Florida Senate - 2016                          SENATOR AMENDMENT
       Bill No. CS/SB 12, 2nd Eng.
       
       
       
       
       
       
                                Ì259190-Î259190                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                Floor: 1/RE/RM         .                                
             03/11/2016 01:56 PM       .                                
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       Senator Garcia moved the following:
       
    1         Senate Amendment to House Amendment (171349) (with title
    2  amendment)
    3  
    4         Delete lines 5 - 4950
    5  and insert:
    6         Section 1. Paragraph (e) is added to subsection (10) of
    7  section 29.004, Florida Statutes, to read:
    8         29.004 State courts system.—For purposes of implementing s.
    9  14, Art. V of the State Constitution, the elements of the state
   10  courts system to be provided from state revenues appropriated by
   11  general law are as follows:
   12         (10) Case management. Case management includes:
   13         (e)Service referral, coordination, monitoring, and
   14  tracking for treatment-based mental health court programs under
   15  chapter 394.
   16  
   17  Case management may not include costs associated with the
   18  application of therapeutic jurisprudence principles by the
   19  courts. Case management also may not include case intake and
   20  records management conducted by the clerk of court.
   21         Section 2. Subsections (65) through (79) of section 39.01,
   22  Florida Statutes, are renumbered as subsections (66) through
   23  (80), respectively, and a new subsection (65) is added to that
   24  section to read:
   25         39.01 Definitions.—When used in this chapter, unless the
   26  context otherwise requires:
   27         (65)“Qualified professional” means a physician or a
   28  physician assistant licensed under chapter 458 or chapter 459; a
   29  psychiatrist licensed under chapter 458 or chapter 459; a
   30  psychologist as defined in s. 490.003(7) or a professional
   31  licensed under chapter 491; or a psychiatric nurse as defined in
   32  s. 394.455.
   33         Section 3. Paragraph (c) of subsection (6) of section
   34  39.407, Florida Statutes, is amended to read:
   35         39.407 Medical, psychiatric, and psychological examination
   36  and treatment of child; physical, mental, or substance abuse
   37  examination of person with or requesting child custody.—
   38         (6) Children who are in the legal custody of the department
   39  may be placed by the department, without prior approval of the
   40  court, in a residential treatment center licensed under s.
   41  394.875 or a hospital licensed under chapter 395 for residential
   42  mental health treatment only pursuant to this section or may be
   43  placed by the court in accordance with an order of involuntary
   44  examination or involuntary placement entered pursuant to s.
   45  394.463 or s. 394.467. All children placed in a residential
   46  treatment program under this subsection must have a guardian ad
   47  litem appointed.
   48         (c) Before a child is admitted under this subsection, the
   49  child shall be assessed for suitability for residential
   50  treatment by a qualified evaluator who has conducted a personal
   51  examination and assessment of the child and has made written
   52  findings that:
   53         1. The child appears to have an emotional disturbance
   54  serious enough to require residential treatment and is
   55  reasonably likely to benefit from the treatment.
   56         2. The child has been provided with a clinically
   57  appropriate explanation of the nature and purpose of the
   58  treatment.
   59         3. All available modalities of treatment less restrictive
   60  than residential treatment have been considered, and a less
   61  restrictive alternative that would offer comparable benefits to
   62  the child is unavailable.
   63  
   64  A copy of the written findings of the evaluation and suitability
   65  assessment must be provided to the department, and to the
   66  guardian ad litem, and, if the child is a member of a Medicaid
   67  managed care plan, to the plan that is financially responsible
   68  for the child’s care in residential treatment, all of whom must
   69  be provided with who shall have the opportunity to discuss the
   70  findings with the evaluator.
   71         Section 4. Section 394.453, Florida Statutes, is amended to
   72  read:
   73         394.453 Legislative intent.—
   74         (1) It is the intent of the Legislature:
   75         (a) To authorize and direct the Department of Children and
   76  Families to evaluate, research, plan, and recommend to the
   77  Governor and the Legislature programs designed to reduce the
   78  occurrence, severity, duration, and disabling aspects of mental,
   79  emotional, and behavioral disorders.
   80         (b)It is the intent of the Legislature That treatment
   81  programs for such disorders shall include, but not be limited
   82  to, comprehensive health, social, educational, and
   83  rehabilitative services to persons requiring intensive short
   84  term and continued treatment in order to encourage them to
   85  assume responsibility for their treatment and recovery. It is
   86  intended that:
   87         1. Such persons be provided with emergency service and
   88  temporary detention for evaluation when required;
   89         2.Such persons that they be admitted to treatment
   90  facilities on a voluntary basis when extended or continuing care
   91  is needed and unavailable in the community;
   92         3.that Involuntary placement be provided only when expert
   93  evaluation determines that it is necessary;
   94         4.that Any involuntary treatment or examination be
   95  accomplished in a setting that which is clinically appropriate
   96  and most likely to facilitate the person’s return to the
   97  community as soon as possible; and
   98         5.that Individual dignity and human rights be guaranteed
   99  to all persons who are admitted to mental health facilities or
  100  who are being held under s. 394.463.
  101         (c)That services provided to persons in this state use the
  102  coordination-of-care principles characteristic of recovery
  103  oriented services and include social support services, such as
  104  housing support, life skills and vocational training, and
  105  employment assistance, necessary for persons with mental health
  106  disorders and co-occurring mental health and substance use
  107  disorders to live successfully in their communities.
  108         (d)That licensed, qualified health professionals be
  109  authorized to practice to the fullest extent of their education
  110  and training in the performance of professional functions
  111  necessary to carry out the intent of this part.
  112         (2)It is the further intent of the Legislature that the
  113  least restrictive means of intervention be employed based on the
  114  individual needs of each person, within the scope of available
  115  services. It is the policy of this state that the use of
  116  restraint and seclusion on clients is justified only as an
  117  emergency safety measure to be used in response to imminent
  118  danger to the client or others. It is, therefore, the intent of
  119  the Legislature to achieve an ongoing reduction in the use of
  120  restraint and seclusion in programs and facilities serving
  121  persons with mental illness.
  122         Section 5. Section 394.4573, Florida Statutes, is amended
  123  to read:
  124         394.4573 Coordinated system of care; annual assessment;
  125  essential elements Continuity of care management system;
  126  measures of performance; system improvement grants; reports.—On
  127  or before December 1 of each year, the department shall submit
  128  to the Governor, the President of the Senate, and the Speaker of
  129  the House of Representatives an assessment of the behavioral
  130  health services in this state. The assessment shall consider, at
  131  a minimum, the extent to which designated receiving systems
  132  function as no-wrong-door models, the availability of treatment
  133  and recovery services that use recovery-oriented and peer
  134  involved approaches, the availability of less-restrictive
  135  services, and the use of evidence-informed practices. The
  136  department’s assessment shall consider, at a minimum, the needs
  137  assessments conducted by the managing entities pursuant to s.
  138  394.9082(5). Beginning in 2017, the department shall compile and
  139  include in the report all plans submitted by managing entities
  140  pursuant to s. 394.9082(8) and the department’s evaluation of
  141  each plan.
  142         (1) As used in For the purposes of this section:
  143         (a)“Care coordination” means the implementation of
  144  deliberate and planned organizational relationships and service
  145  procedures that improve the effectiveness and efficiency of the
  146  behavioral health system by engaging in purposeful interactions
  147  with individuals who are not yet effectively connected with
  148  services to ensure service linkage. Examples of care
  149  coordination activities include development of referral
  150  agreements, shared protocols, and information exchange
  151  procedures. The purpose of care coordination is to enhance the
  152  delivery of treatment services and recovery supports and to
  153  improve outcomes among priority populations.
  154         (b)(a) “Case management” means those direct services
  155  provided to a client in order to assess his or her activities
  156  aimed at assessing client needs, plan, or arrange planning
  157  services, coordinate service providers, link linking the service
  158  system to a client, monitor coordinating the various system
  159  components, monitoring service delivery, and evaluate patient
  160  outcomes to ensure the client is receiving the appropriate
  161  services evaluating the effect of service delivery.
  162         (b)“Case manager” means an individual who works with
  163  clients, and their families and significant others, to provide
  164  case management.
  165         (c)“Client manager” means an employee of the department
  166  who is assigned to specific provider agencies and geographic
  167  areas to ensure that the full range of needed services is
  168  available to clients.
  169         (c)(d) “Coordinated system Continuity of care management
  170  system” means a system that assures, within available resources,
  171  that clients have access to the full array of behavioral and
  172  related services in a region or community offered by all service
  173  providers, whether participating under contract with the
  174  managing entity or by another method of community partnership or
  175  mutual agreement within the mental health services delivery
  176  system.
  177         (d)“No-wrong-door model” means a model for the delivery of
  178  acute care services to persons who have mental health or
  179  substance use disorders, or both, which optimizes access to
  180  care, regardless of the entry point to the behavioral health
  181  care system.
  182         (2) The essential elements of a coordinated system of care
  183  include:
  184         (a)Community interventions, such as prevention, primary
  185  care for behavioral health needs, therapeutic and supportive
  186  services, crisis response services, and diversion programs.
  187         (b)A designated receiving system that consists of one or
  188  more facilities serving a defined geographic area and
  189  responsible for assessment and evaluation, both voluntary and
  190  involuntary, and treatment or triage of patients who have a
  191  mental health or substance use disorder, or co-occurring
  192  disorders.
  193         1.A county or several counties shall plan the designated
  194  receiving system using a process that includes the managing
  195  entity and is open to participation by individuals with
  196  behavioral health needs and their families, service providers,
  197  law enforcement agencies, and other parties. The county or
  198  counties, in collaboration with the managing entity, shall
  199  document the designated receiving system through written
  200  memoranda of agreement or other binding arrangements. The county
  201  or counties and the managing entity shall complete the plan and
  202  implement the designated receiving system by July 1, 2017, and
  203  the county or counties and the managing entity shall review and
  204  update, as necessary, the designated receiving system at least
  205  once every 3 years.
  206         2.To the extent permitted by available resources, the
  207  designated receiving system shall function as a no-wrong-door
  208  model. The designated receiving system may be organized in any
  209  manner which functions as a no-wrong-door model that responds to
  210  individual needs and integrates services among various
  211  providers. Such models include, but are not limited to:
  212         a.A central receiving system that consists of a designated
  213  central receiving facility that serves as a single entry point
  214  for persons with mental health or substance use disorders, or
  215  co-occurring disorders. The central receiving facility shall be
  216  capable of assessment, evaluation, and triage or treatment or
  217  stabilization of persons with mental health or substance use
  218  disorders, or co-occurring disorders.
  219         b.A coordinated receiving system that consists of multiple
  220  entry points that are linked by shared data systems, formal
  221  referral agreements, and cooperative arrangements for care
  222  coordination and case management. Each entry point shall be a
  223  designated receiving facility and shall, within existing
  224  resources, provide or arrange for necessary services following
  225  an initial assessment and evaluation.
  226         c.A tiered receiving system that consists of multiple
  227  entry points, some of which offer only specialized or limited
  228  services. Each service provider shall be classified according to
  229  its capabilities as either a designated receiving facility or
  230  another type of service provider, such as a triage center, a
  231  licensed detoxification facility, or an access center. All
  232  participating service providers shall, within existing
  233  resources, be linked by methods to share data, formal referral
  234  agreements, and cooperative arrangements for care coordination
  235  and case management.
  236  
  237  An accurate inventory of the participating service providers
  238  which specifies the capabilities and limitations of each
  239  provider and its ability to accept patients under the designated
  240  receiving system agreements and the transportation plan
  241  developed pursuant to this section shall be maintained and made
  242  available at all times to all first responders in the service
  243  area.
  244         (c)Transportation in accordance with a plan developed
  245  under s. 394.462.
  246         (d)Crisis services, including mobile response teams,
  247  crisis stabilization units, addiction receiving facilities, and
  248  detoxification facilities.
  249         (e) Case management. Each case manager or person directly
  250  supervising a case manager who provides Medicaid-funded targeted
  251  case management services shall hold a valid certification from a
  252  department-approved credentialing entity as defined in s.
  253  397.311(9) by July 1, 2017, and, thereafter, within 6 months
  254  after hire.
  255         (f)Care coordination that involves coordination with other
  256  local systems and entities, public and private, which are
  257  involved with the individual, such as primary care, child
  258  welfare, behavioral health care, and criminal and juvenile
  259  justice organizations.
  260         (g)Outpatient services.
  261         (h)Residential services.
  262         (i)Hospital inpatient care.
  263         (j)Aftercare and other post-discharge services.
  264         (k)Medication-assisted treatment and medication
  265  management.
  266         (l)Recovery support, including, but not limited to,
  267  support for competitive employment, educational attainment,
  268  independent living skills development, family support and
  269  education, wellness management and self-care, and assistance in
  270  obtaining housing that meets the individual’s needs. Such
  271  housing may include mental health residential treatment
  272  facilities, limited mental health assisted living facilities,
  273  adult family care homes, and supportive housing. Housing
  274  provided using state funds must provide a safe and decent
  275  environment free from abuse and neglect.
  276         (m) Care plans shall assign specific responsibility for
  277  initial and ongoing evaluation of the supervision and support
  278  needs of the individual and the identification of housing that
  279  meets such needs. For purposes of this paragraph, the term
  280  “supervision” means oversight of and assistance with compliance
  281  with the clinical aspects of an individual’s care plan.
  282         (3) SYSTEM IMPROVEMENT GRANTS.—Subject to a specific
  283  appropriation by the Legislature, the department may award
  284  system improvement grants to managing entities based on a
  285  detailed plan to enhance services in accordance with the no
  286  wrong-door model as defined in subsection (1) and to address
  287  specific needs identified in the assessment prepared by the
  288  department pursuant to this section. Such a grant must be
  289  awarded through a performance-based contract that links payments
  290  to the documented and measurable achievement of system
  291  improvements. The department is directed to implement a
  292  continuity of care management system for the provision of mental
  293  health care, through the provision of client and case
  294  management, including clients referred from state treatment
  295  facilities to community mental health facilities. Such system
  296  shall include a network of client managers and case managers
  297  throughout the state designed to:
  298         (a)Reduce the possibility of a client’s admission or
  299  readmission to a state treatment facility.
  300         (b)Provide for the creation or designation of an agency in
  301  each county to provide single intake services for each person
  302  seeking mental health services. Such agency shall provide
  303  information and referral services necessary to ensure that
  304  clients receive the most appropriate and least restrictive form
  305  of care, based on the individual needs of the person seeking
  306  treatment. Such agency shall have a single telephone number,
  307  operating 24 hours per day, 7 days per week, where practicable,
  308  at a central location, where each client will have a central
  309  record.
  310         (c)Advocate on behalf of the client to ensure that all
  311  appropriate services are afforded to the client in a timely and
  312  dignified manner.
  313         (d)Require that any public receiving facility initiating a
  314  patient transfer to a licensed hospital for acute care mental
  315  health services not accessible through the public receiving
  316  facility shall notify the hospital of such transfer and send all
  317  records relating to the emergency psychiatric or medical
  318  condition.
  319         (3)The department is directed to develop and include in
  320  contracts with service providers measures of performance with
  321  regard to goals and objectives as specified in the state plan.
  322  Such measures shall use, to the extent practical, existing data
  323  collection methods and reports and shall not require, as a
  324  result of this subsection, additional reports on the part of
  325  service providers. The department shall plan monitoring visits
  326  of community mental health facilities with other state, federal,
  327  and local governmental and private agencies charged with
  328  monitoring such facilities.
  329         Section 6. Section 394.461, Florida Statutes, is amended to
  330  read:
  331         394.461 Designation of receiving and treatment facilities
  332  and receiving systems.—The department is authorized to designate
  333  and monitor receiving facilities, and treatment facilities, and
  334  receiving systems and may suspend or withdraw such designation
  335  for failure to comply with this part and rules adopted under
  336  this part. Unless designated by the department, facilities are
  337  not permitted to hold or treat involuntary patients under this
  338  part.
  339         (1) RECEIVING FACILITY.—The department may designate any
  340  community facility as a receiving facility. Any other facility
  341  within the state, including a private facility or a federal
  342  facility, may be so designated by the department, provided that
  343  such designation is agreed to by the governing body or authority
  344  of the facility.
  345         (2) TREATMENT FACILITY.—The department may designate any
  346  state-owned, state-operated, or state-supported facility as a
  347  state treatment facility. A civil patient shall not be admitted
  348  to a state treatment facility without previously undergoing a
  349  transfer evaluation. Before a court hearing for involuntary
  350  placement in a state treatment facility, the court shall receive
  351  and consider the information documented in the transfer
  352  evaluation. Any other facility, including a private facility or
  353  a federal facility, may be designated as a treatment facility by
  354  the department, provided that such designation is agreed to by
  355  the appropriate governing body or authority of the facility.
  356         (3) PRIVATE FACILITIES.—Private facilities designated as
  357  receiving and treatment facilities by the department may provide
  358  examination and treatment of involuntary patients, as well as
  359  voluntary patients, and are subject to all the provisions of
  360  this part.
  361         (4) REPORTING REQUIREMENTS.—
  362         (a) A facility designated as a public receiving or
  363  treatment facility under this section shall report to the
  364  department on an annual basis the following data, unless these
  365  data are currently being submitted to the Agency for Health Care
  366  Administration:
  367         1. Number of licensed beds.
  368         2. Number of contract days.
  369         3. Number of admissions by payor class and diagnoses.
  370         4. Number of bed days by payor class.
  371         5. Average length of stay by payor class.
  372         6. Total revenues by payor class.
  373         (b) For the purposes of this subsection, “payor class”
  374  means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private
  375  pay health insurance, private-pay health maintenance
  376  organization, private preferred provider organization, the
  377  Department of Children and Families, other government programs,
  378  self-pay patients, and charity care.
  379         (c) The data required under this subsection shall be
  380  submitted to the department no later than 90 days following the
  381  end of the facility’s fiscal year. A facility designated as a
  382  public receiving or treatment facility shall submit its initial
  383  report for the 6-month period ending June 30, 2008.
  384         (d) The department shall issue an annual report based on
  385  the data required pursuant to this subsection. The report shall
  386  include individual facilities’ data, as well as statewide
  387  totals. The report shall be submitted to the Governor, the
  388  President of the Senate, and the Speaker of the House of
  389  Representatives.
  390         (5)RECEIVING SYSTEM.—The department shall designate as a
  391  receiving system one or more facilities serving a defined
  392  geographic area developed pursuant to s. 394.4573 which is
  393  responsible for assessment and evaluation, both voluntary and
  394  involuntary, and treatment, stabilization, or triage for
  395  patients who have a mental illness, a substance use disorder, or
  396  co-occurring disorders. Any transportation plans developed
  397  pursuant to s. 394.462 must support the operation of the
  398  receiving system.
  399         (6)(5) RULES.—The department may shall adopt rules relating
  400  to:
  401         (a) Procedures and criteria for receiving and evaluating
  402  facility applications for designation, which may include onsite
  403  facility inspection and evaluation of an applicant’s licensing
  404  status and performance history, as well as consideration of
  405  local service needs.
  406         (b) Minimum standards consistent with this part that a
  407  facility must meet and maintain in order to be designated as a
  408  receiving or treatment facility and procedures for monitoring
  409  continued adherence to such standards.
  410         (c)Procedures and criteria for designating receiving
  411  systems which may include consideration of the adequacy of
  412  services provided by facilities within the receiving system to
  413  meet the needs of the geographic area using available resources.
  414         (d)(c) Procedures for receiving complaints against a
  415  designated facility or designated receiving system and for
  416  initiating inspections and investigations of facilities or
  417  receiving systems alleged to have violated the provisions of
  418  this part or rules adopted under this part.
  419         (e)(d) Procedures and criteria for the suspension or
  420  withdrawal of designation as a receiving facility or receiving
  421  system.
  422         Section 7. Section 394.675, Florida Statutes, is repealed.
  423         Section 8. Subsection (3) and paragraph (b) of subsection
  424  (4) of section 394.75, Florida Statutes, are amended to read:
  425         394.75 State and district substance abuse and mental health
  426  plans.—
  427         (3) The district health and human services board shall
  428  prepare an integrated district substance abuse and mental health
  429  plan. The plan shall be prepared and updated on a schedule
  430  established by the Alcohol, Drug Abuse, and Mental Health
  431  Program Office. The plan shall reflect the needs and program
  432  priorities established by the department and the needs of the
  433  district established under ss. 394.4573 and 394.674 and 394.675.
  434  The plan must list in order of priority the mental health and
  435  the substance abuse treatment needs of the district and must
  436  rank each program separately. The plan shall include:
  437         (a) A record of the total amount of money available in the
  438  district for mental health and substance abuse services.
  439         (b) A description of each service that will be purchased
  440  with state funds.
  441         (c) A record of the amount of money allocated for each
  442  service identified in the plan as being purchased with state
  443  funds.
  444         (d) A record of the total funds allocated to each provider.
  445         (e) A record of the total funds allocated to each provider
  446  by type of service to be purchased with state funds.
  447         (f) Input from community-based persons, organizations, and
  448  agencies interested in substance abuse and mental health
  449  treatment services; local government entities that contribute
  450  funds to the public substance abuse and mental health treatment
  451  systems; and consumers of publicly funded substance abuse and
  452  mental health services, and their family members. The plan must
  453  describe the means by which this local input occurred.
  454  
  455  The plan shall be submitted by the district board to the
  456  district administrator and to the governing bodies for review,
  457  comment, and approval.
  458         (4) The district plan shall:
  459         (b) Provide the means for meeting the needs of the
  460  district’s eligible clients, specified in ss. 394.4573 and
  461  394.674 and 394.675, for substance abuse and mental health
  462  services.
  463         Section 9. Paragraph (a) of subsection (3) of section
  464  394.76, Florida Statutes, is amended to read:
  465         394.76 Financing of district programs and services.—If the
  466  local match funding level is not provided in the General
  467  Appropriations Act or the substantive bill implementing the
  468  General Appropriations Act, such funding level shall be provided
  469  as follows:
  470         (3) The state share of financial participation shall be
  471  determined by the following formula:
  472         (a) The state share of approved program costs shall be a
  473  percentage of the net balance determined by deducting from the
  474  total operating cost of services and programs, as specified in
  475  s. 394.4573 394.675(1), those expenditures which are ineligible
  476  for state participation as provided in subsection (7) and those
  477  ineligible expenditures established by rule of the department
  478  pursuant to s. 394.78.
  479         Section 10. Paragraphs (d) and (e) of subsection (2) of
  480  section 394.4597, Florida Statutes, are amended to read:
  481         394.4597 Persons to be notified; patient’s representative.—
  482         (2) INVOLUNTARY PATIENTS.—
  483         (d) When the receiving or treatment facility selects a
  484  representative, first preference shall be given to a health care
  485  surrogate, if one has been previously selected by the patient.
  486  If the patient has not previously selected a health care
  487  surrogate, the selection, except for good cause documented in
  488  the patient’s clinical record, shall be made from the following
  489  list in the order of listing:
  490         1. The patient’s spouse.
  491         2. An adult child of the patient.
  492         3. A parent of the patient.
  493         4. The adult next of kin of the patient.
  494         5. An adult friend of the patient.
  495         6.The appropriate Florida local advocacy council as
  496  provided in s. 402.166.
  497         (e) The following persons are prohibited from selection as
  498  a patient’s representative:
  499         1.A professional providing clinical services to the
  500  patient under this part.
  501         2.The licensed professional who initiated the involuntary
  502  examination of the patient, if the examination was initiated by
  503  professional certificate.
  504         3.An employee, an administrator, or a board member of the
  505  facility providing the examination of the patient.
  506         4.An employee, an administrator, or a board member of a
  507  treatment facility providing treatment for the patient.
  508         5.A person providing any substantial professional services
  509  to the patient, including clinical services.
  510         6.A creditor of the patient.
  511         7.A person subject to an injunction for protection against
  512  domestic violence under s. 741.30, whether the order of
  513  injunction is temporary or final, and for which the patient was
  514  the petitioner.
  515         8.A person subject to an injunction for protection against
  516  repeat violence, stalking, sexual violence, or dating violence
  517  under s. 784.046, whether the order of injunction is temporary
  518  or final, and for which the patient was the petitioner A
  519  licensed professional providing services to the patient under
  520  this part, an employee of a facility providing direct services
  521  to the patient under this part, a department employee, a person
  522  providing other substantial services to the patient in a
  523  professional or business capacity, or a creditor of the patient
  524  shall not be appointed as the patient’s representative.
  525         Section 11. Subsections (2) through (7) of section
  526  394.4598, Florida Statutes, are renumbered as subsections (3)
  527  through (8), respectively, a new subsection (2) is added to that
  528  section, and present subsections (3) and (4) of that section are
  529  amended, to read:
  530         394.4598 Guardian advocate.—
  531         (2)The following persons are prohibited from appointment
  532  as a patient’s guardian advocate:
  533         (a)A professional providing clinical services to the
  534  patient under this part.
  535         (b)The licensed professional who initiated the involuntary
  536  examination of the patient, if the examination was initiated by
  537  professional certificate.
  538         (c)An employee, an administrator, or a board member of the
  539  facility providing the examination of the patient.
  540         (d)An employee, an administrator, or a board member of a
  541  treatment facility providing treatment of the patient.
  542         (e)A person providing any substantial professional
  543  services, excluding public and professional guardians, to the
  544  patient, including clinical services.
  545         (f)A creditor of the patient.
  546         (g)A person subject to an injunction for protection
  547  against domestic violence under s. 741.30, whether the order of
  548  injunction is temporary or final, and for which the patient was
  549  the petitioner.
  550         (h)A person subject to an injunction for protection
  551  against repeat violence, stalking, sexual violence, or dating
  552  violence under s. 784.046, whether the order of injunction is
  553  temporary or final, and for which the patient was the
  554  petitioner.
  555         (4)(3)In lieu of the training required of guardians
  556  appointed pursuant to chapter 744, Prior to a guardian advocate
  557  must, at a minimum, participate in a 4-hour training course
  558  approved by the court before exercising his or her authority,
  559  the guardian advocate shall attend a training course approved by
  560  the court. At a minimum, this training course, of not less than
  561  4 hours, must include, at minimum, information about the patient
  562  rights, psychotropic medications, the diagnosis of mental
  563  illness, the ethics of medical decisionmaking, and duties of
  564  guardian advocates. This training course shall take the place of
  565  the training required for guardians appointed pursuant to
  566  chapter 744.
  567         (5)(4) The required training course and the information to
  568  be supplied to prospective guardian advocates before prior to
  569  their appointment and the training course for guardian advocates
  570  must be developed and completed through a course developed by
  571  the department, and approved by the chief judge of the circuit
  572  court, and taught by a court-approved organization, which.
  573  Court-approved organizations may include, but is are not limited
  574  to, a community college community or junior colleges, a
  575  guardianship organization guardianship organizations, a and the
  576  local bar association, or The Florida Bar. The training course
  577  may be web-based, provided in video format, or other electronic
  578  means but must be capable of ensuring the identity and
  579  participation of the prospective guardian advocate. The court
  580  may, in its discretion, waive some or all of the training
  581  requirements for guardian advocates or impose additional
  582  requirements. The court shall make its decision on a case-by
  583  case basis and, in making its decision, shall consider the
  584  experience and education of the guardian advocate, the duties
  585  assigned to the guardian advocate, and the needs of the patient.
  586         Section 12. Section 394.462, Florida Statutes, is amended
  587  to read:
  588         394.462 Transportation.—A transportation plan shall be
  589  developed and implemented by each county by July 1, 2017, in
  590  collaboration with the managing entity in accordance with this
  591  section. A county may enter into a memorandum of understanding
  592  with the governing boards of nearby counties to establish a
  593  shared transportation plan. When multiple counties enter into a
  594  memorandum of understanding for this purpose, the counties shall
  595  notify the managing entity and provide it with a copy of the
  596  agreement. The transportation plan shall describe methods of
  597  transport to a facility within the designated receiving system
  598  for individuals subject to involuntary examination under s.
  599  394.463 or involuntary admission under s. 397.6772, s. 397.679,
  600  s. 397.6798, or s. 397.6811, and may identify responsibility for
  601  other transportation to a participating facility when necessary
  602  and agreed to by the facility. The plan may rely on emergency
  603  medical transport services or private transport companies, as
  604  appropriate. The plan shall comply with the transportation
  605  provisions of this section and ss. 397.6772, 397.6795, 397.6822,
  606  and 397.697.
  607         (1) TRANSPORTATION TO A RECEIVING FACILITY.—
  608         (a) Each county shall designate a single law enforcement
  609  agency within the county, or portions thereof, to take a person
  610  into custody upon the entry of an ex parte order or the
  611  execution of a certificate for involuntary examination by an
  612  authorized professional and to transport that person to the
  613  appropriate facility within the designated receiving system
  614  pursuant to a transportation plan or an exception under
  615  subsection (4), or to the nearest receiving facility if neither
  616  apply for examination.
