Florida Senate - 2016              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. SB 12
       
       
       
       
       
                               Ì821992AÎ821992                          
       
       576-02646-16                                                    
       Proposed Committee Substitute by the Committee on Appropriations
       (Appropriations Subcommittee on Health and Human Services)
    1                        A bill to be entitled                      
    2         An act relating to mental health and substance abuse;
    3         amending s. 29.004, F.S.; including services provided
    4         to treatment-based mental health programs within case
    5         management funded from state revenues as an element of
    6         the state courts system; amending s. 39.001, F.S.;
    7         providing legislative intent regarding mental illness
    8         for purposes of the child welfare system; amending s.
    9         39.507, F.S.; providing for consideration of mental
   10         health issues and involvement in treatment-based
   11         mental health programs in adjudicatory hearings and
   12         orders; amending s. 39.521, F.S.; providing for
   13         consideration of mental health issues and involvement
   14         in treatment-based mental health programs in
   15         disposition hearings; amending s. 394.455, F.S.;
   16         defining terms; revising definitions; amending s.
   17         394.4573, F.S.; requiring the Department of Children
   18         and Families to submit a certain assessment to the
   19         Governor and the Legislature by a specified date;
   20         redefining terms; providing essential elements of a
   21         coordinated system of care; providing requirements for
   22         the department’s annual assessment; authorizing the
   23         department to award certain grants; deleting duties
   24         and measures of the department regarding continuity of
   25         care management systems; amending s. 394.4597, F.S.;
   26         revising the prioritization of health care surrogates
   27         to be selected for involuntary patients; specifying
   28         certain persons who are prohibited from being selected
   29         as an individual’s representative; amending s.
   30         394.4598, F.S.; specifying certain persons who are
   31         prohibited from being appointed as a person’s guardian
   32         advocate; amending s. 394.462, F.S.; requiring that
   33         counties develop and implement transportation plans;
   34         providing requirements for the plans; revising
   35         requirements for transportation to a receiving
   36         facility and treatment facility; deleting exceptions
   37         to such requirements; amending s. 394.463, F.S.;
   38         authorizing county or circuit courts to enter ex parte
   39         orders for involuntary examinations; requiring a
   40         facility to provide copies of ex parte orders,
   41         reports, and certifications to managing entities and
   42         the department, rather than the Agency for Health Care
   43         Administration; requiring the managing entity and
   44         department to receive certain orders, certificates,
   45         and reports; requiring the department to provide such
   46         documents to the Agency for Health Care
   47         Administration; requiring certain individuals to be
   48         released to law enforcement custody; providing
   49         exceptions; amending s. 394.4655, F.S.; providing for
   50         involuntary outpatient services; requiring a service
   51         provider to document certain inquiries; requiring the
   52         managing entity to document certain efforts; making
   53         technical changes; amending s. 394.467, F.S.; revising
   54         criteria for involuntary inpatient placement;
   55         requiring a facility filing a petition for involuntary
   56         inpatient placement to send a copy to the department
   57         and managing entity; revising criteria for a hearing
   58         on involuntary inpatient placement; revising criteria
   59         for a procedure for continued involuntary inpatient
   60         services; specifying requirements for a certain waiver
   61         of the patient’s attendance at a hearing; requiring
   62         the court to consider certain testimony and evidence
   63         regarding a patient’s incompetence; amending s.
   64         394.46715, F.S.; revising rulemaking authority of the
   65         department; creating s. 394.761, F.S.; authorizing the
   66         agency and the department to develop a plan for
   67         revenue maximization; requiring the plan to be
   68         submitted to the Legislature by a certain date;
   69         amending s. 394.875, F.S.; requiring the department to
   70         modify licensure rules and procedures to create an
   71         option for a single, consolidated license for certain
   72         providers by a specified date; amending s. 394.9082,
   73         F.S.; providing a purpose for behavioral health
   74         managing entities; revising definitions; providing
   75         duties of the department; requiring the department to
   76         revise its contracts with managing entities; providing
   77         duties for managing entities; deleting provisions
   78         relating to legislative findings and intent, service
   79         delivery strategies, essential elements, reporting
   80         requirements, and rulemaking authority; amending s.
   81         397.311, F.S.; defining the term “involuntary
   82         services”; revising the definition of the term
   83         “qualified professional”; conforming a cross
   84         reference; amending s. 397.675, F.S.; revising the
   85         criteria for involuntary admissions due to substance
   86         abuse or co-occurring mental health disorders;
   87         amending s. 397.679, F.S.; specifying the licensed
   88         professionals who may complete a certificate for the
   89         involuntary admission of an individual; amending s.
   90         397.6791, F.S.; providing a list of professionals
   91         authorized to initiate a certificate for an emergency
   92         assessment or admission of a person with a substance
   93         abuse disorder; amending s. 397.6793, F.S.; revising
   94         the criteria for initiation of a certificate for an
   95         emergency admission for a person who is substance
   96         abuse impaired; amending s. 397.6795, F.S.; revising
   97         the list of persons who may deliver a person for an
   98         emergency assessment; amending s. 397.681, F.S.;
   99         prohibiting the court from charging a fee for
  100         involuntary petitions; amending s. 397.6811, F.S.;
  101         revising the list of persons who may file a petition
  102         for an involuntary assessment and stabilization;
  103         amending s. 397.6814, F.S.; prohibiting a fee from
  104         being charged for the filing of a petition for
  105         involuntary assessment and stabilization; amending s.
  106         397.6819, F.S.; revising the responsibilities of
  107         service providers who admit an individual for an
  108         involuntary assessment and stabilization; amending s.
  109         397.695, F.S.; authorizing certain persons to file a
  110         petition for involuntary outpatient services of an
  111         individual; providing procedures and requirements for
  112         such petitions; amending s. 397.6951, F.S.; requiring
  113         that certain additional information be included in a
  114         petition for involuntary outpatient services; amending
  115         s. 397.6955, F.S.; requiring a court to fulfill
  116         certain additional duties upon the filing of petition
  117         for involuntary outpatient services; amending s.
  118         397.6957, F.S.; providing additional requirements for
  119         a hearing on a petition for involuntary outpatient
  120         services; amending s. 397.697, F.S.; authorizing a
  121         court to make a determination of involuntary
  122         outpatient services; prohibiting a court from ordering
  123         involuntary outpatient services under certain
  124         circumstances; requiring the service provider to
  125         document certain inquiries; requiring the managing
  126         entity to document certain efforts; requiring a copy
  127         of the court’s order to be sent to the department and
  128         managing entity; providing procedures for
  129         modifications to such orders; amending s. 397.6971,
  130         F.S.; establishing the requirements for an early
  131         release from involuntary outpatient services; amending
  132         s. 397.6975, F.S.; requiring the court to appoint
  133         certain counsel; providing requirements for hearings
  134         on petitions for continued involuntary outpatient
  135         services; requiring notice of such hearings; amending
  136         s. 397.6977, F.S.; conforming provisions to changes
  137         made by the act; creating s. 397.6978, F.S.; providing
  138         for the appointment of guardian advocates if an
  139         individual is found incompetent to consent to
  140         treatment; providing a list of persons prohibited from
  141         being appointed as an individual’s guardian advocate;
  142         providing requirements for a facility requesting the
  143         appointment of a guardian advocate; requiring a
  144         training course for guardian advocates; providing
  145         requirements for the training course; providing
  146         requirements for the prioritization of individuals to
  147         be selected as guardian advocates; authorizing certain
  148         guardian advocates to consent to medical treatment;
  149         providing exceptions; providing procedures for the
  150         discharge of a guardian advocate; amending ss. 39.407,
  151         212.055, 394.4599, 394.495, 394.496, 394.9085,
  152         397.405, 397.407, 397.416, 409.972, 440.102, 744.704,
  153         and 790.065, F.S.; conforming cross-references;
  154         providing an effective date.
  155          
  156  Be It Enacted by the Legislature of the State of Florida:
  157  
  158         Section 1. Paragraph (e) is added to subsection (10) of
  159  section 29.004, Florida Statutes, to read:
  160         29.004 State courts system.—For purposes of implementing s.
  161  14, Art. V of the State Constitution, the elements of the state
  162  courts system to be provided from state revenues appropriated by
  163  general law are as follows:
  164         (10) Case management. Case management includes:
  165         (e) Service referral, coordination, monitoring, and
  166  tracking for mental health programs under chapter 394.
  167  
  168  Case management may not include costs associated with the
  169  application of therapeutic jurisprudence principles by the
  170  courts. Case management also may not include case intake and
  171  records management conducted by the clerk of court.
  172         Section 2. Subsection (6) of section 39.001, Florida
  173  Statutes, is amended to read:
  174         39.001 Purposes and intent; personnel standards and
  175  screening.—
  176         (6) MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES.—
  177         (a) The Legislature recognizes that early referral and
  178  comprehensive treatment can help combat mental illness and
  179  substance abuse disorders in families and that treatment is
  180  cost-effective.
  181         (b) The Legislature establishes the following goals for the
  182  state related to mental illness and substance abuse treatment
  183  services in the dependency process:
  184         1. To ensure the safety of children.
  185         2. To prevent and remediate the consequences of mental
  186  illness and substance abuse disorders on families involved in
  187  protective supervision or foster care and reduce the occurrences
  188  of mental illness and substance abuse disorders, including
  189  alcohol abuse or other related disorders, for families who are
  190  at risk of being involved in protective supervision or foster
  191  care.
  192         3. To expedite permanency for children and reunify healthy,
  193  intact families, when appropriate.
  194         4. To support families in recovery.
  195         (c) The Legislature finds that children in the care of the
  196  state’s dependency system need appropriate health care services,
  197  that the impact of mental illnesses and substance abuse on
  198  health indicates the need for health care services to include
  199  treatment for mental health and substance abuse disorders for
  200  services to children and parents where appropriate, and that it
  201  is in the state’s best interest that such children be provided
  202  the services they need to enable them to become and remain
  203  independent of state care. In order to provide these services,
  204  the state’s dependency system must have the ability to identify
  205  and provide appropriate intervention and treatment for children
  206  with personal or family-related mental illness and substance
  207  abuse problems.
  208         (d) It is the intent of the Legislature to encourage the
  209  use of the mental health programs established under chapter 394
  210  and the drug court program model established under by s. 397.334
  211  and authorize courts to assess children and persons who have
  212  custody or are requesting custody of children where good cause
  213  is shown to identify and address mental illnesses and substance
  214  abuse disorders problems as the court deems appropriate at every
  215  stage of the dependency process. Participation in treatment,
  216  including a treatment-based mental health court program or a
  217  treatment-based drug court program, may be required by the court
  218  following adjudication. Participation in assessment and
  219  treatment before prior to adjudication is shall be voluntary,
  220  except as provided in s. 39.407(16).
  221         (e) It is therefore the purpose of the Legislature to
  222  provide authority for the state to contract with mental health
  223  service providers and community substance abuse treatment
  224  providers for the development and operation of specialized
  225  support and overlay services for the dependency system, which
  226  will be fully implemented and used as resources permit.
  227         (f) Participation in a treatment-based mental health court
  228  program or a the treatment-based drug court program does not
  229  divest any public or private agency of its responsibility for a
  230  child or adult, but is intended to enable these agencies to
  231  better meet their needs through shared responsibility and
  232  resources.
  233         Section 3. Subsection (10) of section 39.507, Florida
  234  Statutes, is amended to read:
  235         39.507 Adjudicatory hearings; orders of adjudication.—
  236         (10) After an adjudication of dependency, or a finding of
  237  dependency where adjudication is withheld, the court may order a
  238  person who has custody or is requesting custody of the child to
  239  submit to a mental health or substance abuse disorder assessment
  240  or evaluation. The assessment or evaluation must be administered
  241  by a qualified professional, as defined in s. 397.311. The court
  242  may also require such person to participate in and comply with
  243  treatment and services identified as necessary, including, when
  244  appropriate and available, participation in and compliance with
  245  a mental health program established under chapter 394 or a
  246  treatment-based drug court program established under s. 397.334.
  247  In addition to supervision by the department, the court,
  248  including a treatment-based mental health court program or a the
  249  treatment-based drug court program, may oversee the progress and
  250  compliance with treatment by a person who has custody or is
  251  requesting custody of the child. The court may impose
  252  appropriate available sanctions for noncompliance upon a person
  253  who has custody or is requesting custody of the child or make a
  254  finding of noncompliance for consideration in determining
  255  whether an alternative placement of the child is in the child’s
  256  best interests. Any order entered under this subsection may be
  257  made only upon good cause shown. This subsection does not
  258  authorize placement of a child with a person seeking custody,
  259  other than the parent or legal custodian, who requires mental
  260  health or substance abuse disorder treatment.
  261         Section 4. Paragraph (b) of subsection (1) of section
  262  39.521, Florida Statutes, is amended to read:
  263         39.521 Disposition hearings; powers of disposition.—
  264         (1) A disposition hearing shall be conducted by the court,
  265  if the court finds that the facts alleged in the petition for
  266  dependency were proven in the adjudicatory hearing, or if the
  267  parents or legal custodians have consented to the finding of
  268  dependency or admitted the allegations in the petition, have
  269  failed to appear for the arraignment hearing after proper
  270  notice, or have not been located despite a diligent search
  271  having been conducted.
  272         (b) When any child is adjudicated by a court to be
  273  dependent, the court having jurisdiction of the child has the
  274  power by order to:
  275         1. Require the parent and, when appropriate, the legal
  276  custodian and the child to participate in treatment and services
  277  identified as necessary. The court may require the person who
  278  has custody or who is requesting custody of the child to submit
  279  to a mental illness or substance abuse disorder assessment or
  280  evaluation. The assessment or evaluation must be administered by
  281  a qualified professional, as defined in s. 397.311. The court
  282  may also require such person to participate in and comply with
  283  treatment and services identified as necessary, including, when
  284  appropriate and available, participation in and compliance with
  285  a mental health program established under chapter 394 or a
  286  treatment-based drug court program established under s. 397.334.
  287  In addition to supervision by the department, the court,
  288  including a treatment-based mental health court program or a the
  289  treatment-based drug court program, may oversee the progress and
  290  compliance with treatment by a person who has custody or is
  291  requesting custody of the child. The court may impose
  292  appropriate available sanctions for noncompliance upon a person
  293  who has custody or is requesting custody of the child or make a
  294  finding of noncompliance for consideration in determining
  295  whether an alternative placement of the child is in the child’s
  296  best interests. Any order entered under this subparagraph may be
  297  made only upon good cause shown. This subparagraph does not
  298  authorize placement of a child with a person seeking custody of
  299  the child, other than the child’s parent or legal custodian, who
  300  requires mental health or substance abuse treatment.
  301         2. Require, if the court deems necessary, the parties to
  302  participate in dependency mediation.
  303         3. Require placement of the child either under the
  304  protective supervision of an authorized agent of the department
  305  in the home of one or both of the child’s parents or in the home
  306  of a relative of the child or another adult approved by the
  307  court, or in the custody of the department. Protective
  308  supervision continues until the court terminates it or until the
  309  child reaches the age of 18, whichever date is first. Protective
  310  supervision shall be terminated by the court whenever the court
  311  determines that permanency has been achieved for the child,
  312  whether with a parent, another relative, or a legal custodian,
  313  and that protective supervision is no longer needed. The
  314  termination of supervision may be with or without retaining
  315  jurisdiction, at the court’s discretion, and shall in either
  316  case be considered a permanency option for the child. The order
  317  terminating supervision by the department must shall set forth
  318  the powers of the custodian of the child and shall include the
  319  powers ordinarily granted to a guardian of the person of a minor
  320  unless otherwise specified. Upon the court’s termination of
  321  supervision by the department, no further judicial reviews are
  322  not required if, so long as permanency has been established for
  323  the child.
  324         Section 5. Section 394.455, Florida Statutes, is amended to
  325  read:
  326         394.455 Definitions.—As used in this part, unless the
  327  context clearly requires otherwise, the term:
  328         (1) Access center” means a facility staffed by medical,
  329  behavioral, and substance abuse professionals which provides
  330  emergency screening and evaluation for mental health or
  331  substance abuse disorders and may provide transportation to an
  332  appropriate facility if an individual is in need of more
  333  intensive services.
  334         (2) “Addictions receiving facility” means a secure, acute
  335  care facility that, at a minimum, provides emergency screening,
  336  evaluation, and short-term stabilization services; is operated
  337  24 hours per day, 7 days per week; and is designated by the
  338  department to serve individuals found to have substance abuse
  339  impairment who qualify for services under this part.
  340         (3)(1) “Administrator” means the chief administrative
  341  officer of a receiving or treatment facility or his or her
  342  designee.
  343         (4) “Adult” means an individual who is 18 years of age or
  344  older or who has had the disability of nonage removed under
  345  chapter 743.
  346         (5) “Advanced registered nurse practitioner” means any
  347  person licensed in this state to practice professional nursing
  348  who is certified in advanced or specialized nursing practice
  349  under s. 464.012.
  350         (6)(2) “Clinical psychologist” means a psychologist as
  351  defined in s. 490.003(7) with 3 years of postdoctoral experience
  352  in the practice of clinical psychology, inclusive of the
  353  experience required for licensure, or a psychologist employed by
  354  a facility operated by the United States Department of Veterans
  355  Affairs that qualifies as a receiving or treatment facility
  356  under this part.
  357         (7)(3) “Clinical record” means all parts of the record
  358  required to be maintained and includes all medical records,
  359  progress notes, charts, and admission and discharge data, and
  360  all other information recorded by a facility staff which
  361  pertains to the patient’s hospitalization or treatment.
  362         (8)(4) “Clinical social worker” means a person licensed as
  363  a clinical social worker under s. 491.005 or s. 491.006 chapter
  364  491.
