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DAVIS,BROUSSARD,8e STEGER,PLLC VuLEE Office

Clyde W.Davis
463049 State Road 200
Michael l.Broussard
ATTORNEYS AT LAW VULEE,FLORroA 32097
Brett L.Steger (P):904-225-8885

Licensed in fl& GA Amelia Island Office


960185 Gateway Boulevard
Suite 104
Respond TO Brett Steger
Fernandina Beach,FL 32034
AtThe Ameua Island Office
(P):904-261-2848
(F):904-261-4476
(E):BLS@NEFLAW.COM

April 19, 2017

Speaker Richard Corcoran


420 The Capitol
402 South Monroe Street
Tallahassee, Florida 32399-1300

Re: Florida Psychological Associates, LLC

Dear Speaker Corcoran:

Enclosed are the documents you requested from my client, Florida Psychological
Associates, LLC(FPA),on April 10,2017. After having an opportunity to compile and redact
the enclosed documents,I believe that we have provided everything responsive to your requests.

In my initial letter to you on April 13'*', I advised that I would not burden your office with
additional copies of what Florida State University(FSU)has already provided, l^le I have
tried to limit the number of duplicates provided to you,I have erred on the side of disclosure so I
apologize in advance for any duplicate copies we are providing.

Many ofthe enclosed documents are responsive to more than one ofthe paragraphs in
your request letter. Because ofthis, I have organized the enclosed documents by the type of
document rather than paragraph numbers to which they apply.

You will find the "deliverables" ofthe project are located within Attachment A to the
contract between FSU and FPA. The deliverables are broken down into eight(8)categories,
which are:

1) Review,summarize and recommend an evidence-based, best practice model of screening,


engagement, and outcomes by piloting the implementation ofan early identification
system to recognize those in need of mental health services within the pilot counties.

2) Provide technical assistance to identify and address service and clinical capacity issues in
Florida by conducting needs assessment, in light ofclinical guidelines and evidence-
based care, ofkey mental health screening providers with specific focus on staff training
needs and use of best-practice outcomes measures with standard reporting capacity
vrithin the pilot counties.
Speaker Richard Corcoran
April 19,2017
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3) Discover effective models to facilitate mental health access in order to improve


outcomes.

4) Collect vital data associated with the pilot project in schools and justice system.

5) Develop a HIPAA-compliant data repository with capacity to collect key data from
relevant data sources so that aggregation, standardization, management,analyses and
reporting can be created and maintained.

6) As data is collected, data management,cleaning and analyses will be done.

7) Screen population as follows:

Attempt to screen a target of4,500 students in the following school district:


Clay County (target goal of 1,500)
Duval County (target goal of 1,500)
Nassau County (target goal of 1,500)

Attempt to screen a target of2,600 individuals who have entered into the Fourth
Judicial Circuit's judicial system as follows:
Clay County (target goal of700)
Duval County (target goal of 1,300)
Nassau County (target goal of600)

8) Prepare and submit appropriate report to the Florida Legislature.

In order to determine whether FPA has met the deliverables pursuant to the contract, one
must first understand the process and timeline of events. Before FPA could begin screening any
students or court participants, it first had to obtain approval from the FSU Institutional Review
Board (IRB). This approval process effectively encompassed two(2)screening projects, one for
the school system and one for the court system.

FPA submitted its initial IRB application to FSU on Jvme 17, 2016. Over the next four
(4) months,the IRB application was tabled at the Human Subject Committee meetings. FPA
diligently followed up with FSU over that period oftime and submitted numerous revisions to its
application. On October 13,2016,the IRB application for the school screenings was approved
while the IRB application for court screenings was tabled once again.

Once FPA obtained IRB approval to begin screening students, it also had to obtain
consent from the various school leaders to implement the program at the schools. On October
24,2016,the Nassau County School Superintendent granted approval for FPA to implement the
screening process in all ofthe Nassau County schools. Following this approval, members of
speaker Richard Corcoran
April 19,2017
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FPA met with the Principeils of all Nassau County schools, received pre-survey information, and
provided information regarding the importance ofthe mental health screening project.

Once the project was approved by the school leaders, the next step was for FPA to obtain
consent from the students' parents in order to perform the screenings. In November of2016,
FPA began distributing parental consent forms to the Nassau County schools. During the same
month,initial screenings were performed on students whose parents had returned the proper
authorization for screening.

Once the screening program had been implemented in Nassau County, FPA turned its
efforts to the school systems in Duval and Clay counties. Administrators within the various
schools advised FPA that the return ofthe parental consent forms would be higher ifthey are
presented to the parents during the open house sessions that take place at the beginning ofthe
school year.

FPA is currently working to implement the screening programs in Duval and Clay
counties. Further, FPA anticipates having the ability to provide the parental consent forms in all
three(3)counties at the beginning ofthe school year,thereby resulting in a much higher return
on the authorizations for screening. As indicated in the timeline above,FPA did not have the
option of providing the parental consent forms during the new school year open houses because
IRB approval was not given until November. The end result is anticipated to be a larger return
ofauthorizations which will lead to an increased number ofstudent screenings.

While school screenings were taking place, FPA continued to constantly monitor the
status ofIRB approval for court screenings. The IRB application for court screening approval
was tabled at monthly meetings ofthe FSU Human Subject Committee until it was finely
approved this month. During the ten(10)month tabling period from June of2016 to April of
2017,FPA submitted no less than six (6)amendments to the application, reflecting the changes,
addition, or deletions that were recommended by the IRB.