  617         (b)1. The designated law enforcement agency may decline to
  618  transport the person to a receiving facility only if:
  619         a.1. The jurisdiction designated by the county has
  620  contracted on an annual basis with an emergency medical
  621  transport service or private transport company for
  622  transportation of persons to receiving facilities pursuant to
  623  this section at the sole cost of the county; and
  624         b.2. The law enforcement agency and the emergency medical
  625  transport service or private transport company agree that the
  626  continued presence of law enforcement personnel is not necessary
  627  for the safety of the person or others.
  628         2.3. The entity providing transportation jurisdiction
  629  designated by the county may seek reimbursement for
  630  transportation expenses. The party responsible for payment for
  631  such transportation is the person receiving the transportation.
  632  The county shall seek reimbursement from the following sources
  633  in the following order:
  634         a. From a private or public third-party payor an insurance
  635  company, health care corporation, or other source, if the person
  636  receiving the transportation has applicable coverage is covered
  637  by an insurance policy or subscribes to a health care
  638  corporation or other source for payment of such expenses.
  639         b. From the person receiving the transportation.
  640         c. From a financial settlement for medical care, treatment,
  641  hospitalization, or transportation payable or accruing to the
  642  injured party.
  643         (c)(b)A Any company that transports a patient pursuant to
  644  this subsection is considered an independent contractor and is
  645  solely liable for the safe and dignified transport
  646  transportation of the patient. Such company must be insured and
  647  provide no less than $100,000 in liability insurance with
  648  respect to the transport transportation of patients.
  649         (d)(c) Any company that contracts with a governing board of
  650  a county to transport patients shall comply with the applicable
  651  rules of the department to ensure the safety and dignity of the
  652  patients.
  653         (e)(d) When a law enforcement officer takes custody of a
  654  person pursuant to this part, the officer may request assistance
  655  from emergency medical personnel if such assistance is needed
  656  for the safety of the officer or the person in custody.
  657         (f)(e) When a member of a mental health overlay program or
  658  a mobile crisis response service is a professional authorized to
  659  initiate an involuntary examination pursuant to s. 394.463 or s.
  660  397.675 and that professional evaluates a person and determines
  661  that transportation to a receiving facility is needed, the
  662  service, at its discretion, may transport the person to the
  663  facility or may call on the law enforcement agency or other
  664  transportation arrangement best suited to the needs of the
  665  patient.
  666         (g)(f) When any law enforcement officer has custody of a
  667  person based on either noncriminal or minor criminal behavior
  668  that meets the statutory guidelines for involuntary examination
  669  pursuant to s. 394.463 under this part, the law enforcement
  670  officer shall transport the person to the appropriate facility
  671  within the designated receiving system pursuant to a
  672  transportation plan or an exception under subsection (4), or to
  673  the nearest receiving facility if neither apply for examination.
  674  Persons who meet the statutory guidelines for involuntary
  675  admission pursuant to s. 397.675 may also be transported by law
  676  enforcement officers to the extent resources are available and
  677  as otherwise provided by law. Such persons shall be transported
  678  to an appropriate facility within the designated receiving
  679  system pursuant to a transportation plan or an exception under
  680  subsection (4), or to the nearest facility if neither apply.
  681         (h)(g) When any law enforcement officer has arrested a
  682  person for a felony and it appears that the person meets the
  683  statutory guidelines for involuntary examination or placement
  684  under this part, such person must shall first be processed in
  685  the same manner as any other criminal suspect. The law
  686  enforcement agency shall thereafter immediately notify the
  687  appropriate facility within the designated receiving system
  688  pursuant to a transportation plan or an exception under
  689  subsection (4), or to the nearest public receiving facility if
  690  neither apply. The receiving facility, which shall be
  691  responsible for promptly arranging for the examination and
  692  treatment of the person. A receiving facility is not required to
  693  admit a person charged with a crime for whom the facility
  694  determines and documents that it is unable to provide adequate
  695  security, but shall provide mental health examination and
  696  treatment to the person where he or she is held.
  697         (i)(h) If the appropriate law enforcement officer believes
  698  that a person has an emergency medical condition as defined in
  699  s. 395.002, the person may be first transported to a hospital
  700  for emergency medical treatment, regardless of whether the
  701  hospital is a designated receiving facility.
  702         (j)(i) The costs of transportation, evaluation,
  703  hospitalization, and treatment incurred under this subsection by
  704  persons who have been arrested for violations of any state law
  705  or county or municipal ordinance may be recovered as provided in
  706  s. 901.35.
  707         (k)(j)The appropriate facility within the designated
  708  receiving system pursuant to a transportation plan or an
  709  exception under subsection (4), or the nearest receiving
  710  facility if neither apply, must accept persons brought by law
  711  enforcement officers, or an emergency medical transport service
  712  or a private transport company authorized by the county, for
  713  involuntary examination pursuant to s. 394.463.
  714         (l) The appropriate facility within the designated
  715  receiving system pursuant to a transportation plan or an
  716  exception under subsection (4), or the nearest receiving
  717  facility if neither apply, must provide persons brought by law
  718  enforcement officers, or an emergency medical transport service
  719  or a private transport company authorized by the county,
  720  pursuant to s. 397.675, a basic screening or triage sufficient
  721  to refer the person to the appropriate services.
  722         (m)(k) Each law enforcement agency designated pursuant to
  723  paragraph (a) shall establish a policy that develop a memorandum
  724  of understanding with each receiving facility within the law
  725  enforcement agency’s jurisdiction which reflects a single set of
  726  protocols for the safe and secure transportation of the person
  727  and transfer of custody of the person. Each law enforcement
  728  agency shall provide a copy of the protocols to the managing
  729  entity. These protocols must also address crisis intervention
  730  measures.
  731         (n)(l) When a jurisdiction has entered into a contract with
  732  an emergency medical transport service or a private transport
  733  company for transportation of persons to receiving facilities
  734  within the designated receiving system, such service or company
  735  shall be given preference for transportation of persons from
  736  nursing homes, assisted living facilities, adult day care
  737  centers, or adult family-care homes, unless the behavior of the
  738  person being transported is such that transportation by a law
  739  enforcement officer is necessary.
  740         (o)(m)Nothing in This section may not shall be construed
  741  to limit emergency examination and treatment of incapacitated
  742  persons provided in accordance with the provisions of s.
  743  401.445.
  744         (2) TRANSPORTATION TO A TREATMENT FACILITY.—
  745         (a) If neither the patient nor any person legally obligated
  746  or responsible for the patient is able to pay for the expense of
  747  transporting a voluntary or involuntary patient to a treatment
  748  facility, the transportation plan established by the governing
  749  board of the county or counties must specify how in which the
  750  hospitalized patient will be transported to, from, and between
  751  facilities in a is hospitalized shall arrange for such required
  752  transportation and shall ensure the safe and dignified manner
  753  transportation of the patient. The governing board of each
  754  county is authorized to contract with private transport
  755  companies for the transportation of such patients to and from a
  756  treatment facility.
  757         (b) A Any company that transports a patient pursuant to
  758  this subsection is considered an independent contractor and is
  759  solely liable for the safe and dignified transportation of the
  760  patient. Such company must be insured and provide no less than
  761  $100,000 in liability insurance with respect to the transport
  762  transportation of patients.
  763         (c) A Any company that contracts with one or more counties
  764  the governing board of a county to transport patients in
  765  accordance with this section shall comply with the applicable
  766  rules of the department to ensure the safety and dignity of the
  767  patients.
  768         (d) County or municipal law enforcement and correctional
  769  personnel and equipment may shall not be used to transport
  770  patients adjudicated incapacitated or found by the court to meet
  771  the criteria for involuntary placement pursuant to s. 394.467,
  772  except in small rural counties where there are no cost-efficient
  773  alternatives.
  774         (3) TRANSFER OF CUSTODY.—Custody of a person who is
  775  transported pursuant to this part, along with related
  776  documentation, shall be relinquished to a responsible individual
  777  at the appropriate receiving or treatment facility.
  778         (4) EXCEPTIONS.—An exception to the requirements of this
  779  section may be granted by the secretary of the department for
  780  the purposes of improving service coordination or better meeting
  781  the special needs of individuals. A proposal for an exception
  782  must be submitted to the department by the district
  783  administrator after being approved by the governing boards of
  784  any affected counties, prior to submission to the secretary.
  785         (a) A proposal for an exception must identify the specific
  786  provision from which an exception is requested; describe how the
  787  proposal will be implemented by participating law enforcement
  788  agencies and transportation authorities; and provide a plan for
  789  the coordination of services such as case management.
  790         (b) The exception may be granted only for:
  791         1. An arrangement centralizing and improving the provision
  792  of services within a district, which may include an exception to
  793  the requirement for transportation to the nearest receiving
  794  facility;
  795         2. An arrangement by which a facility may provide, in
  796  addition to required psychiatric or substance use disorder
  797  services, an environment and services which are uniquely
  798  tailored to the needs of an identified group of persons with
  799  special needs, such as persons with hearing impairments or
  800  visual impairments, or elderly persons with physical frailties;
  801  or
  802         3. A specialized transportation system that provides an
  803  efficient and humane method of transporting patients to
  804  receiving facilities, among receiving facilities, and to
  805  treatment facilities.
  806         (c)Any exception approved pursuant to this subsection
  807  shall be reviewed and approved every 5 years by the secretary.
  808  
  809  The exceptions provided in this subsection shall expire on June
  810  30, 2017, and no new exceptions shall be granted after that
  811  date. After June 30, 2017, the transport of a patient to a
  812  facility that is not the nearest facility must be made pursuant
  813  to a plan as provided in this section.
  814         Section 13. Section 394.467, Florida Statutes, is amended
  815  to read:
  816         394.467 Involuntary inpatient placement.—
  817         (1) CRITERIA.—A person may be ordered for placed in
  818  involuntary inpatient placement for treatment upon a finding of
  819  the court by clear and convincing evidence that:
  820         (a) He or she has a mental illness is mentally ill and
  821  because of his or her mental illness:
  822         1.a. He or she has refused voluntary inpatient placement
  823  for treatment after sufficient and conscientious explanation and
  824  disclosure of the purpose of inpatient placement for treatment;
  825  or
  826         b. He or she is unable to determine for himself or herself
  827  whether inpatient placement is necessary; and
  828         2.a. He or she is manifestly incapable of surviving alone
  829  or with the help of willing and responsible family or friends,
  830  including available alternative services, and, without
  831  treatment, is likely to suffer from neglect or refuse to care
  832  for himself or herself, and such neglect or refusal poses a real
  833  and present threat of substantial harm to his or her well-being;
  834  or
  835         b. There is substantial likelihood that in the near future
  836  he or she will inflict serious bodily harm on self or others
  837  himself or herself or another person, as evidenced by recent
  838  behavior causing, attempting, or threatening such harm; and
  839         (b) All available less restrictive treatment alternatives
  840  that which would offer an opportunity for improvement of his or
  841  her condition have been judged to be inappropriate.
  842         (2) ADMISSION TO A TREATMENT FACILITY.—A patient may be
  843  retained by a receiving facility or involuntarily placed in a
  844  treatment facility upon the recommendation of the administrator
  845  of the receiving facility where the patient has been examined
  846  and after adherence to the notice and hearing procedures
  847  provided in s. 394.4599. The recommendation must be supported by
  848  the opinion of a psychiatrist and the second opinion of a
  849  clinical psychologist or another psychiatrist, both of whom have
  850  personally examined the patient within the preceding 72 hours,
  851  that the criteria for involuntary inpatient placement are met.
  852  However, in a county that has a population of fewer than 50,000,
  853  if the administrator certifies that a psychiatrist or clinical
  854  psychologist is not available to provide the second opinion, the
  855  second opinion may be provided by a licensed physician who has
  856  postgraduate training and experience in diagnosis and treatment
  857  of mental illness and nervous disorders or by a psychiatric
  858  nurse. Any second opinion authorized in this subsection may be
  859  conducted through a face-to-face examination, in person, or by
  860  electronic means. Such recommendation shall be entered on a
  861  petition for an involuntary inpatient placement certificate that
  862  authorizes the receiving facility to retain the patient pending
  863  transfer to a treatment facility or completion of a hearing.
  864         (3) PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.—The
  865  administrator of the facility shall file a petition for
  866  involuntary inpatient placement in the court in the county where
  867  the patient is located. Upon filing, the clerk of the court
  868  shall provide copies to the department, the patient, the
  869  patient’s guardian or representative, and the state attorney and
  870  public defender of the judicial circuit in which the patient is
  871  located. A No fee may not shall be charged for the filing of a
  872  petition under this subsection.
  873         (4) APPOINTMENT OF COUNSEL.—Within 1 court working day
  874  after the filing of a petition for involuntary inpatient
  875  placement, the court shall appoint the public defender to
  876  represent the person who is the subject of the petition, unless
  877  the person is otherwise represented by counsel. The clerk of the
  878  court shall immediately notify the public defender of such
  879  appointment. Any attorney representing the patient shall have
  880  access to the patient, witnesses, and records relevant to the
  881  presentation of the patient’s case and shall represent the
  882  interests of the patient, regardless of the source of payment to
  883  the attorney.
  884         (5) CONTINUANCE OF HEARING.—The patient is entitled, with
  885  the concurrence of the patient’s counsel, to at least one
  886  continuance of the hearing. The continuance shall be for a
  887  period of up to 4 weeks.
  888         (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.—
  889         (a)1. The court shall hold the hearing on involuntary
  890  inpatient placement within 5 court working days, unless a
  891  continuance is granted.
  892         2.Except for good cause documented in the court file, the
  893  hearing must shall be held in the county or the facility, as
  894  appropriate, where the patient is located, must and shall be as
  895  convenient to the patient as is may be consistent with orderly
  896  procedure, and shall be conducted in physical settings not
  897  likely to be injurious to the patient’s condition. If the court
  898  finds that the patient’s attendance at the hearing is not
  899  consistent with the best interests of the patient, and the
  900  patient’s counsel does not object, the court may waive the
  901  presence of the patient from all or any portion of the hearing.
  902  The state attorney for the circuit in which the patient is
  903  located shall represent the state, rather than the petitioning
  904  facility administrator, as the real party in interest in the
  905  proceeding.
  906         3.2. The court may appoint a general or special magistrate
  907  to preside at the hearing. One of the professionals who executed
  908  the petition for involuntary inpatient placement certificate
  909  shall be a witness. The patient and the patient’s guardian or
  910  representative shall be informed by the court of the right to an
  911  independent expert examination. If the patient cannot afford
  912  such an examination, the court shall ensure that one is
  913  provided, as otherwise provided for by law provide for one. The
  914  independent expert’s report is shall be confidential and not
  915  discoverable, unless the expert is to be called as a witness for
  916  the patient at the hearing. The testimony in the hearing must be
  917  given under oath, and the proceedings must be recorded. The
  918  patient may refuse to testify at the hearing.
  919         (b) If the court concludes that the patient meets the
  920  criteria for involuntary inpatient placement, it may shall order
  921  that the patient be transferred to a treatment facility or, if
  922  the patient is at a treatment facility, that the patient be
  923  retained there or be treated at any other appropriate receiving
  924  or treatment facility, or that the patient receive services from
  925  a receiving or treatment facility, on an involuntary basis, for
  926  a period of up to 90 days 6 months. However, any order for
  927  involuntary mental health services in a treatment facility may
  928  be for up to 6 months. The order shall specify the nature and
  929  extent of the patient’s mental illness. The court may not order
  930  an individual with traumatic brain injury or dementia who lacks
  931  a co-occurring mental illness to be involuntarily placed in a
  932  state treatment facility. The facility shall discharge a patient
  933  any time the patient no longer meets the criteria for
  934  involuntary inpatient placement, unless the patient has
  935  transferred to voluntary status.
  936         (c) If at any time before prior to the conclusion of the
  937  hearing on involuntary inpatient placement it appears to the
  938  court that the person does not meet the criteria for involuntary
  939  inpatient placement under this section, but instead meets the
  940  criteria for involuntary outpatient services placement, the
  941  court may order the person evaluated for involuntary outpatient
  942  services placement pursuant to s. 394.4655. The petition and
  943  hearing procedures set forth in s. 394.4655 shall apply. If the
  944  person instead meets the criteria for involuntary assessment,
  945  protective custody, or involuntary admission pursuant to s.
  946  397.675, then the court may order the person to be admitted for
  947  involuntary assessment for a period of 5 days pursuant to s.
  948  397.6811. Thereafter, all proceedings are shall be governed by
  949  chapter 397.
  950         (d) At the hearing on involuntary inpatient placement, the
  951  court shall consider testimony and evidence regarding the
  952  patient’s competence to consent to treatment. If the court finds
  953  that the patient is incompetent to consent to treatment, it
  954  shall appoint a guardian advocate as provided in s. 394.4598.
  955         (e) The administrator of the petitioning receiving facility
  956  shall provide a copy of the court order and adequate
  957  documentation of a patient’s mental illness to the administrator
  958  of a treatment facility if the whenever a patient is ordered for
  959  involuntary inpatient placement, whether by civil or criminal
  960  court. The documentation must shall include any advance
  961  directives made by the patient, a psychiatric evaluation of the
  962  patient, and any evaluations of the patient performed by a
  963  psychiatric nurse, a clinical psychologist, a marriage and
  964  family therapist, a mental health counselor, or a clinical
  965  social worker. The administrator of a treatment facility may
  966  refuse admission to any patient directed to its facilities on an
  967  involuntary basis, whether by civil or criminal court order, who
  968  is not accompanied at the same time by adequate orders and
  969  documentation.
  970         (7) PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT
  971  PLACEMENT.—
  972         (a) Hearings on petitions for continued involuntary
  973  inpatient placement of an individual placed at any treatment
  974  facility are shall be administrative hearings and must shall be
  975  conducted in accordance with the provisions of s. 120.57(1),
  976  except that any order entered by the administrative law judge is
  977  shall be final and subject to judicial review in accordance with
  978  s. 120.68. Orders concerning patients committed after
  979  successfully pleading not guilty by reason of insanity are shall
  980  be governed by the provisions of s. 916.15.
  981         (b) If the patient continues to meet the criteria for
  982  involuntary inpatient placement and is being treated at a
  983  treatment facility, the administrator shall, before prior to the
  984  expiration of the period during which the treatment facility is
  985  authorized to retain the patient, file a petition requesting
  986  authorization for continued involuntary inpatient placement. The
  987  request must shall be accompanied by a statement from the
  988  patient’s physician, psychiatrist, psychiatric nurse, or
  989  clinical psychologist justifying the request, a brief
  990  description of the patient’s treatment during the time he or she
  991  was involuntarily placed, and an individualized plan of
  992  continued treatment. Notice of the hearing must shall be
  993  provided as provided set forth in s. 394.4599. If a patient’s
  994  attendance at the hearing is voluntarily waived, the
  995  administrative law judge must determine that the waiver is
  996  knowing and voluntary before waiving the presence of the patient
  997  from all or a portion of the hearing. Alternatively, if at the
  998  hearing the administrative law judge finds that attendance at
  999  the hearing is not consistent with the best interests of the
 1000  patient, the administrative law judge may waive the presence of
 1001  the patient from all or any portion of the hearing, unless the
 1002  patient, through counsel, objects to the waiver of presence. The
 1003  testimony in the hearing must be under oath, and the proceedings
 1004  must be recorded.
 1005         (c) Unless the patient is otherwise represented or is
 1006  ineligible, he or she shall be represented at the hearing on the
 1007  petition for continued involuntary inpatient placement by the
 1008  public defender of the circuit in which the facility is located.
 1009         (d) If at a hearing it is shown that the patient continues
 1010  to meet the criteria for involuntary inpatient placement, the
 1011  administrative law judge shall sign the order for continued
 1012  involuntary inpatient placement for up to 90 days a period not
 1013  to exceed 6 months. However, any order for involuntary mental
 1014  health services in a treatment facility may be for up to 6
 1015  months. The same procedure shall be repeated before prior to the
 1016  expiration of each additional period the patient is retained.
 1017         (e) If continued involuntary inpatient placement is
 1018  necessary for a patient admitted while serving a criminal
 1019  sentence, but his or her whose sentence is about to expire, or
 1020  for a minor patient involuntarily placed, while a minor but who
 1021  is about to reach the age of 18, the administrator shall
 1022  petition the administrative law judge for an order authorizing
 1023  continued involuntary inpatient placement.
 1024         (f) If the patient has been previously found incompetent to
 1025  consent to treatment, the administrative law judge shall
 1026  consider testimony and evidence regarding the patient’s
 1027  competence. If the administrative law judge finds evidence that
 1028  the patient is now competent to consent to treatment, the
 1029  administrative law judge may issue a recommended order to the
 1030  court that found the patient incompetent to consent to treatment
 1031  that the patient’s competence be restored and that any guardian
 1032  advocate previously appointed be discharged.
 1033         (g)If the patient has been ordered to undergo involuntary
 1034  inpatient placement and has previously been found incompetent to
 1035  consent to treatment, the court shall consider testimony and
 1036  evidence regarding the patient’s incompetence. If the patient’s
 1037  competency to consent to treatment is restored, the discharge of
 1038  the guardian advocate shall be governed by s. 394.4598.
 1039  
 1040  The procedure required in this subsection must be followed
 1041  before the expiration of each additional period the patient is
 1042  involuntarily receiving services.
 1043         (8) RETURN TO FACILITY OF PATIENTS.—If a patient
 1044  involuntarily held When a patient at a treatment facility under
 1045  this part leaves the facility without the administrator’s
 1046  authorization, the administrator may authorize a search for the
 1047  patient and his or her the return of the patient to the
 1048  facility. The administrator may request the assistance of a law
 1049  enforcement agency in this regard the search for and return of
 1050  the patient.
 1051         Section 14. Section 394.46715, Florida Statutes, is amended
 1052  to read:
 1053         394.46715 Rulemaking authority.—The department may adopt
 1054  rules to administer this part Department of Children and
 1055  Families shall have rulemaking authority to implement the
 1056  provisions of ss. 394.455, 394.4598, 394.4615, 394.463,
 1057  394.4655, and 394.467 as amended or created by this act. These
 1058  rules shall be for the purpose of protecting the health, safety,
 1059  and well-being of persons examined, treated, or placed under
 1060  this act.
 1061         Section 15. Subsection (2) of section 394.4685, Florida
 1062  Statutes, is amended to read:
 1063         394.4685 Transfer of patients among facilities.—
 1064         (2) TRANSFER FROM PUBLIC TO PRIVATE FACILITIES.—
 1065         (a) A patient who has been admitted to a public receiving
 1066  or public treatment facility and has requested, either
 1067  personally or through his or her guardian or guardian advocate,
 1068  and is able to pay for treatment in a private facility shall be
 1069  transferred at the patient’s expense to a private facility upon
 1070  acceptance of the patient by the private facility.
 1071         (b)A public receiving facility initiating a patient
 1072  transfer to a licensed hospital for acute care mental health
 1073  services not accessible through the public receiving facility
 1074  shall notify the hospital of such transfer and send the hospital
 1075  all records relating to the emergency psychiatric or medical
 1076  condition.
 1077         Section 16. Section 394.656, Florida Statutes, is amended
 1078  to read:
 1079         394.656 Criminal Justice, Mental Health, and Substance
 1080  Abuse Reinvestment Grant Program.—
 1081         (1) There is created within the Department of Children and
 1082  Families the Criminal Justice, Mental Health, and Substance
 1083  Abuse Reinvestment Grant Program. The purpose of the program is
 1084  to provide funding to counties with which they may use to can
 1085  plan, implement, or expand initiatives that increase public
 1086  safety, avert increased spending on criminal justice, and
 1087  improve the accessibility and effectiveness of treatment
 1088  services for adults and juveniles who have a mental illness,
 1089  substance abuse disorder, or co-occurring mental health and
 1090  substance abuse disorders and who are in, or at risk of
 1091  entering, the criminal or juvenile justice systems.
 1092         (2) The department shall establish a Criminal Justice,
 1093  Mental Health, and Substance Abuse Statewide Grant Review
 1094  Committee. The committee shall include:
 1095         (a) One representative of the Department of Children and
 1096  Families;
 1097         (b) One representative of the Department of Corrections;
 1098         (c) One representative of the Department of Juvenile
 1099  Justice;
 1100         (d) One representative of the Department of Elderly
 1101  Affairs; and
 1102         (e) One representative of the Office of the State Courts
 1103  Administrator;.
 1104         (f)One representative of the Department of Veterans’
 1105  Affairs;
 1106         (g)One representative of the Florida Sheriffs Association;
 1107         (h)One representative of the Florida Police Chiefs
 1108  Association;
 1109         (i)One representative of the Florida Association of
 1110  Counties;
 1111         (j)One representative of the Florida Alcohol and Drug
 1112  Abuse Association;
 1113         (k)One representative of the Florida Association of
 1114  Managing Entities;
 1115         (l)One representative of the Florida Council for Community
 1116  Mental Health;
 1117         (m)One representative of the National Alliance of Mental
 1118  Illness;
 1119         (n)One representative of the Florida Prosecuting Attorneys
 1120  Association;
 1121         (o)One representative of the Florida Public Defender
 1122  Association; and
 1123         (p)One administrator of an assisted living facility that
 1124  holds a limited mental health license.
 1125         (3)The committee shall serve as the advisory body to
 1126  review policy and funding issues that help reduce the impact of
 1127  persons with mental illness and substance abuse disorders on
 1128  communities, criminal justice agencies, and the court system.
 1129  The committee shall advise the department in selecting
 1130  priorities for grants and investing awarded grant moneys.
 1131         (4)The committee must have experience in substance use and
 1132  mental health disorders, community corrections, and law
 1133  enforcement. To the extent possible, the members of the
 1134  committee shall have expertise in grant review writing, grant
 1135  reviewing, and grant application scoring.
 1136         (5)(a)(3)(a) A county, or a not-for-profit community
 1137  provider or managing entity designated by the county planning
 1138  council or committee, as described in s. 394.657, may apply for
 1139  a 1-year planning grant or a 3-year implementation or expansion
 1140  grant. The purpose of the grants is to demonstrate that
 1141  investment in treatment efforts related to mental illness,
 1142  substance abuse disorders, or co-occurring mental health and
 1143  substance abuse disorders results in a reduced demand on the
 1144  resources of the judicial, corrections, juvenile detention, and
 1145  health and social services systems.
 1146         (b) To be eligible to receive a 1-year planning grant or a
 1147  3-year implementation or expansion grant:,
 1148         1. A county applicant must have a county planning council
 1149  or committee that is in compliance with the membership
 1150  requirements set forth in this section.
 1151         2.A not-for-profit community provider or managing entity
 1152  must be designated by the county planning council or committee
 1153  and have written authorization to submit an application. A not
 1154  for-profit community provider or managing entity must have
 1155  written authorization for each submitted application.
 1156         (c)The department may award a 3-year implementation or
 1157  expansion grant to an applicant who has not received a 1-year
 1158  planning grant.
 1159         (d)The department may require an applicant to conduct
 1160  sequential intercept mapping for a project. For purposes of this
 1161  paragraph, the term “sequential intercept mapping” means a
 1162  process for reviewing a local community’s mental health,
 1163  substance abuse, criminal justice, and related systems and
 1164  identifying points of interceptions where interventions may be
 1165  made to prevent an individual with a substance abuse disorder or
 1166  mental illness from deeper involvement in the criminal justice
 1167  system.
 1168         (6)(4) The grant review and selection committee shall
 1169  select the grant recipients and notify the department of
 1170  Children and Families in writing of the recipients’ names of the
 1171  applicants who have been selected by the committee to receive a
 1172  grant. Contingent upon the availability of funds and upon
 1173  notification by the grant review and selection committee of
 1174  those applicants approved to receive planning, implementation,
 1175  or expansion grants, the department of Children and Families may
 1176  transfer funds appropriated for the grant program to a selected
 1177  grant recipient to any county awarded a grant.
 1178         Section 17. Section 394.761, Florida Statutes, is created
 1179  to read:
 1180         394.761Revenue maximization.—
 1181         (1) The agency and the department shall develop a plan to
 1182  obtain federal approval for increasing the availability of
 1183  federal Medicaid funding for behavioral health care. Increased
 1184  funding shall be used to advance the goal of improved
 1185  integration of behavioral health services and primary care
 1186  services for individuals eligible for Medicaid through the
 1187  development and effective implementation of the behavioral
 1188  health system of care as described in s. 394.4573.