  365         (9)(5) “Community facility” means a any community service
  366  provider that contracts contracting with the department to
  367  furnish substance abuse or mental health services under part IV
  368  of this chapter.
  369         (10)(6) “Community mental health center or clinic” means a
  370  publicly funded, not-for-profit center that which contracts with
  371  the department for the provision of inpatient, outpatient, day
  372  treatment, or emergency services.
  373         (11)(7) “Court,” unless otherwise specified, means the
  374  circuit court.
  375         (12)(8) “Department” means the Department of Children and
  376  Families.
  377         (13)“Designated receiving facility” means a facility
  378  approved by the department which may be a crisis stabilization
  379  unit, addictions receiving facility and provides, at a minimum,
  380  emergency screening, evaluation, and short-term stabilization
  381  for mental health or substance abuse disorders, and which may
  382  have an agreement with a corresponding facility for
  383  transportation and services.
  384         (14) “Detoxification facility” means a facility licensed to
  385  provide detoxification services under chapter 397.
  386         (15) “Electronic means” is a form of telecommunication
  387  which requires all parties to maintain visual as well as audio
  388  communication.
  389         (16)(9) “Express and informed consent” means consent
  390  voluntarily given in writing, by a competent person, after
  391  sufficient explanation and disclosure of the subject matter
  392  involved to enable the person to make a knowing and willful
  393  decision without any element of force, fraud, deceit, duress, or
  394  other form of constraint or coercion.
  395         (17)(10) “Facility” means any hospital, community facility,
  396  public or private facility, or receiving or treatment facility
  397  providing for the evaluation, diagnosis, care, treatment,
  398  training, or hospitalization of persons who appear to have a
  399  mental illness or who have been diagnosed as having a mental
  400  illness or substance abuse impairment. The term “Facility” does
  401  not include a any program or an entity licensed under pursuant
  402  to chapter 400 or chapter 429.
  403         (18) “Governmental facility” means a facility owned,
  404  operated, or administered by the Department of Corrections or
  405  the United States Department of Veterans Affairs.
  406         (19)(11) “Guardian” means the natural guardian of a minor,
  407  or a person appointed by a court to act on behalf of a ward’s
  408  person if the ward is a minor or has been adjudicated
  409  incapacitated.
  410         (20)(12) “Guardian advocate” means a person appointed by a
  411  court to make decisions regarding mental health or substance
  412  abuse treatment on behalf of a patient who has been found
  413  incompetent to consent to treatment pursuant to this part. The
  414  guardian advocate may be granted specific additional powers by
  415  written order of the court, as provided in this part.
  416         (21)(13) “Hospital” means a hospital facility as defined in
  417  s. 395.002 and licensed under chapter 395 and part II of chapter
  418  408.
  419         (22)(14) “Incapacitated” means that a person has been
  420  adjudicated incapacitated pursuant to part V of chapter 744 and
  421  a guardian of the person has been appointed.
  422         (23)(15) “Incompetent to consent to treatment” means a
  423  state in which that a person’s judgment is so affected by a his
  424  or her mental illness, a substance abuse impairment, that he or
  425  she the person lacks the capacity to make a well-reasoned,
  426  willful, and knowing decision concerning his or her medical, or
  427  mental health, or substance abuse treatment.
  428         (24) “Involuntary examination” means an examination
  429  performed under s. 394.463 or s. 397.675 to determine whether a
  430  person qualifies for involuntary outpatient services pursuant to
  431  s. 394.4655 or involuntary inpatient placement.
  432         (25) “Involuntary services” means court-ordered outpatient
  433  services or inpatient placement for mental health treatment
  434  pursuant to s. 394.4655 or s. 394.467.
  435         (26)(16) “Law enforcement officer” has the same meaning as
  436  provided means a law enforcement officer as defined in s.
  437  943.10.
  438         (27) “Marriage and family therapist” means a person
  439  licensed to practice marriage and family therapy under s.
  440  491.005 or s. 491.006.
  441         (28) “Mental health counselor” means a person licensed to
  442  practice mental health counseling under s. 491.005 or s.
  443  491.006.
  444         (29)(17) “Mental health overlay program” means a mobile
  445  service that which provides an independent examination for
  446  voluntary admission admissions and a range of supplemental
  447  onsite services to persons with a mental illness in a
  448  residential setting such as a nursing home, an assisted living
  449  facility, or an adult family-care home, or a nonresidential
  450  setting such as an adult day care center. Independent
  451  examinations provided pursuant to this part through a mental
  452  health overlay program must only be provided under contract with
  453  the department for this service or be attached to a public
  454  receiving facility that is also a community mental health
  455  center.
  456         (30)(18) “Mental illness” means an impairment of the mental
  457  or emotional processes that exercise conscious control of one’s
  458  actions or of the ability to perceive or understand reality,
  459  which impairment substantially interferes with the person’s
  460  ability to meet the ordinary demands of living. For the purposes
  461  of this part, the term does not include a developmental
  462  disability as defined in chapter 393, intoxication, or
  463  conditions manifested only by antisocial behavior or substance
  464  abuse impairment.
  465         (31) “Minor” means an individual who is 17 years of age or
  466  younger and who has not had the disability of nonage removed
  467  pursuant to s. 743.01 or s. 743.015.
  468         (32)(19) “Mobile crisis response service” means a
  469  nonresidential crisis service attached to a public receiving
  470  facility and available 24 hours a day, 7 days a week, through
  471  which provides immediate intensive assessments and
  472  interventions, including screening for admission into a mental
  473  health receiving facility, an addictions receiving facility, or
  474  a detoxification facility, take place for the purpose of
  475  identifying appropriate treatment services.
  476         (33)(20) “Patient” means any person who is held or accepted
  477  for mental health or substance abuse treatment.
  478         (34)(21) “Physician” means a medical practitioner licensed
  479  under chapter 458 or chapter 459 who has experience in the
  480  diagnosis and treatment of mental and nervous disorders or a
  481  physician employed by a facility operated by the United States
  482  Department of Veterans Affairs or the United States Department
  483  of Defense which qualifies as a receiving or treatment facility
  484  under this part.
  485         (35) “Physician assistant” means a person licensed under
  486  chapter 458 or chapter 459 who has experience in the diagnosis
  487  and treatment of mental disorders.
  488         (36)(22) “Private facility” means any hospital or facility
  489  operated by a for-profit or not-for-profit corporation or
  490  association which that provides mental health or substance abuse
  491  services and is not a public facility.
  492         (37)(23) “Psychiatric nurse” means an advanced registered
  493  nurse practitioner certified under s. 464.012 who has a master’s
  494  or doctoral degree in psychiatric nursing, holds a national
  495  advanced practice certification as a psychiatric mental health
  496  advanced practice nurse, and has 2 years of post-master’s
  497  clinical experience under the supervision of a physician.
  498         (38)(24) “Psychiatrist” means a medical practitioner
  499  licensed under chapter 458 or chapter 459 who has primarily
  500  diagnosed and treated mental and nervous disorders for at least
  501  a period of not less than 3 years, inclusive of psychiatric
  502  residency.
  503         (39)(25) “Public facility” means a any facility that has
  504  contracted with the department to provide mental health or
  505  substance abuse services to all persons, regardless of their
  506  ability to pay, and is receiving state funds for such purpose.
  507         (40) “Qualified professional” means a physician or a
  508  physician assistant licensed under chapter 458 or chapter 459; a
  509  professional licensed under chapter 490.003(7) or chapter 491; a
  510  psychiatrist licensed under chapter 458 or chapter 459; or a
  511  psychiatric nurse as defined in subsection (37).
  512         (41)(26) “Receiving facility” means any public or private
  513  facility designated by the department to receive and hold or
  514  refer, as appropriate, involuntary patients under emergency
  515  conditions or for mental health or substance abuse psychiatric
  516  evaluation and to provide short-term treatment or transportation
  517  to the appropriate service provider. The term does not include a
  518  county jail.
  519         (42)(27) “Representative” means a person selected to
  520  receive notice of proceedings during the time a patient is held
  521  in or admitted to a receiving or treatment facility.
  522         (43)(28)(a) “Restraint” means: a physical device, method,
  523  or drug used to control behavior.
  524         (a) A physical restraint, including is any manual method or
  525  physical or mechanical device, material, or equipment attached
  526  or adjacent to an the individual’s body so that he or she cannot
  527  easily remove the restraint and which restricts freedom of
  528  movement or normal access to one’s body. Physical restraint
  529  includes the physical holding of a person during a procedure to
  530  forcibly administer psychotropic medication. Physical restraint
  531  does not include physical devices such as orthopedically
  532  prescribed appliances, surgical dressings and bandages,
  533  supportive body bands, or other physical holding when necessary
  534  for routine physical examinations and tests or for purposes of
  535  orthopedic, surgical, or other similar medical treatment, when
  536  used to provide support for the achievement of functional body
  537  position or proper balance, or when used to protect a person
  538  from falling out of bed.
  539         (b) A drug or used as a restraint is a medication used to
  540  control a the person’s behavior or to restrict his or her
  541  freedom of movement which and is not part of the standard
  542  treatment regimen of a person with a diagnosed mental illness
  543  who is a client of the department. Physically holding a person
  544  during a procedure to forcibly administer psychotropic
  545  medication is a physical restraint.
  546         (c) Restraint does not include physical devices, such as
  547  orthopedically prescribed appliances, surgical dressings and
  548  bandages, supportive body bands, or other physical holding when
  549  necessary for routine physical examinations and tests; or for
  550  purposes of orthopedic, surgical, or other similar medical
  551  treatment; when used to provide support for the achievement of
  552  functional body position or proper balance; or when used to
  553  protect a person from falling out of bed.
  554         (44) “School psychologist” has the same meaning as in s.
  555  490.003.
  556         (45)(29) “Seclusion” means the physical segregation of a
  557  person in any fashion or involuntary isolation of a person in a
  558  room or area from which the person is prevented from leaving.
  559  The prevention may be by physical barrier or by a staff member
  560  who is acting in a manner, or who is physically situated, so as
  561  to prevent the person from leaving the room or area. For
  562  purposes of this part chapter, the term does not mean isolation
  563  due to a person’s medical condition or symptoms.
  564         (46)(30) “Secretary” means the Secretary of Children and
  565  Families.
  566         (47) “Service provider” means a receiving facility, any
  567  facility licensed under chapter 397, a treatment facility, an
  568  entity under contract with the department to provide mental
  569  health or substance abuse services, a community mental health
  570  center or clinic, a psychologist, a clinical social worker, a
  571  marriage and family therapist, a mental health counselor, a
  572  physician, a psychiatrist, an advanced registered nurse
  573  practitioner, a psychiatric nurse, or a qualified professional
  574  as defined in this section.
  575         (48) “Substance abuse impairment” means a condition
  576  involving the use of alcoholic beverages or any psychoactive or
  577  mood-altering substance in such a manner that a person has lost
  578  the power of self-control and has inflicted or is likely to
  579  inflict physical harm on himself or herself or others.
  580         (49)(31) “Transfer evaluation” means the process by which,
  581  as approved by the appropriate district office of the
  582  department, whereby a person who is being considered for
  583  placement in a state treatment facility is first evaluated for
  584  appropriateness of admission to a state treatment the facility
  585  by a community-based public receiving facility or by a community
  586  mental health center or clinic if the public receiving facility
  587  is not a community mental health center or clinic.
  588         (50)(32) “Treatment facility” means a any state-owned,
  589  state-operated, or state-supported hospital, center, or clinic
  590  designated by the department for extended treatment and
  591  hospitalization, beyond that provided for by a receiving
  592  facility, of persons who have a mental illness, including
  593  facilities of the United States Government, and any private
  594  facility designated by the department when rendering such
  595  services to a person pursuant to the provisions of this part.
  596  Patients treated in facilities of the United States Government
  597  shall be solely those whose care is the responsibility of the
  598  United States Department of Veterans Affairs.
  599         (51) “Triage center” means a facility that is approved by
  600  the department and has medical, behavioral, and substance abuse
  601  professionals present or on call to provide emergency screening
  602  and evaluation of individuals transported to the center by a law
  603  enforcement officer.
  604         (33) “Service provider” means any public or private
  605  receiving facility, an entity under contract with the Department
  606  of Children and Families to provide mental health services, a
  607  clinical psychologist, a clinical social worker, a marriage and
  608  family therapist, a mental health counselor, a physician, a
  609  psychiatric nurse as defined in subsection (23), or a community
  610  mental health center or clinic as defined in this part.
  611         (34) “Involuntary examination” means an examination
  612  performed under s. 394.463 to determine if an individual
  613  qualifies for involuntary inpatient treatment under s.
  614  394.467(1) or involuntary outpatient treatment under s.
  615  394.4655(1).
  616         (35) “Involuntary placement” means either involuntary
  617  outpatient treatment pursuant to s. 394.4655 or involuntary
  618  inpatient treatment pursuant to s. 394.467.
  619         (36) “Marriage and family therapist” means a person
  620  licensed as a marriage and family therapist under chapter 491.
  621         (37) “Mental health counselor” means a person licensed as a
  622  mental health counselor under chapter 491.
  623         (38) “Electronic means” means a form of telecommunication
  624  that requires all parties to maintain visual as well as audio
  625  communication.
  626         Section 6. Section 394.4573, Florida Statutes, is amended
  627  to read:
  628         394.4573 Coordinated system of care; annual assessment;
  629  essential elements Continuity of care management system;
  630  measures of performance; system improvement grants; reports.—On
  631  or before October 1 of each year, the department shall submit to
  632  the Governor, the President of the Senate, and the Speaker of
  633  the House of Representatives an assessment of the behavioral
  634  health services in this state in the context of the No-Wrong
  635  Door model and standards set forth in this section. The
  636  department’s assessment shall be based on both quantitative and
  637  qualitative data and must identify any significant regional
  638  variations. The assessment must include information gathered
  639  from managing entities, service providers, law enforcement,
  640  judicial officials, local governments, behavioral health
  641  consumers and their family members, and the public.
  642         (1) As used in For the purposes of this section:
  643         (a) “Case management” means those direct services provided
  644  to a client in order to assess his or her activities aimed at
  645  assessing client needs, plan or arrange planning services,
  646  coordinate service providers, monitor linking the service system
  647  to a client, coordinating the various system components,
  648  monitoring service delivery, and evaluate patient outcomes
  649  evaluating the effect of service delivery.
  650         (b) “Case manager” means an individual who works with
  651  clients, and their families and significant others, to provide
  652  case management.
  653         (c) “Client manager” means an employee of the managing
  654  entity or entity under contract with the managing entity
  655  department who is assigned to specific provider agencies and
  656  geographic areas to ensure that the full range of needed
  657  services is available to clients.
  658         (d) “Coordinated system Continuity of care management
  659  system” means a system that assures, within available resources,
  660  that clients have access to the full array of behavioral and
  661  related services in a region or community offered by all service
  662  providers, whether participating under contract with the
  663  managing entity or another method of community partnership or
  664  mutual agreement within the mental health services delivery
  665  system.
  666         (e) “No-Wrong-Door model” means a model for the delivery of
  667  health care services to persons who have mental health or
  668  substance abuse disorders, or both, which optimizes access to
  669  care, regardless of the entry point to the behavioral health
  670  care system.
  671         (2) The essential elements of a coordinated system of care
  672  include:
  673         (a) Community interventions, such as prevention, primary
  674  care for behavioral health needs, therapeutic and supportive
  675  services, crisis response services, and diversion programs.
  676         (b) A designated receiving system consisting of one or more
  677  facilities serving a defined geographic area and responsible for
  678  assessment and evaluation, both voluntary and involuntary, and
  679  treatment or triage for patients who present with mental
  680  illness, substance abuse disorder, or co-occurring disorders.
  681  The system must be approved by each county or by several
  682  counties, planned through an inclusive process, approved by the
  683  managing entity, and documented through written memoranda of
  684  agreement or other binding arrangements. The designated
  685  receiving system may be organized in any of the following ways
  686  so long as it functions as a No-Wrong-Door model that responds
  687  to individual needs and integrates services among various
  688  providers:
  689         1. A central receiving system, which consists of a
  690  designated central receiving facility that serves as a single
  691  entry point for persons with mental health or substance abuse
  692  disorders, or both. The designated receiving facility must be
  693  capable of assessment, evaluation, and triage or treatment for
  694  various conditions and circumstances.
  695         2. A coordinated receiving system, which consists of
  696  multiple entry points that are linked by shared data systems,
  697  formal referral agreements, and cooperative arrangements for
  698  care coordination and case management. Each entry point must be
  699  a designated receiving facility and must provide or arrange for
  700  necessary services following an initial assessment and
  701  evaluation.
  702         3. A tiered receiving system, which consists of multiple
  703  entry points, some of which offer only specialized or limited
  704  services. Each service provider must be classified according to
  705  its capabilities as either a designated receiving facility, or
  706  another type of service provider such as a triage center, or an
  707  access center. All participating service providers must be
  708  linked by methods to share data that are compliant with both
  709  state and federal patient privacy laws, formal referral
  710  agreements, and cooperative arrangements for care coordination
  711  and case management. An accurate inventory of the participating
  712  service providers which specifies the capabilities and
  713  limitations of each provider must be maintained and made
  714  available at all times to all first responders in the service
  715  area.
  716         (c) Transportation in accordance with a plan developed
  717  under s. 394.462.
  718         (d) Crisis services, including mobile response teams,
  719  crisis stabilization units, addiction receiving facilities, and
  720  detoxification facilities.
  721         (e) Case management, including intensive case management
  722  for individuals determined to be high-need or high-utilization
  723  individuals under s. 394.9082(2(e).
  724         (f) Outpatient services.
  725         (g) Residential services.
  726         (h) Hospital inpatient care.
  727         (i) Aftercare and other post-discharge services.
  728         (j) Medication Assisted Treatment and medication
  729  management.
