qualified behavioral health professionals. The development of this assessment center will allow the Broward General Medical Center to create a separate and private entrance to the hospital with direct accessibility to law enforcement and emergency medical transport workers. The floor plan allows for behavioral health and criminal justice patients who are in custody based on misdemeanor criminal behavior to be safely and effectively managed in a secured environment while the psychiatric screening and medical clearance take place. The design of the Behavioral Health Assessment Center will allow for criminal justice mental health patients to be released from law enforcement handcuffs, have access to showers, and change out of jail issued clothing in a private area that protects their rights to confidentiality (as mandated within Chapter 394). Access to an elevator will be provided allowing for confidential transport patients requiring inpatient treatment in the newly built out crisis screening and stabilization unit which will be located on 4 North West wing of Broward General Medical Center. History- The North Broward Hospital District has been engaged in a contractual relationship with the State of Florida Department of Children and Families in Broward County since 1995. The basis of these contracts is the operation of crisis screening and stabilization services for the seriously and persistently mentally ill indigent adult patients who populate the northern two-thirds of Broward County. Specifically, the contracts encompass the operation of a 24-hour, 7 day a week behavioral health screening and referral intake service to all clients eligible for "Baker Act" funds. The services include access to a 24-hour crisis phone line, crisis screening and assessment services, inpatient psychiatric stabilization and provision of medical clearance and emergency medical care as required. In conjunction with the contractual arrangements, Broward General Medical Center agreed to become designate as a public Baker Act receiving facility. At the time that the original contract was negotiated, it was agreed that Broward General Medical Center would continue to operate the 20-bed CSU facility located at 2677 NW 19th St. in Ft. Lauderdale on an interim basis. The current plan of the North Broward Hospital District is to close the 19th St. CSU and consolidate services on the campus of Broward General Medical Center. This plan will create a single point of entry and a single provider of care for crisis screening and stabilization services in northern Broward County. The patient population presenting for crisis screening and stabilization services at Broward General Medical Center and the 19th St. CSU has changed significantly over the past few years. In June 1997, the Broward County Mental Health Court was established by Chief Judge Dale Ross, in collaboration with Judge Mark A. Spiezer. Judge Ginger Lerner-Wren was appointed to preside over the Circuit's newly created Mental Health Division. Among the key goals of the Mental Health Court is to divert mentally ill defendants with misdemeanor criminal charges to community based mental health services. Due to Broward General and the 19th St. CSU proximity to the Court House and the jails, these facilities serve as the public Baker Act receiving facilities that receive the majority of the mental health crisis referrals from the criminal justice system in Broward County. * During FY-98 (7/1/97-6/30/98) there was a total of approximately 110 inmates with misdemeanor criminal charges referred and admitted for crisis screening and stabilization services. * In comparison, during FY-99 (7/1/98-6/30/99) there was a total of 182 inmates with misdemeanor criminal charges referred and admitted, representing a 66% increase over the previous year. * Currently, approximately 70% of the patients served at the 19th Street CSU have pending misdemeanor legal charges. In addition, there are typically around 5-6 criminal justice patients with misdemeanor charges on the Broward General Medical Center Behavioral Health units at any given time. The majority of these patients are referred from the criminal justice system in Broward County for Baker Act evaluation. * Recent statistics released by the Broward County Sheriff's Office have indicated that the Broward Jail system has on average 500 prisoners who receive psychotropic drugs and up to 150 prisoners are held in the mental health unit at the North Pompano Detention Center. The 19th St. CSU and/or Broward General Medical Center routinely receives court orders regarding inmates in psychiatric crisis stating "jail is not a treatment facility". These inmates are screened and evaluated in our facility and in the vast majority of cases, are admitted for inpatient treatment. In FY 98 and FY 99, 91% and 92% respectively, of patients screened were admitted for inpatient treatment. Summary- The North Broward Hospital District has demonstrated our commitment as a designated public Baker Act receiving facility since 1995. As illustrated above, there has been a significant shift in the number of seriously and persistently mentally ill adults who often cycle between the judicial and mental health system in Broward County. The CSU and Broward General Medical Center is seeing more patients with a prior history of violence and poor impulse control. It is not uncommon to discover a history of violent/assaultive behavior and high risk for elopement associated with the criminal justice mental health patients referred for crisis screening and stabilization services. The development of a specially designed and secured assessment area with a separate entrance within the Medical Center would significantly improve the environment of care by enhancing safety and improving patient confidentiality.
Services Provided/Benefit to State:
This request supports the Governor's and Legislature's initatives to develop community alternatives for diverting from the criminal justice system to the civil Baker Act system, any person with mental illness who is arrested for a misdemeanor. HB 2003, which passed during the 1999 session, contains a provision to evaluate the effectiveness of the Broward County Mental Health Court. The ability for the North Broward Hospital District to provide appropriate treatment alternatives for these criminal justice patients with mental illness who are being diverted through this initiative supports the Governor's and Legislature's goals. In addition, the project supports the statutory provisions within Florida's mental law, CH 394 (Part 1), F.S., the Baker Act, which encourages local communities to provide mental health treatment to persons who exhibit non-violent criminal behavior rather than to place them in the criminal justice system. It also addresses the issues of community safety and appropriate treatment alternatives for misdemeanants with mental illness who commit misdemeanors and who cycle in and out of the county jails becasue they do not have access to appropriate mental health treatment support services. This also supports collaboration and maximizes the effectiveness of resources among the North Broward Hospital District, Department of Children and Families, Broward Sheriff's Office, and other agencies serving misdemeanants with mental illness.
Measurable Outcome Anticipated:
The project will support the collection of data specific to Mental Health Court clients and system outcomes and cost efficiencies. The initiative also supports the collection of outcome dates to document improvement in the number or percentage of misdemeanants with mental illness who are taken directly to a Baker Act receiving facility, as opposed to a county detention center and the measurement of the associated cost offsets.
Amount requested from the State for this project this year:				$400,000
Total cost of the project:		$600,000

Request has been made to fund:			Construction
Is there Local Government or Private match for this request?					Yes
				In-Kind Amount:	$200,000
Was this project previously funded by the State?					No
Is future-year funding likely to be requested?					No
Was this project included in an Agency's Budget Request?					Unknown
Was this project included in the Governor's Recommended Budget?					Unknown
Is there a documented need for this project?					Yes
	Documentation:	Broward County 17th Circuit Mental Health Court Report, USF Mental Health Institute Report
Was this project request heard before a publicly noticed meeting of a body of elected officials (municipal, county, or state)?					Yes
	Hearing Body:	Broward Legislative Delegation
	Meeting Date:	02/01/2000