 1189         (2) The agency and the department shall identify in the
 1190  plan the amount of general revenue funding appropriated for
 1191  mental health and substance abuse services eligible to be used
 1192  as state Medicaid match. The agency and the department shall
 1193  evaluate alternative uses of increased Medicaid funding,
 1194  including seeking Medicaid eligibility for the severely and
 1195  persistently mentally ill or persons with substance use
 1196  disorders, increased reimbursement rates for behavioral health
 1197  services, adjustments to the capitation rate for Medicaid
 1198  enrollees with chronic mental illness and substance use
 1199  disorders, targeted case management for individuals with
 1200  substance use disorders as a Medicaid-funded service,
 1201  supplemental payments to mental health and substance abuse
 1202  service providers through a designated state health program or
 1203  other mechanisms, and innovative programs to provide incentives
 1204  for improved outcomes for behavioral health conditions. The
 1205  agency and the department shall identify in the plan the
 1206  advantages and disadvantages of each alternative and assess each
 1207  alternative’s potential for achieving improved integration of
 1208  services. The agency and the department shall identify in the
 1209  plan the types of federal approvals necessary to implement each
 1210  alternative and project a timeline for implementation.
 1211         (3) The department, in coordination with the agency and the
 1212  managing entities, shall compile detailed documentation of the
 1213  cost and reimbursements for Medicaid covered services provided
 1214  to Medicaid eligible individuals by providers of behavioral
 1215  health services that are also funded for programs authorized by
 1216  this chapter and chapter 397. The department’s documentation,
 1217  along with a report of general revenue funds supporting
 1218  behavioral health services that are not counted as maintenance
 1219  of effort or match for any other federal program, must be
 1220  submitted to the agency by December 31, 2016.
 1221         (4) If the report presents clear evidence that Medicaid
 1222  reimbursements are less than the costs of providing the
 1223  services, the agency and the department shall request such
 1224  additional trust fund authority as is necessary to draw federal
 1225  Medicaid funds as a match for the documented general revenue
 1226  expenditures supporting covered services delivered to eligible
 1227  individuals. Payment of the federal funds shall be made to
 1228  providers in such a manner as is allowed by federal law and
 1229  regulations.
 1230         (5) The agency and the department shall submit the written
 1231  plan and report required in this section to the President of the
 1232  Senate and the Speaker of the House of Representatives by
 1233  December 31, 2016.
 1234         Section 18. Subsection (5) of section 394.879, Florida
 1235  Statutes, is amended and subsection (6) is added to that
 1236  section, to read:
 1237         394.879 Rules; enforcement.—
 1238         (5) The agency or the department may not adopt any rule
 1239  governing the design, construction, erection, alteration,
 1240  modification, repair, or demolition of crisis stabilization
 1241  units. It is the intent of the Legislature to preempt that
 1242  function to the Florida Building commission and the State Fire
 1243  Marshal through adoption and maintenance of the Florida Building
 1244  Code and the Florida Fire Prevention Code. However, a crisis
 1245  stabilization unit, a short-term residential treatment facility,
 1246  or an integrated adult mental health crisis stabilization and
 1247  addictions receiving facility that is collocated with a
 1248  centralized receiving facility may be in a multi-story building
 1249  and may be authorized on floors other than the ground floor. The
 1250  agency shall provide technical assistance to the commission and
 1251  the State Fire Marshal in updating the construction standards of
 1252  the Florida Building Code and the Florida Fire Prevention Code
 1253  which govern crisis stabilization units. In addition, the agency
 1254  may enforce the special-occupancy provisions of the Florida
 1255  Building code and the Florida Fire Prevention Code which apply
 1256  to crisis stabilization units in conducting any inspection
 1257  authorized under this part or part II of chapter 408.
 1258         (6)The department and the Agency for Health Care
 1259  Administration shall develop a plan to provide options for a
 1260  single, consolidated license for a provider that offers multiple
 1261  types of either mental health services or substance abuse
 1262  services, or both, regulated under chapters 394 and 397,
 1263  respectively. In the plan, the department and the agency shall
 1264  identify the statutory revisions necessary to accomplish the
 1265  consolidation. To the extent possible, the department and the
 1266  agency shall accomplish such consolidation administratively and
 1267  by rule. The department and the agency shall submit the plan to
 1268  the Governor, the President of the Senate, and the Speaker of
 1269  the House of Representatives by November 1, 2016.
 1270         Section 19. Section 394.9082, Florida Statutes, is amended
 1271  to read:
 1272         (Substantial rewording of section. See
 1273         s. 394.9082, F.S., for present text.)
 1274         394.9082Behavioral health managing entities.—
 1275         (1)INTENT AND PURPOSE.—
 1276         (a)The Legislature finds that untreated behavioral health
 1277  disorders constitute major health problems for residents of this
 1278  state, are a major economic burden to the citizens of this
 1279  state, and substantially increase demands on the state’s
 1280  juvenile and adult criminal justice systems, the child welfare
 1281  system, and health care systems. The Legislature finds that
 1282  behavioral health disorders respond to appropriate treatment,
 1283  rehabilitation, and supportive intervention. The Legislature
 1284  finds that local communities have also made substantial
 1285  investments in behavioral health services, contracting with
 1286  safety net providers who by mandate and mission provide
 1287  specialized services to vulnerable and hard-to-serve populations
 1288  and have strong ties to local public health and public safety
 1289  agencies. The Legislature finds that a regional management
 1290  structure that facilitates a comprehensive and cohesive system
 1291  of coordinated care for behavioral health treatment and
 1292  prevention services will improve access to care, promote service
 1293  continuity, and provide for more efficient and effective
 1294  delivery of substance abuse and mental health services. It is
 1295  the intent of the Legislature that managing entities work to
 1296  create linkages among various services and systems, including
 1297  juvenile justice and adult criminal justice, child welfare,
 1298  housing services, homeless systems of care, and health care.
 1299         (b)The purpose of the behavioral health managing entities
 1300  is to plan, coordinate, and contract for the delivery of
 1301  community mental health and substance abuse services, to improve
 1302  access to care, to promote service continuity, to purchase
 1303  services, and to support efficient and effective delivery of
 1304  services.
 1305         (2)DEFINITIONS.—As used in this section, the term:
 1306         (a)“Behavioral health services” means mental health
 1307  services and substance abuse prevention and treatment services
 1308  as described in this chapter and chapter 397.
 1309         (b)“Coordinated system of care” means the array of mental
 1310  health services and substance abuse services described in s.
 1311  394.4573.
 1312         (c)“Geographic area” means one or more contiguous
 1313  counties, circuits, or regions as described in s. 409.966.
 1314         (d)“Managed behavioral health organization” means a
 1315  Medicaid managed care organization currently under contract with
 1316  the statewide Medicaid managed medical assistance program in
 1317  this state pursuant to part IV of chapter 409, including a
 1318  managed care organization operating as a behavioral health
 1319  specialty plan.
 1320         (e)“Managing entity” means a corporation selected by and
 1321  under contract with the department to manage the daily
 1322  operational delivery of behavioral health services through a
 1323  coordinated system of care.
 1324         (f)“Provider network” means the group of direct service
 1325  providers, facilities, and organizations under contract with a
 1326  managing entity to provide a comprehensive array of emergency,
 1327  acute care, residential, outpatient, recovery support, and
 1328  consumer support services, including prevention services.
 1329         (g)“Subregion” means a distinct portion of a managing
 1330  entity’s geographic region defined by unifying service and
 1331  provider utilization patterns.
 1332         (3)DEPARTMENT DUTIES.—The department shall:
 1333         (a)Contract with organizations to serve as managing
 1334  entities in accordance with the requirements of this section and
 1335  conduct a readiness review of any new managing entities before
 1336  such entities assume their responsibilities.
 1337         (b)Specify data reporting requirements and use of shared
 1338  data systems.
 1339         (c)Define the priority populations that will benefit from
 1340  receiving care coordination. In defining such populations, the
 1341  department shall take into account the availability of resources
 1342  and consider:
 1343         1. The number and duration of involuntary admissions within
 1344  a specified time.
 1345         2. The degree of involvement with the criminal justice
 1346  system and the risk to public safety posed by the individual.
 1347         3. Whether the individual has recently resided in or is
 1348  currently awaiting admission to or discharge from a treatment
 1349  facility as defined in s. 394.455.
 1350         4. The degree of utilization of behavioral health services.
 1351         5. Whether the individual is a parent or caregiver who is
 1352  involved with the child welfare system.
 1353         (d)Support the development and implementation of a
 1354  coordinated system of care by requiring each provider that
 1355  receives state funds for behavioral health services through a
 1356  direct contract with the department to work with the managing
 1357  entity in the provider’s service area to coordinate the
 1358  provision of behavioral health services as part of the contract
 1359  with the department.
 1360         (e)Provide technical assistance to the managing entities.
 1361         (f)Promote the coordination of behavioral health care and
 1362  primary care.
 1363         (g)Facilitate coordination between the managing entity and
 1364  other payors of behavioral health care.
 1365         (h)Develop and provide a unique identifier for clients
 1366  receiving behavioral health services through the managing entity
 1367  to coordinate care.
 1368         (i)Coordinate procedures for the referral and admission of
 1369  patients to, and the discharge of patients from, treatment
 1370  facilities as defined in s. 394.455 and their return to the
 1371  community.
 1372         (j)Ensure that managing entities comply with state and
 1373  federal laws, rules, regulations, and grant requirements.
 1374         (k)Develop rules for the operations of, and the
 1375  requirements that shall be met by, the managing entity, if
 1376  necessary.
 1377         (l)Periodically review contract and reporting requirements
 1378  and reduce costly, duplicative, and unnecessary administrative
 1379  requirements.
 1380         (4)CONTRACT WITH MANAGING ENTITIES.—
 1381         (a)In contracting for services with managing entities
 1382  under this section, the department shall first attempt to
 1383  contract with not-for-profit, community-based organizations with
 1384  competence in managing provider networks serving persons with
 1385  mental health and substance use disorders to serve as managing
 1386  entities.
 1387         (b)The department shall issue an invitation to negotiate
 1388  under s. 287.057 to select an organization to serve as a
 1389  managing entity. If the department receives fewer than two
 1390  responsive bids to the solicitation, the department shall
 1391  reissue the solicitation and managed behavioral health
 1392  organizations shall be eligible to bid and be awarded a
 1393  contract.
 1394         (c)If the managing entity is a not-for-profit, community
 1395  based organization, it must have a governing board that is
 1396  representative. At a minimum, the governing board must include
 1397  consumers and their family members; representatives of local
 1398  government, area law enforcement agencies, health care
 1399  facilities, and community-based care lead agencies; business
 1400  leaders; and providers of substance abuse and mental health
 1401  services as defined in this chapter and chapter 397.
 1402         (d)If the managing entity is a managed behavioral health
 1403  organization, it must establish an advisory board that meets the
 1404  same requirements specified in paragraph (c) for a governing
 1405  board.
 1406         (e)If the department issues an invitation to negotiate
 1407  pursuant to paragraph (b), the department shall consider, at a
 1408  minimum, the following factors:
 1409         1.Experience serving persons with mental health and
 1410  substance use disorders.
 1411         2.Established community partnerships with behavioral
 1412  health care providers.
 1413         3.Demonstrated organizational capabilities for network
 1414  management functions.
 1415         4.Capability to coordinate behavioral health services with
 1416  primary care services.
 1417         5.Willingness to provide recovery-oriented services and
 1418  systems of care and work collaboratively with persons with
 1419  mental health and substance use disorders and their families in
 1420  designing such systems and delivering such services.
 1421         (f)The department’s contracts with managing entities must
 1422  support efficient and effective administration of the behavioral
 1423  health system and ensure accountability for performance.
 1424         (g)A contractor serving as a managing entity shall operate
 1425  under the same data reporting, administrative, and
 1426  administrative rate requirements, regardless of whether it is a
 1427  for-profit or not-for-profit entity.
 1428         (h)The contract must designate the geographic area that
 1429  will be served by the managing entity, which area must be of
 1430  sufficient size in population, funding, and services to allow
 1431  for flexibility and efficiency.
 1432         (i)The contract must require that, when there is a change
 1433  in the managing entity in a geographic area, the managing entity
 1434  work with the department to develop and implement a transition
 1435  plan that ensures continuity of care for patients receiving
 1436  behavioral health services.
 1437         (j)By June 30, 2019, if all other contract requirements
 1438  and performance standards are met and the department determines
 1439  that a managing entity under contract as of July 1, 2016, has
 1440  received network accreditation pursuant to subsection (6), the
 1441  department may continue its contract with the managing entity
 1442  for up to, but not exceeding, 5 years, including any and all
 1443  renewals and extensions. Thereafter, the department must issue a
 1444  competitive solicitation pursuant to paragraph (b).
 1445         (5)MANAGING ENTITY DUTIES.—A managing entity shall:
 1446         (a)Maintain a governing board or, if a managed behavioral
 1447  health organization, an advisory board as provided in paragraph
 1448  (4)(c) or paragraph (4)(d), respectively.
 1449         (b)Conduct a community behavioral health care needs
 1450  assessment every 3 years in the geographic area served by the
 1451  managing entity which identifies needs by subregion. The process
 1452  for conducting the needs assessment shall include an opportunity
 1453  for public participation. The assessment shall include, at a
 1454  minimum, the information the department needs for its annual
 1455  report to the Governor and Legislature pursuant to s. 394.4573.
 1456  The managing entity shall provide the needs assessment to the
 1457  department.
 1458         (c)Determine the optimal array of services to meet the
 1459  needs identified in the community behavioral health care needs
 1460  assessment and expand the scope of services as resources become
 1461  available.
 1462         (d) Promote the development and effective implementation of
 1463  a coordinated system of care pursuant to s. 394.4573.
 1464         (e) Provide assistance to counties to develop a designated
 1465  receiving system pursuant to s. 394.4573 and a transportation
 1466  plan pursuant to s. 394.462.
 1467         (f) Develop strategies to divert persons with mental
 1468  illness or substance use disorders from the criminal and
 1469  juvenile justice systems in collaboration with the court system
 1470  and the Department of Juvenile Justice and to integrate
 1471  behavioral health services with the child welfare system.
 1472         (g) Promote and support care coordination activities that
 1473  will improve outcomes among individuals identified as priority
 1474  populations pursuant to paragraph (3)(c).
 1475         (h)Work independently and collaboratively with
 1476  stakeholders to improve access to and effectiveness, quality,
 1477  and outcomes of behavioral health services. This work may
 1478  include, but is not limited to, facilitating the dissemination
 1479  and use of evidence-informed practices.
 1480         (i)Develop a comprehensive provider network of qualified
 1481  providers to deliver behavioral health services. The managing
 1482  entity is not required to competitively procure network
 1483  providers but shall publicize opportunities to join the provider
 1484  network and evaluate providers in the network to determine if
 1485  they may remain in the network. The managing entity shall
 1486  publish these processes on its website. The managing entity
 1487  shall ensure continuity of care for clients if a provider ceases
 1488  to provide a service or leaves the network.
 1489         (j)As appropriate, develop resources by pursuing third
 1490  party payments for services, applying for grants, assisting
 1491  providers in securing local matching funds and in-kind services,
 1492  and employing any other method needed to ensure that services
 1493  are available and accessible.
 1494         (k)Enter into cooperative agreements with local homeless
 1495  councils and organizations for sharing information about
 1496  clients, available resources, and other data or information for
 1497  addressing the homelessness of persons suffering from a
 1498  behavioral health crisis. All information sharing must comply
 1499  with federal and state privacy and confidentiality laws,
 1500  statutes, and regulations.
 1501         (l)Work collaboratively with public receiving facilities
 1502  and licensed housing providers to establish a network of
 1503  licensed housing resources for mental health consumers that will
 1504  prevent and reduce readmissions to public receiving facilities.
 1505         (m)Monitor network providers’ performance and their
 1506  compliance with contract requirements and federal and state
 1507  laws, rules, regulations, and grant requirements.
 1508         (n)Manage and allocate funds for services to meet federal
 1509  and state laws, rules, and regulations.
 1510         (o)Promote coordination of behavioral health care with
 1511  primary care.
 1512         (p)Implement shared data systems necessary for the
 1513  delivery of coordinated care and integrated services, the
 1514  assessment of managing entity performance and provider
 1515  performance, and the reporting of outcomes and costs of
 1516  services.
 1517         (q)Operate in a transparent manner, providing public
 1518  access to information, notice of meetings, and opportunities for
 1519  public participation in managing entity decisionmaking.
 1520         (r)Establish and maintain effective relationships with
 1521  community stakeholders, including individuals served by the
 1522  behavioral health system of care and their families, local
 1523  governments, and other community organizations that meet the
 1524  needs of individuals with mental illness or substance use
 1525  disorders.
 1526         (s)Collaborate with and encourage increased coordination
 1527  between the provider network and other systems, programs, and
 1528  entities, such as the child welfare system, law enforcement
 1529  agencies, the criminal and juvenile justice systems, the
 1530  Medicaid program, offices of the public defender, and offices of
 1531  criminal conflict and civil regional counsel.
 1532         1.Collaboration with the criminal and juvenile justice
 1533  systems shall seek, at a minimum, to divert persons with mental
 1534  illness, substance use disorders, or co-occurring conditions
 1535  from these systems.
 1536         2.Collaboration with the court system shall seek, at a
 1537  minimum, to develop specific written procedures and agreements
 1538  to maximize the use of involuntary outpatient services, reduce
 1539  involuntary inpatient treatment, and increase diversion from the
 1540  criminal and juvenile justice systems.
 1541         3.Collaboration with the child welfare system shall seek,
 1542  at a minimum, to provide effective and timely services to
 1543  parents and caregivers involved in the child welfare system.
 1544         (6)NETWORK ACCREDITATION AND SYSTEMS COORDINATION
 1545  AGREEMENTS.—
 1546         (a)1.The department shall identify acceptable
 1547  accreditations which address coordination within a network and,
 1548  if possible, between the network and major systems and programs
 1549  with which the network interacts, such as the child welfare
 1550  system, the courts system, and the Medicaid program. In
 1551  identifying acceptable accreditations, the department shall
 1552  consider whether the accreditation facilitates integrated
 1553  strategic planning, resource coordination, technology
 1554  integration, performance measurement, and increased value to
 1555  consumers through choice of and access to services, improved
 1556  coordination of services, and effectiveness and efficiency of
 1557  service delivery.
 1558         2.All managing entities under contract with the state by
 1559  July 1, 2016, shall earn accreditation deemed acceptable by the
 1560  department pursuant to subparagraph 1. by June 30, 2019.
 1561  Managing entities whose initial contract with the state is
 1562  executed after July 1, 2016, shall earn network accreditation
 1563  within 3 years after the contract execution date. Pursuant to
 1564  paragraph (4)(j), the department may continue the contract of a
 1565  managing entity under contract as of July 1, 2016, that earns
 1566  the network accreditation within the required timeframe and
 1567  maintains it throughout the contract term.
 1568         (b)If no accreditations are available or deemed acceptable
 1569  pursuant to paragraph (a) which address coordination between the
 1570  provider network and major systems and programs with which the
 1571  provider network interacts, each managing entity shall enter
 1572  into memoranda of understanding which details mechanisms for
 1573  communication and coordination. The managing entity shall enter
 1574  into such memoranda with any community-based care lead agencies,
 1575  circuit courts, county courts, sheriffs’ offices, offices of the
 1576  public defender, offices of criminal conflict and civil regional
 1577  counsel, Medicaid managed medical assistance plans, and homeless
 1578  coalitions in its service area. Each managing entity under
 1579  contract on July 1, 2016, shall enter into such memoranda by
 1580  June 30, 2017, and each managing entity under contract after
 1581  July 1, 2016, shall enter into such memoranda within 1 year
 1582  after its contract execution date.
 1583         (7)PERFORMANCE MEASUREMENT AND ACCOUNTABILITY.-Managing
 1584  entities shall collect and submit data to the department
 1585  regarding persons served, outcomes of persons served, costs of
 1586  services provided through the department’s contract, and other
 1587  data as required by the department. The department shall
 1588  evaluate managing entity performance and the overall progress
 1589  made by the managing entity, together with other systems, in
 1590  meeting the community’s behavioral health needs, based on
 1591  consumer-centered outcome measures that reflect national
 1592  standards, if possible, that can be accurately measured. The
 1593  department shall work with managing entities to establish
 1594  performance standards, including, but not limited to:
 1595         (a)The extent to which individuals in the community
 1596  receive services, including, but not limited to, parents or
 1597  caregivers involved in the child welfare system who need
 1598  behavioral health services.
 1599         (b)The improvement in the overall behavioral health of a
 1600  community.
 1601         (c)The improvement in functioning or progress in the
 1602  recovery of individuals served by the managing entity, as
 1603  determined using person-centered measures tailored to the
 1604  population.
 1605         (d)The success of strategies to:
 1606         1.Divert admissions from acute levels of care, jails,
 1607  prisons, and forensic facilities as measured by, at a minimum,
 1608  the total number and percentage of clients who, during a
 1609  specified period, experience multiple admissions to acute levels
 1610  of care, jails, prisons, or forensic facilities;
 1611         2. Integrate behavioral health services with the child
 1612  welfare system; and
 1613         3.Address the housing needs of individuals being released
 1614  from public receiving facilities who are homeless.
 1615         (e)Consumer and family satisfaction.
 1616         (f)The level of engagement of key community
 1617  constituencies, such as law enforcement agencies, community
 1618  based care lead agencies, juvenile justice agencies, the courts,
 1619  school districts, local government entities, hospitals, and
 1620  other organizations, as appropriate, for the geographical
 1621  service area of the managing entity.
 1622         (8)ENHANCEMENT PLANS.—By September 1 of each year,
 1623  beginning in 2017, each managing entity shall develop and submit
 1624  to the department a description of strategies for enhancing
 1625  services and addressing three to five priority needs in the
 1626  service area. The planning process sponsored by the managing
 1627  entity shall include consumers and their families, community
 1628  based care lead agencies, local governments, law enforcement
 1629  agencies, service providers, community partners and other
 1630  stakeholders. Each strategy must be described in detail and
 1631  accompanied by an implementation plan that specifies action
 1632  steps, identifies responsible parties, and delineates specific
 1633  services that would be purchased, projected costs, the projected
 1634  number of individuals that would be served, and the estimated
 1635  benefits of the services. All or parts of these enhancement
 1636  plans may be included in the department’s annual budget requests
 1637  submitted to the Legislature.
 1638         (9)FUNDING FOR MANAGING ENTITIES.—
 1639         (a)A contract established between the department and a
 1640  managing entity under this section shall be funded by general
 1641  revenue, other applicable state funds, or applicable federal
 1642  funding sources. A managing entity may carry forward documented
 1643  unexpended state funds from one fiscal year to the next, but the
 1644  cumulative amount carried forward may not exceed 8 percent of
 1645  the annual amount of the contract. Any unexpended state funds in
 1646  excess of that percentage shall be returned to the department.
 1647  The funds carried forward may not be used in a way that would
 1648  increase future recurring obligations or for any program or
 1649  service that was not authorized under the existing contract with
 1650  the department. Expenditures of funds carried forward shall be
 1651  separately reported to the department. Any unexpended funds that
 1652  remain at the end of the contract period shall be returned to
 1653  the department. Funds carried forward may be retained through
 1654  contract renewals and new contract procurements as long as the
 1655  same managing entity is retained by the department.
 1656         (b)The method of payment for a fixed-price contract with a
 1657  managing entity shall provide for a 2-month advance payment at
 1658  the beginning of each fiscal year and equal monthly payments
 1659  thereafter.
 1660         (10)ACUTE CARE SERVICES UTILIZATION DATABASE.—The
 1661  department shall develop, implement, and maintain standards
 1662  under which a managing entity shall collect utilization data
 1663  from all public receiving facilities situated within its
 1664  geographical service area and all detoxification and addictions
 1665  receiving facilities under contract with the managing entity. As
 1666  used in this subsection, the term “public receiving facility”
 1667  means an entity that meets the licensure requirements of, and is
 1668  designated by, the department to operate as a public receiving
 1669  facility under s. 394.875 and that is operating as a licensed
 1670  crisis stabilization unit.
 1671         (a)The department shall develop standards and protocols to
 1672  be used for data collection, storage, transmittal, and analysis.
 1673  The standards and protocols shall allow for compatibility of
 1674  data and data transmittal between public receiving facilities,
 1675  detoxification facilities, addictions receiving facilities,
 1676  managing entities, and the department for the implementation,
 1677  and to meet the requirements, of this subsection.
 1678         (b)A managing entity shall require providers specified in
 1679  paragraph (a) to submit data, in real time or at least daily, to
 1680  the managing entity for:
 1681         1.All admissions and discharges of clients receiving
 1682  public receiving facility services who qualify as indigent, as
 1683  defined in s. 394.4787.
 1684         2.All admissions and discharges of clients receiving
 1685  substance abuse services in an addictions receiving facility or
 1686  detoxification facility pursuant to parts IV and V of chapter
 1687  397 who qualify as indigent.
 1688         3.The current active census of total licensed and utilized
 1689  beds, the number of beds purchased by the department, the number
 1690  of clients qualifying as indigent who occupy any of those beds,
 1691  the total number of unoccupied licensed beds, regardless of
 1692  funding, and the number in excess of licensed capacity. Crisis
 1693  units licensed for both adult and child use will report as a
 1694  single unit.
 1695         (c)A managing entity shall require providers specified in
 1696  paragraph (a) to submit data, on a monthly basis, to the
 1697  managing entity which aggregates the daily data submitted under
 1698  paragraph (b). The managing entity shall reconcile the data in
 1699  the monthly submission to the data received by the managing
 1700  entity under paragraph (b) to check for consistency. If the
 1701  monthly aggregate data submitted by a provider under this
 1702  paragraph are inconsistent with the daily data submitted under
 1703  paragraph (b), the managing entity shall consult with the
 1704  provider to make corrections necessary to ensure accurate data.
 1705         (d)A managing entity shall require providers specified in
 1706  paragraph (a) within its provider network to submit data, on an
 1707  annual basis, to the managing entity which aggregates the data
 1708  submitted and reconciled under paragraph (c). The managing
 1709  entity shall reconcile the data in the annual submission to the
 1710  data received and reconciled by the managing entity under
 1711  paragraph (c) to check for consistency. If the annual aggregate
 1712  data submitted by a provider under this paragraph are
 1713  inconsistent with the data received and reconciled under
 1714  paragraph (c), the managing entity shall consult with the
 1715  provider to make corrections necessary to ensure accurate data.
 1716         (e)After ensuring the accuracy of data pursuant to
 1717  paragraphs (c) and (d), the managing entity shall submit the
 1718  data to the department on a monthly and an annual basis. The
 1719  department shall create a statewide database for the data
 1720  described under paragraph (b) and submitted under this paragraph
 1721  for the purpose of analyzing the use of publicly funded crisis
 1722  stabilization services and detoxification and addictions
 1723  receiving services provided on a statewide and an individual
 1724  provider basis.
 1725         Section 20. Subsections (4) through (9) of section 397.305,
 1726  Florida Statutes, are renumbered as subsections (6) though (11),
 1727  respectively, and new subsections (4) and (5) are added to that
 1728  section, to read:
 1729         397.305 Legislative findings, intent, and purpose.—
 1730         (4)It is the intent of the Legislature that licensed,
 1731  qualified health professionals be authorized to practice to the
 1732  full extent of their education and training in the performance
 1733  of professional functions necessary to carry out the intent of
 1734  this chapter.
 1735         (5)It is the intent of the Legislature to establish
 1736  expectations that services provided to persons in this state use
 1737  the coordination-of-care principles characteristic of recovery
 1738  oriented services and include social support services, such as
 1739  housing support, life skills and vocational training, and
 1740  employment assistance necessary for persons who have substance
 1741  use disorders or co-occurring substance use and mental health
 1742  disorders to live successfully in their communities.
 1743         Section 21. Present subsection (19) of section 391.311,
 1744  Florida Statutes, is redesignated as subsection (20), present
 1745  subsections (20) through (45) of that section are redesignated
 1746  as subsections (23) through (48), respectively, new subsections
 1747  (19), (21), and (22) are added to that section, and present
 1748  subsections (30) and (38) of that section are amended, to read:
 1749         397.311 Definitions.—As used in this chapter, except part
 1750  VIII, the term:
 1751         (19)“Incompetent to consent to treatment” means a state in
 1752  which a person’s judgment is so affected by a substance abuse
 1753  impairment that he or she lacks the capacity to make a well
 1754  reasoned, willful, and knowing decision concerning his or her
 1755  medical health, mental health, or substance abuse treatment.
 1756         (21)“Informed consent” means consent voluntarily given in
 1757  writing by a competent person after sufficient explanation and
 1758  disclosure of the subject matter involved to enable the person
 1759  to make a knowing and willful decision without any element of
 1760  force, fraud, deceit, duress, or other form of constraint or
 1761  coercion.
 1762         (22)“Involuntary services” means an array of behavioral
 1763  health services that may be ordered by the court for persons
 1764  with substance abuse impairment or co-occurring substance abuse
 1765  impairment and mental health disorders.