  730         (k) Recovery support, including housing assistance and
  731  support for competitive employment, educational attainment,
  732  independent living skills development, family support and
  733  education, and wellness management and self-care.
  734         (3) The department’s annual assessment must compare the
  735  status and performance of the extant behavioral health system
  736  with the following standards and any other standards or measures
  737  that the department determines to be applicable.
  738         (a) The capacity of the contracted service providers to
  739  meet estimated need when such estimates are based on credible
  740  evidence and sound methodologies.
  741         (b) The extent to which the behavioral health system uses
  742  evidence-informed practices and broadly disseminates the results
  743  of quality improvement activities to all service providers.
  744         (c) The degree to which services are offered in the least
  745  restrictive and most appropriate therapeutic environment.
  746         (d) The scope of systemwide accountability activities used
  747  to monitor patient outcomes and measure continuous improvement
  748  in the behavioral health system.
  749         (4) Subject to a specific appropriation by the Legislature,
  750  the department may award system improvement grants to managing
  751  entities based on the submission of a detailed plan to enhance
  752  services, coordination, or performance measurement in accordance
  753  with the model and standards specified in this section. Such a
  754  grant must be awarded through a performance-based contract that
  755  links payments to the documented and measurable achievement of
  756  system improvements The department is directed to implement a
  757  continuity of care management system for the provision of mental
  758  health care, through the provision of client and case
  759  management, including clients referred from state treatment
  760  facilities to community mental health facilities. Such system
  761  shall include a network of client managers and case managers
  762  throughout the state designed to:
  763         (a) Reduce the possibility of a client’s admission or
  764  readmission to a state treatment facility.
  765         (b) Provide for the creation or designation of an agency in
  766  each county to provide single intake services for each person
  767  seeking mental health services. Such agency shall provide
  768  information and referral services necessary to ensure that
  769  clients receive the most appropriate and least restrictive form
  770  of care, based on the individual needs of the person seeking
  771  treatment. Such agency shall have a single telephone number,
  772  operating 24 hours per day, 7 days per week, where practicable,
  773  at a central location, where each client will have a central
  774  record.
  775         (c) Advocate on behalf of the client to ensure that all
  776  appropriate services are afforded to the client in a timely and
  777  dignified manner.
  778         (d) Require that any public receiving facility initiating a
  779  patient transfer to a licensed hospital for acute care mental
  780  health services not accessible through the public receiving
  781  facility shall notify the hospital of such transfer and send all
  782  records relating to the emergency psychiatric or medical
  783  condition.
  784         (3) The department is directed to develop and include in
  785  contracts with service providers measures of performance with
  786  regard to goals and objectives as specified in the state plan.
  787  Such measures shall use, to the extent practical, existing data
  788  collection methods and reports and shall not require, as a
  789  result of this subsection, additional reports on the part of
  790  service providers. The department shall plan monitoring visits
  791  of community mental health facilities with other state, federal,
  792  and local governmental and private agencies charged with
  793  monitoring such facilities.
  794         Section 7. Paragraphs (d) and (e) of subsection (2) of
  795  section 394.4597, Florida Statutes, are amended to read:
  796         394.4597 Persons to be notified; patient’s representative.—
  797         (2) INVOLUNTARY PATIENTS.—
  798         (d) When the receiving or treatment facility selects a
  799  representative, first preference shall be given to a health care
  800  surrogate, if one has been previously selected by the patient.
  801  If the patient has not previously selected a health care
  802  surrogate, the selection, except for good cause documented in
  803  the patient’s clinical record, shall be made from the following
  804  list in the order of listing:
  805         1. The patient’s spouse.
  806         2. An adult child of the patient.
  807         3. A parent of the patient.
  808         4. The adult next of kin of the patient.
  809         5. An adult friend of the patient.
  810         6. The appropriate Florida local advocacy council as
  811  provided in s. 402.166.
  812         (e) The following persons are prohibited from selection as
  813  a patient’s representative:
  814         1. A professional providing clinical services to the
  815  patient under this part.
  816         2. The licensed professional who initiated the involuntary
  817  examination of the patient, if the examination was initiated by
  818  professional certificate.
  819         3. An employee, an administrator, or a board member of the
  820  facility providing the examination of the patient.
  821         4. An employee, an administrator, or a board member of a
  822  treatment facility providing treatment for the patient.
  823         5. A person providing any substantial professional services
  824  to the patient, including clinical services.
  825         6. A creditor of the patient.
  826         7. A person subject to an injunction for protection against
  827  domestic violence under s. 741.30, whether the order of
  828  injunction is temporary or final, and for which the patient was
  829  the petitioner.
  830         8. A person subject to an injunction for protection against
  831  repeat violence, sexual violence, or dating violence under s.
  832  784.046, whether the order of injunction is temporary or final,
  833  and for which the patient was the petitioner A licensed
  834  professional providing services to the patient under this part,
  835  an employee of a facility providing direct services to the
  836  patient under this part, a department employee, a person
  837  providing other substantial services to the patient in a
  838  professional or business capacity, or a creditor of the patient
  839  shall not be appointed as the patient’s representative.
  840         Section 8. Present subsections (2) through (7) of section
  841  394.4598, Florida Statutes, are redesignated as subsections (3)
  842  through (8), respectively, a new subsection (2) is added to that
  843  section, and present subsections (3) and (4) of that section are
  844  amended, to read:
  845         394.4598 Guardian advocate.—
  846         (2) The following persons are prohibited from appointment
  847  as a patient’s guardian advocate:
  848         (a) A professional providing clinical services to the
  849  patient under this part.
  850         (b) The licensed professional who initiated the involuntary
  851  examination of the patient, if the examination was initiated by
  852  professional certificate.
  853         (c) An employee, an administrator, or a board member of the
  854  facility providing the examination of the patient.
  855         (d) An employee, an administrator, or a board member of a
  856  treatment facility providing treatment of the patient.
  857         (e) A person providing any substantial professional
  858  services to the patient, including clinical services.
  859         (f) A creditor of the patient.
  860         (g) A person subject to an injunction for protection
  861  against domestic violence under s. 741.30, whether the order of
  862  injunction is temporary or final, and for which the patient was
  863  the petitioner.
  864         (h) A person subject to an injunction for protection
  865  against repeat violence, sexual violence, or dating violence
  866  under s. 784.046, whether the order of injunction is temporary
  867  or final, and for which the patient was the petitioner.
  868         (4)(3)In lieu of the training required of guardians
  869  appointed pursuant to chapter 744, Prior to a guardian advocate
  870  must, at a minimum, participate in a 4-hour training course
  871  approved by the court before exercising his or her authority,
  872  the guardian advocate shall attend a training course approved by
  873  the court. At a minimum, this training course, of not less than
  874  4 hours, must include, at minimum, information about the patient
  875  rights, psychotropic medications, the diagnosis of mental
  876  illness, the ethics of medical decisionmaking, and duties of
  877  guardian advocates. This training course shall take the place of
  878  the training required for guardians appointed pursuant to
  879  chapter 744.
  880         (5)(4) The required training course and the information to
  881  be supplied to prospective guardian advocates before prior to
  882  their appointment and the training course for guardian advocates
  883  must be developed and completed through a course developed by
  884  the department, and approved by the chief judge of the circuit
  885  court, and taught by a court-approved organization, which.
  886  Court-approved organizations may include, but is are not limited
  887  to, a community college community or junior colleges, a
  888  guardianship organization guardianship organizations, a and the
  889  local bar association, or The Florida Bar. The training course
  890  may be web-based, provided in video format, or other electronic
  891  means but must be capable of ensuring the identity and
  892  participation of the prospective guardian advocate. The court
  893  may, in its discretion, waive some or all of the training
  894  requirements for guardian advocates or impose additional
  895  requirements. The court shall make its decision on a case-by
  896  case basis and, in making its decision, shall consider the
  897  experience and education of the guardian advocate, the duties
  898  assigned to the guardian advocate, and the needs of the patient.
  899         Section 9. Section 394.462, Florida Statutes, is amended to
  900  read:
  901         394.462 Transportation.—A transportation plan must be
  902  developed and implemented by each county in accordance with this
  903  section. A county may enter into a memorandum of understanding
  904  with the governing boards of nearby counties to establish a
  905  shared transportation plan. When multiple counties enter into a
  906  memorandum of understanding for this purpose, the managing
  907  entity must be notified and provided a copy of the agreement.
  908  The transportation plan must describe methods of transport to a
  909  facility within the designated receiving system and may identify
  910  responsibility for other transportation to a participating
  911  facility when necessary and agreed to by the facility. The plan
  912  must ensure that individuals who meet the criteria for
  913  involuntary assessment and evaluation pursuant to ss. 394.463
  914  and 397.675 will be transported. The plan may rely on emergency
  915  medical transport services or private transport companies as
  916  appropriate.
  917         (1) TRANSPORTATION TO A RECEIVING FACILITY.—
  918         (a) Each county shall designate a single law enforcement
  919  agency within the county, or portions thereof, to take a person
  920  into custody upon the entry of an ex parte order or the
  921  execution of a certificate for involuntary examination by an
  922  authorized professional and to transport that person to an
  923  appropriate facility within the designated receiving system the
  924  nearest receiving facility for examination.
  925         (b)1. The designated law enforcement agency may decline to
  926  transport the person to a receiving facility only if:
  927         a.1. The jurisdiction designated by the county has
  928  contracted on an annual basis with an emergency medical
  929  transport service or private transport company for
  930  transportation of persons to receiving facilities pursuant to
  931  this section at the sole cost of the county; and
  932         b.2. The law enforcement agency and the emergency medical
  933  transport service or private transport company agree that the
  934  continued presence of law enforcement personnel is not necessary
  935  for the safety of the person or others.
  936         2.3. The entity providing transportation jurisdiction
  937  designated by the county may seek reimbursement for
  938  transportation expenses. The party responsible for payment for
  939  such transportation is the person receiving the transportation.
  940  The county shall seek reimbursement from the following sources
  941  in the following order:
  942         a. From a private or public third-party payor an insurance
  943  company, health care corporation, or other source, if the person
  944  receiving the transportation has applicable coverage is covered
  945  by an insurance policy or subscribes to a health care
  946  corporation or other source for payment of such expenses.
  947         b. From the person receiving the transportation.
  948         c. From a financial settlement for medical care, treatment,
  949  hospitalization, or transportation payable or accruing to the
  950  injured party.
  951         (c)(b)A Any company that transports a patient pursuant to
  952  this subsection is considered an independent contractor and is
  953  solely liable for the safe and dignified transport
  954  transportation of the patient. Such company must be insured and
  955  provide no less than $100,000 in liability insurance with
  956  respect to the transport transportation of patients.
  957         (d)(c) Any company that contracts with a governing board of
  958  a county to transport patients shall comply with the applicable
  959  rules of the department to ensure the safety and dignity of the
  960  patients.
  961         (e)(d) When a law enforcement officer takes custody of a
  962  person pursuant to this part, the officer may request assistance
  963  from emergency medical personnel if such assistance is needed
  964  for the safety of the officer or the person in custody.
  965         (f)(e) When a member of a mental health overlay program or
  966  a mobile crisis response service is a professional authorized to
  967  initiate an involuntary examination pursuant to s. 394.463 or s.
  968  397.675 and that professional evaluates a person and determines
  969  that transportation to a receiving facility is needed, the
  970  service, at its discretion, may transport the person to the
  971  facility or may call on the law enforcement agency or other
  972  transportation arrangement best suited to the needs of the
  973  patient.
  974         (g)(f) When any law enforcement officer has custody of a
  975  person based on either noncriminal or minor criminal behavior
  976  that meets the statutory guidelines for involuntary examination
  977  under this part, the law enforcement officer shall transport the
  978  person to an appropriate the nearest receiving facility within
  979  the designated receiving system for examination.
  980         (h)(g) When any law enforcement officer has arrested a
  981  person for a felony and it appears that the person meets the
  982  statutory guidelines for involuntary examination or placement
  983  under this part, such person must shall first be processed in
  984  the same manner as any other criminal suspect. The law
  985  enforcement agency shall thereafter immediately notify the
  986  appropriate nearest public receiving facility within the
  987  designated receiving system, which shall be responsible for
  988  promptly arranging for the examination and treatment of the
  989  person. A receiving facility is not required to admit a person
  990  charged with a crime for whom the facility determines and
  991  documents that it is unable to provide adequate security, but
  992  shall provide mental health examination and treatment to the
  993  person where he or she is held.
  994         (i)(h) If the appropriate law enforcement officer believes
  995  that a person has an emergency medical condition as defined in
  996  s. 395.002, the person may be first transported to a hospital
  997  for emergency medical treatment, regardless of whether the
  998  hospital is a designated receiving facility.
  999         (j)(i) The costs of transportation, evaluation,
 1000  hospitalization, and treatment incurred under this subsection by
 1001  persons who have been arrested for violations of any state law
 1002  or county or municipal ordinance may be recovered as provided in
 1003  s. 901.35.
 1004         (k)(j) The nearest receiving facility within the designated
 1005  receiving system must accept, pursuant to this part, persons
 1006  brought by law enforcement officers, an emergency medical
 1007  transport service, or a private transport company for
 1008  involuntary examination.
 1009         (l)(k) Each law enforcement agency designated pursuant to
 1010  paragraph (a) shall establish a policy that develop a memorandum
 1011  of understanding with each receiving facility within the law
 1012  enforcement agency’s jurisdiction which reflects a single set of
 1013  protocols approved by the managing entity for the safe and
 1014  secure transportation of the person and transfer of custody of
 1015  the person. These protocols must also address crisis
 1016  intervention measures.
 1017         (m)(l) When a jurisdiction has entered into a contract with
 1018  an emergency medical transport service or a private transport
 1019  company for transportation of persons to receiving facilities
 1020  within the designated receiving system, such service or company
 1021  shall be given preference for transportation of persons from
 1022  nursing homes, assisted living facilities, adult day care
 1023  centers, or adult family-care homes, unless the behavior of the
 1024  person being transported is such that transportation by a law
 1025  enforcement officer is necessary.
 1026         (n)(m)Nothing in This section may not shall be construed
 1027  to limit emergency examination and treatment of incapacitated
 1028  persons provided in accordance with the provisions of s.
 1029  401.445.
 1030         (2) TRANSPORTATION TO A TREATMENT FACILITY.—
 1031         (a) If neither the patient nor any person legally obligated
 1032  or responsible for the patient is able to pay for the expense of
 1033  transporting a voluntary or involuntary patient to a treatment
 1034  facility, the transportation plan established by the governing
 1035  board of the county or counties must specify how in which the
 1036  hospitalized patient will be transported to, from, and between
 1037  facilities in a is hospitalized shall arrange for such required
 1038  transportation and shall ensure the safe and dignified manner
 1039  transportation of the patient. The governing board of each
 1040  county is authorized to contract with private transport
 1041  companies for the transportation of such patients to and from a
 1042  treatment facility.
 1043         (b) A Any company that transports a patient pursuant to
 1044  this subsection is considered an independent contractor and is
 1045  solely liable for the safe and dignified transportation of the
 1046  patient. Such company must be insured and provide no less than
 1047  $100,000 in liability insurance with respect to the transport
 1048  transportation of patients.
 1049         (c) A Any company that contracts with one or more counties
 1050  the governing board of a county to transport patients in
 1051  accordance with this section shall comply with the applicable
 1052  rules of the department to ensure the safety and dignity of the
 1053  patients.
 1054         (d) County or municipal law enforcement and correctional
 1055  personnel and equipment may shall not be used to transport
 1056  patients adjudicated incapacitated or found by the court to meet
 1057  the criteria for involuntary placement pursuant to s. 394.467,
 1058  except in small rural counties where there are no cost-efficient
 1059  alternatives.
 1060         (3) TRANSFER OF CUSTODY.—Custody of a person who is
 1061  transported pursuant to this part, along with related
 1062  documentation, shall be relinquished to a responsible individual
 1063  at the appropriate receiving or treatment facility.
 1064         (4) EXCEPTIONS.—An exception to the requirements of this
 1065  section may be granted by the secretary of the department for
 1066  the purposes of improving service coordination or better meeting
 1067  the special needs of individuals. A proposal for an exception
 1068  must be submitted by the district administrator after being
 1069  approved by the governing boards of any affected counties, prior
 1070  to submission to the secretary.
 1071         (a) A proposal for an exception must identify the specific
 1072  provision from which an exception is requested; describe how the
 1073  proposal will be implemented by participating law enforcement
 1074  agencies and transportation authorities; and provide a plan for
 1075  the coordination of services such as case management.
 1076         (b) The exception may be granted only for:
 1077         1. An arrangement centralizing and improving the provision
 1078  of services within a district, which may include an exception to
 1079  the requirement for transportation to the nearest receiving
 1080  facility;
 1081         2. An arrangement by which a facility may provide, in
 1082  addition to required psychiatric services, an environment and
 1083  services which are uniquely tailored to the needs of an
 1084  identified group of persons with special needs, such as persons
 1085  with hearing impairments or visual impairments, or elderly
 1086  persons with physical frailties; or
 1087         3. A specialized transportation system that provides an
 1088  efficient and humane method of transporting patients to
 1089  receiving facilities, among receiving facilities, and to
 1090  treatment facilities.
 1091         (c) Any exception approved pursuant to this subsection
 1092  shall be reviewed and approved every 5 years by the secretary.