Since obtaining conditional IRB approval on the court screening project earlier this week
on April 16*'', FPA has submitted all ofthe information, consent forms,and participation
agreements to the Administrative Judge for Nassau County. Yesterday, all ofthe required forms
were retumed to FPA,giving my client the authority to proceed with court screenings upon final
IRB approval.

In addressing the budget and expenditures, you will see that FPA is operating under
budget. This was a purposeful strategy on my client's behalfto conserve tax payer resources
where possible. On one hand,FPA was tasked with obtaining all ofthe necessary infrastructure
to be able to proceed right away with the school and court screenings once IRB approval was
given. On the other hand, my client consciously chose not to increase its payroll to include
employees that would perform the school screenings until final IRB approval for the screenings
speaker Richard Corcoran
April 19,2017
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at school was obtained. Likewise,FPA will only now look to increase employees for the court
screenings since IRB approval has been obtained.

The documents I am providing demonstrate that FPA has clearly met the eight(8)
deliverables contained in the contract and listed above. Deliverables 1-6 were met prior to final
IRB approval. Once IRB approval was given, deliverable 7, dealing with the attempted
screenings, is then assessed. As for deliverable 8, you will see that FPA,in conjunction with
FSU,has prepared and submitted the appropriate reports to the Legislature.

The reason that deliverable 7 cannot be measured prior to IRB approval is simple; no
screenings could take place until FSU gave approval ofthe program. Once approval was
obtained, the contract clearly states that FPA will attempt to screen 4,500 students within the
school districts of Clay, Duval,and Nassau coimties.

To date,FPA has made attempts to screen approximately 8,363 students within the
Nassau County School district alone. Again, without parental consent,FPA cannot lawfully
perform screening upon a student. As FPA has delivered the required parental consent forms to
each school in Nassau County,thereby requiring a response from the parents, my client has
attempted to screen 100% ofthe student population in Nassau County between grades 3-12.

As my client is less than five(5)months into its screening period for students(time
within which it has been approved for school screenings), it anticipates the number ofstudents
who will be screened during the course ofthe project will increase dramatically. FPA has
devoted the resources, and has the infrastructure in place, to screen every student in the district
whose parent executes a consent form authorizing screening ofthe child.

Likewise,the number of screenings that have taken place to date do not account for any
court screenings due to the fact that IRB approval was not received until this month. As FPA has
now been approved for court screening in Nassau County,the anticipated number ofcourt
screenings is expected to increase dramatically.

As you will see in the enclosed Agreement Letter for Nassau Coimty Court, a serious
need for mental health screening exists. The Court currently lists its satisfaction level with the
efficiency for determining mental health needs as "not at all."

Any conclusion that FPA has failed in the project because it has not screened a certain
number of individuals is based upon fatally flawed logic. FPA could not legally perform any
student screenings for the first five(5)months ofthe project, through no fault ofits own.
Likewise,FPA could not legally perform any court screenings for the first ten(10)months ofthe
project. In sum,the lack ofIRB approval has prevented FPA from conducting the screenings it
has sought to perform from the very beginning.
Speaker Richard Corcoran
April 19, 2017
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The contract between FPA and FSU requires that FPA attempt to screen a target of4,500
students, which is comprised of 1,500 students from Nassau County, 1,500 students from Duval
County, and 1,500 students from Clay County. In only five (5)months, FPA has attempted to
screen nearly twice as many students as required per the contract.

As for court screenings, the contract requires that FPA attempt to screen a target of2,600
individuals within the court system, which is comprised of600 people in Nassau County, 1,300
people in Duval County, and 700 people in Clay County. Though FPA was only given
permission to proceed in the Nassau County Courts yesterday, an estimate from the Court is that
1,200 people in need of mental health treatment will be processed through the Nassau County
Court system over the next twelve(12) months. This is twice the number of target individuals
for Nassau County. Further, this number does not include the number ofscreenings that will
take place in Duval and Clay counties once FPA has expanded into those court systems as well.

In addition to your review ofthese documents, I would invite you come and speak with
the Judges, teachers, paraprofessionals, and parents who have seen the project firsthand. You
will no doubt learn that this legislatively funded program is making a positive difference in the
lives ofthose who are screened. I likewise believe that you will hear positive results from the
court screenings once they are implemented in the coming weeks.

My client looks forward to continuing the valuable screening work it is performing


within the Nassau County school district while it expands into the Duval and Clay county school
systems. Likewise, FPA is ready for its expansion into the judicial system and eager to provide
you with the numeric results of those screenings.

In conclusion, I would again like to thank the Appropriations Committee for allowing us
to submit the enclosed documents. I believe that the documents, evidence, and results clearly
indicate that not only has FPA been a conservative steward of this taxpayer funding, it has also
implemented a program that will lead the state of Florida to the forefront in the diagnosis,
referral, and treatment of mental healthcare needs.

Should you wish to discuss this matter, please do not hesitate to contact me at 904-261-
2848. With warmest regards, I remain
Sincerely yours,

Brett Steger
c: Via Email
Adam S. Tanenbaum, General Counsel for Florida House of Representatives
President John Thrasher, Florida State University
Dr. Heather Flynn, Florida State University
Dr. Catherine Drew, Florida Psychological Associates, LLC