 1766         (33)(30) “Qualified professional” means a physician or a
 1767  physician assistant licensed under chapter 458 or chapter 459; a
 1768  professional licensed under chapter 490 or chapter 491; an
 1769  advanced registered nurse practitioner having a specialty in
 1770  psychiatry licensed under part I of chapter 464; or a person who
 1771  is certified through a department-recognized certification
 1772  process for substance abuse treatment services and who holds, at
 1773  a minimum, a bachelor’s degree. A person who is certified in
 1774  substance abuse treatment services by a state-recognized
 1775  certification process in another state at the time of employment
 1776  with a licensed substance abuse provider in this state may
 1777  perform the functions of a qualified professional as defined in
 1778  this chapter but must meet certification requirements contained
 1779  in this subsection no later than 1 year after his or her date of
 1780  employment.
 1781         (41)(38) “Service component” or “component” means a
 1782  discrete operational entity within a service provider which is
 1783  subject to licensing as defined by rule. Service components
 1784  include prevention, intervention, and clinical treatment
 1785  described in subsection (25) (22).
 1786         Section 22. Subsections (16) through (20) of section
 1787  397.321, Florida Statutes, are renumbered as subsections (15)
 1788  through (19), respectively, present subsection (15) is amended,
 1789  and a new subsection (20) is added to that section, to read:
 1790         397.321 Duties of the department.—The department shall:
 1791         (15)Appoint a substance abuse impairment coordinator to
 1792  represent the department in efforts initiated by the statewide
 1793  substance abuse impairment prevention and treatment coordinator
 1794  established in s. 397.801 and to assist the statewide
 1795  coordinator in fulfilling the responsibilities of that position.
 1796         (20)Develop and prominently display on its website all
 1797  forms necessary for the implementation and administration of
 1798  parts IV and V of this chapter. These forms shall include, but
 1799  are not limited to, a petition for involuntary admission form
 1800  and all related pleading forms, and a form to be used by law
 1801  enforcement agencies pursuant to s. 397.6772. The department
 1802  shall notify law enforcement agencies, the courts, and other
 1803  state agencies of the existence and availability of such forms.
 1804         Section 23. Section 397.675, Florida Statutes, is amended
 1805  to read:
 1806         397.675 Criteria for involuntary admissions, including
 1807  protective custody, emergency admission, and other involuntary
 1808  assessment, involuntary treatment, and alternative involuntary
 1809  assessment for minors, for purposes of assessment and
 1810  stabilization, and for involuntary treatment.—A person meets the
 1811  criteria for involuntary admission if there is good faith reason
 1812  to believe that the person is substance abuse impaired or has a
 1813  co-occurring mental health disorder and, because of such
 1814  impairment or disorder:
 1815         (1) Has lost the power of self-control with respect to
 1816  substance abuse use; and either
 1817         (2)(a) Has inflicted, or threatened or attempted to
 1818  inflict, or unless admitted is likely to inflict, physical harm
 1819  on himself or herself or another; or
 1820         (b) Is in need of substance abuse services and, by reason
 1821  of substance abuse impairment, his or her judgment has been so
 1822  impaired that he or she the person is incapable of appreciating
 1823  his or her need for such services and of making a rational
 1824  decision in that regard, although thereto; however, mere refusal
 1825  to receive such services does not constitute evidence of lack of
 1826  judgment with respect to his or her need for such services; or
 1827         (b)Without care or treatment, is likely to suffer from
 1828  neglect or refuse to care for himself or herself; that such
 1829  neglect or refusal poses a real and present threat of
 1830  substantial harm to his or her well-being; and that it is not
 1831  apparent that such harm may be avoided through the help of
 1832  willing family members or friends or the provision of other
 1833  services, or there is substantial likelihood that the person has
 1834  inflicted, or threatened to or attempted to inflict, or, unless
 1835  admitted, is likely to inflict, physical harm on himself,
 1836  herself, or another.
 1837         Section 24. Subsection (1) of section 397.6772, Florida
 1838  Statutes, is amended to read:
 1839         397.6772 Protective custody without consent.—
 1840         (1) If a person in circumstances which justify protective
 1841  custody as described in s. 397.677 fails or refuses to consent
 1842  to assistance and a law enforcement officer has determined that
 1843  a hospital or a licensed detoxification or addictions receiving
 1844  facility is the most appropriate place for the person, the
 1845  officer may, after giving due consideration to the expressed
 1846  wishes of the person:
 1847         (a) Take the person to a hospital or to a licensed
 1848  detoxification or addictions receiving facility against the
 1849  person’s will but without using unreasonable force. The officer
 1850  shall use the standard form developed by the department pursuant
 1851  to s. 397.321 to execute a written report detailing the
 1852  circumstances under which the person was taken into custody. The
 1853  written report shall be included in the patient’s clinical
 1854  record; or
 1855         (b) In the case of an adult, detain the person for his or
 1856  her own protection in any municipal or county jail or other
 1857  appropriate detention facility.
 1858  
 1859  Such detention is not to be considered an arrest for any
 1860  purpose, and no entry or other record may be made to indicate
 1861  that the person has been detained or charged with any crime. The
 1862  officer in charge of the detention facility must notify the
 1863  nearest appropriate licensed service provider within the first 8
 1864  hours after detention that the person has been detained. It is
 1865  the duty of the detention facility to arrange, as necessary, for
 1866  transportation of the person to an appropriate licensed service
 1867  provider with an available bed. Persons taken into protective
 1868  custody must be assessed by the attending physician within the
 1869  72-hour period and without unnecessary delay, to determine the
 1870  need for further services.
 1871         Section 25. Paragraph (a) of subsection (1) of section
 1872  397.6773, Florida Statutes, is amended to read:
 1873         397.6773 Dispositional alternatives after protective
 1874  custody.—
 1875         (1) An individual who is in protective custody must be
 1876  released by a qualified professional when:
 1877         (a) The individual no longer meets the involuntary
 1878  admission criteria in s. 397.675 397.675(1);
 1879         Section 26. Section 397.679, Florida Statutes, is amended
 1880  to read:
 1881         397.679 Emergency admission; circumstances justifying.—A
 1882  person who meets the criteria for involuntary admission in s.
 1883  397.675 may be admitted to a hospital or to a licensed
 1884  detoxification facility or addictions receiving facility for
 1885  emergency assessment and stabilization, or to a less intensive
 1886  component of a licensed service provider for assessment only,
 1887  upon receipt by the facility of a the physician’s certificate by
 1888  a physician, an advanced registered nurse practitioner, a
 1889  psychiatric nurse, a clinical psychologist, a clinical social
 1890  worker, a marriage and family therapist, a mental health
 1891  counselor, a physician assistant working under the scope of
 1892  practice of the supervising physician, or a master’s-level
 1893  certified addictions professional for substance abuse services,
 1894  if the certificate is specific to substance abuse impairment,
 1895  and the completion of an application for emergency admission.
 1896         Section 27. Section 397.6791, Florida Statutes, is amended
 1897  to read:
 1898         397.6791 Emergency admission; persons who may initiate.—The
 1899  following persons may request a certificate for an emergency
 1900  assessment or admission:
 1901         (1) In the case of an adult, any professional who may issue
 1902  a professional certificate pursuant to s. 397.6793, the
 1903  certifying physician, the person’s spouse or legal guardian, any
 1904  relative of the person, or any other responsible adult who has
 1905  personal knowledge of the person’s substance abuse impairment.
 1906         (2) In the case of a minor, the minor’s parent, legal
 1907  guardian, or legal custodian.
 1908         Section 28. Section 397.6793, Florida Statutes, is amended
 1909  to read:
 1910         397.6793 Professional’s Physician’s certificate for
 1911  emergency admission.—
 1912         (1) A physician, a clinical psychologist, a physician
 1913  assistant working under the scope of practice of the supervising
 1914  physician, a psychiatric nurse, an advanced registered nurse
 1915  practitioner, a mental health counselor, a marriage and family
 1916  therapist, a master’s-level-certified addictions professional
 1917  for substance abuse services, or a clinical social worker may
 1918  execute a professional’s certificate for emergency admission.
 1919  The professional’s physician’s certificate must include the name
 1920  of the person to be admitted, the relationship between the
 1921  person and the professional executing the certificate physician,
 1922  the relationship between the applicant and the professional
 1923  physician, any relationship between the professional physician
 1924  and the licensed service provider, and a statement that the
 1925  person has been examined and assessed within the preceding 5
 1926  days after of the application date, and must include factual
 1927  allegations with respect to the need for emergency admission,
 1928  including:
 1929         (a) The reason for the physician’s belief that the person
 1930  is substance abuse impaired; and
 1931         (b) The reason for the physician’s belief that because of
 1932  such impairment the person has lost the power of self-control
 1933  with respect to substance abuse; and either
 1934         (c)1. The reason for the belief physician believes that,
 1935  without care or treatment, the person is likely to suffer from
 1936  neglect or refuse to care for himself or herself; that such
 1937  neglect or refusal poses a real and present threat of
 1938  substantial harm to his or her well-being; and that it is not
 1939  apparent that such harm may be avoided through the help of
 1940  willing family members or friends or the provision of other
 1941  services, or there is substantial likelihood that the person has
 1942  inflicted or, unless admitted, is likely to inflict, physical
 1943  harm on himself, or herself, or another others unless admitted;
 1944  or
 1945         2. The reason for the belief physician believes that the
 1946  person’s refusal to voluntarily receive care is based on
 1947  judgment so impaired by reason of substance abuse that the
 1948  person is incapable of appreciating his or her need for care and
 1949  of making a rational decision regarding his or her need for
 1950  care.
 1951         (2) The professional’s physician’s certificate must
 1952  recommend the least restrictive type of service that is
 1953  appropriate for the person. The certificate must be signed by
 1954  the professional physician. If other less restrictive means are
 1955  not available, such as voluntary appearance for outpatient
 1956  evaluation, a law enforcement officer shall take the person
 1957  named in the certificate into custody and deliver him or her to
 1958  the appropriate facility for involuntary assessment and
 1959  stabilization.
 1960         (3) A signed copy of the professional’s physician’s
 1961  certificate shall accompany the person, and shall be made a part
 1962  of the person’s clinical record, together with a signed copy of
 1963  the application. The application and the professional’s
 1964  physician’s certificate authorize the involuntary admission of
 1965  the person pursuant to, and subject to the provisions of, ss.
 1966  397.679-397.6797.
 1967         (4) The professional’s certificate is valid for 7 days
 1968  after issuance.
 1969         (5)The professional’s physician’s certificate must
 1970  indicate whether the person requires transportation assistance
 1971  for delivery for emergency admission and specify, pursuant to s.
 1972  397.6795, the type of transportation assistance necessary.
 1973         Section 29. Section 397.6795, Florida Statutes, is amended
 1974  to read:
 1975         397.6795 Transportation-assisted delivery of persons for
 1976  emergency assessment.—An applicant for a person’s emergency
 1977  admission, or the person’s spouse or guardian, or a law
 1978  enforcement officer, or a health officer may deliver a person
 1979  named in the professional’s physician’s certificate for
 1980  emergency admission to a hospital or a licensed detoxification
 1981  facility or addictions receiving facility for emergency
 1982  assessment and stabilization.
 1983         Section 30. Subsection (1) of section 397.681, Florida
 1984  Statutes, is amended to read:
 1985         397.681 Involuntary petitions; general provisions; court
 1986  jurisdiction and right to counsel.—
 1987         (1) JURISDICTION.—The courts have jurisdiction of
 1988  involuntary assessment and stabilization petitions and
 1989  involuntary treatment petitions for substance abuse impaired
 1990  persons, and such petitions must be filed with the clerk of the
 1991  court in the county where the person is located. The clerk of
 1992  the court may not charge a fee for the filing of a petition
 1993  under this section. The chief judge may appoint a general or
 1994  special magistrate to preside over all or part of the
 1995  proceedings. The alleged impaired person is named as the
 1996  respondent.
 1997         Section 31. Subsection (1) of section 397.6811, Florida
 1998  Statutes, is amended to read:
 1999         397.6811 Involuntary assessment and stabilization.—A person
 2000  determined by the court to appear to meet the criteria for
 2001  involuntary admission under s. 397.675 may be admitted for a
 2002  period of 5 days to a hospital or to a licensed detoxification
 2003  facility or addictions receiving facility, for involuntary
 2004  assessment and stabilization or to a less restrictive component
 2005  of a licensed service provider for assessment only upon entry of
 2006  a court order or upon receipt by the licensed service provider
 2007  of a petition. Involuntary assessment and stabilization may be
 2008  initiated by the submission of a petition to the court.
 2009         (1) If the person upon whose behalf the petition is being
 2010  filed is an adult, a petition for involuntary assessment and
 2011  stabilization may be filed by the respondent’s spouse or legal
 2012  guardian, any relative, a private practitioner, the director of
 2013  a licensed service provider or the director’s designee, or an
 2014  adult any three adults who has direct have personal knowledge of
 2015  the respondent’s substance abuse impairment.
 2016         Section 32. Section 397.6814, Florida Statutes, is amended
 2017  to read:
 2018         397.6814 Involuntary assessment and stabilization; contents
 2019  of petition.—A petition for involuntary assessment and
 2020  stabilization must contain the name of the respondent,; the name
 2021  of the applicant or applicants,; the relationship between the
 2022  respondent and the applicant, and; the name of the respondent’s
 2023  attorney, if known, and a statement of the respondent’s ability
 2024  to afford an attorney; and must state facts to support the need
 2025  for involuntary assessment and stabilization, including:
 2026         (1) The reason for the petitioner’s belief that the
 2027  respondent is substance abuse impaired; and
 2028         (2) The reason for the petitioner’s belief that because of
 2029  such impairment the respondent has lost the power of self
 2030  control with respect to substance abuse; and either
 2031         (3)(a) The reason the petitioner believes that the
 2032  respondent has inflicted or is likely to inflict physical harm
 2033  on himself or herself or others unless admitted; or
 2034         (b) The reason the petitioner believes that the
 2035  respondent’s refusal to voluntarily receive care is based on
 2036  judgment so impaired by reason of substance abuse that the
 2037  respondent is incapable of appreciating his or her need for care
 2038  and of making a rational decision regarding that need for care.
 2039  If the respondent has refused to submit to an assessment, such
 2040  refusal must be alleged in the petition.
 2041  
 2042  A fee may not be charged for the filing of a petition pursuant
 2043  to this section.
 2044         Section 33. Subsection (4) is added to section 397.6818,
 2045  Florida Statutes, to read:
 2046         397.6818 Court determination.—At the hearing initiated in
 2047  accordance with s. 397.6811(1), the court shall hear all
 2048  relevant testimony. The respondent must be present unless the
 2049  court has reason to believe that his or her presence is likely
 2050  to be injurious to him or her, in which event the court shall
 2051  appoint a guardian advocate to represent the respondent. The
 2052  respondent has the right to examination by a court-appointed
 2053  qualified professional. After hearing all the evidence, the
 2054  court shall determine whether there is a reasonable basis to
 2055  believe the respondent meets the involuntary admission criteria
 2056  of s. 397.675.
 2057         (4)The order is valid only for the period specified in the
 2058  order or, if a period is not specified, for 7 days after the
 2059  order is signed.
 2060         Section 34. Section 397.6819, Florida Statutes, is amended
 2061  to read:
 2062         397.6819 Involuntary assessment and stabilization;
 2063  responsibility of licensed service provider.—A licensed service
 2064  provider may admit an individual for involuntary assessment and
 2065  stabilization for a period not to exceed 5 days unless a
 2066  petition for involuntary services has been initiated and the
 2067  individual is being retained pursuant to s. 397.6822(3) or a
 2068  request for an extension of time has been filed with the court
 2069  pursuant to s. 397.6821. The assessment of the individual must
 2070  occur within 72 hours be assessed without unnecessary delay by a
 2071  qualified professional. If an assessment is performed by a
 2072  qualified professional who is not a physician, the assessment
 2073  must be reviewed by a physician before the end of the assessment
 2074  period.
 2075         Section 35. Section 397.695, Florida Statutes, is amended
 2076  to read:
 2077         397.695 Involuntary services treatment; persons who may
 2078  petition.—
 2079         (1) If the respondent is an adult, a petition for
 2080  involuntary services treatment may be filed by the respondent’s
 2081  spouse or legal guardian, any relative, a service provider, or
 2082  an adult any three adults who has direct have personal knowledge
 2083  of the respondent’s substance abuse impairment and his or her
 2084  prior course of assessment and treatment.
 2085         (2) If the respondent is a minor, a petition for
 2086  involuntary treatment may be filed by a parent, legal guardian,
 2087  or service provider.
 2088         Section 36. Section 397.6951, Florida Statutes, is amended
 2089  to read:
 2090         397.6951 Contents of petition for involuntary services
 2091  treatment.—A petition for involuntary services treatment must
 2092  contain the name of the respondent to be admitted; the name of
 2093  the petitioner or petitioners; the relationship between the
 2094  respondent and the petitioner; the name of the respondent’s
 2095  attorney, if known, and a statement of the petitioner’s
 2096  knowledge of the respondent’s ability to afford an attorney; the
 2097  findings and recommendations of the assessment performed by the
 2098  qualified professional; and the factual allegations presented by
 2099  the petitioner establishing the need for involuntary outpatient
 2100  services. The factual allegations must demonstrate treatment,
 2101  including:
 2102         (1) The reason for the petitioner’s belief that the
 2103  respondent is substance abuse impaired; and
 2104         (2) The reason for the petitioner’s belief that because of
 2105  such impairment the respondent has lost the power of self
 2106  control with respect to substance abuse; and either
 2107         (3)(a) The reason the petitioner believes that the
 2108  respondent has inflicted or is likely to inflict physical harm
 2109  on himself or herself or others unless the court orders the
 2110  involuntary services admitted; or
 2111         (b) The reason the petitioner believes that the
 2112  respondent’s refusal to voluntarily receive care is based on
 2113  judgment so impaired by reason of substance abuse that the
 2114  respondent is incapable of appreciating his or her need for care
 2115  and of making a rational decision regarding that need for care.
 2116         Section 37. Section 397.6955, Florida Statutes, is amended
 2117  to read:
 2118         397.6955 Duties of court upon filing of petition for
 2119  involuntary services treatment.—
 2120         (1) Upon the filing of a petition for the involuntary
 2121  services for treatment of a substance abuse impaired person with
 2122  the clerk of the court, the court shall immediately determine
 2123  whether the respondent is represented by an attorney or whether
 2124  the appointment of counsel for the respondent is appropriate. If
 2125  the court appoints counsel for the person, the clerk of the
 2126  court shall immediately notify the office of criminal conflict
 2127  and civil regional counsel, created pursuant to s. 27.511, of
 2128  the appointment. The office of criminal conflict and civil
 2129  regional counsel shall represent the person until the petition
 2130  is dismissed, the court order expires, or the person is
 2131  discharged from involuntary services. An attorney that
 2132  represents the person named in the petition shall have access to
 2133  the person, witnesses, and records relevant to the presentation
 2134  of the person’s case and shall represent the interests of the
 2135  person, regardless of the source of payment to the attorney.
 2136         (2) The court shall schedule a hearing to be held on the
 2137  petition within 5 10 days unless a continuance is granted. The
 2138  court may appoint a magistrate to preside at the hearing.
 2139         (3) A copy of the petition and notice of the hearing must
 2140  be provided to the respondent; the respondent’s parent,
 2141  guardian, or legal custodian, in the case of a minor; the
 2142  respondent’s attorney, if known; the petitioner; the
 2143  respondent’s spouse or guardian, if applicable; and such other
 2144  persons as the court may direct. If the respondent is a minor, a
 2145  copy of the petition and notice of the hearing must be and have
 2146  such petition and order personally delivered to the respondent
 2147  if he or she is a minor. The court shall also issue a summons to
 2148  the person whose admission is sought.
 2149         Section 38. Section 397.6957, Florida Statutes, is amended
 2150  to read:
 2151         397.6957 Hearing on petition for involuntary services
 2152  treatment.—
 2153         (1) At a hearing on a petition for involuntary services
 2154  treatment, the court shall hear and review all relevant
 2155  evidence, including the review of results of the assessment
 2156  completed by the qualified professional in connection with the
 2157  respondent’s protective custody, emergency admission,
 2158  involuntary assessment, or alternative involuntary admission.
 2159  The respondent must be present unless the court finds that his
 2160  or her presence is likely to be injurious to himself or herself
 2161  or others, in which event the court must appoint a guardian
 2162  advocate to act in behalf of the respondent throughout the
 2163  proceedings.
 2164         (2) The petitioner has the burden of proving by clear and
 2165  convincing evidence that:
 2166         (a) The respondent is substance abuse impaired and has a
 2167  history of lack of compliance with treatment for substance
 2168  abuse;, and
 2169         (b) Because of such impairment the respondent is unlikely
 2170  to voluntarily participate in the recommended services or is
 2171  unable to determine for himself or herself whether services are
 2172  necessary the respondent has lost the power of self-control with
 2173  respect to substance abuse; and: either
 2174         1. Without services, the respondent is likely to suffer
 2175  from neglect or refuse to care for himself or herself; that such
 2176  neglect or refusal poses a real and present threat of
 2177  substantial harm to his or her well-being; and that there is a
 2178  substantial likelihood that without services the respondent will
 2179  cause serious bodily harm to himself, herself, or another in the
 2180  near future, as evidenced by recent behavior The respondent has
 2181  inflicted or is likely to inflict physical harm on himself or
 2182  herself or others unless admitted; or
 2183         2. The respondent’s refusal to voluntarily receive care is
 2184  based on judgment so impaired by reason of substance abuse that
 2185  the respondent is incapable of appreciating his or her need for
 2186  care and of making a rational decision regarding that need for
 2187  care.
 2188         (3)One of the qualified professionals who executed the
 2189  involuntary services certificate must be a witness. The court
 2190  shall allow testimony from individuals, including family
 2191  members, deemed by the court to be relevant under state law,
 2192  regarding the respondent’s prior history and how that prior
 2193  history relates to the person’s current condition. The testimony
 2194  in the hearing must be under oath, and the proceedings must be
 2195  recorded. The patient may refuse to testify at the hearing.
 2196         (4)(3) At the conclusion of the hearing the court shall
 2197  either dismiss the petition or order the respondent to receive
 2198  undergo involuntary services from his or her substance abuse
 2199  treatment, with the respondent’s chosen licensed service
 2200  provider if to deliver the involuntary substance abuse treatment
 2201  where possible and appropriate.
 2202         Section 39. Section 397.697, Florida Statutes, is amended
 2203  to read:
 2204         397.697 Court determination; effect of court order for
 2205  involuntary services substance abuse treatment.—
 2206         (1) When the court finds that the conditions for
 2207  involuntary services substance abuse treatment have been proved
 2208  by clear and convincing evidence, it may order the respondent to
 2209  receive undergo involuntary services from treatment by a
 2210  publicly funded licensed service provider for a period not to
 2211  exceed 90 60 days. The court may also order a respondent to
 2212  undergo treatment through a privately funded licensed service
 2213  provider if the respondent has the ability to pay for the
 2214  treatment, or if any person on the respondent’s behalf
 2215  voluntarily demonstrates a willingness and an ability to pay for
 2216  the treatment. If the court finds it necessary, it may direct
 2217  the sheriff to take the respondent into custody and deliver him
 2218  or her to the licensed service provider specified in the court
 2219  order, or to the nearest appropriate licensed service provider,
 2220  for involuntary services treatment. When the conditions
 2221  justifying involuntary services treatment no longer exist, the
 2222  individual must be released as provided in s. 397.6971. When the
 2223  conditions justifying involuntary services treatment are
 2224  expected to exist after 90 60 days of services treatment, a
 2225  renewal of the involuntary services treatment order may be
 2226  requested pursuant to s. 397.6975 before prior to the end of the
 2227  90-day 60-day period.
 2228         (2) In all cases resulting in an order for involuntary
 2229  services substance abuse treatment, the court shall retain
 2230  jurisdiction over the case and the parties for the entry of such
 2231  further orders as the circumstances may require. The court’s
 2232  requirements for notification of proposed release must be
 2233  included in the original treatment order.
 2234         (3) An involuntary services treatment order authorizes the
 2235  licensed service provider to require the individual to receive
 2236  services that undergo such treatment as will benefit him or her,
 2237  including services treatment at any licensable service component
 2238  of a licensed service provider.
 2239         (4)If the court orders involuntary services, a copy of the
 2240  order must be sent to the managing entity within 1 working day
 2241  after it is received from the court. Documents may be submitted
 2242  electronically though existing data systems, if applicable.
 2243         Section 40. Section 397.6971, Florida Statutes, is amended
 2244  to read:
 2245         397.6971 Early release from involuntary services substance
 2246  abuse treatment.—
 2247         (1) At any time before prior to the end of the 90-day 60
 2248  day involuntary services treatment period, or before prior to
 2249  the end of any extension granted pursuant to s. 397.6975, an
 2250  individual receiving admitted for involuntary services treatment
 2251  may be determined eligible for discharge to the most appropriate
 2252  referral or disposition for the individual when any of the
 2253  following apply:
 2254         (a) The individual no longer meets the criteria for
 2255  involuntary admission and has given his or her informed consent
 2256  to be transferred to voluntary treatment status.;
 2257         (b) If the individual was admitted on the grounds of
 2258  likelihood of infliction of physical harm upon himself or
 2259  herself or others, such likelihood no longer exists.; or
 2260         (c) If the individual was admitted on the grounds of need
 2261  for assessment and stabilization or treatment, accompanied by
 2262  inability to make a determination respecting such need, either:
 2263         1. Such inability no longer exists; or
 2264         2. It is evident that further treatment will not bring
 2265  about further significant improvements in the individual’s
 2266  condition.;
 2267         (d) The individual is no longer in need of services.; or
 2268         (e) The director of the service provider determines that
 2269  the individual is beyond the safe management capabilities of the
 2270  provider.
 2271         (2) Whenever a qualified professional determines that an
 2272  individual admitted for involuntary services qualifies treatment
 2273  is ready for early release under for any of the reasons listed
 2274  in subsection (1), the service provider shall immediately
 2275  discharge the individual, and must notify all persons specified
 2276  by the court in the original treatment order.
 2277         Section 41. Section 397.6975, Florida Statutes, is amended
 2278  to read:
 2279         397.6975 Extension of involuntary services substance abuse
 2280  treatment period.—
 2281         (1) Whenever a service provider believes that an individual
 2282  who is nearing the scheduled date of his or her release from
 2283  involuntary services treatment continues to meet the criteria
 2284  for involuntary services treatment in s. 397.693, a petition for
 2285  renewal of the involuntary services treatment order may be filed
 2286  with the court at least 10 days before the expiration of the
 2287  court-ordered services treatment period. The court shall
 2288  immediately schedule a hearing to be held not more than 15 days
 2289  after filing of the petition. The court shall provide the copy
 2290  of the petition for renewal and the notice of the hearing to all
 2291  parties to the proceeding. The hearing is conducted pursuant to
 2292  s. 397.6957.
 2293         (2) If the court finds that the petition for renewal of the
 2294  involuntary services treatment order should be granted, it may
 2295  order the respondent to receive undergo involuntary services
 2296  treatment for a period not to exceed an additional 90 days. When
 2297  the conditions justifying involuntary services treatment no
 2298  longer exist, the individual must be released as provided in s.
 2299  397.6971. When the conditions justifying involuntary services
 2300  treatment continue to exist after an additional 90 days of
 2301  service additional treatment, a new petition requesting renewal
 2302  of the involuntary services treatment order may be filed
 2303  pursuant to this section.
 2304         (3)Within 1 court working day after the filing of a
 2305  petition for continued involuntary services, the court shall
 2306  appoint the office of criminal conflict and civil regional
 2307  counsel to represent the respondent, unless the respondent is
 2308  otherwise represented by counsel. The clerk of the court shall
 2309  immediately notify the office of criminal conflict and civil
 2310  regional counsel of such appointment. The office of criminal
 2311  conflict and civil regional counsel shall represent the
 2312  respondent until the petition is dismissed or the court order
 2313  expires or the respondent is discharged from involuntary
 2314  services. Any attorney representing the respondent shall have
 2315  access to the respondent, witnesses, and records relevant to the
 2316  presentation of the respondent’s case and shall represent the
 2317  interests of the respondent, regardless of the source of payment
 2318  to the attorney.
 2319         (4)Hearings on petitions for continued involuntary
 2320  services shall be before the circuit court. The court may
 2321  appoint a magistrate to preside at the hearing. The procedures
 2322  for obtaining an order pursuant to this section shall be in
 2323  accordance with s. 397.697.
 2324         (5)Notice of hearing shall be provided to the respondent
 2325  or his or her counsel. The respondent and the respondent’s
 2326  counsel may agree to a period of continued involuntary services
 2327  without a court hearing.
 2328         (6)The same procedure shall be repeated before the
 2329  expiration of each additional period of involuntary services.