 1093         Section 10. Subsection (2) of section 394.463, Florida
 1094  Statutes, is amended to read:
 1095         394.463 Involuntary examination.—
 1096         (2) INVOLUNTARY EXAMINATION.—
 1097         (a) An involuntary examination may be initiated by any one
 1098  of the following means:
 1099         1. A circuit or county court may enter an ex parte order
 1100  stating that a person appears to meet the criteria for
 1101  involuntary examination and specifying, giving the findings on
 1102  which that conclusion is based. The ex parte order for
 1103  involuntary examination must be based on written or oral sworn
 1104  testimony that includes specific facts that support the
 1105  findings, written or oral. If other, less restrictive, means are
 1106  not available, such as voluntary appearance for outpatient
 1107  evaluation, a law enforcement officer, or other designated agent
 1108  of the court, shall take the person into custody and deliver him
 1109  or her to an appropriate the nearest receiving facility within
 1110  the designated receiving system for involuntary examination. The
 1111  order of the court shall be made a part of the patient’s
 1112  clinical record. A No fee may not shall be charged for the
 1113  filing of an order under this subsection. Any receiving facility
 1114  accepting the patient based on this order must send a copy of
 1115  the order to the managing entity in the region Agency for Health
 1116  Care Administration on the next working day. The order may be
 1117  submitted electronically through existing data systems, if
 1118  available. The order shall be valid only until the person is
 1119  delivered to the appropriate facility executed or, if not
 1120  executed, for the period specified in the order itself,
 1121  whichever comes first. If no time limit is specified in the
 1122  order, the order shall be valid for 7 days after the date that
 1123  the order was signed.
 1124         2. A law enforcement officer shall take a person who
 1125  appears to meet the criteria for involuntary examination into
 1126  custody and deliver the person or have him or her delivered to
 1127  the appropriate nearest receiving facility within the designated
 1128  receiving system for examination. The officer shall execute a
 1129  written report detailing the circumstances under which the
 1130  person was taken into custody, which must and the report shall
 1131  be made a part of the patient’s clinical record. Any receiving
 1132  facility accepting the patient based on this report must send a
 1133  copy of the report to the department and the managing entity
 1134  Agency for Health Care Administration on the next working day.
 1135         3. A physician, clinical psychologist, psychiatric nurse
 1136  practitioner, mental health counselor, marriage and family
 1137  therapist, or clinical social worker may execute a certificate
 1138  stating that he or she has examined a person within the
 1139  preceding 48 hours and finds that the person appears to meet the
 1140  criteria for involuntary examination and stating the
 1141  observations upon which that conclusion is based. If other, less
 1142  restrictive means, such as voluntary appearance for outpatient
 1143  evaluation, are not available, such as voluntary appearance for
 1144  outpatient evaluation, a law enforcement officer shall take into
 1145  custody the person named in the certificate into custody and
 1146  deliver him or her to the appropriate nearest receiving facility
 1147  within the designated receiving system for involuntary
 1148  examination. The law enforcement officer shall execute a written
 1149  report detailing the circumstances under which the person was
 1150  taken into custody. The report and certificate shall be made a
 1151  part of the patient’s clinical record. Any receiving facility
 1152  accepting the patient based on this certificate must send a copy
 1153  of the certificate to the managing entity Agency for Health Care
 1154  Administration on the next working day. The document may be
 1155  submitted electronically through existing data systems, if
 1156  applicable.
 1157         (b) A person may shall not be removed from any program or
 1158  residential placement licensed under chapter 400 or chapter 429
 1159  and transported to a receiving facility for involuntary
 1160  examination unless an ex parte order, a professional
 1161  certificate, or a law enforcement officer’s report is first
 1162  prepared. If the condition of the person is such that
 1163  preparation of a law enforcement officer’s report is not
 1164  practicable before removal, the report shall be completed as
 1165  soon as possible after removal, but in any case before the
 1166  person is transported to a receiving facility. A receiving
 1167  facility admitting a person for involuntary examination who is
 1168  not accompanied by the required ex parte order, professional
 1169  certificate, or law enforcement officer’s report shall notify
 1170  the managing entity Agency for Health Care Administration of
 1171  such admission by certified mail or by e-mail, if available, by
 1172  no later than the next working day. The provisions of this
 1173  paragraph do not apply when transportation is provided by the
 1174  patient’s family or guardian.
 1175         (c) A law enforcement officer acting in accordance with an
 1176  ex parte order issued pursuant to this subsection may serve and
 1177  execute such order on any day of the week, at any time of the
 1178  day or night.
 1179         (d) A law enforcement officer acting in accordance with an
 1180  ex parte order issued pursuant to this subsection may use such
 1181  reasonable physical force as is necessary to gain entry to the
 1182  premises, and any dwellings, buildings, or other structures
 1183  located on the premises, and to take custody of the person who
 1184  is the subject of the ex parte order.
 1185         (e) The managing entity and the department Agency for
 1186  Health Care Administration shall receive and maintain the copies
 1187  of ex parte petitions and orders, involuntary outpatient
 1188  services placement orders issued pursuant to s. 394.4655,
 1189  involuntary inpatient placement orders issued pursuant to s.
 1190  394.467, professional certificates, and law enforcement
 1191  officers’ reports. These documents shall be considered part of
 1192  the clinical record, governed by the provisions of s. 394.4615.
 1193  These documents shall be provided by the department to the
 1194  Agency for Health Care Administration and used by the agency to
 1195  The agency shall prepare annual reports analyzing the data
 1196  obtained from these documents, without information identifying
 1197  patients, and shall provide copies of reports to the department,
 1198  the President of the Senate, the Speaker of the House of
 1199  Representatives, and the minority leaders of the Senate and the
 1200  House of Representatives.
 1201         (f) A patient shall be examined by a physician or, a
 1202  clinical psychologist, or by a psychiatric nurse practitioner,
 1203  performing within the framework of an established protocol with
 1204  a psychiatrist at a receiving facility without unnecessary delay
 1205  to determine if the criteria for involuntary services are met.
 1206  Emergency treatment may be provided and may, upon the order of a
 1207  physician, if the physician determines be given emergency
 1208  treatment if it is determined that such treatment is necessary
 1209  for the safety of the patient or others. The patient may not be
 1210  released by the receiving facility or its contractor without the
 1211  documented approval of a psychiatrist or a clinical psychologist
 1212  or, if the receiving facility is owned or operated by a hospital
 1213  or health system, the release may also be approved by a
 1214  psychiatric nurse practitioner performing within the framework
 1215  of an established protocol with a psychiatrist, or an attending
 1216  emergency department physician with experience in the diagnosis
 1217  and treatment of mental illness and nervous disorders and after
 1218  completion of an involuntary examination pursuant to this
 1219  subsection. A psychiatric nurse practitioner may not approve the
 1220  release of a patient if the involuntary examination was
 1221  initiated by a psychiatrist unless the release is approved by
 1222  the initiating psychiatrist. However, a patient may not be held
 1223  in a receiving facility for involuntary examination longer than
 1224  72 hours.
 1225         (g) A person may not be held for involuntary examination
 1226  for more than 72 hours from the time of his or her arrival at
 1227  the facility. Based on the person’s needs, one of the following
 1228  actions must be taken within the involuntary examination period:
 1229         1. The person must be released with the approval of a
 1230  physician, psychiatrist, psychiatric nurse practitioner, or
 1231  clinical psychologist. However, if the examination is conducted
 1232  in a hospital, an attending emergency department physician with
 1233  experience in the diagnosis and treatment of mental illness may
 1234  approve the release.
 1235         2. The person must be asked to give express and informed
 1236  consent for voluntary admission if a physician, psychiatrist,
 1237  psychiatric nurse practitioner, or clinical psychologist has
 1238  determined that the individual is competent to consent to
 1239  treatment.
 1240         3. A petition for involuntary services must be completed
 1241  and filed in the circuit court by the facility administrator. If
 1242  electronic filing of the petition is not available in the county
 1243  and the 72-hour period ends on a weekend or legal holiday, the
 1244  petition must be filed by the next working day. If involuntary
 1245  services are deemed necessary, the least restrictive treatment
 1246  consistent with the optimum improvement of the person’s
 1247  condition must be made available.
 1248         (h) An individual discharged from a facility on a voluntary
 1249  or an involuntary basis who is currently charged with a crime
 1250  shall be released to the custody of a law enforcement officer,
 1251  unless the individual has been released from law enforcement
 1252  custody by posting of a bond, by a pretrial conditional release,
 1253  or by other judicial release.
 1254         (i)(g) A person for whom an involuntary examination has
 1255  been initiated who is being evaluated or treated at a hospital
 1256  for an emergency medical condition specified in s. 395.002 must
 1257  be examined by an appropriate a receiving facility within 72
 1258  hours. The 72-hour period begins when the patient arrives at the
 1259  hospital and ceases when the attending physician documents that
 1260  the patient has an emergency medical condition. If the patient
 1261  is examined at a hospital providing emergency medical services
 1262  by a professional qualified to perform an involuntary
 1263  examination and is found as a result of that examination not to
 1264  meet the criteria for involuntary outpatient services placement
 1265  pursuant to s. 394.4655(1) or involuntary inpatient placement
 1266  pursuant to s. 394.467(1), the patient may be offered voluntary
 1267  placement, if appropriate, or released directly from the
 1268  hospital providing emergency medical services. The finding by
 1269  the professional that the patient has been examined and does not
 1270  meet the criteria for involuntary inpatient placement or
 1271  involuntary outpatient services placement must be entered into
 1272  the patient’s clinical record. Nothing in This paragraph is not
 1273  intended to prevent a hospital providing emergency medical
 1274  services from appropriately transferring a patient to another
 1275  hospital before prior to stabilization if, provided the
 1276  requirements of s. 395.1041(3)(c) have been met.
 1277         (j)(h) One of the following must occur within 12 hours
 1278  after the patient’s attending physician documents that the
 1279  patient’s medical condition has stabilized or that an emergency
 1280  medical condition does not exist:
 1281         1. The patient must be examined by an appropriate a
 1282  designated receiving facility and released; or
 1283         2. The patient must be transferred to a designated
 1284  receiving facility in which appropriate medical treatment is
 1285  available. However, the receiving facility must be notified of
 1286  the transfer within 2 hours after the patient’s condition has
 1287  been stabilized or after determination that an emergency medical
 1288  condition does not exist.
 1289         (i) Within the 72-hour examination period or, if the 72
 1290  hours ends on a weekend or holiday, no later than the next
 1291  working day thereafter, one of the following actions must be
 1292  taken, based on the individual needs of the patient:
 1293         1. The patient shall be released, unless he or she is
 1294  charged with a crime, in which case the patient shall be
 1295  returned to the custody of a law enforcement officer;
 1296         2. The patient shall be released, subject to the provisions
 1297  of subparagraph 1., for voluntary outpatient treatment;
 1298         3. The patient, unless he or she is charged with a crime,
 1299  shall be asked to give express and informed consent to placement
 1300  as a voluntary patient, and, if such consent is given, the
 1301  patient shall be admitted as a voluntary patient; or
 1302         4. A petition for involuntary placement shall be filed in
 1303  the circuit court when outpatient or inpatient treatment is
 1304  deemed necessary. When inpatient treatment is deemed necessary,
 1305  the least restrictive treatment consistent with the optimum
 1306  improvement of the patient’s condition shall be made available.
 1307  When a petition is to be filed for involuntary outpatient
 1308  placement, it shall be filed by one of the petitioners specified
 1309  in s. 394.4655(3)(a). A petition for involuntary inpatient
 1310  placement shall be filed by the facility administrator.
 1311         Section 11. Section 394.4655, Florida Statutes, is amended
 1312  to read:
 1313         394.4655 Involuntary outpatient services placement.—
 1314         (1) CRITERIA FOR INVOLUNTARY OUTPATIENT SERVICES
 1315  PLACEMENT.—A person may be ordered to involuntary outpatient
 1316  services placement upon a finding of the court, by clear and
 1317  convincing evidence, that the person meets all of the following
 1318  criteria by clear and convincing evidence:
 1319         (a) The person is 18 years of age or older.;
 1320         (b) The person has a mental illness.;
 1321         (c) The person is unlikely to survive safely in the
 1322  community without supervision, based on a clinical
 1323  determination.;
 1324         (d) The person has a history of lack of compliance with
 1325  treatment for mental illness.;
 1326         (e) The person has:
 1327         1. At least twice within the immediately preceding 36
 1328  months been involuntarily admitted to a receiving or treatment
 1329  facility as defined in s. 394.455, or has received mental health
 1330  services in a forensic or correctional facility. The 36-month
 1331  period does not include any period during which the person was
 1332  admitted or incarcerated; or
 1333         2. Engaged in one or more acts of serious violent behavior
 1334  toward self or others, or attempts at serious bodily harm to
 1335  himself or herself or others, within the preceding 36 months.;
 1336         (f) The person is, as a result of his or her mental
 1337  illness, unlikely to voluntarily participate in the recommended
 1338  treatment plan and either he or she has refused voluntary
 1339  services placement for treatment after sufficient and
 1340  conscientious explanation and disclosure of why the services are
 1341  necessary purpose of placement for treatment or he or she is
 1342  unable to determine for himself or herself whether services are
 1343  placement is necessary.;
 1344         (g) In view of the person’s treatment history and current
 1345  behavior, the person is in need of involuntary outpatient
 1346  services placement in order to prevent a relapse or
 1347  deterioration that would be likely to result in serious bodily
 1348  harm to himself or herself or others, or a substantial harm to
 1349  his or her well-being as set forth in s. 394.463(1).;
 1350         (h) It is likely that the person will benefit from
 1351  involuntary outpatient services. placement; and
 1352         (i) All available, less restrictive alternatives that would
 1353  offer an opportunity for improvement of his or her condition
 1354  have been judged to be inappropriate or unavailable.
 1355         (2) INVOLUNTARY OUTPATIENT SERVICES PLACEMENT.—
 1356         (a)1. A patient who is being recommended for involuntary
 1357  outpatient services placement by the administrator of the
 1358  receiving facility where the patient has been examined may be
 1359  retained by the facility after adherence to the notice
 1360  procedures provided in s. 394.4599. The recommendation must be
 1361  supported by the opinion of two qualified professionals a
 1362  psychiatrist and the second opinion of a clinical psychologist
 1363  or another psychiatrist, both of whom have personally examined
 1364  the patient within the preceding 72 hours, that the criteria for
 1365  involuntary outpatient services placement are met. However, in a
 1366  county having a population of fewer than 50,000, if the
 1367  administrator certifies that a qualified professional
 1368  psychiatrist or clinical psychologist is not available to
 1369  provide the second opinion, the second opinion may be provided
 1370  by a licensed physician who has postgraduate training and
 1371  experience in diagnosis and treatment of mental and nervous
 1372  disorders or by a psychiatric nurse practitioner. Any second
 1373  opinion authorized in this subparagraph may be conducted through
 1374  a face-to-face examination, in person or by electronic means.
 1375  Such recommendation must be entered on an involuntary outpatient
 1376  services placement certificate that authorizes the receiving
 1377  facility to retain the patient pending completion of a hearing.
 1378  The certificate must shall be made a part of the patient’s
 1379  clinical record.
 1380         2. If the patient has been stabilized and no longer meets
 1381  the criteria for involuntary examination pursuant to s.
 1382  394.463(1), the patient must be released from the receiving
 1383  facility while awaiting the hearing for involuntary outpatient
 1384  services placement. Before filing a petition for involuntary
 1385  outpatient services treatment, the administrator of the a
 1386  receiving facility or a designated department representative
 1387  must identify the service provider that will have primary
 1388  responsibility for service provision under an order for
 1389  involuntary outpatient services placement, unless the person is
 1390  otherwise participating in outpatient psychiatric treatment and
 1391  is not in need of public financing for that treatment, in which
 1392  case the individual, if eligible, may be ordered to involuntary
 1393  treatment pursuant to the existing psychiatric treatment
 1394  relationship.
 1395         3. The service provider shall prepare a written proposed
 1396  treatment plan in consultation with the patient or the patient’s
 1397  guardian advocate, if appointed, for the court’s consideration
 1398  for inclusion in the involuntary outpatient services placement
 1399  order. The service provider shall also provide a copy of the
 1400  treatment plan that addresses the nature and extent of the
 1401  mental illness and any co-occurring substance use disorders that
 1402  necessitate involuntary outpatient services. The treatment plan
 1403  must specify the likely level of care, including the use of
 1404  medication, and anticipated discharge criteria for terminating
 1405  involuntary outpatient services. The service provider shall also
 1406  provide a copy of the proposed treatment plan to the patient and
 1407  the administrator of the receiving facility. The treatment plan
 1408  must specify the nature and extent of the patient’s mental
 1409  illness, address the reduction of symptoms that necessitate
 1410  involuntary outpatient placement, and include measurable goals
 1411  and objectives for the services and treatment that are provided
 1412  to treat the person’s mental illness and assist the person in
 1413  living and functioning in the community or to prevent a relapse
 1414  or deterioration. Service providers may select and supervise
 1415  other individuals to implement specific aspects of the treatment
 1416  plan. The services in the treatment plan must be deemed
 1417  clinically appropriate by a physician, clinical psychologist,
 1418  psychiatric nurse practitioner, mental health counselor,
 1419  marriage and family therapist, or clinical social worker who
 1420  consults with, or is employed or contracted by, the service
 1421  provider. The service provider must certify to the court in the
 1422  proposed treatment plan whether sufficient services for
 1423  improvement and stabilization are currently available and
 1424  whether the service provider agrees to provide those services.
 1425  If the service provider certifies that the services in the
 1426  proposed treatment plan are not available, the petitioner may
 1427  not file the petition. The service provider must notify the
 1428  managing entity as to the availability of the requested
 1429  services. The managing entity must document such efforts to
 1430  obtain the requested services.
