SAC's Presentation at CAFE'
CAFÉ was a great success for both SAC and LAC members and those in attendance. SAC's presentation was "How To Be an Advocate". This presentation taught consumers and families how to advocate at five levels: 1) self-advocacy, 2) advocating as a parent/guardian, 3) advocating as a provider, 4) advocating as an organization and, 5) advocating from a legal point. There was standing room only and unfortunately, many people had to be turned away. At the 2002 CAFE, SAC expanded this presentation and increased the room size to accommodate a larger than ever audience.

Monitoring South Florida State Hospital (SFSH)
SAC has been monitoring SFSH since it opened under a contract with Atlantic Shores. SAC is honored to inform you that we are extremely pleased with the operation of SFSH. We have found the use of restraints has dropped dramatically during the last year and are pleased with the administration direction to eliminate all use of restraints. In addition, SAC endorses the community involvement that the hospital has taken to make sure patients' discharges are a success. Lastly, the number of activities that patients are involved in has increased significantly. Patients are no longer sitting in lounge areas with nothing to do. SAC has received the full cooperation from the hospital administration and their staff in dealing with any problems we have found and working together on solutions.

Monitoring G. Pierce Wood Memorial Hospital (GPW)
As a result of the 2000-2001 closing of G. Pierce Wood Memorial Hospital, a state operated mental health facility, the State and Local Advocacy Councils continue to monitor the ability of the communities to provide appropriate and adequate services to our consumers who have mental illnesses.

Psychotropic Drug Investigation
During 2001-2002, SAC continued to investigate the use of psychotropic drugs in foster children with specific concentration on children under the age of five. The full report on the investigation is near completion; however, the Council has released a report on problems discovered during the review of foster care records and is awaiting action plan by the Department of Children and Family Services. The final report will be ready for distribution in 2003.

Operation Spot Check (Jacksonville)
The LACs in the Jacksonville area have been participating with the Office of the State's Attorney in "Operation Spot Check" to clean up facilities that are not up to standards and/or codes of the state, city or county. All of the facilities visited to date have been assisted living facilities, of which 9 have been closed. All of the closures have related to some type of violation, which places the residents in a life-threatening manner. The LACs continue to participate with the Operation Spot Check.

Faith-Based Day Care Centers
After a number of complaints, SAC approached the faith-based organization about tightening up the rules and regulations associated with their exemptions to state regulations and their ability to police themselves. Changes to the policies and laws have been accepted by the faith-based organizations to provide additional safeguards for children.

New LACs Now Operating
SAC approved new LACs in Panama City, Jacksonville, Wildwood, Ft. Lauderdale, West Palm Beach, Sarasota and Vero Beach. There are three councils that have been approved and should be operational soon. They are the Florida Keys, Taylor/Madison and Tampa.

Orange Item Report on the Department of Children and Family Services Foster Care Records (June 2002)
As part of SAC's Psychotropic Drug Investigation into the use of psychotropic drugs in foster care issues, an Orange Item Report was issued on the condition of foster care records. Based on an inspection of 1,181 records, 53 different problem areas with the records were identified. They are: foster care files in general, physical location of foster children, foster care files that violate state and federal laws and rules, foster care staff, medical records in foster care files and Medical Passports.

Standards and Training
SAC's Standard and Training Committee during the past year (FY 2001-2002) updated and modernized the training program for both new members and local council officer training.

Downgrading Abuse Report Response Time
It was discovered during a LAC investigation that an abuse investigator, with the permission of a supervisor, could downgrade the response time to see an alleged victim from immediate to 24 hours for victims in state custody. After an unfortunate incident with two run away girls, this policy was changed when brought to the attention of the Department of Children and Family Services. Field staff or supervisors can no longer downgrade reports.

1st Health
1st Health was a contracted provider for AHCA in the area of prior authorization for children's mental health services. As part of the contract, 1st Health was to make a determination on a request of children services within 24 hours of receipt. It was determined that many children were being denied services, due to 1st Health's inability to respond to request for services within the contracted period of 24 hours. Once this problem was brought to the attention of AHCA, vast improvements have been made and authorizations are now being handled timely, for the most part, due to AHCA's enforcement of the contract.

Children in Crisis Stabilization Units (CSU)
An article in the Orlando Sentinel stated that children were being held in CSUs for long periods of time. At the request of the Florida Senate, SAC and LAC members reviewed CSUs statewide to determine the current status. Out of the 141 records that were reviewed, 128 children spent ten days or less in the CSU. Only four out of the 13 that were over ten days were considered extreme. All four of them were removed within a few days of SAC/LAC notification. It was determined that children are not being held for excessive periods of time in CSUs. However, SAC/LACs did discover that many of the children placed in a CSU by the Department of Children and Family Services are not receiving the proper hearing prior to admission.

Home and Community-Based Waiver (HCBW) for the Developmentally Disabled Provider Application
SAC received numerous complaints from LACs that the HCBW application process was very long and cumbersome for providers and actually served as a disincentive to become a provider. With the assistance of AHCA and DCF, the application was shortened considerably for current Medicaid providers applying for the waiver process.

Telephone Listings
SAC listed the 1-800-324-0825 in the public service portion of all but a couple of telephone books statewide at no expense Florida's taxpayers.

Florida Mental Health Institute's Study on State Hospital Continuity of Care
SAC requested that AHCA fund a study on the continuity of care for clients that are discharged from state hospitals. This report was completed and released in FY 2001-2002. The study raised many questions on effectiveness of community care and a follow up study is being conducted.