 2330         (7)If the respondent has previously been found incompetent
 2331  to consent to treatment, the court shall consider testimony and
 2332  evidence regarding the respondent’s competence.
 2333         Section 42. Section 397.6977, Florida Statutes, is amended
 2334  to read:
 2335         397.6977 Disposition of individual upon completion of
 2336  involuntary services substance abuse treatment.—At the
 2337  conclusion of the 90-day 60-day period of court-ordered
 2338  involuntary services treatment, the respondent individual is
 2339  automatically discharged unless a motion for renewal of the
 2340  involuntary services treatment order has been filed with the
 2341  court pursuant to s. 397.6975.
 2342         Section 43. Section 397.6978, Florida Statutes, is created
 2343  to read:
 2344         397.6978Guardian advocate; patient incompetent to consent;
 2345  substance abuse disorder.—
 2346         (1)The administrator of a receiving facility or an
 2347  addictions receiving facility may petition the court for the
 2348  appointment of a guardian advocate based upon the opinion of a
 2349  qualified professional that the patient is incompetent to
 2350  consent to treatment. If the court finds that a patient is
 2351  incompetent to consent to treatment and has not been adjudicated
 2352  incapacitated and that a guardian with the authority to consent
 2353  to substance abuse treatment has not been appointed, it may
 2354  appoint a guardian advocate. The patient has the right to have
 2355  an attorney represent him or her at the hearing. If the person
 2356  is indigent, the court shall appoint the office of criminal
 2357  conflict and civil regional counsel to represent him or her at
 2358  the hearing. The patient has the right to testify, cross-examine
 2359  witnesses, and present witnesses. The proceeding shall be
 2360  recorded electronically or stenographically, and testimony must
 2361  be provided under oath. One of the qualified professionals
 2362  authorized to give an opinion in support of a petition for
 2363  involuntary services, as described in s. 397.693, must testify.
 2364  A guardian advocate must meet the qualifications of a guardian
 2365  contained in part IV of chapter 744. The person who is appointed
 2366  as a guardian advocate must agree to the appointment.
 2367         (2)The following persons are prohibited from appointment
 2368  as a patient’s guardian advocate:
 2369         (a)A professional providing clinical services to the
 2370  individual under this part.
 2371         (b)The qualified professional who initiated the
 2372  involuntary examination of the individual, if the examination
 2373  was initiated by a qualified professional’s certificate.
 2374         (c)An employee, an administrator, or a board member of the
 2375  facility providing the examination of the individual.
 2376         (d)An employee, an administrator, or a board member of the
 2377  treatment facility providing treatment of the individual.
 2378         (e)A person providing any substantial professional
 2379  services, excluding public guardians or professional guardians,
 2380  to the individual, including clinical services.
 2381         (f)A creditor of the individual.
 2382         (g)A person subject to an injunction for protection
 2383  against domestic violence under s. 741.30, whether the order of
 2384  injunction is temporary or final, and for which the individual
 2385  was the petitioner.
 2386         (h)A person subject to an injunction for protection
 2387  against repeat violence, stalking, sexual violence, or dating
 2388  violence under s. 784.046, whether the order of injunction is
 2389  temporary or final, and for which the individual was the
 2390  petitioner.
 2391         (3)A facility requesting appointment of a guardian
 2392  advocate must, before the appointment, provide the prospective
 2393  guardian advocate with information about the duties and
 2394  responsibilities of guardian advocates, including information
 2395  about the ethics of medical decisionmaking. Before asking a
 2396  guardian advocate to give consent to treatment for a patient,
 2397  the facility must provide to the guardian advocate sufficient
 2398  information so that the guardian advocate can decide whether to
 2399  give express and informed consent to the treatment. Such
 2400  information must include information that demonstrates that the
 2401  treatment is essential to the care of the patient and does not
 2402  present an unreasonable risk of serious, hazardous, or
 2403  irreversible side effects. If possible, before giving consent to
 2404  treatment, the guardian advocate must personally meet and talk
 2405  with the patient and the patient’s physician. If that is not
 2406  possible, the discussion may be conducted by telephone. The
 2407  decision of the guardian advocate may be reviewed by the court,
 2408  upon petition of the patient’s attorney, the patient’s family,
 2409  or the facility administrator.
 2410         (4)In lieu of the training required for guardians
 2411  appointed pursuant to chapter 744, a guardian advocate shall
 2412  attend at least a 4-hour training course approved by the court
 2413  before exercising his or her authority. At a minimum, the
 2414  training course must include information about patient rights,
 2415  the diagnosis of substance abuse disorders, the ethics of
 2416  medical decisionmaking, and the duties of guardian advocates.
 2417         (5)The required training course and the information to be
 2418  supplied to prospective guardian advocates before their
 2419  appointment must be developed by the department, approved by the
 2420  chief judge of the circuit court, and taught by a court-approved
 2421  organization, which may include, but need not be limited to, a
 2422  community college, a guardianship organization, a local bar
 2423  association, or The Florida Bar. The training course may be web
 2424  based, provided in video format, or provided in other electronic
 2425  means but must be capable of ensuring the identity and
 2426  participation of the prospective guardian advocate. The court
 2427  may waive some or all of the training requirements for guardian
 2428  advocates or impose additional requirements. The court shall
 2429  make its decision on a case-by-case basis and, in making its
 2430  decision, shall consider the experience and education of the
 2431  guardian advocate, the duties assigned to the guardian advocate,
 2432  and the needs of the patient.
 2433         (6)In selecting a guardian advocate, the court shall give
 2434  preference to the patient’s health care surrogate, if one has
 2435  already been designated by the patient. If the patient has not
 2436  previously designated a health care surrogate, the selection
 2437  shall be made, except for good cause documented in the court
 2438  record, from among the following persons, listed in order of
 2439  priority:
 2440         (a)The spouse of the patient.
 2441         (b)An adult child of the patient.
 2442         (c)A parent of the patient.
 2443         (d)The adult next of kin of the patient.
 2444         (e)An adult friend of the patient.
 2445         (f)An adult trained and willing to serve as the guardian
 2446  advocate for the patient.
 2447         (7)If a guardian with the authority to consent to medical
 2448  treatment has not already been appointed, or if the patient has
 2449  not already designated a health care surrogate, the court may
 2450  authorize the guardian advocate to consent to medical treatment
 2451  as well as substance abuse disorder treatment. Unless otherwise
 2452  limited by the court, a guardian advocate with authority to
 2453  consent to medical treatment has the same authority to make
 2454  health care decisions and is subject to the same restrictions as
 2455  a proxy appointed under part IV of chapter 765. Unless the
 2456  guardian advocate has sought and received express court approval
 2457  in a proceeding separate from the proceeding to determine the
 2458  competence of the patient to consent to medical treatment, the
 2459  guardian advocate may not consent to:
 2460         (a)Abortion.
 2461         (b)Sterilization.
 2462         (c)Electroshock therapy.
 2463         (d)Psychosurgery.
 2464         (e)Experimental treatments that have not been approved by
 2465  a federally approved institutional review board in accordance
 2466  with 45 C.F.R. part 46 or 21 C.F.R. part 56.
 2467  
 2468  The court must base its authorization on evidence that the
 2469  treatment or procedure is essential to the care of the patient
 2470  and that the treatment does not present an unreasonable risk of
 2471  serious, hazardous, or irreversible side effects. In complying
 2472  with this subsection, the court shall follow the procedures set
 2473  forth in subsection (1).
 2474         (8)The guardian advocate shall be discharged when the
 2475  patient is discharged from an order for involuntary services or
 2476  when the patient is transferred from involuntary to voluntary
 2477  status. The court or a hearing officer shall consider the
 2478  competence of the patient as provided in subsection (1) and may
 2479  consider an involuntarily placed patient’s competence to consent
 2480  to services at any hearing. Upon sufficient evidence, the court
 2481  may restore, or the magistrate may recommend that the court
 2482  restore, the patient’s competence. A copy of the order restoring
 2483  competence or the certificate of discharge containing the
 2484  restoration of competence shall be provided to the patient and
 2485  the guardian advocate.
 2486         Section 44. Paragraphs (d) through (m) of subsection (2) of
 2487  section 409.967, are redesignated as paragraphs (e) through (n),
 2488  respectively, and a new paragraph (d) is added to that
 2489  subsection to read:
 2490         409.967 Managed care plan accountability.—
 2491         (2) The agency shall establish such contract requirements
 2492  as are necessary for the operation of the statewide managed care
 2493  program. In addition to any other provisions the agency may deem
 2494  necessary, the contract must require:
 2495         (d)Quality care.—Managed care plans shall provide, or
 2496  contract for the provision of, care coordination to facilitate
 2497  the appropriate delivery of behavioral health care services in
 2498  the least restrictive setting with treatment and recovery
 2499  capabilities that address the needs of the patient. Services
 2500  shall be provided in a manner that integrates behavioral health
 2501  services and primary care. Plans shall be required to achieve
 2502  specific behavioral health outcome standards, established by the
 2503  agency in consultation with the department.
 2504         Section 45. Subsection (5) is added to section 409.973,
 2505  Florida Statutes, to read:
 2506         409.973 Benefits.—
 2507         (5)INTEGRATED BEHAVIORAL HEALTH INITIATIVE.—Each plan
 2508  operating in the managed medical assistance program shall work
 2509  with the managing entity in its service area to establish
 2510  specific organizational supports and protocols that enhance the
 2511  integration and coordination of primary care and behavioral
 2512  health services for Medicaid recipients. Progress in this
 2513  initiative shall be measured using the integration framework and
 2514  core measures developed by the Agency for Healthcare Research
 2515  and Quality.
 2516         Section 46. Notwithstanding the amendment made to s.
 2517  409.975(6), Florida Statutes, by HB 5101, 1st Eng., 2016 Regular
 2518  Session, subsection (6) of section 409.975, Florida Statutes, is
 2519  reenacted to read:
 2520         409.975 Managed care plan accountability.—In addition to
 2521  the requirements of s. 409.967, plans and providers
 2522  participating in the managed medical assistance program shall
 2523  comply with the requirements of this section.
 2524         (6) PROVIDER PAYMENT.—Managed care plans and hospitals
 2525  shall negotiate mutually acceptable rates, methods, and terms of
 2526  payment. For rates, methods, and terms of payment negotiated
 2527  after the contract between the agency and the plan is executed,
 2528  plans shall pay hospitals, at a minimum, the rate the agency
 2529  would have paid on the first day of the contract between the
 2530  provider and the plan. Such payments to hospitals may not exceed
 2531  120 percent of the rate the agency would have paid on the first
 2532  day of the contract between the provider and the plan, unless
 2533  specifically approved by the agency. Payment rates may be
 2534  updated periodically.
 2535         Section 47. It is the intent of the Legislature that the
 2536  reenactment of s. 409.975(6), Florida Statutes, shall control
 2537  over the amendment to that subsection made by HB 5101, 1st Eng.,
 2538  2016 Regular Session, regardless of the order in which they are
 2539  enacted.
 2540         Section 48. Section 491.0045, Florida Statutes, is amended
 2541  to read:
 2542         491.0045 Intern registration; requirements.—
 2543         (1) Effective January 1, 1998, An individual who has not
 2544  satisfied intends to practice in Florida to satisfy the
 2545  postgraduate or post-master’s level experience requirements, as
 2546  specified in s. 491.005(1)(c), (3)(c), or (4)(c), must register
 2547  as an intern in the profession for which he or she is seeking
 2548  licensure before prior to commencing the post-master’s
 2549  experience requirement or an individual who intends to satisfy
 2550  part of the required graduate-level practicum, internship, or
 2551  field experience, outside the academic arena for any profession,
 2552  must register as an intern in the profession for which he or she
 2553  is seeking licensure before prior to commencing the practicum,
 2554  internship, or field experience.
 2555         (2) The department shall register as a clinical social
 2556  worker intern, marriage and family therapist intern, or mental
 2557  health counselor intern each applicant who the board certifies
 2558  has:
 2559         (a) Completed the application form and remitted a
 2560  nonrefundable application fee not to exceed $200, as set by
 2561  board rule;
 2562         (b)1. Completed the education requirements as specified in
 2563  s. 491.005(1)(c), (3)(c), or (4)(c) for the profession for which
 2564  he or she is applying for licensure, if needed; and
 2565         2. Submitted an acceptable supervision plan, as determined
 2566  by the board, for meeting the practicum, internship, or field
 2567  work required for licensure that was not satisfied in his or her
 2568  graduate program.
 2569         (c) Identified a qualified supervisor.
 2570         (3) An individual registered under this section must remain
 2571  under supervision while practicing under registered intern
 2572  status until he or she is in receipt of a license or a letter
 2573  from the department stating that he or she is licensed to
 2574  practice the profession for which he or she applied.
 2575         (4)An individual who has applied for intern registration
 2576  on or before December 31, 2001, and has satisfied the education
 2577  requirements of s. 491.005 that are in effect through December
 2578  31, 2000, will have met the educational requirements for
 2579  licensure for the profession for which he or she has applied.
 2580         (4)(5)An individual who fails Individuals who have
 2581  commenced the experience requirement as specified in s.
 2582  491.005(1)(c), (3)(c), or (4)(c) but failed to register as
 2583  required by subsection (1) shall register with the department
 2584  before January 1, 2000. Individuals who fail to comply with this
 2585  section may subsection shall not be granted a license under this
 2586  chapter, and any time spent by the individual completing the
 2587  experience requirement as specified in s. 491.005(1)(c), (3)(c),
 2588  or (4)(c) before prior to registering as an intern does shall
 2589  not count toward completion of the such requirement.
 2590         (5)An intern registration is valid for 5 years.
 2591         (6)A registration issued on or before March 31, 2017,
 2592  expires March 31, 2022, and may not be renewed or reissued. Any
 2593  registration issued after March 31, 2017, expires 60 months
 2594  after the date it is issued. A subsequent intern registration
 2595  may not be issued unless the candidate has passed the theory and
 2596  practice examination described in s. 491.005(1)(d), (3)(d), and
 2597  (4)(d).
 2598         (7)An individual who has held a provisional license issued
 2599  by the board may not apply for an intern registration in the
 2600  same profession.
 2601         Section 49. Section 394.4674, Florida Statutes, is
 2602  repealed.
 2603         Section 50. Section 394.4985, Florida Statutes, is
 2604  repealed.
 2605         Section 51. Section 394.745, Florida Statutes, is repealed.
 2606         Section 52. Section 397.331, Florida Statutes, is repealed.
 2607         Section 53. Section 397.801, Florida Statutes, is repealed.
 2608         Section 54. Section 397.811, Florida Statutes, is repealed.
 2609         Section 55. Section 397.821, Florida Statutes, is repealed.
 2610         Section 56. Section 397.901, Florida Statutes, is repealed.
 2611         Section 57. Section 397.93, Florida Statutes, is repealed.
 2612         Section 58. Section 397.94, Florida Statutes, is repealed.
 2613         Section 59. Section 397.951, Florida Statutes, is repealed.
 2614         Section 60. Section 397.97, Florida Statutes, is repealed.
 2615         Section 61. Section 397.98, Florida Statutes, is repealed.
 2616         Section 62. Paragraph (a) of subsection (3) of section
 2617  39.407, Florida Statutes, is amended to read:
 2618         39.407 Medical, psychiatric, and psychological examination
 2619  and treatment of child; physical, mental, or substance abuse
 2620  examination of person with or requesting child custody.—
 2621         (3)(a)1. Except as otherwise provided in subparagraph (b)1.
 2622  or paragraph (e), before the department provides psychotropic
 2623  medications to a child in its custody, the prescribing physician
 2624  shall attempt to obtain express and informed consent, as defined
 2625  in s. 394.455(15) s. 394.455(9) and as described in s.
 2626  394.459(3)(a), from the child’s parent or legal guardian. The
 2627  department must take steps necessary to facilitate the inclusion
 2628  of the parent in the child’s consultation with the physician.
 2629  However, if the parental rights of the parent have been
 2630  terminated, the parent’s location or identity is unknown or
 2631  cannot reasonably be ascertained, or the parent declines to give
 2632  express and informed consent, the department may, after
 2633  consultation with the prescribing physician, seek court
 2634  authorization to provide the psychotropic medications to the
 2635  child. Unless parental rights have been terminated and if it is
 2636  possible to do so, the department shall continue to involve the
 2637  parent in the decisionmaking process regarding the provision of
 2638  psychotropic medications. If, at any time, a parent whose
 2639  parental rights have not been terminated provides express and
 2640  informed consent to the provision of a psychotropic medication,
 2641  the requirements of this section that the department seek court
 2642  authorization do not apply to that medication until such time as
 2643  the parent no longer consents.
 2644         2. Any time the department seeks a medical evaluation to
 2645  determine the need to initiate or continue a psychotropic
 2646  medication for a child, the department must provide to the
 2647  evaluating physician all pertinent medical information known to
 2648  the department concerning that child.
 2649         Section 63. Subsection (1) of section 39.524, Florida
 2650  Statutes, is amended to read:
 2651         39.524 Safe-harbor placement.—
 2652         (1) Except as provided in s. 39.407 or s. 985.801, a
 2653  dependent child 6 years of age or older who has been found to be
 2654  a victim of sexual exploitation as defined in s. 39.01(70)(g) s.
 2655  39.01(69)(g) must be assessed for placement in a safe house or
 2656  safe foster home as provided in s. 409.1678 using the initial
 2657  screening and assessment instruments provided in s. 409.1754(1).
 2658  If such placement is determined to be appropriate for the child
 2659  as a result of this assessment, the child may be placed in a
 2660  safe house or safe foster home, if one is available. However,
 2661  the child may be placed in another setting, if the other setting
 2662  is more appropriate to the child’s needs or if a safe house or
 2663  safe foster home is unavailable, as long as the child’s
 2664  behaviors are managed so as not to endanger other children
 2665  served in that setting.
 2666         Section 64. Paragraph (e) of subsection (5) of section
 2667  212.055, Florida Statutes, is amended to read:
 2668         212.055 Discretionary sales surtaxes; legislative intent;
 2669  authorization and use of proceeds.—It is the legislative intent
 2670  that any authorization for imposition of a discretionary sales
 2671  surtax shall be published in the Florida Statutes as a
 2672  subsection of this section, irrespective of the duration of the
 2673  levy. Each enactment shall specify the types of counties
 2674  authorized to levy; the rate or rates which may be imposed; the
 2675  maximum length of time the surtax may be imposed, if any; the
 2676  procedure which must be followed to secure voter approval, if
 2677  required; the purpose for which the proceeds may be expended;
 2678  and such other requirements as the Legislature may provide.
 2679  Taxable transactions and administrative procedures shall be as
 2680  provided in s. 212.054.
 2681         (5) COUNTY PUBLIC HOSPITAL SURTAX.—Any county as defined in
 2682  s. 125.011(1) may levy the surtax authorized in this subsection
 2683  pursuant to an ordinance either approved by extraordinary vote
 2684  of the county commission or conditioned to take effect only upon
 2685  approval by a majority vote of the electors of the county voting
 2686  in a referendum. In a county as defined in s. 125.011(1), for
 2687  the purposes of this subsection, “county public general
 2688  hospital” means a general hospital as defined in s. 395.002
 2689  which is owned, operated, maintained, or governed by the county
 2690  or its agency, authority, or public health trust.
 2691         (e) A governing board, agency, or authority shall be
 2692  chartered by the county commission upon this act becoming law.
 2693  The governing board, agency, or authority shall adopt and
 2694  implement a health care plan for indigent health care services.
 2695  The governing board, agency, or authority shall consist of no
 2696  more than seven and no fewer than five members appointed by the
 2697  county commission. The members of the governing board, agency,
 2698  or authority shall be at least 18 years of age and residents of
 2699  the county. No member may be employed by or affiliated with a
 2700  health care provider or the public health trust, agency, or
 2701  authority responsible for the county public general hospital.
 2702  The following community organizations shall each appoint a
 2703  representative to a nominating committee: the South Florida
 2704  Hospital and Healthcare Association, the Miami-Dade County
 2705  Public Health Trust, the Dade County Medical Association, the
 2706  Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade
 2707  County. This committee shall nominate between 10 and 14 county
 2708  citizens for the governing board, agency, or authority. The
 2709  slate shall be presented to the county commission and the county
 2710  commission shall confirm the top five to seven nominees,
 2711  depending on the size of the governing board. Until such time as
 2712  the governing board, agency, or authority is created, the funds
 2713  provided for in subparagraph (d)2. shall be placed in a
 2714  restricted account set aside from other county funds and not
 2715  disbursed by the county for any other purpose.
 2716         1. The plan shall divide the county into a minimum of four
 2717  and maximum of six service areas, with no more than one
 2718  participant hospital per service area. The county public general
 2719  hospital shall be designated as the provider for one of the
 2720  service areas. Services shall be provided through participants’
 2721  primary acute care facilities.
 2722         2. The plan and subsequent amendments to it shall fund a
 2723  defined range of health care services for both indigent persons
 2724  and the medically poor, including primary care, preventive care,
 2725  hospital emergency room care, and hospital care necessary to
 2726  stabilize the patient. For the purposes of this section,
 2727  “stabilization” means stabilization as defined in s. 397.311(44)
 2728  s. 397.311(41). Where consistent with these objectives, the plan
 2729  may include services rendered by physicians, clinics, community
 2730  hospitals, and alternative delivery sites, as well as at least
 2731  one regional referral hospital per service area. The plan shall
 2732  provide that agreements negotiated between the governing board,
 2733  agency, or authority and providers shall recognize hospitals
 2734  that render a disproportionate share of indigent care, provide
 2735  other incentives to promote the delivery of charity care to draw
 2736  down federal funds where appropriate, and require cost
 2737  containment, including, but not limited to, case management.
 2738  From the funds specified in subparagraphs (d)1. and 2. for
 2739  indigent health care services, service providers shall receive
 2740  reimbursement at a Medicaid rate to be determined by the
 2741  governing board, agency, or authority created pursuant to this
 2742  paragraph for the initial emergency room visit, and a per-member
 2743  per-month fee or capitation for those members enrolled in their
 2744  service area, as compensation for the services rendered
 2745  following the initial emergency visit. Except for provisions of
 2746  emergency services, upon determination of eligibility,
 2747  enrollment shall be deemed to have occurred at the time services
 2748  were rendered. The provisions for specific reimbursement of
 2749  emergency services shall be repealed on July 1, 2001, unless
 2750  otherwise reenacted by the Legislature. The capitation amount or
 2751  rate shall be determined before prior to program implementation
 2752  by an independent actuarial consultant. In no event shall such
 2753  reimbursement rates exceed the Medicaid rate. The plan must also
 2754  provide that any hospitals owned and operated by government
 2755  entities on or after the effective date of this act must, as a
 2756  condition of receiving funds under this subsection, afford
 2757  public access equal to that provided under s. 286.011 as to any
 2758  meeting of the governing board, agency, or authority the subject
 2759  of which is budgeting resources for the retention of charity
 2760  care, as that term is defined in the rules of the Agency for
 2761  Health Care Administration. The plan shall also include
 2762  innovative health care programs that provide cost-effective
 2763  alternatives to traditional methods of service and delivery
 2764  funding.
 2765         3. The plan’s benefits shall be made available to all
 2766  county residents currently eligible to receive health care
 2767  services as indigents or medically poor as defined in paragraph
 2768  (4)(d).
 2769         4. Eligible residents who participate in the health care
 2770  plan shall receive coverage for a period of 12 months or the
 2771  period extending from the time of enrollment to the end of the
 2772  current fiscal year, per enrollment period, whichever is less.
 2773         5. At the end of each fiscal year, the governing board,
 2774  agency, or authority shall prepare an audit that reviews the
 2775  budget of the plan, delivery of services, and quality of
 2776  services, and makes recommendations to increase the plan’s
 2777  efficiency. The audit shall take into account participant
 2778  hospital satisfaction with the plan and assess the amount of
 2779  poststabilization patient transfers requested, and accepted or
 2780  denied, by the county public general hospital.
 2781         Section 65. Paragraph (c) of subsection (2) of section
 2782  394.4599, Florida Statutes, is amended to read:
 2783         394.4599 Notice.—
 2784         (2) INVOLUNTARY ADMISSION.—
 2785         (c)1. A receiving facility shall give notice of the
 2786  whereabouts of a minor who is being involuntarily held for
 2787  examination pursuant to s. 394.463 to the minor’s parent,
 2788  guardian, caregiver, or guardian advocate, in person or by
 2789  telephone or other form of electronic communication, immediately
 2790  after the minor’s arrival at the facility. The facility may
 2791  delay notification for no more than 24 hours after the minor’s
 2792  arrival if the facility has submitted a report to the central
 2793  abuse hotline, pursuant to s. 39.201, based upon knowledge or
 2794  suspicion of abuse, abandonment, or neglect and if the facility
 2795  deems a delay in notification to be in the minor’s best
 2796  interest.
 2797         2. The receiving facility shall attempt to notify the
 2798  minor’s parent, guardian, caregiver, or guardian advocate until
 2799  the receiving facility receives confirmation from the parent,
 2800  guardian, caregiver, or guardian advocate, verbally, by
 2801  telephone or other form of electronic communication, or by
 2802  recorded message, that notification has been received. Attempts
 2803  to notify the parent, guardian, caregiver, or guardian advocate
 2804  must be repeated at least once every hour during the first 12
 2805  hours after the minor’s arrival and once every 24 hours
 2806  thereafter and must continue until such confirmation is
 2807  received, unless the minor is released at the end of the 72-hour
 2808  examination period, or until a petition for involuntary services
 2809  placement is filed with the court pursuant to s. 394.463(2)(g)
 2810  s. 394.463(2)(i). The receiving facility may seek assistance
 2811  from a law enforcement agency to notify the minor’s parent,
 2812  guardian, caregiver, or guardian advocate if the facility has
 2813  not received within the first 24 hours after the minor’s arrival
 2814  a confirmation by the parent, guardian, caregiver, or guardian
 2815  advocate that notification has been received. The receiving
 2816  facility must document notification attempts in the minor’s
 2817  clinical record.
 2818         Section 66. Subsection (3) and paragraph (p) of subsection
 2819  (4) of section 394.495, Florida Statutes, are amended to read:
 2820         394.495 Child and adolescent mental health system of care;
 2821  programs and services.—
 2822         (3) Assessments must be performed by:
 2823         (a) A professional as defined in s. 394.455(5), (7), (32),
 2824  (35), or (36) s. 394.455(2), (4), (21), (23), or (24);
 2825         (b) A professional licensed under chapter 491; or
 2826         (c) A person who is under the direct supervision of a
 2827  qualified professional as defined in s. 394.455(5), (7), (32),
 2828  (35), or (36) s. 394.455(2), (4), (21), (23), or (24) or a
 2829  professional licensed under chapter 491.
 2830         (4) The array of services may include, but is not limited
 2831  to:
 2832         (p) Trauma-informed services for children who have suffered
 2833  sexual exploitation as defined in s. 39.01(70)(g) s.
 2834  39.01(69)(g).
 2835         Section 67. Subsection (5) of section 394.496, Florida
 2836  Statutes, is amended to read:
 2837         394.496 Service planning.—
 2838         (5) A professional as defined in s. 394.455(5), (7), (32),
 2839  (35), or (36) s. 394.455(2), (4), (21), (23), or (24) or a
 2840  professional licensed under chapter 491 must be included among
 2841  those persons developing the services plan.
 2842         Section 68. Subsection (6) of section 394.9085, Florida
 2843  Statutes, is amended to read:
 2844         394.9085 Behavioral provider liability.—
 2845         (6) For purposes of this section, the terms “detoxification
 2846  services,” “addictions receiving facility,” and “receiving
 2847  facility” have the same meanings as those provided in ss.
 2848  397.311(25)(a)4., 397.311(25)(a)1., and 394.455(39) ss.
 2849  397.311(22)(a)4., 397.311(22)(a)1., and 394.455(26),
 2850  respectively.
 2851         Section 69. Subsections (16) through (20) of section
 2852  397.321, Florida Statutes, are renumbered as subsections (15)
 2853  through (19), respectively, and present subsection (15) of that
 2854  section is amended to read:
 2855         397.321 Duties of the department.—The department shall:
 2856         (15)Appoint a substance abuse impairment coordinator to
 2857  represent the department in efforts initiated by the statewide
 2858  substance abuse impairment prevention and treatment coordinator
 2859  established in s. 397.801 and to assist the statewide
 2860  coordinator in fulfilling the responsibilities of that position.
 2861         Section 70. Subsection (8) of section 397.405, Florida
 2862  Statutes, is amended to read:
 2863         397.405 Exemptions from licensure.—The following are exempt
 2864  from the licensing provisions of this chapter:
 2865         (8) A legally cognizable church or nonprofit religious
 2866  organization or denomination providing substance abuse services,
 2867  including prevention services, which are solely religious,
 2868  spiritual, or ecclesiastical in nature. A church or nonprofit
 2869  religious organization or denomination providing any of the
 2870  licensed service components itemized under s. 397.311(25) s.