 1431         (b) If a patient in involuntary inpatient placement meets
 1432  the criteria for involuntary outpatient services placement, the
 1433  administrator of the treatment facility may, before the
 1434  expiration of the period during which the treatment facility is
 1435  authorized to retain the patient, recommend involuntary
 1436  outpatient services placement. The recommendation must be
 1437  supported by the opinion of two qualified professionals a
 1438  psychiatrist and the second opinion of a clinical psychologist
 1439  or another psychiatrist, both of whom have personally examined
 1440  the patient within the preceding 72 hours, that the criteria for
 1441  involuntary outpatient services placement are met. However, in a
 1442  county having a population of fewer than 50,000, if the
 1443  administrator certifies that a qualified professional
 1444  psychiatrist or clinical psychologist is not available to
 1445  provide the second opinion, the second opinion may be provided
 1446  by a licensed physician who has postgraduate training and
 1447  experience in diagnosis and treatment of mental and nervous
 1448  disorders or by a psychiatric nurse practitioner. Any second
 1449  opinion authorized in this paragraph subparagraph may be
 1450  conducted through a face-to-face examination, in person or by
 1451  electronic means. Such recommendation must be entered on an
 1452  involuntary outpatient services placement certificate, and the
 1453  certificate must be made a part of the patient’s clinical
 1454  record.
 1455         (c)1. The administrator of the treatment facility shall
 1456  provide a copy of the involuntary outpatient services placement
 1457  certificate and a copy of the state mental health discharge form
 1458  to the managing entity a department representative in the county
 1459  where the patient will be residing. For persons who are leaving
 1460  a state mental health treatment facility, the petition for
 1461  involuntary outpatient services placement must be filed in the
 1462  county where the patient will be residing.
 1463         2. The service provider that will have primary
 1464  responsibility for service provision shall be identified by the
 1465  designated department representative before prior to the order
 1466  for involuntary outpatient services placement and must, before
 1467  prior to filing a petition for involuntary outpatient services
 1468  placement, certify to the court whether the services recommended
 1469  in the patient’s discharge plan are available in the local
 1470  community and whether the service provider agrees to provide
 1471  those services. The service provider must develop with the
 1472  patient, or the patient’s guardian advocate, if appointed, a
 1473  treatment or service plan that addresses the needs identified in
 1474  the discharge plan. The plan must be deemed to be clinically
 1475  appropriate by a physician, clinical psychologist, psychiatric
 1476  nurse practitioner, mental health counselor, marriage and family
 1477  therapist, or clinical social worker, as defined in this
 1478  chapter, who consults with, or is employed or contracted by, the
 1479  service provider.
 1480         3. If the service provider certifies that the services in
 1481  the proposed treatment or service plan are not available, the
 1482  petitioner may not file the petition. The service provider must
 1483  notify the managing entity as to the availability of the
 1484  requested services. The managing entity must document such
 1485  efforts to obtain the requested services.
 1486         (3) PETITION FOR INVOLUNTARY OUTPATIENT SERVICES
 1487  PLACEMENT.—
 1488         (a) A petition for involuntary outpatient services
 1489  placement may be filed by:
 1490         1. The administrator of a receiving facility; or
 1491         2. The administrator of a treatment facility.
 1492         (b) Each required criterion for involuntary outpatient
 1493  services placement must be alleged and substantiated in the
 1494  petition for involuntary outpatient services placement. A copy
 1495  of the certificate recommending involuntary outpatient services
 1496  placement completed by two a qualified professionals
 1497  professional specified in subsection (2) must be attached to the
 1498  petition. A copy of the proposed treatment plan must be attached
 1499  to the petition. Before the petition is filed, the service
 1500  provider shall certify that the services in the proposed
 1501  treatment plan are available. If the necessary services are not
 1502  available in the patient’s local community to respond to the
 1503  person’s individual needs, the petition may not be filed. The
 1504  service provider must notify the managing entity as to the
 1505  availability of the requested services. The managing entity must
 1506  document such efforts to obtain the requested services.
 1507         (c) The petition for involuntary outpatient services
 1508  placement must be filed in the county where the patient is
 1509  located, unless the patient is being placed from a state
 1510  treatment facility, in which case the petition must be filed in
 1511  the county where the patient will reside. When the petition has
 1512  been filed, the clerk of the court shall provide copies of the
 1513  petition and the proposed treatment plan to the department, the
 1514  managing entity, the patient, the patient’s guardian or
 1515  representative, the state attorney, and the public defender or
 1516  the patient’s private counsel. A fee may not be charged for
 1517  filing a petition under this subsection.
 1518         (4) APPOINTMENT OF COUNSEL.—Within 1 court working day
 1519  after the filing of a petition for involuntary outpatient
 1520  services placement, the court shall appoint the public defender
 1521  to represent the person who is the subject of the petition,
 1522  unless the person is otherwise represented by counsel. The clerk
 1523  of the court shall immediately notify the public defender of the
 1524  appointment. The public defender shall represent the person
 1525  until the petition is dismissed, the court order expires, or the
 1526  patient is discharged from involuntary outpatient services
 1527  placement. An attorney who represents the patient must be
 1528  provided shall have access to the patient, witnesses, and
 1529  records relevant to the presentation of the patient’s case and
 1530  shall represent the interests of the patient, regardless of the
 1531  source of payment to the attorney.
 1532         (5) CONTINUANCE OF HEARING.—The patient is entitled, with
 1533  the concurrence of the patient’s counsel, to at least one
 1534  continuance of the hearing. The continuance shall be for a
 1535  period of up to 4 weeks.
 1536         (6) HEARING ON INVOLUNTARY OUTPATIENT SERVICES PLACEMENT.—
 1537         (a)1. The court shall hold the hearing on involuntary
 1538  outpatient services placement within 5 working days after the
 1539  filing of the petition, unless a continuance is granted. The
 1540  hearing must shall be held in the county where the petition is
 1541  filed, must shall be as convenient to the patient as is
 1542  consistent with orderly procedure, and must shall be conducted
 1543  in physical settings not likely to be injurious to the patient’s
 1544  condition. If the court finds that the patient’s attendance at
 1545  the hearing is not consistent with the best interests of the
 1546  patient and if the patient’s counsel does not object, the court
 1547  may waive the presence of the patient from all or any portion of
 1548  the hearing. The state attorney for the circuit in which the
 1549  patient is located shall represent the state, rather than the
 1550  petitioner, as the real party in interest in the proceeding.
 1551         2. The court may appoint a general or special master to
 1552  preside at the hearing. One of the professionals who executed
 1553  the involuntary outpatient services placement certificate shall
 1554  be a witness. The patient and the patient’s guardian or
 1555  representative shall be informed by the court of the right to an
 1556  independent expert examination. If the patient cannot afford
 1557  such an examination, the court shall ensure that one is
 1558  provided, as otherwise provided by law provide for one. The
 1559  independent expert’s report is shall be confidential and not
 1560  discoverable, unless the expert is to be called as a witness for
 1561  the patient at the hearing. The court shall allow testimony from
 1562  individuals, including family members, deemed by the court to be
 1563  relevant under state law, regarding the person’s prior history
 1564  and how that prior history relates to the person’s current
 1565  condition. The testimony in the hearing must be given under
 1566  oath, and the proceedings must be recorded. The patient may
 1567  refuse to testify at the hearing.
 1568         (b)1. If the court concludes that the patient meets the
 1569  criteria for involuntary outpatient services placement pursuant
 1570  to subsection (1), the court shall issue an order for
 1571  involuntary outpatient services placement. The court order shall
 1572  be for a period of up to 90 days 6 months. The order must
 1573  specify the nature and extent of the patient’s mental illness.
 1574  The order of the court and the treatment plan must shall be made
 1575  part of the patient’s clinical record. The service provider
 1576  shall discharge a patient from involuntary outpatient services
 1577  placement when the order expires or any time the patient no
 1578  longer meets the criteria for involuntary services placement.
 1579  Upon discharge, the service provider shall send a certificate of
 1580  discharge to the court.
 1581         2. The court may not order the department or the service
 1582  provider to provide services if the program or service is not
 1583  available in the patient’s local community, if there is no space
 1584  available in the program or service for the patient, or if
 1585  funding is not available for the program or service. The service
 1586  provider must notify the managing entity as to the availability
 1587  of the requested services. The managing entity must document
 1588  such efforts to obtain the requested services. A copy of the
 1589  order must be sent to the managing entity Agency for Health Care
 1590  Administration by the service provider within 1 working day
 1591  after it is received from the court. The order may be submitted
 1592  electronically through existing data systems. After the
 1593  placement order for involuntary services is issued, the service
 1594  provider and the patient may modify provisions of the treatment
 1595  plan. For any material modification of the treatment plan to
 1596  which the patient or, if one is appointed, the patient’s
 1597  guardian advocate agrees, if appointed, does agree, the service
 1598  provider shall send notice of the modification to the court. Any
 1599  material modifications of the treatment plan which are contested
 1600  by the patient or the patient’s guardian advocate, if applicable
 1601  appointed, must be approved or disapproved by the court
 1602  consistent with subsection (2).
 1603         3. If, in the clinical judgment of a physician, the patient
 1604  has failed or has refused to comply with the treatment ordered
 1605  by the court, and, in the clinical judgment of the physician,
 1606  efforts were made to solicit compliance and the patient may meet
 1607  the criteria for involuntary examination, a person may be
 1608  brought to a receiving facility pursuant to s. 394.463. If,
 1609  after examination, the patient does not meet the criteria for
 1610  involuntary inpatient placement pursuant to s. 394.467, the
 1611  patient must be discharged from the receiving facility. The
 1612  involuntary outpatient services placement order shall remain in
 1613  effect unless the service provider determines that the patient
 1614  no longer meets the criteria for involuntary outpatient services
 1615  placement or until the order expires. The service provider must
 1616  determine whether modifications should be made to the existing
 1617  treatment plan and must attempt to continue to engage the
 1618  patient in treatment. For any material modification of the
 1619  treatment plan to which the patient or the patient’s guardian
 1620  advocate, if applicable appointed, agrees does agree, the
 1621  service provider shall send notice of the modification to the
 1622  court. Any material modifications of the treatment plan which
 1623  are contested by the patient or the patient’s guardian advocate,
 1624  if applicable appointed, must be approved or disapproved by the
 1625  court consistent with subsection (2).
 1626         (c) If, at any time before the conclusion of the initial
 1627  hearing on involuntary outpatient services placement, it appears
 1628  to the court that the person does not meet the criteria for
 1629  involuntary outpatient services placement under this section
 1630  but, instead, meets the criteria for involuntary inpatient
 1631  placement, the court may order the person admitted for
 1632  involuntary inpatient examination under s. 394.463. If the
 1633  person instead meets the criteria for involuntary assessment,
 1634  protective custody, or involuntary admission pursuant to s.
 1635  397.675, the court may order the person to be admitted for
 1636  involuntary assessment for a period of 5 days pursuant to s.
 1637  397.6811. Thereafter, all proceedings are shall be governed by
 1638  chapter 397.
 1639         (d) At the hearing on involuntary outpatient services
 1640  placement, the court shall consider testimony and evidence
 1641  regarding the patient’s competence to consent to treatment. If
 1642  the court finds that the patient is incompetent to consent to
 1643  treatment, it shall appoint a guardian advocate as provided in
 1644  s. 394.4598. The guardian advocate shall be appointed or
 1645  discharged in accordance with s. 394.4598.
 1646         (e) The administrator of the receiving facility or the
 1647  designated department representative shall provide a copy of the
 1648  court order and adequate documentation of a patient’s mental
 1649  illness to the service provider for involuntary outpatient
 1650  services placement. Such documentation must include any advance
 1651  directives made by the patient, a psychiatric evaluation of the
 1652  patient, and any evaluations of the patient performed by a
 1653  clinical psychologist or a clinical social worker.
 1654         (7) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT SERVICES
 1655  PLACEMENT.—
 1656         (a)1. If the person continues to meet the criteria for
 1657  involuntary outpatient services placement, the service provider
 1658  shall, at least 10 days before the expiration of the period
 1659  during which the treatment is ordered for the person, file in
 1660  the circuit court a petition for continued involuntary
 1661  outpatient services placement. The court shall immediately
 1662  schedule a hearing on the petition to be held within 15 days
 1663  after the petition is filed.
 1664         2. The existing involuntary outpatient services placement
 1665  order remains in effect until disposition on the petition for
 1666  continued involuntary outpatient services placement.
 1667         3. A certificate shall be attached to the petition which
 1668  includes a statement from the person’s physician or clinical
 1669  psychologist justifying the request, a brief description of the
 1670  patient’s treatment during the time he or she was receiving
 1671  involuntarily services placed, and an individualized plan of
 1672  continued treatment.
 1673         4. The service provider shall develop the individualized
 1674  plan of continued treatment in consultation with the patient or
 1675  the patient’s guardian advocate, if applicable appointed. When
 1676  the petition has been filed, the clerk of the court shall
 1677  provide copies of the certificate and the individualized plan of
 1678  continued treatment to the department, the patient, the
 1679  patient’s guardian advocate, the state attorney, and the
 1680  patient’s private counsel or the public defender.
 1681         (b) Within 1 court working day after the filing of a
 1682  petition for continued involuntary outpatient services
 1683  placement, the court shall appoint the public defender to
 1684  represent the person who is the subject of the petition, unless
 1685  the person is otherwise represented by counsel. The clerk of the
 1686  court shall immediately notify the public defender of such
 1687  appointment. The public defender shall represent the person
 1688  until the petition is dismissed or the court order expires or
 1689  the patient is discharged from involuntary outpatient services
 1690  placement. Any attorney representing the patient shall have
 1691  access to the patient, witnesses, and records relevant to the
 1692  presentation of the patient’s case and shall represent the
 1693  interests of the patient, regardless of the source of payment to
 1694  the attorney.
 1695         (c) Hearings on petitions for continued involuntary
 1696  outpatient services must placement shall be before the circuit
 1697  court. The court may appoint a general or special master to
 1698  preside at the hearing. The procedures for obtaining an order
 1699  pursuant to this paragraph must meet the requirements of shall
 1700  be in accordance with subsection (6), except that the time
 1701  period included in paragraph (1)(e) does not apply when is not
 1702  applicable in determining the appropriateness of additional
 1703  periods of involuntary outpatient services placement.
 1704         (d) Notice of the hearing must shall be provided as set
 1705  forth in s. 394.4599. The patient and the patient’s attorney may
 1706  agree to a period of continued outpatient services placement
 1707  without a court hearing.
 1708         (e) The same procedure must shall be repeated before the
 1709  expiration of each additional period the patient is placed in
 1710  treatment.
 1711         (f) If the patient has previously been found incompetent to
 1712  consent to treatment, the court shall consider testimony and
 1713  evidence regarding the patient’s competence. Section 394.4598
 1714  governs the discharge of the guardian advocate if the patient’s
 1715  competency to consent to treatment has been restored.
 1716         Section 12. Section 394.467, Florida Statutes, is amended
 1717  to read:
 1718         394.467 Involuntary inpatient placement.—
 1719         (1) CRITERIA.—A person may be ordered for placed in
 1720  involuntary inpatient placement for treatment upon a finding of
 1721  the court by clear and convincing evidence that:
 1722         (a) He or she has a mental illness is mentally ill and
 1723  because of his or her mental illness:
 1724         1.a. He or she has refused voluntary inpatient placement
 1725  for treatment after sufficient and conscientious explanation and
 1726  disclosure of the purpose of inpatient placement for treatment;
 1727  or
 1728         b. He or she is unable to determine for himself or herself
 1729  whether inpatient placement is necessary; and
 1730         2.a. He or she is manifestly incapable of surviving alone
 1731  or with the help of willing and responsible family or friends,
 1732  including available alternative services, and, without
 1733  treatment, is likely to suffer from neglect or refuse to care
 1734  for himself or herself, and such neglect or refusal poses a real
 1735  and present threat of substantial physical or mental harm to his
 1736  or her well-being; or
 1737         b. There is substantial likelihood that in the near future
 1738  he or she will inflict serious bodily harm on self or others
 1739  himself or herself or another person, as evidenced by recent
 1740  behavior causing, attempting, or threatening such harm; and
 1741         (b) All available, less restrictive treatment alternatives
 1742  that which would offer an opportunity for improvement of his or
 1743  her condition have been judged to be inappropriate.
 1744         (2) ADMISSION TO A TREATMENT FACILITY.—A patient may be
 1745  retained by a receiving facility or involuntarily placed in a
 1746  treatment facility upon the recommendation of the administrator
 1747  of the receiving facility where the patient has been examined
 1748  and after adherence to the notice and hearing procedures
 1749  provided in s. 394.4599. The recommendation must be supported by
 1750  the opinion of a psychiatrist and the second opinion of a
 1751  psychiatric nurse practitioner, clinical psychologist, or
 1752  another psychiatrist, both of whom have personally examined the
 1753  patient within the preceding 72 hours, that the criteria for
 1754  involuntary inpatient placement are met. However, in a county
 1755  that has a population of fewer than 50,000, if the administrator
 1756  certifies that a psychiatrist, psychiatric nurse practitioner,
 1757  or clinical psychologist is not available to provide the second
 1758  opinion, the second opinion may be provided by a licensed
 1759  physician who has postgraduate training and experience in
 1760  diagnosis and treatment of mental illness and nervous disorders
 1761  or by a psychiatric nurse practitioner. Any second opinion
 1762  authorized in this subsection may be conducted through a face
 1763  to-face examination, in person or by electronic means. Such
 1764  recommendation shall be entered on a petition for an involuntary
 1765  inpatient placement certificate that authorizes the receiving
 1766  facility to retain the patient pending transfer to a treatment
 1767  facility or completion of a hearing.
 1768         (3) PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.—
 1769         (a) The administrator of the facility shall file a petition
 1770  for involuntary inpatient placement in the court in the county
 1771  where the patient is located. Upon filing, the clerk of the
 1772  court shall provide copies to the department, the patient, the
 1773  patient’s guardian or representative, and the state attorney and
 1774  public defender of the judicial circuit in which the patient is
 1775  located. A No fee may not shall be charged for the filing of a
 1776  petition under this subsection.
 1777         (b) A facility filing a petition under this subsection for
 1778  involuntary inpatient placement shall send a copy of the
 1779  petition to the managing entity in its area.
 1780         (4) APPOINTMENT OF COUNSEL.—Within 1 court working day
 1781  after the filing of a petition for involuntary inpatient
 1782  placement, the court shall appoint the public defender to
 1783  represent the person who is the subject of the petition, unless
 1784  the person is otherwise represented by counsel. The clerk of the
 1785  court shall immediately notify the public defender of such
 1786  appointment. Any attorney representing the patient shall have
 1787  access to the patient, witnesses, and records relevant to the
 1788  presentation of the patient’s case and shall represent the
 1789  interests of the patient, regardless of the source of payment to
 1790  the attorney.
 1791         (5) CONTINUANCE OF HEARING.—The patient is entitled, with
 1792  the concurrence of the patient’s counsel, to at least one
 1793  continuance of the hearing. The continuance shall be for a
 1794  period of up to 4 weeks.
 1795         (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.—
 1796         (a)1. The court shall hold the hearing on involuntary
 1797  inpatient placement within 5 court working days, unless a
 1798  continuance is granted.
 1799         2. Except for good cause documented in the court file, the
 1800  hearing must shall be held in the county or the facility, as
 1801  appropriate, where the patient is located, must and shall be as
 1802  convenient to the patient as is may be consistent with orderly
 1803  procedure, and shall be conducted in physical settings not
 1804  likely to be injurious to the patient’s condition. If the court
 1805  finds that the patient’s attendance at the hearing is not
 1806  consistent with the best interests of the patient, and the
 1807  patient’s counsel does not object, the court may waive the
 1808  presence of the patient from all or any portion of the hearing.
 1809  The state attorney for the circuit in which the patient is
 1810  located shall represent the state, rather than the petitioning
 1811  facility administrator, as the real party in interest in the
 1812  proceeding.
 1813         3.2. The court may appoint a general or special magistrate
 1814  to preside at the hearing. One of the two professionals who
 1815  executed the petition for involuntary inpatient placement
 1816  certificate shall be a witness. The patient and the patient’s
 1817  guardian or representative shall be informed by the court of the
 1818  right to an independent expert examination. If the patient
 1819  cannot afford such an examination, the court shall ensure that
 1820  one is provided, as otherwise provided for by law provide for
 1821  one. The independent expert’s report is shall be confidential
 1822  and not discoverable, unless the expert is to be called as a
 1823  witness for the patient at the hearing. The testimony in the
 1824  hearing must be given under oath, and the proceedings must be
 1825  recorded. The patient may refuse to testify at the hearing.
 1826         (b) If the court concludes that the patient meets the
 1827  criteria for involuntary inpatient placement, it may shall order
 1828  that the patient be transferred to a treatment facility or, if
 1829  the patient is at a treatment facility, that the patient be
 1830  retained there or be treated at any other appropriate receiving
 1831  or treatment facility, or that the patient receive services from
 1832  such a receiving or treatment facility or service provider, on
 1833  an involuntary basis, for a period of up to 90 days 6 months.
 1834  However, any order for involuntary mental health services in a
 1835  treatment facility may be for up to 6 months. The order shall
 1836  specify the nature and extent of the patient’s mental illness
 1837  The court may not order an individual with traumatic brain
 1838  injury or dementia who lacks a co-occurring mental illness to be
 1839  involuntarily placed in a treatment facility. The facility shall
 1840  discharge a patient any time the patient no longer meets the
 1841  criteria for involuntary inpatient placement, unless the patient
 1842  has transferred to voluntary status.
 1843         (c) If at any time before prior to the conclusion of the
 1844  hearing on involuntary inpatient placement it appears to the
 1845  court that the person does not meet the criteria for involuntary
 1846  inpatient placement under this section, but instead meets the
 1847  criteria for involuntary outpatient services placement, the
 1848  court may order the person evaluated for involuntary outpatient
 1849  services placement pursuant to s. 394.4655. The petition and
 1850  hearing procedures set forth in s. 394.4655 shall apply. If the
 1851  person instead meets the criteria for involuntary assessment,
 1852  protective custody, or involuntary admission pursuant to s.
 1853  397.675, then the court may order the person to be admitted for
 1854  involuntary assessment for a period of 5 days pursuant to s.
 1855  397.6811. Thereafter, all proceedings are shall be governed by
 1856  chapter 397.
 1857         (d) At the hearing on involuntary inpatient placement, the
 1858  court shall consider testimony and evidence regarding the
 1859  patient’s competence to consent to treatment. If the court finds
 1860  that the patient is incompetent to consent to treatment, it
 1861  shall appoint a guardian advocate as provided in s. 394.4598.
 1862         (e) The administrator of the petitioning receiving facility
 1863  shall provide a copy of the court order and adequate
 1864  documentation of a patient’s mental illness to the administrator
 1865  of a treatment facility if the whenever a patient is ordered for
 1866  involuntary inpatient placement, whether by civil or criminal
 1867  court. The documentation must shall include any advance
 1868  directives made by the patient, a psychiatric evaluation of the
 1869  patient, and any evaluations of the patient performed by a
 1870  psychiatric nurse practitioner, clinical psychologist, a
 1871  marriage and family therapist, a mental health counselor, or a
 1872  clinical social worker. The administrator of a treatment
 1873  facility may refuse admission to any patient directed to its
 1874  facilities on an involuntary basis, whether by civil or criminal
 1875  court order, who is not accompanied at the same time by adequate
 1876  orders and documentation.
 1877         (7) PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT
 1878  PLACEMENT.—
 1879         (a) Hearings on petitions for continued involuntary
 1880  inpatient placement of an individual placed at any treatment
 1881  facility are shall be administrative hearings and must shall be
 1882  conducted in accordance with the provisions of s. 120.57(1),
 1883  except that any order entered by the administrative law judge is
 1884  shall be final and subject to judicial review in accordance with
 1885  s. 120.68. Orders concerning patients committed after
 1886  successfully pleading not guilty by reason of insanity are shall
 1887  be governed by the provisions of s. 916.15.
 1888         (b) If the patient continues to meet the criteria for
 1889  involuntary inpatient placement and is being treated at a
 1890  treatment facility, the administrator shall, before prior to the
 1891  expiration of the period during which the treatment facility is
 1892  authorized to retain the patient, file a petition requesting
 1893  authorization for continued involuntary inpatient placement. The
 1894  request must shall be accompanied by a statement from the
 1895  patient’s physician, psychiatrist, psychiatric nurse
 1896  practitioner, or clinical psychologist justifying the request, a
 1897  brief description of the patient’s treatment during the time he
 1898  or she was involuntarily placed, and an individualized plan of
 1899  continued treatment. Notice of the hearing must shall be
 1900  provided as provided set forth in s. 394.4599. If a patient’s
 1901  attendance at the hearing is voluntarily waived, the
 1902  administrative law judge must determine that the waiver is
 1903  knowing and voluntary before waiving the presence of the patient
 1904  from all or a portion of the hearing. Alternatively, if at the
 1905  hearing the administrative law judge finds that attendance at
 1906  the hearing is not consistent with the best interests of the
 1907  patient, the administrative law judge may waive the presence of
 1908  the patient from all or any portion of the hearing, unless the
 1909  patient, through counsel, objects to the waiver of presence. The
 1910  testimony in the hearing must be under oath, and the proceedings
 1911  must be recorded.
 1912         (c) Unless the patient is otherwise represented or is
 1913  ineligible, he or she shall be represented at the hearing on the
 1914  petition for continued involuntary inpatient placement by the
 1915  public defender of the circuit in which the facility is located.
 1916         (d) If at a hearing it is shown that the patient continues
 1917  to meet the criteria for involuntary inpatient placement, the
 1918  administrative law judge shall sign the order for continued
 1919  involuntary inpatient placement for a period of up to 90 days
 1920  not to exceed 6 months. However, any order for involuntary
 1921  mental health services in a treatment facility may be for up to
 1922  6 months. The same procedure shall be repeated prior to the
 1923  expiration of each additional period the patient is retained.
 1924         (e) If continued involuntary inpatient placement is
 1925  necessary for a patient admitted while serving a criminal
 1926  sentence, but his or her whose sentence is about to expire, or
 1927  for a minor patient involuntarily placed, while a minor but who
 1928  is about to reach the age of 18, the administrator shall
 1929  petition the administrative law judge for an order authorizing
 1930  continued involuntary inpatient placement.
 1931         (f) If the patient has been previously found incompetent to
 1932  consent to treatment, the administrative law judge shall
 1933  consider testimony and evidence regarding the patient’s
 1934  competence. If the administrative law judge finds evidence that
 1935  the patient is now competent to consent to treatment, the
 1936  administrative law judge may issue a recommended order to the
 1937  court that found the patient incompetent to consent to treatment
 1938  that the patient’s competence be restored and that any guardian
 1939  advocate previously appointed be discharged.
 1940         (g) If the patient has been ordered to undergo involuntary
 1941  inpatient placement and has previously been found incompetent to
 1942  consent to treatment, the court shall consider testimony and
 1943  evidence regarding the patient’s incompetence. If the patient’s
 1944  competency to consent to treatment is restored, the discharge of
 1945  the guardian advocate shall be governed by the provisions of s.
 1946  394.4598.
 1947  
 1948  The procedure required in this subsection must be followed
 1949  before the expiration of each additional period the patient is
 1950  involuntarily receiving services.
 1951         (8) RETURN TO FACILITY OF PATIENTS.—If a patient
 1952  involuntarily held When a patient at a treatment facility under
 1953  this part leaves the facility without the administrator’s
 1954  authorization, the administrator may authorize a search for the
 1955  patient and his or her the return of the patient to the
 1956  facility. The administrator may request the assistance of a law
 1957  enforcement agency in this regard the search for and return of
 1958  the patient.
 1959         Section 13. Section 394.46715, Florida Statutes, is amended
 1960  to read:
 1961         394.46715 Rulemaking authority.—The department may adopt
 1962  rules to administer this part Department of Children and
 1963  Families shall have rulemaking authority to implement the
 1964  provisions of ss. 394.455, 394.4598, 394.4615, 394.463,
 1965  394.4655, and 394.467 as amended or created by this act. These
 1966  rules shall be for the purpose of protecting the health, safety,
 1967  and well-being of persons examined, treated, or placed under
 1968  this act.
 1969         Section 14. Section 394.761, Florida Statutes, is created
 1970  to read:
 1971         394.761 Revenue maximization.—The department, in
 1972  coordination with the managing entities, shall compile detailed
 1973  documentation of the cost and reimbursements for Medicaid
 1974  covered services provided to Medicaid eligible individuals by
 1975  providers of behavioral health services that are also funded for
 1976  programs authorized by this chapter and chapter 397. The
 1977  department’s documentation, along with a report of general
 1978  revenue funds supporting behavioral health services that are not
 1979  counted as maintenance of effort or match for any other federal
 1980  program, will be submitted to the Agency for Health Care
 1981  Administration by December 31, 2016. Copies of the report must
 1982  also be provided to the Governor, the President of the Senate,
 1983  and the Speaker of the House of Representatives. If this report
 1984  presents clear evidence that Medicaid reimbursements are less
 1985  than the costs of providing the services, the Agency for Health
 1986  Care Administration and the Department of Children and Families
 1987  will prepare and submit any budget amendments necessary to use
 1988  unmatched general revenue funds in the 2016-2017 fiscal year to
 1989  draw additional federal funding to increase Medicaid funding to
 1990  behavioral health service providers receiving the unmatched
 1991  general revenue. Payments shall be made to providers in such
 1992  manner as is allowed by federal law and regulations.
 1993         Section 15. Subsection (11) is added to section 394.875,
 1994  Florida Statutes, to read:
 1995         394.875 Crisis stabilization units, residential treatment
 1996  facilities, and residential treatment centers for children and
 1997  adolescents; authorized services; license required.—
 1998         (11) By January 1, 2017, the department and the agency
 1999  shall modify licensure rules and procedures to create an option
 2000  for a single, consolidated license for a provider who offers
 2001  multiple types of mental health and substance abuse services
 2002  regulated under this chapter and chapter 397. Providers eligible
 2003  for a consolidated license shall operate these services through
 2004  a single corporate entity and a unified management structure.
 2005  Any provider serving adults and children must meet department
 2006  standards for separate facilities and other requirements
 2007  necessary to ensure children’s safety and promote therapeutic
 2008  efficacy.
 2009         Section 16. Section 394.9082, Florida Statutes, is amended
 2010  to read:
 2011         (Substantial rewording of section. See
 2012         s. 394.9082, F.S., for present text.)
 2013         394.9082 Behavioral health managing entities purpose;
 2014  definitions; duties; contracting; accountability.—
 2015         (1) PURPOSE.—The purpose of the behavioral health managing
 2016  entities is to plan, coordinate and contract for the delivery of
 2017  community mental health and substance abuse services, to improve
 2018  access to care, to promote service continuity, to purchase
 2019  services, and to support efficient and effective delivery of
 2020  services.
 2021         (2) DEFINITIONS.—As used in this section, the term:
 2022         (a) “Behavioral health services” means mental health
 2023  services and substance abuse prevention and treatment services
 2024  as described in this chapter and chapter 397.
 2025         (b) “Case management” means those direct services provided
 2026  to a client in order to assess needs, plan or arrange services,
 2027  coordinate service providers, monitor service delivery, and
 2028  evaluate outcomes.
 2029         (c) “Coordinated system of care” means the full array of
 2030  behavioral health and related services in a region or a
 2031  community offered by all service providers, whether
 2032  participating under contract with the managing entity or through
 2033  another method of community partnership or mutual agreement.
 2034         (d) “Geographic area” means one or more contiguous
 2035  counties, circuits, or regions as described in s. 409.966 or s.
 2036  381.0406.
 2037         (e) “High-need or high-utilization individual” means a
 2038  recipient who meets one or more of the following criteria and
 2039  may be eligible for intensive case management services:
 2040         1. Has resided in a state mental health facility for at
 2041  least 6 months in the last 36 months;
 2042         2. Has had two or more admissions to a state mental health
 2043  facility in the last 36 months; or
 2044         3. Has had three or more admissions to a crisis
 2045  stabilization unit, an addictions receiving facility, a short
 2046  term residential facility, or an inpatient psychiatric unit
 2047  within the last 12 months.
 2048         (f) “Managing entity” means a corporation designated or
 2049  filed as a nonprofit organization under s. 501(c)(3) of the
 2050  Internal Revenue Code which is selected by, and is under
 2051  contract with, the department to manage the daily operational
 2052  delivery of behavioral health services through a coordinated
 2053  system of care.
 2054         (g) “Provider network” means the group of direct service
 2055  providers, facilities, and organizations under contract with a
 2056  managing entity to provide a comprehensive array of emergency,
 2057  acute care, residential, outpatient, recovery support, and
 2058  consumer support services, including prevention services.
 2059         (h) “Receiving facility” means any public or private
 2060  facility designated by the department to receive and hold or to
 2061  refer, as appropriate, involuntary patients under emergency
 2062  conditions for mental health or substance abuse evaluation and
 2063  to provide treatment or transportation to the appropriate
 2064  service provider. County jails may not be used or designated as
 2065  a receiving facility, a triage center, or an access center.
 2066         (3) DEPARTMENT DUTIES.—The department shall:
 2067         (a)Designate, with input from the managing entity,
 2068  facilities that meet the definitions in s. 394.455(1), (2),
 2069  (13), and (41) and the receiving system developed by one or more
 2070  counties pursuant to s. 394.4573(2)(b).
 2071         (b) Contract with organizations to serve as the managing
 2072  entity in accordance with the requirements of this section.
 2073         (c) Specify the geographic area served.
 2074         (d) Specify data reporting and use of shared data systems.
 2075         (e) Develop strategies to divert persons with mental
 2076  illness or substance abuse disorders from the criminal and
 2077  juvenile justice systems.
 2078         (f) Support the development and implementation of a
 2079  coordinated system of care by requiring each provider that
 2080  receives state funds for behavioral health services through a
 2081  direct contract with the department to work with the managing
 2082  entity in the provider’s service area to coordinate the
 2083  provision of behavioral health services, as part of the contract
 2084  with the department.
 2085         (g) Set performance measures and performance standards for
 2086  managing entities based on nationally recognized standards, such
 2087  as those developed by the National Quality Forum, the National
 2088  Committee for Quality Assurance, or similar credible sources.
 2089  Performance standards must include all of the following:
 2090         1. Annual improvement in the extent to which the need for
 2091  behavioral health services is met by the coordinated system of
 2092  care in the geographic area served.
 2093         2. Annual improvement in the percentage of patients who
 2094  receive services through the coordinated system of care and who
 2095  achieve improved functional status as indicated by health
 2096  condition, employment status, and housing stability.
 2097         3. Annual reduction in the rates of readmissions to acute
 2098  care facilities, jails, prisons, and forensic facilities for
 2099  persons receiving care coordination.
 2100         4. Annual improvement in consumer and family satisfaction.
 2101         (h) Provide technical assistance to the managing entities.
 2102         (i) Promote the integration of behavioral health care and
 2103  primary care.
 2104         (j) Facilitate the coordination between the managing entity
 2105  and other payors of behavioral health care.
 2106         (k) Develop and provide a unique identifier for clients
 2107  receiving services under the managing entity to coordinate care.
 2108         (l) Coordinate procedures for the referral and admission of
 2109  patients to, and the discharge of patients from, state treatment
 2110  facilities and their return to the community.
 2111         (m) Ensure that managing entities comply with state and
 2112  federal laws, rules, and regulations.
 2113         (n) Develop rules for the operations of, and the
 2114  requirements that must be met by, the managing entity, if
 2115  necessary.
 2116         (4) CONTRACT WITH MANAGING ENTITIES.—
 2117         (a) The department’s contracts with managing entities must
 2118  support efficient and effective administration of the behavioral
 2119  health system and ensure accountability for performance.