 2871  397.311(22) is not exempt from substance abuse licensure but
 2872  retains its exemption with respect to all services which are
 2873  solely religious, spiritual, or ecclesiastical in nature.
 2874  
 2875  The exemptions from licensure in this section do not apply to
 2876  any service provider that receives an appropriation, grant, or
 2877  contract from the state to operate as a service provider as
 2878  defined in this chapter or to any substance abuse program
 2879  regulated pursuant to s. 397.406. Furthermore, this chapter may
 2880  not be construed to limit the practice of a physician or
 2881  physician assistant licensed under chapter 458 or chapter 459, a
 2882  psychologist licensed under chapter 490, a psychotherapist
 2883  licensed under chapter 491, or an advanced registered nurse
 2884  practitioner licensed under part I of chapter 464, who provides
 2885  substance abuse treatment, so long as the physician, physician
 2886  assistant, psychologist, psychotherapist, or advanced registered
 2887  nurse practitioner does not represent to the public that he or
 2888  she is a licensed service provider and does not provide services
 2889  to individuals pursuant to part V of this chapter. Failure to
 2890  comply with any requirement necessary to maintain an exempt
 2891  status under this section is a misdemeanor of the first degree,
 2892  punishable as provided in s. 775.082 or s. 775.083.
 2893         Section 71. Subsections (1) and (5) of section 397.407,
 2894  Florida Statutes, are amended to read:
 2895         397.407 Licensure process; fees.—
 2896         (1) The department shall establish the licensure process to
 2897  include fees and categories of licenses and must prescribe a fee
 2898  range that is based, at least in part, on the number and
 2899  complexity of programs listed in s. 397.311(25) s. 397.311(22)
 2900  which are operated by a licensee. The fees from the licensure of
 2901  service components are sufficient to cover at least 50 percent
 2902  of the costs of regulating the service components. The
 2903  department shall specify a fee range for public and privately
 2904  funded licensed service providers. Fees for privately funded
 2905  licensed service providers must exceed the fees for publicly
 2906  funded licensed service providers.
 2907         (5) The department may issue probationary, regular, and
 2908  interim licenses. The department shall issue one license for
 2909  each service component that is operated by a service provider
 2910  and defined pursuant to s. 397.311(25) s. 397.311(22). The
 2911  license is valid only for the specific service components listed
 2912  for each specific location identified on the license. The
 2913  licensed service provider shall apply for a new license at least
 2914  60 days before the addition of any service components or 30 days
 2915  before the relocation of any of its service sites. Provision of
 2916  service components or delivery of services at a location not
 2917  identified on the license may be considered an unlicensed
 2918  operation that authorizes the department to seek an injunction
 2919  against operation as provided in s. 397.401, in addition to
 2920  other sanctions authorized by s. 397.415. Probationary and
 2921  regular licenses may be issued only after all required
 2922  information has been submitted. A license may not be
 2923  transferred. As used in this subsection, the term “transfer”
 2924  includes, but is not limited to, the transfer of a majority of
 2925  the ownership interest in the licensed entity or transfer of
 2926  responsibilities under the license to another entity by
 2927  contractual arrangement.
 2928         Section 72. Section 397.416, Florida Statutes, is amended
 2929  to read:
 2930         397.416 Substance abuse treatment services; qualified
 2931  professional.—Notwithstanding any other provision of law, a
 2932  person who was certified through a certification process
 2933  recognized by the former Department of Health and Rehabilitative
 2934  Services before January 1, 1995, may perform the duties of a
 2935  qualified professional with respect to substance abuse treatment
 2936  services as defined in this chapter, and need not meet the
 2937  certification requirements contained in s. 397.311(33) s.
 2938  397.311(30).
 2939         Section 73. Subsection (2) of section 397.4871, Florida
 2940  Statutes, is amended to read:
 2941         397.4871 Recovery residence administrator certification.—
 2942         (2) The department shall approve at least one credentialing
 2943  entity by December 1, 2015, for the purpose of developing and
 2944  administering a voluntary credentialing program for
 2945  administrators. The department shall approve any credentialing
 2946  entity that the department endorses pursuant to s. 397.321(15)
 2947  s. 397.321(16) if the credentialing entity also meets the
 2948  requirements of this section. The approved credentialing entity
 2949  shall:
 2950         (a) Establish recovery residence administrator core
 2951  competencies, certification requirements, testing instruments,
 2952  and recertification requirements.
 2953         (b) Establish a process to administer the certification
 2954  application, award, and maintenance processes.
 2955         (c) Develop and administer:
 2956         1. A code of ethics and disciplinary process.
 2957         2. Biennial continuing education requirements and annual
 2958  certification renewal requirements.
 2959         3. An education provider program to approve training
 2960  entities that are qualified to provide precertification training
 2961  to applicants and continuing education opportunities to
 2962  certified persons.
 2963         Section 74. Paragraph (c) of subsection (1) and paragraphs
 2964  (a) and (b) of subsection (6) of section 409.1678, Florida
 2965  Statutes, are amended to read:
 2966         409.1678 Specialized residential options for children who
 2967  are victims of sexual exploitation.—
 2968         (1) DEFINITIONS.—As used in this section, the term:
 2969         (c) “Sexually exploited child” means a child who has
 2970  suffered sexual exploitation as defined in s. 39.01(70)(g) s.
 2971  39.01(69)(g) and is ineligible for relief and benefits under the
 2972  federal Trafficking Victims Protection Act, 22 U.S.C. ss. 7101
 2973  et seq.
 2974         (6) LOCATION INFORMATION.—
 2975         (a) Information about the location of a safe house, safe
 2976  foster home, or other residential facility serving victims of
 2977  sexual exploitation, as defined in s. 39.01(70)(g) s.
 2978  39.01(69)(g), which is held by an agency, as defined in s.
 2979  119.011, is confidential and exempt from s. 119.07(1) and s.
 2980  24(a), Art. I of the State Constitution. This exemption applies
 2981  to such confidential and exempt information held by an agency
 2982  before, on, or after the effective date of the exemption.
 2983         (b) Information about the location of a safe house, safe
 2984  foster home, or other residential facility serving victims of
 2985  sexual exploitation, as defined in s. 39.01(70)(g) s.
 2986  39.01(69)(g), may be provided to an agency, as defined in s.
 2987  119.011, as necessary to maintain health and safety standards
 2988  and to address emergency situations in the safe house, safe
 2989  foster home, or other residential facility.
 2990         Section 75. Paragraph (e) of subsection (3) of section
 2991  409.966, Florida Statutes, is amended to read:
 2992         409.966 Eligible plans; selection.—
 2993         (3) QUALITY SELECTION CRITERIA.—
 2994         (e) To ensure managed care plan participation in Regions 1
 2995  and 2, the agency shall award an additional contract to each
 2996  plan with a contract award in Region 1 or Region 2. Such
 2997  contract shall be in any other region in which the plan
 2998  submitted a responsive bid and negotiates a rate acceptable to
 2999  the agency. If a plan that is awarded an additional contract
 3000  pursuant to this paragraph is subject to penalties pursuant to
 3001  s. 409.967(2)(i) s. 409.967(2)(h) for activities in Region 1 or
 3002  Region 2, the additional contract is automatically terminated
 3003  180 days after the imposition of the penalties. The plan must
 3004  reimburse the agency for the cost of enrollment changes and
 3005  other transition activities.
 3006         Section 76. Paragraph (b) of subsection (1) of section
 3007  409.972, Florida Statutes, is amended to read:
 3008         409.972 Mandatory and voluntary enrollment.—
 3009         (1) The following Medicaid-eligible persons are exempt from
 3010  mandatory managed care enrollment required by s. 409.965, and
 3011  may voluntarily choose to participate in the managed medical
 3012  assistance program:
 3013         (b) Medicaid recipients residing in residential commitment
 3014  facilities operated through the Department of Juvenile Justice
 3015  or a mental health treatment facility facilities as defined in
 3016  s. 394.455(47) by s. 394.455(32).
 3017         Section 77. Paragraphs (d) and (g) of subsection (1) of
 3018  section 440.102, Florida Statutes, are amended to read:
 3019         440.102 Drug-free workplace program requirements.—The
 3020  following provisions apply to a drug-free workplace program
 3021  implemented pursuant to law or to rules adopted by the Agency
 3022  for Health Care Administration:
 3023         (1) DEFINITIONS.—Except where the context otherwise
 3024  requires, as used in this act:
 3025         (d) “Drug rehabilitation program” means a service provider,
 3026  established pursuant to s. 397.311(42) s. 397.311(39), that
 3027  provides confidential, timely, and expert identification,
 3028  assessment, and resolution of employee drug abuse.
 3029         (g) “Employee assistance program” means an established
 3030  program capable of providing expert assessment of employee
 3031  personal concerns; confidential and timely identification
 3032  services with regard to employee drug abuse; referrals of
 3033  employees for appropriate diagnosis, treatment, and assistance;
 3034  and followup services for employees who participate in the
 3035  program or require monitoring after returning to work. If, in
 3036  addition to the above activities, an employee assistance program
 3037  provides diagnostic and treatment services, these services shall
 3038  in all cases be provided by service providers pursuant to s.
 3039  397.311(42) s. 397.311(39).
 3040         Section 78. Subsection (7) of section 744.704, Florida
 3041  Statutes, is amended to read:
 3042         744.704 Powers and duties.—
 3043         (7) A public guardian may shall not commit a ward to a
 3044  mental health treatment facility, as defined in s. 394.455(47)
 3045  s. 394.455(32), without an involuntary placement proceeding as
 3046  provided by law.
 3047         Section 79. Subsection (5) of section 960.065, Florida
 3048  Statutes, is amended to read:
 3049         960.065 Eligibility for awards.—
 3050         (5) A person is not ineligible for an award pursuant to
 3051  paragraph (2)(a), paragraph (2)(b), or paragraph (2)(c) if that
 3052  person is a victim of sexual exploitation of a child as defined
 3053  in s. 39.01(70)(g) s. 39.01(69)(g).
 3054         Section 80. The Secretary of Children and Families shall
 3055  appoint a workgroup to consider the feasibility of individuals
 3056  using advance directives to express the treatment wishes for
 3057  substance use disorders. The workgroup shall be composed of
 3058  individuals with expertise in the treatment of substance use
 3059  disorders. The workgroup must review the use of advance
 3060  directives in mental health, the use of advance directives for
 3061  substance use disorders in other states, and the use of similar
 3062  legal instruments to express the treatment wishes of individuals
 3063  suffering from substance use disorders. The workgroup shall
 3064  provide a report to the Governor, the President of the Senate,
 3065  and the Speaker of the House of Representatives by January 1,
 3066  2017. The report must include recommendations on the feasibility
 3067  of using advance directives for individuals with substance use
 3068  disorders and recommendations for any revisions to state laws or
 3069  agency rules. The members of the workgroup are not entitled to
 3070  reimbursement from the Department of Children and Families for
 3071  travel for workgroup meetings unless they are employees of the
 3072  department. This section expires on May 6, 2017.
 3073         Section 81. Paragraph (b) of subsection (2) of section
 3074  61.13, Florida Statutes, is amended to read:
 3075         61.13 Support of children; parenting and time-sharing;
 3076  powers of court.—
 3077         (2)
 3078         (b) A parenting plan approved by the court must, at a
 3079  minimum:,
 3080         1. Describe in adequate detail how the parents will share
 3081  and be responsible for the daily tasks associated with the
 3082  upbringing of the child;
 3083         2.Include the time-sharing schedule arrangements that
 3084  specify the time that the minor child will spend with each
 3085  parent;
 3086         3.Designate a designation of who will be responsible for:
 3087         a. Any and all forms of health care. If the court orders
 3088  shared parental responsibility over health care decisions, the
 3089  parenting plan must provide that either parent may consent to
 3090  mental health treatment for the child.
 3091         b. School-related matters, including the address to be used
 3092  for school-boundary determination and registration., and
 3093         c. Other activities; and
 3094         4.Describe in adequate detail the methods and technologies
 3095  that the parents will use to communicate with the child.
 3096         Section 82. Subsection (6) of section 39.001, Florida
 3097  Statutes, is amended to read:
 3098         39.001 Purposes and intent; personnel standards and
 3099  screening.—
 3100         (6) MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES.—
 3101         (a) The Legislature recognizes that early referral and
 3102  comprehensive treatment can help combat mental illnesses and
 3103  substance abuse disorders in families and that treatment is
 3104  cost-effective.
 3105         (b) The Legislature establishes the following goals for the
 3106  state related to mental illness and substance abuse treatment
 3107  services in the dependency process:
 3108         1. To ensure the safety of children.
 3109         2. To prevent and remediate the consequences of mental
 3110  illnesses and substance abuse disorders on families involved in
 3111  protective supervision or foster care and reduce the occurrences
 3112  of mental illnesses and substance abuse disorders, including
 3113  alcohol abuse or related disorders, for families who are at risk
 3114  of being involved in protective supervision or foster care.
 3115         3. To expedite permanency for children and reunify healthy,
 3116  intact families, when appropriate.
 3117         4. To support families in recovery.
 3118         (c) The Legislature finds that children in the care of the
 3119  state’s dependency system need appropriate health care services,
 3120  that the impact of mental illnesses and substance abuse
 3121  disorders on health indicates the need for health care services
 3122  to include treatment for mental health and substance abuse
 3123  disorders for services to children and parents, where
 3124  appropriate, and that it is in the state’s best interest that
 3125  such children be provided the services they need to enable them
 3126  to become and remain independent of state care. In order to
 3127  provide these services, the state’s dependency system must have
 3128  the ability to identify and provide appropriate intervention and
 3129  treatment for children with personal or family-related mental
 3130  illness and substance abuse problems.
 3131         (d) It is the intent of the Legislature to encourage the
 3132  use of the mental health court program model established under
 3133  chapter 394 and the drug court program model established under
 3134  by s. 397.334 and authorize courts to assess children and
 3135  persons who have custody or are requesting custody of children
 3136  where good cause is shown to identify and address mental
 3137  illnesses and substance abuse disorders problems as the court
 3138  deems appropriate at every stage of the dependency process.
 3139  Participation in treatment, including a mental health court
 3140  program or a treatment-based drug court program, may be required
 3141  by the court following adjudication. Participation in assessment
 3142  and treatment before prior to adjudication is shall be
 3143  voluntary, except as provided in s. 39.407(16).
 3144         (e) It is therefore the purpose of the Legislature to
 3145  provide authority for the state to contract with mental health
 3146  service providers and community substance abuse treatment
 3147  providers for the development and operation of specialized
 3148  support and overlay services for the dependency system, which
 3149  will be fully implemented and used as resources permit.
 3150         (f) Participation in a mental health court program or a the
 3151  treatment-based drug court program does not divest any public or
 3152  private agency of its responsibility for a child or adult, but
 3153  is intended to enable these agencies to better meet their needs
 3154  through shared responsibility and resources.
 3155         Section 83. Subsection (10) of section 39.507, Florida
 3156  Statutes, is amended to read:
 3157         39.507 Adjudicatory hearings; orders of adjudication.—
 3158         (10) After an adjudication of dependency, or a finding of
 3159  dependency in which where adjudication is withheld, the court
 3160  may order a person who has custody or is requesting custody of
 3161  the child to submit to a mental health or substance abuse
 3162  disorder assessment or evaluation. The order may be made only
 3163  upon good cause shown and pursuant to notice and procedural
 3164  requirements provided under the Florida Rules of Juvenile
 3165  Procedure. The assessment or evaluation must be administered by
 3166  an appropriate a qualified professional, as defined in s. 39.01
 3167  or s. 397.311. The court may also require such person to
 3168  participate in and comply with treatment and services identified
 3169  as necessary, including, when appropriate and available,
 3170  participation in and compliance with a mental health court
 3171  program established under chapter 394 or a treatment-based drug
 3172  court program established under s. 397.334. In addition to
 3173  supervision by the department, the court, including the mental
 3174  health court program or treatment-based drug court program, may
 3175  oversee the progress and compliance with treatment by a person
 3176  who has custody or is requesting custody of the child. The court
 3177  may impose appropriate available sanctions for noncompliance
 3178  upon a person who has custody or is requesting custody of the
 3179  child or make a finding of noncompliance for consideration in
 3180  determining whether an alternative placement of the child is in
 3181  the child’s best interests. Any order entered under this
 3182  subsection may be made only upon good cause shown. This
 3183  subsection does not authorize placement of a child with a person
 3184  seeking custody, other than the parent or legal custodian, who
 3185  requires mental health or substance abuse disorder treatment.
 3186         Section 84. Paragraph (b) of subsection (1) of section
 3187  39.521, Florida Statutes, is amended to read:
 3188         39.521 Disposition hearings; powers of disposition.—
 3189         (1) A disposition hearing shall be conducted by the court,
 3190  if the court finds that the facts alleged in the petition for
 3191  dependency were proven in the adjudicatory hearing, or if the
 3192  parents or legal custodians have consented to the finding of
 3193  dependency or admitted the allegations in the petition, have
 3194  failed to appear for the arraignment hearing after proper
 3195  notice, or have not been located despite a diligent search
 3196  having been conducted.
 3197         (b) When any child is adjudicated by a court to be
 3198  dependent, the court having jurisdiction of the child has the
 3199  power by order to:
 3200         1. Require the parent and, when appropriate, the legal
 3201  custodian and the child to participate in treatment and services
 3202  identified as necessary. The court may require the person who
 3203  has custody or who is requesting custody of the child to submit
 3204  to a mental health or substance abuse disorder assessment or
 3205  evaluation. The order may be made only upon good cause shown and
 3206  pursuant to notice and procedural requirements provided under
 3207  the Florida Rules of Juvenile Procedure. The mental health
 3208  assessment or evaluation must be administered by a qualified
 3209  professional, as defined in s. 39.01, and the substance abuse
 3210  assessment or evaluation must be administered by a qualified
 3211  professional as defined in s. 397.311. The court may also
 3212  require such person to participate in and comply with treatment
 3213  and services identified as necessary, including, when
 3214  appropriate and available, participation in and compliance with
 3215  a mental health court program established under chapter 394 or a
 3216  treatment-based drug court program established under s. 397.334.
 3217  In addition to supervision by the department, the court,
 3218  including the mental health court program or the treatment-based
 3219  drug court program, may oversee the progress and compliance with
 3220  treatment by a person who has custody or is requesting custody
 3221  of the child. The court may impose appropriate available
 3222  sanctions for noncompliance upon a person who has custody or is
 3223  requesting custody of the child or make a finding of
 3224  noncompliance for consideration in determining whether an
 3225  alternative placement of the child is in the child’s best
 3226  interests. Any order entered under this subparagraph may be made
 3227  only upon good cause shown. This subparagraph does not authorize
 3228  placement of a child with a person seeking custody of the child,
 3229  other than the child’s parent or legal custodian, who requires
 3230  mental health or substance abuse disorder treatment.
 3231         2. Require, if the court deems necessary, the parties to
 3232  participate in dependency mediation.
 3233         3. Require placement of the child either under the
 3234  protective supervision of an authorized agent of the department
 3235  in the home of one or both of the child’s parents or in the home
 3236  of a relative of the child or another adult approved by the
 3237  court, or in the custody of the department. Protective
 3238  supervision continues until the court terminates it or until the
 3239  child reaches the age of 18, whichever date is first. Protective
 3240  supervision shall be terminated by the court whenever the court
 3241  determines that permanency has been achieved for the child,
 3242  whether with a parent, another relative, or a legal custodian,
 3243  and that protective supervision is no longer needed. The
 3244  termination of supervision may be with or without retaining
 3245  jurisdiction, at the court’s discretion, and shall in either
 3246  case be considered a permanency option for the child. The order
 3247  terminating supervision by the department must shall set forth
 3248  the powers of the custodian of the child and shall include the
 3249  powers ordinarily granted to a guardian of the person of a minor
 3250  unless otherwise specified. Upon the court’s termination of
 3251  supervision by the department, no further judicial reviews are
 3252  not required if, so long as permanency has been established for
 3253  the child.
 3254         Section 85. Section 394.4655, Florida Statutes, is amended
 3255  to read:
 3256         394.4655 Involuntary outpatient services placement.—
 3257         (1)DEFINITIONS.—As used in this section, the term:
 3258         (a)“Court” means a circuit court or a criminal county
 3259  court.
 3260         (b)“Criminal county court” means a county court exercising
 3261  its original jurisdiction in a misdemeanor case under s. 34.01.
 3262         (2)(1) CRITERIA FOR INVOLUNTARY OUTPATIENT SERVICES
 3263  PLACEMENT.—A person may be ordered to involuntary outpatient
 3264  services placement upon a finding of the court, by clear and
 3265  convincing evidence, that the person meets all of the following
 3266  criteria by clear and convincing evidence:
 3267         (a) The person is 18 years of age or older.;
 3268         (b) The person has a mental illness.;
 3269         (c) The person is unlikely to survive safely in the
 3270  community without supervision, based on a clinical
 3271  determination.;
 3272         (d) The person has a history of lack of compliance with
 3273  treatment for mental illness.;
 3274         (e) The person has:
 3275         1. At least twice within the immediately preceding 36
 3276  months been involuntarily admitted to a receiving or treatment
 3277  facility as defined in s. 394.455, or has received mental health
 3278  services in a forensic or correctional facility. The 36-month
 3279  period does not include any period during which the person was
 3280  admitted or incarcerated; or
 3281         2. Engaged in one or more acts of serious violent behavior
 3282  toward self or others, or attempts at serious bodily harm to
 3283  himself or herself or others, within the preceding 36 months.;
 3284         (f) The person is, as a result of his or her mental
 3285  illness, unlikely to voluntarily participate in the recommended
 3286  treatment plan and either he or she has refused voluntary
 3287  services placement for treatment after sufficient and
 3288  conscientious explanation and disclosure of why the services are
 3289  necessary purpose of placement for treatment or he or she is
 3290  unable to determine for himself or herself whether services are
 3291  placement is necessary.;
 3292         (g) In view of the person’s treatment history and current
 3293  behavior, the person is in need of involuntary outpatient
 3294  services placement in order to prevent a relapse or
 3295  deterioration that would be likely to result in serious bodily
 3296  harm to himself or herself or others, or a substantial harm to
 3297  his or her well-being as set forth in s. 394.463(1).;
 3298         (h) It is likely that the person will benefit from
 3299  involuntary outpatient services. placement; and
 3300         (i) All available, less restrictive alternatives that would
 3301  offer an opportunity for improvement of his or her condition
 3302  have been judged to be inappropriate or unavailable.
 3303         (3)(2) INVOLUNTARY OUTPATIENT SERVICES PLACEMENT.—
 3304         (a)1. A patient who is being recommended for involuntary
 3305  outpatient services placement by the administrator of the
 3306  receiving facility where the patient has been examined may be
 3307  retained by the facility after adherence to the notice
 3308  procedures provided in s. 394.4599. The recommendation must be
 3309  supported by the opinion of a psychiatrist and the second
 3310  opinion of a clinical psychologist or another psychiatrist, both
 3311  of whom have personally examined the patient within the
 3312  preceding 72 hours, that the criteria for involuntary outpatient
 3313  services placement are met. However, in a county having a
 3314  population of fewer than 50,000, if the administrator certifies
 3315  that a psychiatrist or clinical psychologist is not available to
 3316  provide the second opinion, the second opinion may be provided
 3317  by a licensed physician who has postgraduate training and
 3318  experience in diagnosis and treatment of mental illness, a
 3319  physician assistant who has at least 3 years’ experience and is
 3320  supervised by such licensed physician or a psychiatrist, a
 3321  clinical social worker, and nervous disorders or by a
 3322  psychiatric nurse. Any second opinion authorized in this
 3323  subparagraph may be conducted through a face-to-face
 3324  examination, in person or by electronic means. Such
 3325  recommendation must be entered on an involuntary outpatient
 3326  services placement certificate that authorizes the receiving
 3327  facility to retain the patient pending completion of a hearing.
 3328  The certificate must shall be made a part of the patient’s
 3329  clinical record.
 3330         2. If the patient has been stabilized and no longer meets
 3331  the criteria for involuntary examination pursuant to s.
 3332  394.463(1), the patient must be released from the receiving
 3333  facility while awaiting the hearing for involuntary outpatient
 3334  services placement. Before filing a petition for involuntary
 3335  outpatient services treatment, the administrator of the a
 3336  receiving facility or a designated department representative
 3337  must identify the service provider that will have primary
 3338  responsibility for service provision under an order for
 3339  involuntary outpatient services placement, unless the person is
 3340  otherwise participating in outpatient psychiatric treatment and
 3341  is not in need of public financing for that treatment, in which
 3342  case the individual, if eligible, may be ordered to involuntary
 3343  treatment pursuant to the existing psychiatric treatment
 3344  relationship.
 3345         3. The service provider shall prepare a written proposed
 3346  treatment plan in consultation with the patient or the patient’s
 3347  guardian advocate, if appointed, for the court’s consideration
 3348  for inclusion in the involuntary outpatient services placement
 3349  order that addresses the nature and extent of the mental illness
 3350  and any co-occurring substance use disorder that necessitate
 3351  involuntary outpatient services. The treatment plan must specify
 3352  the likely level of care, including the use of medication, and
 3353  anticipated discharge criteria for terminating involuntary
 3354  outpatient services. The service provider shall also provide a
 3355  copy of the proposed treatment plan to the patient and the
 3356  administrator of the receiving facility. The treatment plan must
 3357  specify the nature and extent of the patient’s mental illness,
 3358  address the reduction of symptoms that necessitate involuntary
 3359  outpatient placement, and include measurable goals and
 3360  objectives for the services and treatment that are provided to
 3361  treat the person’s mental illness and assist the person in
 3362  living and functioning in the community or to prevent a relapse
 3363  or deterioration. Service providers may select and supervise
 3364  other individuals to implement specific aspects of the treatment
 3365  plan. The services in the treatment plan must be deemed
 3366  clinically appropriate by a physician, clinical psychologist,
 3367  psychiatric nurse, mental health counselor, marriage and family
 3368  therapist, or clinical social worker who consults with, or is
 3369  employed or contracted by, the service provider. The service
 3370  provider must certify to the court in the proposed treatment
 3371  plan whether sufficient services for improvement and
 3372  stabilization are currently available and whether the service
 3373  provider agrees to provide those services. If the service
 3374  provider certifies that the services in the proposed treatment
 3375  plan are not available, the petitioner may not file the
 3376  petition. The service provider must notify the managing entity
 3377  if the requested services are not available. The managing entity
 3378  must document such efforts to obtain the requested services.
 3379         (b) If a patient in involuntary inpatient placement meets
 3380  the criteria for involuntary outpatient services placement, the
 3381  administrator of the treatment facility may, before the
 3382  expiration of the period during which the treatment facility is
 3383  authorized to retain the patient, recommend involuntary
 3384  outpatient services placement. The recommendation must be
 3385  supported by the opinion of a psychiatrist and the second
 3386  opinion of a clinical psychologist or another psychiatrist, both
 3387  of whom have personally examined the patient within the
 3388  preceding 72 hours, that the criteria for involuntary outpatient
 3389  services placement are met. However, in a county having a
 3390  population of fewer than 50,000, if the administrator certifies
 3391  that a psychiatrist or clinical psychologist is not available to
 3392  provide the second opinion, the second opinion may be provided
 3393  by a licensed physician who has postgraduate training and
 3394  experience in diagnosis and treatment of mental illness, a
 3395  physician assistant who has at least three years’ experience and
 3396  is supervised by such licensed physician or a psychiatrist, a
 3397  clinical social worker, and nervous disorders or by a
 3398  psychiatric nurse. Any second opinion authorized in this
 3399  subparagraph may be conducted through a face-to-face
 3400  examination, in person or by electronic means. Such
 3401  recommendation must be entered on an involuntary outpatient
 3402  services placement certificate, and the certificate must be made
 3403  a part of the patient’s clinical record.
 3404         (c)1. The administrator of the treatment facility shall
 3405  provide a copy of the involuntary outpatient services placement
 3406  certificate and a copy of the state mental health discharge form
 3407  to the managing entity a department representative in the county
 3408  where the patient will be residing. For persons who are leaving
 3409  a state mental health treatment facility, the petition for
 3410  involuntary outpatient services placement must be filed in the
 3411  county where the patient will be residing.
 3412         2. The service provider that will have primary
 3413  responsibility for service provision shall be identified by the
 3414  designated department representative before prior to the order
 3415  for involuntary outpatient services placement and must, before
 3416  prior to filing a petition for involuntary outpatient services
 3417  placement, certify to the court whether the services recommended
 3418  in the patient’s discharge plan are available in the local
 3419  community and whether the service provider agrees to provide
 3420  those services. The service provider must develop with the
 3421  patient, or the patient’s guardian advocate, if appointed, a
 3422  treatment or service plan that addresses the needs identified in
 3423  the discharge plan. The plan must be deemed to be clinically
 3424  appropriate by a physician, clinical psychologist, psychiatric
 3425  nurse, mental health counselor, marriage and family therapist,
 3426  or clinical social worker, as defined in this chapter, who
 3427  consults with, or is employed or contracted by, the service
 3428  provider.
 3429         3. If the service provider certifies that the services in
 3430  the proposed treatment or service plan are not available, the
 3431  petitioner may not file the petition. The service provider must
 3432  notify the managing entity if the requested services are not
 3433  available. The managing entity must document such efforts to
 3434  obtain the requested services.
 3435         (4)(3) PETITION FOR INVOLUNTARY OUTPATIENT SERVICES
 3436  PLACEMENT.—
 3437         (a) A petition for involuntary outpatient services
 3438  placement may be filed by:
 3439         1. The administrator of a receiving facility; or
 3440         2. The administrator of a treatment facility.
 3441         (b) Each required criterion for involuntary outpatient
 3442  services placement must be alleged and substantiated in the
 3443  petition for involuntary outpatient services placement. A copy
 3444  of the certificate recommending involuntary outpatient services
 3445  placement completed by a qualified professional specified in
 3446  subsection (3) (2) must be attached to the petition. A copy of
 3447  the proposed treatment plan must be attached to the petition.
 3448  Before the petition is filed, the service provider shall certify
 3449  that the services in the proposed treatment plan are available.
 3450  If the necessary services are not available in the patient’s
 3451  local community to respond to the person’s individual needs, the
 3452  petition may not be filed. The service provider must notify the
 3453  managing entity if the requested services are not available. The
 3454  managing entity must document such efforts to obtain the
 3455  requested services.
 3456         (c) The petition for involuntary outpatient services
 3457  placement must be filed in the county where the patient is
 3458  located, unless the patient is being placed from a state
 3459  treatment facility, in which case the petition must be filed in
 3460  the county where the patient will reside. When the petition has
 3461  been filed, the clerk of the court shall provide copies of the
 3462  petition and the proposed treatment plan to the department, the
 3463  managing entity, the patient, the patient’s guardian or
 3464  representative, the state attorney, and the public defender or
 3465  the patient’s private counsel. A fee may not be charged for
 3466  filing a petition under this subsection.
 3467         (5)(4) APPOINTMENT OF COUNSEL.—Within 1 court working day
 3468  after the filing of a petition for involuntary outpatient
 3469  services placement, the court shall appoint the public defender
 3470  to represent the person who is the subject of the petition,
 3471  unless the person is otherwise represented by counsel. The clerk
 3472  of the court shall immediately notify the public defender of the
 3473  appointment. The public defender shall represent the person
 3474  until the petition is dismissed, the court order expires, or the
 3475  patient is discharged from involuntary outpatient services
 3476  placement. An attorney who represents the patient must be
 3477  provided shall have access to the patient, witnesses, and
 3478  records relevant to the presentation of the patient’s case and
 3479  shall represent the interests of the patient, regardless of the
 3480  source of payment to the attorney.
 3481         (6)(5) CONTINUANCE OF HEARING.—The patient is entitled,
 3482  with the concurrence of the patient’s counsel, to at least one
 3483  continuance of the hearing. The continuance shall be for a
 3484  period of up to 4 weeks.
 3485         (7)(6) HEARING ON INVOLUNTARY OUTPATIENT SERVICES
 3486  PLACEMENT.—
 3487         (a)1. The court shall hold the hearing on involuntary
 3488  outpatient services placement within 5 working days after the
 3489  filing of the petition, unless a continuance is granted. The
 3490  hearing must shall be held in the county where the petition is
 3491  filed, must shall be as convenient to the patient as is
 3492  consistent with orderly procedure, and must shall be conducted
 3493  in physical settings not likely to be injurious to the patient’s
 3494  condition. If the court finds that the patient’s attendance at
 3495  the hearing is not consistent with the best interests of the
 3496  patient and if the patient’s counsel does not object, the court
 3497  may waive the presence of the patient from all or any portion of
 3498  the hearing. The state attorney for the circuit in which the
 3499  patient is located shall represent the state, rather than the
 3500  petitioner, as the real party in interest in the proceeding.
 3501         2. The court may appoint a magistrate master to preside at
 3502  the hearing. One of the professionals who executed the
 3503  involuntary outpatient services placement certificate shall be a
 3504  witness. The patient and the patient’s guardian or
 3505  representative shall be informed by the court of the right to an
 3506  independent expert examination. If the patient cannot afford
 3507  such an examination, the court shall ensure that one is
 3508  provided, as otherwise provided by law provide for one. The
 3509  independent expert’s report is shall be confidential and not
 3510  discoverable, unless the expert is to be called as a witness for
 3511  the patient at the hearing. The court shall allow testimony from
 3512  individuals, including family members, deemed by the court to be
 3513  relevant under state law, regarding the person’s prior history
 3514  and how that prior history relates to the person’s current
 3515  condition. The testimony in the hearing must be given under
 3516  oath, and the proceedings must be recorded. The patient may
 3517  refuse to testify at the hearing.
 3518         (b)1. If the court concludes that the patient meets the
 3519  criteria for involuntary outpatient services placement pursuant
 3520  to subsection (2) (1), the court shall issue an order for
 3521  involuntary outpatient services placement. The court order shall
 3522  be for a period of up to 90 days 6 months. The order must
 3523  specify the nature and extent of the patient’s mental illness.
 3524  The order of the court and the treatment plan must shall be made
 3525  part of the patient’s clinical record. The service provider
 3526  shall discharge a patient from involuntary outpatient services
 3527  placement when the order expires or any time the patient no
 3528  longer meets the criteria for involuntary placement. Upon
 3529  discharge, the service provider shall send a certificate of
 3530  discharge to the court.
 3531         2. The court may not order the department or the service
 3532  provider to provide services if the program or service is not
 3533  available in the patient’s local community, if there is no space
 3534  available in the program or service for the patient, or if
 3535  funding is not available for the program or service. The service
 3536  provider must notify the managing entity if the requested
 3537  services are not available. The managing entity must document
 3538  such efforts to obtain the requested services. A copy of the
 3539  order must be sent to the managing entity Agency for Health Care
 3540  Administration by the service provider within 1 working day
 3541  after it is received from the court. The order may be submitted
 3542  electronically through existing data systems. After the
 3543  placement order for involuntary services is issued, the service
 3544  provider and the patient may modify provisions of the treatment
 3545  plan. For any material modification of the treatment plan to
 3546  which the patient or, if one is appointed, the patient’s
 3547  guardian advocate agrees, if appointed, does agree, the service
 3548  provider shall send notice of the modification to the court. Any
 3549  material modifications of the treatment plan which are contested
 3550  by the patient or the patient’s guardian advocate, if applicable
 3551  appointed, must be approved or disapproved by the court
 3552  consistent with subsection (3) (2).
 3553         3. If, in the clinical judgment of a physician, the patient
 3554  has failed or has refused to comply with the treatment ordered
 3555  by the court, and, in the clinical judgment of the physician,
 3556  efforts were made to solicit compliance and the patient may meet
 3557  the criteria for involuntary examination, a person may be
 3558  brought to a receiving facility pursuant to s. 394.463. If,
 3559  after examination, the patient does not meet the criteria for
 3560  involuntary inpatient placement pursuant to s. 394.467, the
 3561  patient must be discharged from the receiving facility. The
 3562  involuntary outpatient services placement order shall remain in
 3563  effect unless the service provider determines that the patient
 3564  no longer meets the criteria for involuntary outpatient services
 3565  placement or until the order expires. The service provider must
 3566  determine whether modifications should be made to the existing
 3567  treatment plan and must attempt to continue to engage the
 3568  patient in treatment. For any material modification of the
 3569  treatment plan to which the patient or the patient’s guardian
 3570  advocate, if applicable appointed, agrees does agree, the
 3571  service provider shall send notice of the modification to the
 3572  court. Any material modifications of the treatment plan which
 3573  are contested by the patient or the patient’s guardian advocate,
 3574  if applicable appointed, must be approved or disapproved by the
 3575  court consistent with subsection (3) (2).
 3576         (c) If, at any time before the conclusion of the initial
 3577  hearing on involuntary outpatient services placement, it appears
 3578  to the court that the person does not meet the criteria for
 3579  involuntary outpatient services placement under this section
 3580  but, instead, meets the criteria for involuntary inpatient
 3581  placement, the court may order the person admitted for
 3582  involuntary inpatient examination under s. 394.463. If the
 3583  person instead meets the criteria for involuntary assessment,
 3584  protective custody, or involuntary admission pursuant to s.
 3585  397.675, the court may order the person to be admitted for
 3586  involuntary assessment for a period of 5 days pursuant to s.
 3587  397.6811. Thereafter, all proceedings are shall be governed by
 3588  chapter 397.
 3589         (d) At the hearing on involuntary outpatient services
 3590  placement, the court shall consider testimony and evidence
 3591  regarding the patient’s competence to consent to services
 3592  treatment. If the court finds that the patient is incompetent to
 3593  consent to treatment, it shall appoint a guardian advocate as
 3594  provided in s. 394.4598. The guardian advocate shall be
 3595  appointed or discharged in accordance with s. 394.4598.
 3596         (e) The administrator of the receiving facility or the
 3597  designated department representative shall provide a copy of the
 3598  court order and adequate documentation of a patient’s mental
 3599  illness to the service provider for involuntary outpatient
 3600  services placement. Such documentation must include any advance
 3601  directives made by the patient, a psychiatric evaluation of the
 3602  patient, and any evaluations of the patient performed by a
 3603  clinical psychologist or a clinical social worker.
 3604         (8)(7) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT
 3605  SERVICES PLACEMENT.—
 3606         (a)1. If the person continues to meet the criteria for
 3607  involuntary outpatient services placement, the service provider
 3608  shall, at least 10 days before the expiration of the period
 3609  during which the treatment is ordered for the person, file in
 3610  the circuit court that issued the order for involuntary
 3611  outpatient services a petition for continued involuntary
 3612  outpatient services placement. The court shall immediately
 3613  schedule a hearing on the petition to be held within 15 days
 3614  after the petition is filed.
 3615         2. The existing involuntary outpatient services placement
 3616  order remains in effect until disposition on the petition for
 3617  continued involuntary outpatient services placement.
 3618         3. A certificate shall be attached to the petition which
 3619  includes a statement from the person’s physician or clinical
 3620  psychologist justifying the request, a brief description of the
 3621  patient’s treatment during the time he or she was receiving
 3622  involuntary services involuntarily placed, and an individualized
 3623  plan of continued treatment.
 3624         4. The service provider shall develop the individualized
 3625  plan of continued treatment in consultation with the patient or
 3626  the patient’s guardian advocate, if applicable appointed. When
 3627  the petition has been filed, the clerk of the court shall
 3628  provide copies of the certificate and the individualized plan of
 3629  continued services treatment to the department, the patient, the
 3630  patient’s guardian advocate, the state attorney, and the
 3631  patient’s private counsel or the public defender.
 3632         (b) Within 1 court working day after the filing of a
 3633  petition for continued involuntary outpatient services
 3634  placement, the court shall appoint the public defender to
 3635  represent the person who is the subject of the petition, unless
 3636  the person is otherwise represented by counsel. The clerk of the
 3637  court shall immediately notify the public defender of such
 3638  appointment. The public defender shall represent the person
 3639  until the petition is dismissed or the court order expires or
 3640  the patient is discharged from involuntary outpatient services
 3641  placement. Any attorney representing the patient shall have
 3642  access to the patient, witnesses, and records relevant to the
 3643  presentation of the patient’s case and shall represent the
 3644  interests of the patient, regardless of the source of payment to
 3645  the attorney.
 3646         (c) Hearings on petitions for continued involuntary
 3647  outpatient services must placement shall be before the circuit
 3648  court that issued the order for involuntary outpatient services.
 3649  The court may appoint a magistrate master to preside at the
 3650  hearing. The procedures for obtaining an order pursuant to this
 3651  paragraph must meet the requirements of shall be in accordance
 3652  with subsection (7) (6), except that the time period included in
 3653  paragraph (2)(e) (1)(e) is not applicable in determining the
 3654  appropriateness of additional periods of involuntary outpatient
 3655  placement.
 3656         (d) Notice of the hearing must shall be provided as set
 3657  forth in s. 394.4599. The patient and the patient’s attorney may
 3658  agree to a period of continued outpatient services placement
 3659  without a court hearing.
 3660         (e) The same procedure must shall be repeated before the
 3661  expiration of each additional period the patient is placed in
 3662  treatment.
 3663         (f) If the patient has previously been found incompetent to
 3664  consent to treatment, the court shall consider testimony and
 3665  evidence regarding the patient’s competence. Section 394.4598
 3666  governs the discharge of the guardian advocate if the patient’s
 3667  competency to consent to treatment has been restored.
 3668         Section 86. Paragraphs (c) and (d) of subsection (2) of
 3669  section 394.4599, Florida Statutes, are amended to read:
 3670         394.4599 Notice.—
 3671         (2) INVOLUNTARY ADMISSION.—
 3672         (c)1. A receiving facility shall give notice of the
 3673  whereabouts of a minor who is being involuntarily held for
 3674  examination pursuant to s. 394.463 to the minor’s parent,
 3675  guardian, caregiver, or guardian advocate, in person or by
 3676  telephone or other form of electronic communication, immediately
 3677  after the minor’s arrival at the facility. The facility may
 3678  delay notification for no more than 24 hours after the minor’s
 3679  arrival if the facility has submitted a report to the central
 3680  abuse hotline, pursuant to s. 39.201, based upon knowledge or
 3681  suspicion of abuse, abandonment, or neglect and if the facility
 3682  deems a delay in notification to be in the minor’s best
 3683  interest.
 3684         2. The receiving facility shall attempt to notify the
 3685  minor’s parent, guardian, caregiver, or guardian advocate until
 3686  the receiving facility receives confirmation from the parent,
 3687  guardian, caregiver, or guardian advocate, verbally, by
 3688  telephone or other form of electronic communication, or by
 3689  recorded message, that notification has been received. Attempts
 3690  to notify the parent, guardian, caregiver, or guardian advocate
 3691  must be repeated at least once every hour during the first 12
 3692  hours after the minor’s arrival and once every 24 hours
 3693  thereafter and must continue until such confirmation is
 3694  received, unless the minor is released at the end of the 72-hour
 3695  examination period, or until a petition for involuntary services
 3696  placement is filed with the court pursuant to s. 394.463(2)(g)
 3697  s. 394.463(2)(i). The receiving facility may seek assistance
 3698  from a law enforcement agency to notify the minor’s parent,
 3699  guardian, caregiver, or guardian advocate if the facility has
 3700  not received within the first 24 hours after the minor’s arrival
 3701  a confirmation by the parent, guardian, caregiver, or guardian
 3702  advocate that notification has been received. The receiving
 3703  facility must document notification attempts in the minor’s
 3704  clinical record.
 3705         (d) The written notice of the filing of the petition for
 3706  involuntary services for placement of an individual being held
 3707  must contain the following:
 3708         1. Notice that the petition for:
 3709         a.Involuntary inpatient treatment pursuant to s. 394.467
 3710  has been filed with the circuit court in the county in which the
 3711  individual is hospitalized and the address of such court; or
 3712         b.Involuntary outpatient services pursuant to s. 394.4655
 3713  has been filed with the criminal county court, as defined in s.
 3714  394.4655(1), or the circuit court, as applicable, in the county
 3715  in which the individual is hospitalized and the address of such
 3716  court.
 3717         2. Notice that the office of the public defender has been
 3718  appointed to represent the individual in the proceeding, if the
 3719  individual is not otherwise represented by counsel.
 3720         3. The date, time, and place of the hearing and the name of
 3721  each examining expert and every other person expected to testify
 3722  in support of continued detention.
 3723         4. Notice that the individual, the individual’s guardian,
 3724  guardian advocate, health care surrogate or proxy, or
 3725  representative, or the administrator may apply for a change of
 3726  venue for the convenience of the parties or witnesses or because
 3727  of the condition of the individual.
 3728         5. Notice that the individual is entitled to an independent
 3729  expert examination and, if the individual cannot afford such an
 3730  examination, that the court will provide for one.
 3731         Section 87. Section 394.455, Florida Statutes, is amended
 3732  to read:
 3733         394.455 Definitions.—As used in this part, unless the
 3734  context clearly requires otherwise, the term:
 3735         (1)“Access center” means a facility that has medical,
 3736  mental health, and substance abuse professionals to provide
 3737  emergency screening and evaluation for mental health or
 3738  substance abuse disorders and may provide transportation to an
 3739  appropriate facility if an individual is in need of more
 3740  intensive services.
 3741         (2)“Addictions receiving facility” is a secure, acute care
 3742  facility that, at a minimum, provides emergency screening,
 3743  evaluation, detoxification, and stabilization services; is
 3744  operated 24 hours per day, 7 days per week; and is designated by
 3745  the department to serve individuals found to have substance
 3746  abuse impairment who qualify for services under this part.
 3747         (3)(1) “Administrator” means the chief administrative
 3748  officer of a receiving or treatment facility or his or her
 3749  designee.
 3750         (4)“Adult” means an individual who is 18 years of age or
 3751  older or who has had the disability of nonage removed under
 3752  chapter 743.
 3753         (5)(2) “Clinical psychologist” means a psychologist as
 3754  defined in s. 490.003(7) with 3 years of postdoctoral experience
 3755  in the practice of clinical psychology, inclusive of the
 3756  experience required for licensure, or a psychologist employed by
 3757  a facility operated by the United States Department of Veterans
 3758  Affairs that qualifies as a receiving or treatment facility
 3759  under this part.
 3760         (6)(3) “Clinical record” means all parts of the record
 3761  required to be maintained and includes all medical records,
 3762  progress notes, charts, and admission and discharge data, and
 3763  all other information recorded by a facility staff which
 3764  pertains to the patient’s hospitalization or treatment.
 3765         (7)(4) “Clinical social worker” means a person licensed as
 3766  a clinical social worker under s. 491.005 or s. 491.006 chapter
 3767  491.
 3768         (8)(5) “Community facility” means a any community service
 3769  provider that contracts contracting with the department to
 3770  furnish substance abuse or mental health services under part IV
 3771  of this chapter.
 3772         (9)(6) “Community mental health center or clinic” means a
 3773  publicly funded, not-for-profit center that which contracts with
 3774  the department for the provision of inpatient, outpatient, day
 3775  treatment, or emergency services.
 3776         (10)(7) “Court,” unless otherwise specified, means the
 3777  circuit court.
 3778         (11)(8) “Department” means the Department of Children and
 3779  Families.
 3780         (12)“Designated receiving facility” means a facility
 3781  approved by the department which may be a public or private
 3782  hospital, crisis stabilization unit, or addictions receiving
 3783  facility; which provides, at a minimum, emergency screening,
 3784  evaluation, and short-term stabilization for mental health or
 3785  substance abuse disorders; and which may have an agreement with
 3786  a corresponding facility for transportation and services.
 3787         (13)“Detoxification facility” means a facility licensed to
 3788  provide detoxification services under chapter 397.
 3789         (14)“Electronic means” means a form of telecommunication
 3790  which requires all parties to maintain visual as well as audio
 3791  communication when being used to conduct an examination by a
 3792  qualified professional.
 3793         (15)(9) “Express and informed consent” means consent
 3794  voluntarily given in writing, by a competent person, after
 3795  sufficient explanation and disclosure of the subject matter
 3796  involved to enable the person to make a knowing and willful
 3797  decision without any element of force, fraud, deceit, duress, or
 3798  other form of constraint or coercion.
 3799         (16)(10) “Facility” means any hospital, community facility,
 3800  public or private facility, or receiving or treatment facility
 3801  providing for the evaluation, diagnosis, care, treatment,
 3802  training, or hospitalization of persons who appear to have a
 3803  mental illness or who have been diagnosed as having a mental
 3804  illness or substance abuse impairment. The term “Facility” does
 3805  not include a any program or an entity licensed under pursuant
 3806  to chapter 400 or chapter 429.
 3807         (17)(11) “Guardian” means the natural guardian of a minor,
 3808  or a person appointed by a court to act on behalf of a ward’s
 3809  person if the ward is a minor or has been adjudicated
 3810  incapacitated.
 3811         (18)(12) “Guardian advocate” means a person appointed by a
 3812  court to make decisions regarding mental health treatment on
 3813  behalf of a patient who has been found incompetent to consent to
 3814  treatment pursuant to this part. The guardian advocate may be
 3815  granted specific additional powers by written order of the
 3816  court, as provided in this part.
 3817         (19)(13) “Hospital” means a hospital facility as defined in
 3818  s. 395.002 and licensed under chapter 395 and part II of chapter
 3819  408.
 3820         (20)(14) “Incapacitated” means that a person has been
 3821  adjudicated incapacitated pursuant to part V of chapter 744 and
 3822  a guardian of the person has been appointed.
 3823         (21)(15) “Incompetent to consent to treatment” means a
 3824  state in which that a person’s judgment is so affected by a his
 3825  or her mental illness or a substance abuse impairment that he or
 3826  she the person lacks the capacity to make a well-reasoned,
 3827  willful, and knowing decision concerning his or her medical, or
 3828  mental health, or substance abuse treatment.
 3829         (22)“Involuntary examination” means an examination
 3830  performed under s. 394.463, s. 397.6772, s. 397.679, s.
 3831  397.6798, or s. 397.6811 to determine whether a person qualifies
 3832  for involuntary services.
 3833         (23)“Involuntary services” means court-ordered outpatient
 3834  services or inpatient placement for mental health treatment
 3835  pursuant to s. 394.4655 or s. 394.467.
 3836         (24)(16) “Law enforcement officer” has the same meaning as
 3837  provided means a law enforcement officer as defined in s.
 3838  943.10.
 3839         (25)“Marriage and family therapist” means a person
 3840  licensed to practice marriage and family therapy under s.
 3841  491.005 or s. 491.006.
 3842         (26)“Mental health counselor” means a person licensed to
 3843  practice mental health counseling under s. 491.005 or s.
 3844  491.006.
 3845         (27)(17) “Mental health overlay program” means a mobile
 3846  service that which provides an independent examination for
 3847  voluntary admission admissions and a range of supplemental
 3848  onsite services to persons with a mental illness in a
 3849  residential setting such as a nursing home, an assisted living
 3850  facility, or an adult family-care home, or a nonresidential
 3851  setting such as an adult day care center. Independent
 3852  examinations provided pursuant to this part through a mental
 3853  health overlay program must only be provided under contract with
 3854  the department for this service or be attached to a public
 3855  receiving facility that is also a community mental health
 3856  center.
 3857         (28)(18) “Mental illness” means an impairment of the mental
 3858  or emotional processes that exercise conscious control of one’s
 3859  actions or of the ability to perceive or understand reality,
 3860  which impairment substantially interferes with the person’s
 3861  ability to meet the ordinary demands of living. For the purposes
 3862  of this part, the term does not include a developmental
 3863  disability as defined in chapter 393, intoxication, or
 3864  conditions manifested only by antisocial behavior or substance
 3865  abuse impairment.
 3866         (29)“Minor” means an individual who is 17 years of age or
 3867  younger and who has not had the disability of nonage removed
 3868  pursuant to s. 743.01 or s. 743.015.
 3869         (30)(19) “Mobile crisis response service” means a
 3870  nonresidential crisis service attached to a public receiving
 3871  facility and available 24 hours per a day, 7 days per a week,
 3872  through which provides immediate intensive assessments and
 3873  interventions, including screening for admission into a mental
 3874  health receiving facility, an addictions receiving facility, or
 3875  a detoxification facility, take place for the purpose of
 3876  identifying appropriate treatment services.
 3877         (31)(20) “Patient” means any person, with or without a co
 3878  occurring substance abuse disorder, who is held or accepted for
 3879  mental health treatment.
 3880         (32)(21) “Physician” means a medical practitioner licensed
 3881  under chapter 458 or chapter 459 who has experience in the
 3882  diagnosis and treatment of mental illness and nervous disorders
 3883  or a physician employed by a facility operated by the United
 3884  States Department of Veterans Affairs or the United States
 3885  Department of Defense which qualifies as a receiving or
 3886  treatment facility under this part.
 3887         (33)“Physician assistant” means a person licensed under
 3888  chapter 458 or chapter 459 who has experience in the diagnosis
 3889  and treatment of mental disorders.
 3890         (34)(22) “Private facility” means a any hospital or
 3891  facility operated by a for-profit or not-for-profit corporation
 3892  or association which that provides mental health or substance
 3893  abuse services and is not a public facility.
 3894         (35)(23) “Psychiatric nurse” means an advanced registered
 3895  nurse practitioner certified under s. 464.012 who has a master’s
 3896  or doctoral degree in psychiatric nursing, holds a national
 3897  advanced practice certification as a psychiatric mental health
 3898  advanced practice nurse, and has 2 years of post-master’s
 3899  clinical experience under the supervision of a physician.
 3900         (36)(24) “Psychiatrist” means a medical practitioner
 3901  licensed under chapter 458 or chapter 459 who has primarily
 3902  diagnosed and treated mental and nervous disorders for at least
 3903  a period of not less than 3 years, inclusive of psychiatric
 3904  residency.
 3905         (37)(25) “Public facility” means a any facility that has
 3906  contracted with the department to provide mental health services
 3907  to all persons, regardless of their ability to pay, and is
 3908  receiving state funds for such purpose.
 3909         (38)“Qualified professional” means a physician or a
 3910  physician assistant licensed under chapter 458 or chapter 459; a
 3911  psychiatrist licensed under chapter 458 or chapter 459; a
 3912  psychologist as defined in s. 490.003(7); or a psychiatric nurse
 3913  as defined in s. 394.455.
 3914         (39)(26) “Receiving facility” means a any public or private
 3915  facility or hospital designated by the department to receive and
 3916  hold or refer, as appropriate, involuntary patients under
 3917  emergency conditions or for mental health or substance abuse
 3918  psychiatric evaluation and to provide short-term treatment or
 3919  transportation to the appropriate service provider. The term
 3920  does not include a county jail.
 3921         (40)(27) “Representative” means a person selected to
 3922  receive notice of proceedings during the time a patient is held
 3923  in or admitted to a receiving or treatment facility.
 3924         (41)(28)(a) “Restraint” means: a physical device, method,
 3925  or drug used to control behavior.
 3926         (a) A physical restraint, including is any manual method or
 3927  physical or mechanical device, material, or equipment attached
 3928  or adjacent to an the individual’s body so that he or she cannot
 3929  easily remove the restraint and which restricts freedom of
 3930  movement or normal access to one’s body. “Physical restraint”
 3931  includes the physical holding of a person during a procedure to
 3932  forcibly administer psychotropic medication. “Physical
 3933  restraint” does not include physical devices such as
 3934  orthopedically prescribed appliances, surgical dressings and
 3935  bandages, supportive body bands, or other physical holding when
 3936  necessary for routine physical examinations and tests or for
 3937  purposes of orthopedic, surgical, or other similar medical
 3938  treatment when used to provide support for the achievement of
 3939  functional body position or proper balance or when used to
 3940  protect a person from falling out of bed.
 3941         (b) A drug or used as a restraint is a medication used to
 3942  control a the person’s behavior or to restrict his or her
 3943  freedom of movement which and is not part of the standard
 3944  treatment regimen of a person with a diagnosed mental illness
 3945  who is a client of the department. Physically holding a person
 3946  during a procedure to forcibly administer psychotropic
 3947  medication is a physical restraint.
 3948         (c)Restraint does not include physical devices, such as
 3949  orthopedically prescribed appliances, surgical dressings and
 3950  bandages, supportive body bands, or other physical holding when
 3951  necessary for routine physical examinations and tests; or for
 3952  purposes of orthopedic, surgical, or other similar medical
 3953  treatment; when used to provide support for the achievement of
 3954  functional body position or proper balance; or when used to
 3955  protect a person from falling out of bed.
 3956         (42)(29) “Seclusion” means the physical segregation of a
 3957  person in any fashion or involuntary isolation of a person in a
 3958  room or area from which the person is prevented from leaving.
 3959  The prevention may be by physical barrier or by a staff member
 3960  who is acting in a manner, or who is physically situated, so as
 3961  to prevent the person from leaving the room or area. For
 3962  purposes of this part chapter, the term does not mean isolation
 3963  due to a person’s medical condition or symptoms.
 3964         (43)(30) “Secretary” means the Secretary of Children and
 3965  Families.
 3966         (44)“Service provider” means a receiving facility, a
 3967  facility licensed under chapter 397, a treatment facility, an
 3968  entity under contract with the department to provide mental
 3969  health or substance abuse services, a community mental health
 3970  center or clinic, a psychologist, a clinical social worker, a
 3971  marriage and family therapist, a mental health counselor, a
 3972  physician, a psychiatrist, an advanced registered nurse
 3973  practitioner, a psychiatric nurse, or a qualified professional
 3974  as defined in s. 39.01.