 2120         (b) Beginning July 1, 2018, managing entities under
 2121  contract with the department are subject to a contract
 2122  performance review. The review must include:
 2123         1. Analysis of the duties and performance measures
 2124  described in this section;
 2125         2. The results of contract monitoring compiled during the
 2126  term of the contract; and
 2127         3. Related compliance and performance issues.
 2128         (c) For the managing entities whose performance is
 2129  determined satisfactory after completion of the review pursuant
 2130  to paragraph (b), and before the end of the term of the
 2131  contract, the department may negotiate and enter into a contract
 2132  with the managing entity for a period of 4 years pursuant to s.
 2133  287.057(3)(e).
 2134         (d) The performance review must be completed by the
 2135  beginning of the third year of the 4-year contract. In the event
 2136  the managing entity does not meet the requirements of the
 2137  performance review, a corrective action plan must be created by
 2138  the department. The managing entity must complete the corrective
 2139  action plan before the beginning of the fourth year of the
 2140  contract. If the corrective action plan is not satisfactorily
 2141  completed, the department shall provide notice to the managing
 2142  entity that the contract will be terminated at the end of the
 2143  contract term and the department shall initiate a competitive
 2144  procurement process to select a new managing entity pursuant to
 2145  s. 287.057.
 2146         (5) MANAGING ENTITIES DUTIES.—A managing entity shall:
 2147         (a)Maintain a board of directors that is representative of
 2148  the community and that, at a minimum, includes consumers and
 2149  family members, community stakeholders and organizations, and
 2150  providers of mental health and substance abuse services,
 2151  including public and private receiving facilities.
 2152         (b) Conduct a community behavioral health care needs
 2153  assessment in the geographic area served by the managing entity.
 2154  The needs assessment must be updated annually and provided to
 2155  the department. The assessment must include, at a minimum, the
 2156  information the department needs for its annual report to the
 2157  Governor and Legislature pursuant to s. 394.4573.
 2158         (c) Develop local resources by pursuing third-party
 2159  payments for services, applying for grants, securing local
 2160  matching funds and in-kind services, and any other methods
 2161  needed to ensure services are available and accessible.
 2162         (d) Provide assistance to counties to develop a designated
 2163  receiving system pursuant to s. 394.4573(2)(b) and a
 2164  transportation plan pursuant to s. 394.462.
 2165         (e) Promote the development and effective implementation of
 2166  a coordinated system of care pursuant to s. 394.4573.
 2167         (f) Develop a comprehensive network of qualified providers
 2168  to deliver behavioral health services. The managing entity is
 2169  not required to competitively procure network providers, but
 2170  must have a process in place to publicize opportunities to join
 2171  the network and to evaluate providers in the network to
 2172  determine if they can remain in the network. These processes
 2173  must be published on the website of the managing entity. The
 2174  managing entity must ensure continuity of care for clients if a
 2175  provider ceases to provide a service or leaves the network.
 2176         (g) Enter into cooperative agreements with local homeless
 2177  councils and organizations to allow the sharing of available
 2178  resource information, shared client information, client referral
 2179  services, and any other data or information that may be useful
 2180  in addressing the homelessness of persons suffering from a
 2181  behavioral health crisis.
 2182         (h)Monitor network providers performance and their
 2183  compliance with contract requirements and federal and state
 2184  laws, rules, and regulations.
 2185         (i)Provide or contract for case management services.
 2186         (j) Manage and allocate funds for services to meet the
 2187  requirements of law or rule.
 2188         (k) Promote integration of behavioral health with primary
 2189  care.
 2190         (l) Implement shared data systems necessary for the
 2191  delivery of coordinated care and integrated services, the
 2192  assessment of managing entity performance and provider
 2193  performance, and the reporting of outcomes and costs of
 2194  services.
 2195         (m) Operate in a transparent manner, providing public
 2196  access to information, notice of meetings, and opportunities for
 2197  public participation in managing entity decisionmaking.
 2198         (n) Establish and maintain effective relationships with
 2199  community stakeholders, including local governments and other
 2200  organizations that serve individuals with behavioral health
 2201  needs.
 2202         (o) Collaborate with local criminal and juvenile justice
 2203  systems to divert persons with mental illness or substance abuse
 2204  disorders, or both, from the criminal and juvenile justice
 2205  systems.
 2206         (p) Collaborate with the local court system to develop
 2207  procedures to maximize the use of involuntary outpatient
 2208  services; reduce involuntary inpatient treatment; and increase
 2209  diversion from the criminal and juvenile justice systems.
 2210         (6) FUNDING FOR MANAGING ENTITIES.—
 2211         (a) A contract established between the department and a
 2212  managing entity under this section must be funded by general
 2213  revenue, other applicable state funds, or applicable federal
 2214  funding sources. A managing entity may carry forward documented
 2215  unexpended state funds from one fiscal year to the next, but the
 2216  cumulative amount carried forward may not exceed 8 percent of
 2217  the total value of the contract. Any unexpended state funds in
 2218  excess of that percentage must be returned to the department.
 2219  The funds carried forward may not be used in a way that would
 2220  increase future recurring obligations or for any program or
 2221  service that was not authorized as of July 1, 2016, under the
 2222  existing contract with the department. Expenditures of funds
 2223  carried forward must be separately reported to the department.
 2224  Any unexpended funds that remain at the end of the contract
 2225  period must be returned to the department. Funds carried forward
 2226  may be retained through contract renewals and new contract
 2227  procurements as long as the same managing entity is retained by
 2228  the department.
 2229         (b) The method of payment for a fixed-price contract with a
 2230  managing entity must provide for a 2-month advance payment at
 2231  the beginning of each fiscal year and equal monthly payments
 2232  thereafter.
 2233         (7) CRISIS STABILIZATION SERVICES UTILIZATION DATABASE.—The
 2234  department shall develop, implement, and maintain standards
 2235  under which a managing entity shall collect utilization data
 2236  from all public receiving facilities situated within its
 2237  geographic service area. As used in this subsection, the term
 2238  “public receiving facility” means an entity that meets the
 2239  licensure requirements of, and is designated by, the department
 2240  to operate as a public receiving facility under s. 394.875 and
 2241  that is operating as a licensed crisis stabilization unit.
 2242         (a) The department shall develop standards and protocols
 2243  for managing entities and public receiving facilities to be used
 2244  for data collection, storage, transmittal, and analysis. The
 2245  standards and protocols must allow for compatibility of data and
 2246  data transmittal between public receiving facilities, managing
 2247  entities, and the department for the implementation and
 2248  requirements of this subsection.
 2249         (b) A managing entity shall require a public receiving
 2250  facility within its provider network to submit data, in real
 2251  time or at least daily, to the managing entity for:
 2252         1. All admissions and discharges of clients receiving
 2253  public receiving facility services who qualify as indigent, as
 2254  defined in s. 394.4787; and
 2255         2. The current active census of total licensed beds, the
 2256  number of beds purchased by the department, the number of
 2257  clients qualifying as indigent who occupy those beds, and the
 2258  total number of unoccupied licensed beds regardless of funding.
 2259         (c) A managing entity shall require a public receiving
 2260  facility within its provider network to submit data, on a
 2261  monthly basis, to the managing entity which aggregates the daily
 2262  data submitted under paragraph (b). The managing entity shall
 2263  reconcile the data in the monthly submission to the data
 2264  received by the managing entity under paragraph (b) to check for
 2265  consistency. If the monthly aggregate data submitted by a public
 2266  receiving facility under this paragraph are inconsistent with
 2267  the daily data submitted under paragraph (b), the managing
 2268  entity shall consult with the public receiving facility to make
 2269  corrections necessary to ensure accurate data.
 2270         (d) A managing entity shall require a public receiving
 2271  facility within its provider network to submit data, on an
 2272  annual basis, to the managing entity which aggregates the data
 2273  submitted and reconciled under paragraph (c). The managing
 2274  entity shall reconcile the data in the annual submission to the
 2275  data received and reconciled by the managing entity under
 2276  paragraph (c) to check for consistency. If the annual aggregate
 2277  data submitted by a public receiving facility under this
 2278  paragraph are inconsistent with the data received and reconciled
 2279  under paragraph (c), the managing entity shall consult with the
 2280  public receiving facility to make corrections necessary to
 2281  ensure accurate data.
 2282         (e) After ensuring the accuracy of data pursuant to
 2283  paragraphs (c) and (d), the managing entity shall submit the
 2284  data to the department on a monthly and an annual basis. The
 2285  department shall create a statewide database for the data
 2286  described under paragraph (b) and submitted under this paragraph
 2287  for the purpose of analyzing the payments for and the use of
 2288  crisis stabilization services funded by the Baker Act on a
 2289  statewide basis and on an individual public receiving facility
 2290  basis.
 2291         Section 17. Present subsections (20) through (45) of
 2292  section 397.311, Florida Statutes, are redesignated as
 2293  subsections (21) through (46), respectively, a new subsection
 2294  (20) is added to that section, and present subsections (30) and
 2295  (38) of that section are amended, to read:
 2296         397.311 Definitions.—As used in this chapter, except part
 2297  VIII, the term:
 2298         (20) “Involuntary services” means court-ordered outpatient
 2299  services or treatment for substance abuse disorders or services
 2300  provided in an inpatient placement in a receiving facility or
 2301  treatment facility.
 2302         (31)(30) “Qualified professional” means a physician or a
 2303  physician assistant licensed under chapter 458 or chapter 459; a
 2304  professional licensed under chapter 490 or chapter 491; an
 2305  advanced registered nurse practitioner having a specialty in
 2306  psychiatry licensed under part I of chapter 464; or a person who
 2307  is certified through a department-recognized certification
 2308  process for substance abuse treatment services and who holds, at
 2309  a minimum, a bachelor’s degree. A person who is certified in
 2310  substance abuse treatment services by a state-recognized
 2311  certification process in another state at the time of employment
 2312  with a licensed substance abuse provider in this state may
 2313  perform the functions of a qualified professional as defined in
 2314  this chapter but must meet certification requirements contained
 2315  in this subsection no later than 1 year after his or her date of
 2316  employment.
 2317         (39)(38) “Service component” or “component” means a
 2318  discrete operational entity within a service provider which is
 2319  subject to licensing as defined by rule. Service components
 2320  include prevention, intervention, and clinical treatment
 2321  described in subsection (23) (22).
 2322         Section 18. Section 397.675, Florida Statutes, is amended
 2323  to read:
 2324         397.675 Criteria for involuntary admissions, including
 2325  protective custody, emergency admission, and other involuntary
 2326  assessment, involuntary treatment, and alternative involuntary
 2327  assessment for minors, for purposes of assessment and
 2328  stabilization, and for involuntary treatment.—A person meets the
 2329  criteria for involuntary admission if there is good faith reason
 2330  to believe that the person has a substance abuse or co-occurring
 2331  mental health disorder is substance abuse impaired and, because
 2332  of such disorder impairment:
 2333         (1) Has lost the power of self-control with respect to
 2334  substance abuse use; and either
 2335         (2)(a) Has inflicted, or threatened or attempted to
 2336  inflict, or unless admitted is likely to inflict, physical harm
 2337  on himself or herself or another; or
 2338         (b) Is in need of substance abuse services and, by reason
 2339  of substance abuse impairment, his or her judgment has been so
 2340  impaired that he or she the person is incapable of appreciating
 2341  his or her need for such services and of making a rational
 2342  decision in that regard, although thereto; however, mere refusal
 2343  to receive such services does not constitute evidence of lack of
 2344  judgment with respect to his or her need for such services.
 2345         (b) Without care or treatment, is likely to suffer from
 2346  neglect or to refuse to care for himself or herself, that such
 2347  neglect or refusal poses a real and present threat of
 2348  substantial harm to his or her well-being and that it is not
 2349  apparent that such harm may be avoided through the help of
 2350  willing family members or friends or the provision of other
 2351  services, or there is substantial likelihood that the person has
 2352  inflicted, or threatened to or attempted to inflict, or, unless
 2353  admitted, is likely to inflict, physical harm on himself,
 2354  herself, or another.
 2355         Section 19. Section 397.679, Florida Statutes, is amended
 2356  to read:
 2357         397.679 Emergency admission; circumstances justifying.—A
 2358  person who meets the criteria for involuntary admission in s.
 2359  397.675 may be admitted to a hospital or to a licensed
 2360  detoxification facility or addictions receiving facility for
 2361  emergency assessment and stabilization, or to a less intensive
 2362  component of a licensed service provider for assessment only,
 2363  upon receipt by the facility of a the physician’s certificate by
 2364  a physician, an advanced registered nurse practitioner, a
 2365  clinical psychologist, a licensed clinical social worker, a
 2366  licensed marriage and family therapist, a licensed mental health
 2367  counselor, a physician assistant working under the scope of
 2368  practice of the supervising physician, or a master’s-level
 2369  certified addictions professional, if the certificate is
 2370  specific to substance abuse disorders, and the completion of an
 2371  application for emergency admission.
 2372         Section 20. Section 397.6791, Florida Statutes, is amended
 2373  to read:
 2374         397.6791 Emergency admission; persons who may initiate.—The
 2375  following professionals persons may request a certificate for an
 2376  emergency assessment or admission:
 2377         (1) In the case of an adult, physicians, advanced
 2378  registered nurse practitioners, clinical psychologists, licensed
 2379  clinical social workers, licensed marriage and family
 2380  therapists, licensed mental health counselors, physician
 2381  assistants working under the scope of practice of the
 2382  supervising physician, and a master’s-level-certified addictions
 2383  professional, if the certificate is specific to substance abuse
 2384  disorders the certifying physician, the person’s spouse or legal
 2385  guardian, any relative of the person, or any other responsible
 2386  adult who has personal knowledge of the person’s substance abuse
 2387  impairment.
 2388         (2) In the case of a minor, the minor’s parent, legal
 2389  guardian, or legal custodian.
 2390         Section 21. Section 397.6793, Florida Statutes, is amended
 2391  to read:
 2392         397.6793 Professional’s Physician’s certificate for
 2393  emergency admission.—
 2394         (1) The professional’s physician’s certificate must include
 2395  the name of the person to be admitted, the relationship between
 2396  the person and the professional executing the certificate
 2397  physician, the relationship between the applicant and the
 2398  professional physician, any relationship between the
 2399  professional physician and the licensed service provider, and a
 2400  statement that the person has been examined and assessed within
 2401  the preceding 5 days of the application date, and must include
 2402  factual allegations with respect to the need for emergency
 2403  admission, including:
 2404         (a) The reason for the physician’s belief that the person
 2405  is substance abuse impaired; and
 2406         (b) The reason for the physician’s belief that because of
 2407  such impairment the person has lost the power of self-control
 2408  with respect to substance abuse; and either
 2409         (c)1. The reason for the belief physician believes that,
 2410  without care or treatment, the person is likely to suffer from
 2411  neglect or refuse to care for himself or herself; that such
 2412  neglect or refusal poses a real and present threat of
 2413  substantial harm to his or her well-being; and that it is not
 2414  apparent that such harm may be avoided through the help of
 2415  willing family members or friends or the provision of other
 2416  services or there is substantial likelihood that the person has
 2417  inflicted or is likely to inflict physical harm on himself or
 2418  herself or others unless admitted; or
 2419         2. The reason for the belief physician believes that the
 2420  person’s refusal to voluntarily receive care is based on
 2421  judgment so impaired by reason of substance abuse that the
 2422  person is incapable of appreciating his or her need for care and
 2423  of making a rational decision regarding his or her need for
 2424  care.
 2425         (2) The professional’s physician’s certificate must
 2426  recommend the least restrictive type of service that is
 2427  appropriate for the person. The certificate must be signed by
 2428  the professional physician. If other less restrictive means are
 2429  not available, such as voluntary appearance for outpatient
 2430  evaluation, a law enforcement officer shall take the person
 2431  named in the certificate into custody and deliver him or her to
 2432  the appropriate facility for involuntary examination.
 2433         (3) A signed copy of the professional’s physician’s
 2434  certificate shall accompany the person, and shall be made a part
 2435  of the person’s clinical record, together with a signed copy of
 2436  the application. The application and the professional’s
 2437  physician’s certificate authorize the involuntary admission of
 2438  the person pursuant to, and subject to the provisions of, ss.
 2439  397.679-397.6797.
 2440         (4) The professional’s certificate is valid for 7 days
 2441  after issuance.
 2442         (5)The professional’s physician’s certificate must
 2443  indicate whether the person requires transportation assistance
 2444  for delivery for emergency admission and specify, pursuant to s.
 2445  397.6795, the type of transportation assistance necessary.
 2446         Section 22. Section 397.6795, Florida Statutes, is amended
 2447  to read:
 2448         397.6795 Transportation-assisted delivery of persons for
 2449  emergency assessment.—An applicant for a person’s emergency
 2450  admission, or the person’s spouse or guardian, or a law
 2451  enforcement officer, or a health officer may deliver a person
 2452  named in the professional’s physician’s certificate for
 2453  emergency admission to a hospital or a licensed detoxification
 2454  facility or addictions receiving facility for emergency
 2455  assessment and stabilization.
 2456         Section 23. Subsection (1) of section 397.681, Florida
 2457  Statutes, is amended to read:
 2458         397.681 Involuntary petitions; general provisions; court
 2459  jurisdiction and right to counsel.—
 2460         (1) JURISDICTION.—The courts have jurisdiction of
 2461  involuntary assessment and stabilization petitions and
 2462  involuntary treatment petitions for substance abuse impaired
 2463  persons, and such petitions must be filed with the clerk of the
 2464  court in the county where the person is located. The clerk of
 2465  the court may not charge a fee for the filing of a petition
 2466  under this section. The chief judge may appoint a general or
 2467  special magistrate to preside over all or part of the
 2468  proceedings. The alleged impaired person is named as the
 2469  respondent.