 3975         (45)“Substance abuse impairment” means a condition
 3976  involving the use of alcoholic beverages or any psychoactive or
 3977  mood-altering substance in such a manner that a person has lost
 3978  the power of self-control and has inflicted or is likely to
 3979  inflict physical harm on himself, herself, or another.
 3980         (46)(31) “Transfer evaluation” means the process by which,
 3981  as approved by the appropriate district office of the
 3982  department, whereby a person who is being considered for
 3983  placement in a state treatment facility is first evaluated for
 3984  appropriateness of admission to such the facility by a
 3985  community-based public receiving facility or by a community
 3986  mental health center or clinic if the public receiving facility
 3987  is not a community mental health center or clinic.
 3988         (47)(32) “Treatment facility” means a any state-owned,
 3989  state-operated, or state-supported hospital, center, or clinic
 3990  designated by the department for extended treatment and
 3991  hospitalization, beyond that provided for by a receiving
 3992  facility, of persons who have a mental illness, including
 3993  facilities of the United States Government, and any private
 3994  facility designated by the department when rendering such
 3995  services to a person pursuant to the provisions of this part.
 3996  Patients treated in facilities of the United States Government
 3997  shall be solely those whose care is the responsibility of the
 3998  United States Department of Veterans Affairs.
 3999         (48)“Triage center” means a facility that has medical,
 4000  mental health, and substance abuse professionals present or on
 4001  call to provide emergency screening and evaluation for mental
 4002  health or substance abuse disorders for individuals transported
 4003  to the center by a law enforcement officer.
 4004         (33)“Service provider” means any public or private
 4005  receiving facility, an entity under contract with the Department
 4006  of Children and Families to provide mental health services, a
 4007  clinical psychologist, a clinical social worker, a marriage and
 4008  family therapist, a mental health counselor, a physician, a
 4009  psychiatric nurse as defined in subsection (23), or a community
 4010  mental health center or clinic as defined in this part.
 4011         (34)“Involuntary examination” means an examination
 4012  performed under s. 394.463 to determine if an individual
 4013  qualifies for involuntary inpatient treatment under s.
 4014  394.467(1) or involuntary outpatient treatment under s.
 4015  394.4655(1).
 4016         (35)“Involuntary placement” means either involuntary
 4017  outpatient treatment pursuant to s. 394.4655 or involuntary
 4018  inpatient treatment pursuant to s. 394.467.
 4019         (36)“Marriage and family therapist” means a person
 4020  licensed as a marriage and family therapist under chapter 491.
 4021         (37)“Mental health counselor” means a person licensed as a
 4022  mental health counselor under chapter 491.
 4023         (38)“Electronic means” means a form of telecommunication
 4024  that requires all parties to maintain visual as well as audio
 4025  communication.
 4026         Section 88. Subsection (2) of section 394.463, Florida
 4027  Statutes, is amended to read:
 4028         394.463 Involuntary examination.—
 4029         (2) INVOLUNTARY EXAMINATION.—
 4030         (a) An involuntary examination may be initiated by any one
 4031  of the following means:
 4032         1. A circuit or county court may enter an ex parte order
 4033  stating that a person appears to meet the criteria for
 4034  involuntary examination and specifying, giving the findings on
 4035  which that conclusion is based. The ex parte order for
 4036  involuntary examination must be based on written or oral sworn
 4037  testimony that includes specific facts that support the
 4038  findings, written or oral. If other less restrictive means are
 4039  not available, such as voluntary appearance for outpatient
 4040  evaluation, a law enforcement officer, or other designated agent
 4041  of the court, shall take the person into custody and deliver him
 4042  or her to an appropriate, or the nearest, receiving facility
 4043  within the designated receiving system pursuant to s. 394.462
 4044  for involuntary examination. The order of the court shall be
 4045  made a part of the patient’s clinical record. A No fee may not
 4046  shall be charged for the filing of an order under this
 4047  subsection. A Any receiving facility accepting the patient based
 4048  on this order must send a copy of the order to the department
 4049  Agency for Health Care Administration on the next working day.
 4050  The order may be submitted electronically through existing data
 4051  systems, if available. The order shall be valid only until the
 4052  person is delivered to the facility or executed or, if not
 4053  executed, for the period specified in the order itself,
 4054  whichever comes first. If no time limit is specified in the
 4055  order, the order shall be valid for 7 days after the date that
 4056  the order was signed.
 4057         2. A law enforcement officer shall take a person who
 4058  appears to meet the criteria for involuntary examination into
 4059  custody and deliver the person or have him or her delivered to
 4060  an appropriate, or the nearest, receiving facility within the
 4061  designated receiving system pursuant to s. 394.462 for
 4062  examination. The officer shall execute a written report
 4063  detailing the circumstances under which the person was taken
 4064  into custody, which must and the report shall be made a part of
 4065  the patient’s clinical record. Any receiving facility accepting
 4066  the patient based on this report must send a copy of the report
 4067  to the department Agency for Health Care Administration on the
 4068  next working day.
 4069         3. A physician, clinical psychologist, psychiatric nurse,
 4070  mental health counselor, marriage and family therapist, or
 4071  clinical social worker may execute a certificate stating that he
 4072  or she has examined a person within the preceding 48 hours and
 4073  finds that the person appears to meet the criteria for
 4074  involuntary examination and stating the observations upon which
 4075  that conclusion is based. If other less restrictive means, such
 4076  as voluntary appearance for outpatient evaluation, are not
 4077  available, such as voluntary appearance for outpatient
 4078  evaluation, a law enforcement officer shall take into custody
 4079  the person named in the certificate into custody and deliver him
 4080  or her to the appropriate, or nearest, receiving facility within
 4081  the designated receiving system pursuant to s. 394.462 for
 4082  involuntary examination. The law enforcement officer shall
 4083  execute a written report detailing the circumstances under which
 4084  the person was taken into custody. The report and certificate
 4085  shall be made a part of the patient’s clinical record. Any
 4086  receiving facility accepting the patient based on this
 4087  certificate must send a copy of the certificate to the
 4088  department Agency for Health Care Administration on the next
 4089  working day. The document may be submitted electronically
 4090  through existing data systems, if applicable.
 4091         (b) A person may shall not be removed from any program or
 4092  residential placement licensed under chapter 400 or chapter 429
 4093  and transported to a receiving facility for involuntary
 4094  examination unless an ex parte order, a professional
 4095  certificate, or a law enforcement officer’s report is first
 4096  prepared. If the condition of the person is such that
 4097  preparation of a law enforcement officer’s report is not
 4098  practicable before removal, the report shall be completed as
 4099  soon as possible after removal, but in any case before the
 4100  person is transported to a receiving facility. A receiving
 4101  facility admitting a person for involuntary examination who is
 4102  not accompanied by the required ex parte order, professional
 4103  certificate, or law enforcement officer’s report shall notify
 4104  the department Agency for Health Care Administration of such
 4105  admission by certified mail or by e-mail, if available, by no
 4106  later than the next working day. The provisions of this
 4107  paragraph do not apply when transportation is provided by the
 4108  patient’s family or guardian.
 4109         (c) A law enforcement officer acting in accordance with an
 4110  ex parte order issued pursuant to this subsection may serve and
 4111  execute such order on any day of the week, at any time of the
 4112  day or night.
 4113         (d) A law enforcement officer acting in accordance with an
 4114  ex parte order issued pursuant to this subsection may use such
 4115  reasonable physical force as is necessary to gain entry to the
 4116  premises, and any dwellings, buildings, or other structures
 4117  located on the premises, and to take custody of the person who
 4118  is the subject of the ex parte order.
 4119         (e) The department Agency for Health Care Administration
 4120  shall receive and maintain the copies of ex parte orders,
 4121  involuntary outpatient services placement orders issued pursuant
 4122  to s. 394.4655, involuntary inpatient placement orders issued
 4123  pursuant to s. 394.467, professional certificates, and law
 4124  enforcement officers’ reports. These documents shall be
 4125  considered part of the clinical record, governed by the
 4126  provisions of s. 394.4615. These documents shall be used to The
 4127  agency shall prepare annual reports analyzing the data obtained
 4128  from these documents, without information identifying patients,
 4129  and shall provide copies of reports to the department, the
 4130  President of the Senate, the Speaker of the House of
 4131  Representatives, and the minority leaders of the Senate and the
 4132  House of Representatives.
 4133         (f) A patient shall be examined by a physician or, a
 4134  clinical psychologist, or by a psychiatric nurse performing
 4135  within the framework of an established protocol with a
 4136  psychiatrist at a receiving facility without unnecessary delay
 4137  to determine if the criteria for involuntary services are met.
 4138  Emergency treatment may be provided and may, upon the order of a
 4139  physician if the physician determines, be given emergency
 4140  treatment if it is determined that such treatment is necessary
 4141  for the safety of the patient or others. The patient may not be
 4142  released by the receiving facility or its contractor without the
 4143  documented approval of a psychiatrist or a clinical psychologist
 4144  or, if the receiving facility is owned or operated by a hospital
 4145  or health system, the release may also be approved by a
 4146  psychiatric nurse performing within the framework of an
 4147  established protocol with a psychiatrist, or an attending
 4148  emergency department physician with experience in the diagnosis
 4149  and treatment of mental illness and nervous disorders and after
 4150  completion of an involuntary examination pursuant to this
 4151  subsection. A psychiatric nurse may not approve the release of a
 4152  patient if the involuntary examination was initiated by a
 4153  psychiatrist unless the release is approved by the initiating
 4154  psychiatrist. However, a patient may not be held in a receiving
 4155  facility for involuntary examination longer than 72 hours.
 4156         (g)Within the 72-hour examination period or, if the 72
 4157  hours ends on a weekend or holiday, no later than the next
 4158  working day thereafter, one of the following actions must be
 4159  taken, based on the individual needs of the patient:
 4160         1.The patient shall be released, unless he or she is
 4161  charged with a crime, in which case the patient shall be
 4162  returned to the custody of a law enforcement officer;
 4163         2.The patient shall be released, subject to the provisions
 4164  of subparagraph 1., for voluntary outpatient treatment;
 4165         3.The patient, unless he or she is charged with a crime,
 4166  shall be asked to give express and informed consent to placement
 4167  as a voluntary patient and, if such consent is given, the
 4168  patient shall be admitted as a voluntary patient; or
 4169         4.A petition for involuntary services shall be filed in
 4170  the circuit court if inpatient treatment is deemed necessary or
 4171  with the criminal county court, as defined in s. 394.4655(1), as
 4172  applicable. When inpatient treatment is deemed necessary, the
 4173  least restrictive treatment consistent with the optimum
 4174  improvement of the patient’s condition shall be made available.
 4175  When a petition is to be filed for involuntary outpatient
 4176  placement, it shall be filed by one of the petitioners specified
 4177  in s. 394.4655(4)(a). A petition for involuntary inpatient
 4178  placement shall be filed by the facility administrator.
 4179         (h)(g) A person for whom an involuntary examination has
 4180  been initiated who is being evaluated or treated at a hospital
 4181  for an emergency medical condition specified in s. 395.002 must
 4182  be examined by a receiving facility within 72 hours. The 72-hour
 4183  period begins when the patient arrives at the hospital and
 4184  ceases when the attending physician documents that the patient
 4185  has an emergency medical condition. If the patient is examined
 4186  at a hospital providing emergency medical services by a
 4187  professional qualified to perform an involuntary examination and
 4188  is found as a result of that examination not to meet the
 4189  criteria for involuntary outpatient services placement pursuant
 4190  to s. 394.4655(2) 394.4655(1) or involuntary inpatient placement
 4191  pursuant to s. 394.467(1), the patient may be offered voluntary
 4192  services or placement, if appropriate, or released directly from
 4193  the hospital providing emergency medical services. The finding
 4194  by the professional that the patient has been examined and does
 4195  not meet the criteria for involuntary inpatient services
 4196  placement or involuntary outpatient placement must be entered
 4197  into the patient’s clinical record. Nothing in This paragraph is
 4198  not intended to prevent a hospital providing emergency medical
 4199  services from appropriately transferring a patient to another
 4200  hospital before prior to stabilization if, provided the
 4201  requirements of s. 395.1041(3)(c) have been met.
 4202         (i)(h) One of the following must occur within 12 hours
 4203  after the patient’s attending physician documents that the
 4204  patient’s medical condition has stabilized or that an emergency
 4205  medical condition does not exist:
 4206         1. The patient must be examined by a designated receiving
 4207  facility and released; or
 4208         2. The patient must be transferred to a designated
 4209  receiving facility in which appropriate medical treatment is
 4210  available. However, the receiving facility must be notified of
 4211  the transfer within 2 hours after the patient’s condition has
 4212  been stabilized or after determination that an emergency medical
 4213  condition does not exist.
 4214         (i)Within the 72-hour examination period or, if the 72
 4215  hours ends on a weekend or holiday, no later than the next
 4216  working day thereafter, one of the following actions must be
 4217  taken, based on the individual needs of the patient:
 4218         1.The patient shall be released, unless he or she is
 4219  charged with a crime, in which case the patient shall be
 4220  returned to the custody of a law enforcement officer;
 4221         2.The patient shall be released, subject to the provisions
 4222  of subparagraph 1., for voluntary outpatient treatment;
 4223         3.The patient, unless he or she is charged with a crime,
 4224  shall be asked to give express and informed consent to placement
 4225  as a voluntary patient, and, if such consent is given, the
 4226  patient shall be admitted as a voluntary patient; or
 4227         4.A petition for involuntary placement shall be filed in
 4228  the circuit court when outpatient or inpatient treatment is
 4229  deemed necessary. When inpatient treatment is deemed necessary,
 4230  the least restrictive treatment consistent with the optimum
 4231  improvement of the patient’s condition shall be made available.
 4232  When a petition is to be filed for involuntary outpatient
 4233  placement, it shall be filed by one of the petitioners specified
 4234  in s. 394.4655(3)(a). A petition for involuntary inpatient
 4235  placement shall be filed by the facility administrator.
 4236         Section 89. Subsection (3) of section 394.4615, Florida
 4237  Statutes, is amended to read:
 4238         394.4615 Clinical records; confidentiality.—
 4239         (3) Information from the clinical record may be released in
 4240  the following circumstances:
 4241         (a) When a patient has declared an intention to harm other
 4242  persons. When such declaration has been made, the administrator
 4243  may authorize the release of sufficient information to provide
 4244  adequate warning to the person threatened with harm by the
 4245  patient.
 4246         (b) When the administrator of the facility or secretary of
 4247  the department deems release to a qualified researcher as
 4248  defined in administrative rule, an aftercare treatment provider,
 4249  or an employee or agent of the department is necessary for
 4250  treatment of the patient, maintenance of adequate records,
 4251  compilation of treatment data, aftercare planning, or evaluation
 4252  of programs.
 4253  
 4254  For the purpose of determining whether a person meets the
 4255  criteria for involuntary outpatient placement or for preparing
 4256  the proposed treatment plan pursuant to s. 394.4655, the
 4257  clinical record may be released to the state attorney, the
 4258  public defender or the patient’s private legal counsel, the
 4259  court, and to the appropriate mental health professionals,
 4260  including the service provider identified in s. 394.4655(7)(b)2.
 4261  394.4655(6)(b)2., in accordance with state and federal law.
 4262         Section 90. For the 2016-2017 fiscal year, the sum of
 4263  $400,000 in nonrecurring funds is appropriated from the
 4264  Operations and Maintenance Trust Fund to the Department of
 4265  Children and Families for the purpose of modifying the existing
 4266  crisis stabilization database to collect and analyze data and
 4267  information pursuant to s. 397.321, Florida Statutes, as amended
 4268  by this act.
 4269         Section 91. This act shall take effect July 1, 2016.
 4270  
 4271  ================= T I T L E  A M E N D M E N T ================
 4272  And the title is amended as follows:
 4273         Delete lines 4956 - 5263
 4274  and insert:
 4275                        A bill to be entitled                      
 4276         An act relating to mental health and substance abuse;
 4277         amending s. 29.004, F.S.; including services provided
 4278         to treatment-based mental health programs within case
 4279         management funded from state revenues as an element of
 4280         the state courts system; amending s. 39.01, F.S.;
 4281         defining a term; amending s. 39.407, F.S.; requiring
 4282         assessment findings to be provided to the plan that is
 4283         financially responsible for a child’s care in
 4284         residential treatment under certain circumstances;
 4285         amending s. 394.453, F.S.; revising legislative
 4286         intent; amending s. 394.4573, F.S.; requiring the
 4287         Department of Children and Families to submit a
 4288         certain assessment to the Governor and Legislature by
 4289         a specified date; defining and revising terms;
 4290         providing essential elements of a coordinated system
 4291         of care; providing requirements for the department’s
 4292         annual assessment; authorizing the department to award
 4293         certain grants; deleting duties and measures of the
 4294         department regarding continuity of care management
 4295         systems; amending s. 394.461, F.S.; creating a
 4296         designated receiving system that functions as a no
 4297         wrong-door model, based on certain receiving system
 4298         models; authorizing, rather than requiring, the
 4299         department to adopt rules to implement the designated
 4300         receiving system; repealing s. 394.675, F.S., relating
 4301         to the substance abuse and mental health service
 4302         system; amending ss. 394.75 and 394.76, F.S.;
 4303         conforming provisions and cross-references to changes
 4304         made by the act; amending s. 394.4597, F.S.; revising
 4305         the prioritization of health care surrogates to be
 4306         selected for involuntary patients; specifying certain
 4307         persons who are prohibited from being selected as an
 4308         individual’s representative; amending s. 394.4598,
 4309         F.S.; specifying certain persons who are prohibited
 4310         from being appointed as a person’s guardian advocate;
 4311         amending s. 394.462, F.S.; requiring that counties
 4312         develop and implement transportation plans; providing
 4313         requirements for the plans; revising requirements for
 4314         transportation to receiving facilities and treatment
 4315         facilities; revising exceptions to such requirements;
 4316         amending s. 394.467, F.S.; revising criteria for
 4317         involuntary inpatient placement; revising criteria for
 4318         a procedure for continued involuntary inpatient
 4319         services; specifying requirements for a certain waiver
 4320         of the patient’s attendance at a hearing; requiring
 4321         the court to consider certain testimony and evidence
 4322         regarding a patient’s incompetence; amending s.
 4323         394.46715, F.S.; revising rulemaking authority of the
 4324         department; amending s. 394.4685, F.S.; requiring a
 4325         public receiving facility initiating a patient
 4326         transfer to a licensed hospital for certain mental
 4327         health services to provide notice and transfer patient
 4328         records to the hospital; amending s. 394.656, F.S.;
 4329         revising the membership of the Criminal Justice,
 4330         Mental Health, and Substance Abuse Statewide Grant
 4331         Review Committee; providing duties for the committee;
 4332         authorizing a not-for-profit community provider or
 4333         managing entity to apply for certain grants; revising
 4334         eligibility for such grants; defining a term; creating
 4335         s. 394.761, F.S.; requiring the agency and the
 4336         department to develop a plan for revenue maximization;
 4337         providing requirements for the plan; providing duties
 4338         for the agency and department relating to the plan;
 4339         requiring the plan to be submitted to the Legislature
 4340         by a certain date; amending s. 394.879, F.S.;
 4341         providing that certain facilities may be in a multi
 4342         story building and authorized on certain floors;
 4343         requiring the department to develop a plan to create
 4344         an option for a single, consolidated license for
 4345         certain providers by a specified date; amending s.
 4346         394.9082, F.S.; providing a purpose for behavioral
 4347         health managing entities; revising definitions;
 4348         providing duties of the department; requiring the
 4349         department to revise its contracts with managing
 4350         entities; providing duties for managing entities;
 4351         providing requirements for network accreditation and
 4352         systems coordination agreements; providing for
 4353         performance measurement and accountability and
 4354         enhancements plans; providing a funding mechanism for
 4355         managing entities; renaming the Crisis Stabilization
 4356         Services Utilization Database as the Acute Care
 4357         Services Utilization Database; requiring certain
 4358         providers to provide utilization data; deleting
 4359         provisions relating to legislative findings and
 4360         intent, service delivery strategies, essential
 4361         elements, reporting requirements, and rulemaking
 4362         authority; amending s. 397.305, F.S.; providing
 4363         legislative intent; amending s. 397.311, F.S.;
 4364         defining and redefining terms; conforming a cross
 4365         reference; amending s. 397.321, F.S.; deleting a
 4366         requirement for the department to appoint a substance
 4367         abuse impairment coordinator; requiring the department
 4368         to develop certain forms, display such forms on its
 4369         website, and notify certain entities of the existence
 4370         and availability of such forms; amending s. 397.675,
 4371         F.S.; revising the criteria for involuntary admissions
 4372         due to substance abuse or co-occurring mental health
 4373         disorders; amending s. 397.6772, F.S.; requiring law
 4374         enforcement officers to use standard forms developed
 4375         by the department to execute a certain written report;
 4376         amending s. 397.6773, F.S.; revising a cross
 4377         reference; amending s. 397.679, F.S.; authorizing
 4378         specified licensed professionals to complete a
 4379         certificate for the involuntary admission of an
 4380         individual; amending s. 397.6791, F.S.; providing a
 4381         list of professionals authorized to initiate a
 4382         certificate for an emergency assessment or admission
 4383         of a person who has a substance abuse disorder;
 4384         amending s. 397.6793, F.S.; revising the criteria for
 4385         initiation of a certificate for an emergency admission
 4386         for a person who is substance abuse impaired; amending
 4387         s. 397.6795, F.S.; revising the list of persons
 4388         authorized to deliver a person for an emergency
 4389         assessment; amending s. 397.681, F.S.; prohibiting the
 4390         court from charging a fee for involuntary petitions;
 4391         amending s. 397.6811, F.S.; revising the list of
 4392         persons authorized to file a petition for an
 4393         involuntary assessment and stabilization; amending s.
 4394         397.6814, F.S.; prohibiting a fee from being charged
 4395         for the filing of a petition for involuntary
 4396         assessment and stabilization; amending s. 397.6818,
 4397         F.S.; limiting the validity of an order for
 4398         involuntary admission to 7 days after it is signed
 4399         unless otherwise specified in the order; amending s.
 4400         397.6819, F.S.; revising the responsibilities of
 4401         service providers who admit an individual for an
 4402         involuntary assessment and stabilization; amending s.
 4403         397.695, F.S.; authorizing certain persons to file a
 4404         petition for involuntary outpatient services of an
 4405         individual; providing procedures and requirements for
 4406         such petitions; amending s. 397.6951, F.S.; requiring
 4407         that certain additional information be included in a
 4408         petition for involuntary outpatient services; amending
 4409         s. 397.6955, F.S.; requiring a court to fulfill
 4410         certain additional duties upon the filing of a
 4411         petition for involuntary outpatient services; amending
 4412         s. 397.6957, F.S.; providing additional requirements
 4413         for a hearing on a petition for involuntary outpatient
 4414         services; amending s. 397.697, F.S.; authorizing a
 4415         court to make a determination of involuntary
 4416         outpatient services; extending the timeframe a
 4417         respondent receives certain publicly funded licensed
 4418         services; authorizing a court to order a respondent to
 4419         undergo treatment through a publicly or privately
 4420         funded licensed service provider under certain
 4421         circumstances; requiring a copy of the court’s order
 4422         to be sent to the managing entity; amending s.
 4423         397.6971, F.S.; establishing the requirements for an
 4424         early release from involuntary outpatient services;
 4425         amending s. 397.6975, F.S.; requiring the court to
 4426         appoint certain counsel; providing requirements for
 4427         hearings on petitions for continued involuntary
 4428         outpatient services; requiring notice of such
 4429         hearings; amending s. 397.6977, F.S.; conforming
 4430         provisions to changes made by the act; creating s.
 4431         397.6978, F.S.; providing for the appointment of
 4432         guardian advocates if an individual is found
 4433         incompetent to consent to treatment; prohibiting
 4434         specified persons from being appointed as an
 4435         individual’s guardian advocate; providing requirements
 4436         for a facility requesting the appointment of a
 4437         guardian advocate; requiring a training course for
 4438         guardian advocates; providing requirements for the
 4439         training course; providing requirements for the
 4440         prioritization of individuals to be selected as
 4441         guardian advocates; authorizing certain guardian
 4442         advocates to consent to medical treatment; providing
 4443         exceptions; providing procedures for the discharge of
 4444         a guardian advocate; amending s. 409.967, F.S.;
 4445         requiring managed care plans to provide for quality
 4446         care; amending s. 409.973, F.S.; providing an
 4447         integrated behavioral health initiative; reenacting s.
 4448         409.975(6), F.S., relating to provider payment;
 4449         providing legislative intent; amending s. 491.0045,
 4450         F.S.; revising registration requirements for interns;
 4451         repealing s. 394.4674, F.S., relating to the
 4452         comprehensive plan and report on the
 4453         deinstitutionalization of patients in a treatment
 4454         facility; repealing s. 394.4985, F.S., relating to the
 4455         implementation of a districtwide information and
 4456         referral network; repealing s. 394.745, F.S., relating
 4457         to the annual report on the compliance of providers
 4458         under contract with the department; repealing s.
 4459         397.331, F.S., relating to definitions and legislative
 4460         intent; repealing part IX of chapter 397, F.S.,
 4461         consisting of ss. 397.801, 397.811, and 397.821, F.S.,
 4462         relating to substance abuse impairment coordination,
 4463         juvenile substance abuse impairment coordination, and
 4464         juvenile substance abuse impairment prevention and
 4465         early intervention councils, respectively; repealing
 4466         s. 397.901, F.S., relating to prototype juvenile
 4467         addictions receiving facilities; repealing s. 397.93,
 4468         F.S., relating to target populations for children’s
 4469         substance abuse services; repealing s. 397.94, F.S.,
 4470         relating to the information and referral network for
 4471         children’s substance abuse services; repealing s.
 4472         397.951, F.S., relating to substance abuse treatment
 4473         and sanctions; repealing s. 397.97, F.S., relating to
 4474         demonstration models for children’s substance abuse
 4475         services; repealing s. 397.98, F.S., relating to
 4476         utilization management for children’s substance abuse
 4477         services; amending ss. 39.407, 39.524, 212.055,
 4478         394.4599, 394.495, 394.496, 394.9085, 397.321,
 4479         397.405, 397.407, 397.416, 397.4871, 409.1678,
 4480         409.966, 409.972, 440.102, 744.704, and 960.065, F.S.;
 4481         conforming cross-references; requiring the Secretary
 4482         of Children and Families to appoint a workgroup on the
 4483         use of advance directives for substance use disorders;
 4484         requiring a report to the Governor and Legislature by
 4485         a specified date; providing for expiration of the
 4486         workgroup; amending s. 61.13, F.S.; providing that a
 4487         parenting plan that provides for shared parental
 4488         responsibility over health care decisions must
 4489         authorize either parent to consent to mental health
 4490         treatment for the child; amending s. 39.001, F.S.;
 4491         conforming provisions to changes made by the act;
 4492         amending ss. 39.507 and 39.521, F.S.; providing for
 4493         consideration of mental health issues and involvement
 4494         in mental health programs in adjudicatory hearings and
 4495         orders; providing requirements for certain court
 4496         orders; revising the qualifications for administrators
 4497         of mental health and substance abuse assessments or
 4498         evaluations; amending s. 394.4655, F.S.; defining the
 4499         terms “court” and “criminal county court”; providing
 4500         for involuntary outpatient services; authorizing
 4501         certain licensed physicians and psychiatric nurses to
 4502         provide a second opinion regarding a recommendation
 4503         for involuntary outpatient services under certain
 4504         circumstances; requiring a service provider to
 4505         document certain inquiries; requiring the managing
 4506         entity to document certain efforts; making technical
 4507         changes; amending s. 394.4599, F.S.; conforming
 4508         provisions to changes made by the act; amending s.
 4509         394.455, F.S.; defining and redefining terms; amending
 4510         s. 394.463, F.S.; authorizing circuit or county courts
 4511         to enter ex parte orders for involuntary examinations;
 4512         requiring a facility to provide copies of ex parte
 4513         orders, reports, and certificates to the department,
 4514         rather than the Agency for Health Care Administration;
 4515         requiring the department to receive certain orders,
 4516         certificates, and reports; requiring the department to
 4517         receive and maintain copies of certain documents;
 4518         prohibiting a person from being held for involuntary
 4519         examination for more than a specified period of time;
 4520         providing exceptions; requiring certain individuals to
 4521         be released to law enforcement custody; providing
 4522         exceptions; conforming cross-references; amending s.
 4523         394.4615, F.S.; conforming a cross-reference;
 4524         providing an appropriation; providing an effective
 4525         date.