 2470         Section 24. Subsection (1) of section 397.6811, Florida
 2471  Statutes, is amended to read:
 2472         397.6811 Involuntary assessment and stabilization.—A person
 2473  determined by the court to appear to meet the criteria for
 2474  involuntary admission under s. 397.675 may be admitted for a
 2475  period of 5 days to a hospital or to a licensed detoxification
 2476  facility or addictions receiving facility, for involuntary
 2477  assessment and stabilization or to a less restrictive component
 2478  of a licensed service provider for assessment only upon entry of
 2479  a court order or upon receipt by the licensed service provider
 2480  of a petition. Involuntary assessment and stabilization may be
 2481  initiated by the submission of a petition to the court.
 2482         (1) If the person upon whose behalf the petition is being
 2483  filed is an adult, a petition for involuntary assessment and
 2484  stabilization may be filed by the respondent’s spouse or ,legal
 2485  guardian, any relative, a private practitioner, the director of
 2486  a licensed service provider or the director’s designee, or any
 2487  individual three adults who has direct have personal knowledge
 2488  of the respondent’s substance abuse impairment.
 2489         Section 25. Section 397.6814, Florida Statutes, is amended
 2490  to read:
 2491         397.6814 Involuntary assessment and stabilization; contents
 2492  of petition.—A petition for involuntary assessment and
 2493  stabilization must contain the name of the respondent,; the name
 2494  of the applicant or applicants,; the relationship between the
 2495  respondent and the applicant, and; the name of the respondent’s
 2496  attorney, if known, and a statement of the respondent’s ability
 2497  to afford an attorney; and must state facts to support the need
 2498  for involuntary assessment and stabilization, including:
 2499         (1) The reason for the petitioner’s belief that the
 2500  respondent is substance abuse impaired; and
 2501         (2) The reason for the petitioner’s belief that because of
 2502  such impairment the respondent has lost the power of self
 2503  control with respect to substance abuse; and either
 2504         (3)(a) The reason the petitioner believes that the
 2505  respondent has inflicted or is likely to inflict physical harm
 2506  on himself or herself or others unless admitted; or
 2507         (b) The reason the petitioner believes that the
 2508  respondent’s refusal to voluntarily receive care is based on
 2509  judgment so impaired by reason of substance abuse that the
 2510  respondent is incapable of appreciating his or her need for care
 2511  and of making a rational decision regarding that need for care.
 2512  If the respondent has refused to submit to an assessment, such
 2513  refusal must be alleged in the petition.
 2514  
 2515  A fee may not be charged for the filing of a petition pursuant
 2516  to this section.
 2517         Section 26. Section 397.6819, Florida Statutes, is amended
 2518  to read:
 2519         397.6819 Involuntary assessment and stabilization;
 2520  responsibility of licensed service provider.—A licensed service
 2521  provider may admit an individual for involuntary assessment and
 2522  stabilization for a period not to exceed 5 days unless a
 2523  petition for involuntary outpatient services has been initiated
 2524  which authorizes the licensed service provider to retain
 2525  physical custody of the person pending further order of the
 2526  court pursuant to s. 397.6821. The individual must be assessed
 2527  within 24 hours without unnecessary delay by a qualified
 2528  professional. The person may not be held pursuant to this
 2529  section beyond the 24-hour assessment period unless the
 2530  assessment has been reviewed and authorized by a licensed
 2531  physician as necessary for continued stabilization. If an
 2532  assessment is performed by a qualified professional who is not a
 2533  physician, the assessment must be reviewed by a physician before
 2534  the end of the assessment period.
 2535         Section 27. Section 397.695, Florida Statutes, is amended
 2536  to read:
 2537         397.695 Involuntary outpatient services treatment; persons
 2538  who may petition.—
 2539         (1)(a) If the respondent is an adult, a petition for
 2540  involuntary outpatient services treatment may be filed by the
 2541  respondent’s spouse or legal guardian, any relative, a service
 2542  provider, or any individual three adults who has direct have
 2543  personal knowledge of the respondent’s substance abuse
 2544  impairment and his or her prior course of assessment and
 2545  treatment.
 2546         (b) The administrator of a receiving facility, a crisis
 2547  stabilization unit, or an addictions receiving facility where
 2548  the patient has been examined may retain the patient at the
 2549  facility after adherence to the notice procedures provided in s.
 2550  397.6955. The recommendation for involuntary outpatient services
 2551  must be supported by the opinion of a qualified professional as
 2552  defined in s. 397.311(31) or a master’s-level-certified
 2553  addictions professional and by the second opinion of a
 2554  psychologist, a physician, or an advanced registered nurse
 2555  practitioner licensed under chapter 464, both of whom have
 2556  personally examined the patient within the preceding 72 hours,
 2557  that the criteria for involuntary outpatient services are met.
 2558  However, in a county having a population of fewer than 50,000,
 2559  if the administrator of the facility certifies that a qualified
 2560  professional is not available to provide the second opinion, the
 2561  second opinion may be provided by a physician who has
 2562  postgraduate training and experience in the diagnosis and
 2563  treatment of substance abuse disorders. Any second opinion
 2564  authorized in this section may be conducted through face-to-face
 2565  examination, in person, or by electronic means. Such
 2566  recommendation must be entered on an involuntary outpatient
 2567  certificate that authorizes the facility to retain the patient
 2568  pending completion of a hearing. The certificate must be made a
 2569  part of the patient’s clinical record.
 2570         (c) If the patient has been stabilized and no longer meets
 2571  the criteria for involuntary assessment and stabilization
 2572  pursuant to s. 397.6811, the patient must be released from the
 2573  facility while awaiting the hearing for involuntary outpatient
 2574  services. Before filing a petition for involuntary outpatient
 2575  services, the administrator of the facility must identify the
 2576  service provider that will have responsibility for service
 2577  provision under the order for involuntary outpatient services,
 2578  unless the person is otherwise participating in outpatient
 2579  substance abuse disorder services and is not in need of public
 2580  financing of the services, in which case the person, if
 2581  eligible, may be ordered to involuntary outpatient services
 2582  pursuant to the existing provision-of-services relationship he
 2583  or she has for substance abuse disorder services.
 2584         (d) The service provider shall prepare a written proposed
 2585  treatment plan in consultation with the patient or the patient’s
 2586  guardian advocate, if applicable, for the order for outpatient
 2587  services and provide a copy of the proposed treatment plan to
 2588  the patient and the administrator of the facility. The service
 2589  provider shall also provide a treatment plan that addresses the
 2590  nature and extent of the substance abuse disorder and any co
 2591  occurring mental illness and the risks that necessitates
 2592  involuntary outpatient services. The treatment plan must
 2593  indicate the likely level of care, including medication and the
 2594  anticipated discharge criteria for terminating involuntary
 2595  outpatient services. Service providers may coordinate, select,
 2596  and supervise other individuals to implement specific aspects of
 2597  the treatment plan. The services in the treatment plan must be
 2598  deemed clinically appropriate by a qualified professional who
 2599  consults with, or is employed by, the service provider. The
 2600  service provider must certify that the recommended services in
 2601  the treatment plan are available for the stabilization and
 2602  improvement of the patient. If the service provider certifies
 2603  that the recommended services in the proposed treatment plan are
 2604  not available, the petition may not be filed. The service
 2605  provider must document its inquiry with the department and the
 2606  managing entity as to the availability of the requested
 2607  services. The managing entity must document such efforts to
 2608  obtain the requested services.
 2609         (e) If a patient in involuntary inpatient placement meets
 2610  the criteria for involuntary outpatient services, the
 2611  administrator of the treatment facility may, before the
 2612  expiration of the period during which the treatment facility is
 2613  authorized to retain the patient, recommend involuntary
 2614  outpatient services. The recommendation must be supported by the
 2615  opinion of a qualified professional as defined in s. 397.311(31)
 2616  or a master’s-level-certified addictions professional and by the
 2617  second opinion of a psychologist, a physician, an advanced
 2618  registered nurse practitioner licensed under chapter 464, or a
 2619  mental health professional licensed under chapter 491, both of
 2620  whom have personally examined the patient within the preceding
 2621  72 hours, that the criteria for involuntary outpatient services
 2622  are met. However, in a county having a population of fewer than
 2623  50,000, if the administrator of the facility certifies that a
 2624  qualified professional is not available to provide the second
 2625  opinion, the second opinion may be provided by a physician who
 2626  has postgraduate training and experience in the diagnosis and
 2627  treatment of substance abuse disorders. Any second opinion
 2628  authorized in this section may be conducted through face-to-face
 2629  examination, in person, or by electronic means. Such
 2630  recommendation must be entered on an involuntary outpatient
 2631  certificate that authorizes the facility to retain the patient
 2632  pending completion of a hearing. The certificate must be made a
 2633  part of the patient’s clinical record.
 2634         (f) The service provider who is responsible for providing
 2635  services under the order for involuntary outpatient services
 2636  must be identified before the entry of the order for outpatient
 2637  services. The service provider shall certify to the court that
 2638  the recommended services in the treatment plan are available for
 2639  the stabilization and improvement of the patient. If the service
 2640  provider certifies that the recommended services in the proposed
 2641  treatment plan are not available, the petition may not be filed.
 2642  The service provider must document notify the managing entity as
 2643  to the availability of the requested services. The managing
 2644  entity must document such efforts to obtain the requested
 2645  services.
 2646         (2) If the respondent is a minor, a petition for
 2647  involuntary treatment may be filed by a parent, legal guardian,
 2648  or service provider.
 2649         Section 28. Section 397.6951, Florida Statutes, is amended
 2650  to read:
 2651         397.6951 Contents of petition for involuntary outpatient
 2652  services treatment.—A petition for involuntary outpatient
 2653  services treatment must contain the name of the respondent to be
 2654  admitted; the name of the petitioner or petitioners; the
 2655  relationship between the respondent and the petitioner; the name
 2656  of the respondent’s attorney, if known, and a statement of the
 2657  petitioner’s knowledge of the respondent’s ability to afford an
 2658  attorney; the findings and recommendations of the assessment
 2659  performed by the qualified professional; and the factual
 2660  allegations presented by the petitioner establishing the need
 2661  for involuntary outpatient services. The factual allegations
 2662  must demonstrate treatment, including:
 2663         (1) The reason for the petitioner’s belief that the
 2664  respondent is substance abuse impaired; and
 2665         (2) The respondent’s history of failure to comply with
 2666  requirements for treatment for substance abuse and that the
 2667  respondent has been involuntarily admitted to a receiving or
 2668  treatment facility at least twice within the immediately
 2669  preceding 36 months; The reason for the petitioner’s belief that
 2670  because of such impairment the respondent has lost the power of
 2671  self-control with respect to substance abuse; and either
 2672         (3) That the respondent is, as a result of his or her
 2673  substance abuse disorder, unlikely to voluntarily participate in
 2674  the recommended services after sufficient and conscientious
 2675  explanation and disclosure of the purpose of the services or he
 2676  or she is unable to determine for himself or herself whether
 2677  outpatient services are necessary;
 2678         (4) That, in view of the person’s treatment history and
 2679  current behavior, the person is in need of involuntary
 2680  outpatient services; that without services, the person is likely
 2681  to suffer from neglect or to refuse to care for himself or
 2682  herself; that such neglect or refusal poses a real and present
 2683  threat of substantial harm to his or her well-being; and that
 2684  there is a substantial likelihood that without services the
 2685  person will cause serious bodily harm to himself, herself, or
 2686  others in the near future, as evidenced by recent behavior; and
 2687         (5) That it is likely that the person will benefit from
 2688  involuntary outpatient services.
 2689         (3)(a) The reason the petitioner believes that the
 2690  respondent has inflicted or is likely to inflict physical harm
 2691  on himself or herself or others unless admitted; or
 2692         (b) The reason the petitioner believes that the
 2693  respondent’s refusal to voluntarily receive care is based on
 2694  judgment so impaired by reason of substance abuse that the
 2695  respondent is incapable of appreciating his or her need for care
 2696  and of making a rational decision regarding that need for care.
 2697         Section 29. Section 397.6955, Florida Statutes, is amended
 2698  to read:
 2699         397.6955 Duties of court upon filing of petition for
 2700  involuntary outpatient services treatment.—
 2701         (1) Upon the filing of a petition for the involuntary
 2702  outpatient services for treatment of a substance abuse impaired
 2703  person with the clerk of the court, the court shall immediately
 2704  determine whether the respondent is represented by an attorney
 2705  or whether the appointment of counsel for the respondent is
 2706  appropriate. If the court appoints counsel for the person, the
 2707  clerk of the court shall immediately notify the regional
 2708  conflict counsel, created pursuant to s. 27.511, of the
 2709  appointment. The regional conflict counsel shall represent the
 2710  person until the petition is dismissed, the court order expires,
 2711  or the person is discharged from involuntary outpatient
 2712  services. An attorney that represents the person named in the
 2713  petition shall have access to the person, witnesses, and records
 2714  relevant to the presentation of the person’s case and shall
 2715  represent the interests of the person, regardless of the source
 2716  of payment to the attorney.
 2717         (2) The court shall schedule a hearing to be held on the
 2718  petition within 5 10 days unless a continuance is granted. The
 2719  court may appoint a general or special master to preside at the
 2720  hearing.
 2721         (3) A copy of the petition and notice of the hearing must
 2722  be provided to the respondent; the respondent’s parent,
 2723  guardian, or legal custodian, in the case of a minor; the
 2724  respondent’s attorney, if known; the petitioner; the
 2725  respondent’s spouse or guardian, if applicable; and such other
 2726  persons as the court may direct. If the respondent is a minor, a
 2727  copy of the petition and notice of the hearing must be and have
 2728  such petition and order personally delivered to the respondent
 2729  if he or she is a minor. The court shall also issue a summons to
 2730  the person whose admission is sought.
 2731         Section 30. Section 397.6957, Florida Statutes, is amended
 2732  to read:
 2733         397.6957 Hearing on petition for involuntary outpatient
 2734  services treatment.—
 2735         (1) At a hearing on a petition for involuntary outpatient
 2736  services treatment, the court shall hear and review all relevant
 2737  evidence, including the review of results of the assessment
 2738  completed by the qualified professional in connection with the
 2739  respondent’s protective custody, emergency admission,
 2740  involuntary assessment, or alternative involuntary admission.
 2741  The respondent must be present unless the court finds that his
 2742  or her presence is likely to be injurious to himself or herself
 2743  or others, in which event the court must appoint a guardian
 2744  advocate to act in behalf of the respondent throughout the
 2745  proceedings.
 2746         (2) The petitioner has the burden of proving by clear and
 2747  convincing evidence that:
 2748         (a) The respondent is substance abuse impaired and has a
 2749  history of lack of compliance with treatment for substance
 2750  abuse;, and
 2751         (b) Because of such impairment the respondent is unlikely
 2752  to voluntarily participate in the recommended treatment or is
 2753  unable to determine for himself or herself whether outpatient
 2754  services are necessary the respondent has lost the power of
 2755  self-control with respect to substance abuse; and either
 2756         1. Without services, the respondent is likely to suffer
 2757  from neglect or to refuse to care for himself or herself; that
 2758  such neglect or refusal poses a real and present threat of
 2759  substantial harm to his or her well-being; and that there is a
 2760  substantial likelihood that without services the respondent will
 2761  cause serious bodily harm to himself or herself or others in the
 2762  near future, as evidenced by recent behavior The respondent has
 2763  inflicted or is likely to inflict physical harm on himself or
 2764  herself or others unless admitted; or
 2765         2. The respondent’s refusal to voluntarily receive care is
 2766  based on judgment so impaired by reason of substance abuse that
 2767  the respondent is incapable of appreciating his or her need for
 2768  care and of making a rational decision regarding that need for
 2769  care.
 2770         (3) One of the qualified professionals who executed the
 2771  involuntary outpatient services certificate must be a witness.
 2772  The court shall allow testimony from individuals, including
 2773  family members, deemed by the court to be relevant under state
 2774  law, regarding the respondent’s prior history and how that prior
 2775  history relates to the person’s current condition. The testimony
 2776  in the hearing must be under oath, and the proceedings must be
 2777  recorded. The patient may refuse to testify at the hearing.
 2778         (4)(3) At the conclusion of the hearing the court shall
 2779  either dismiss the petition or order the respondent to receive
 2780  undergo involuntary outpatient services from his or her
 2781  substance abuse treatment, with the respondent’s chosen licensed
 2782  service provider if to deliver the involuntary substance abuse
 2783  treatment where possible and appropriate.
 2784         Section 31. Section 397.697, Florida Statutes, is amended
 2785  to read:
 2786         397.697 Court determination; effect of court order for
 2787  involuntary outpatient services substance abuse treatment.—
 2788         (1) When the court finds that the conditions for
 2789  involuntary outpatient services substance abuse treatment have
 2790  been proved by clear and convincing evidence, it may order the
 2791  respondent to receive undergo involuntary outpatient services
 2792  from treatment by a licensed service provider for a period not
 2793  to exceed 60 days. If the court finds it necessary, it may
 2794  direct the sheriff to take the respondent into custody and
 2795  deliver him or her to the licensed service provider specified in
 2796  the court order, or to the nearest appropriate licensed service
 2797  provider, for involuntary outpatient services treatment. When
 2798  the conditions justifying involuntary outpatient services
 2799  treatment no longer exist, the individual must be released as
 2800  provided in s. 397.6971. When the conditions justifying
 2801  involuntary outpatient services treatment are expected to exist
 2802  after 60 days of services treatment, a renewal of the
 2803  involuntary outpatient services treatment order may be requested
 2804  pursuant to s. 397.6975 before prior to the end of the 60-day
 2805  period.
 2806         (2) In all cases resulting in an order for involuntary
 2807  outpatient services substance abuse treatment, the court shall
 2808  retain jurisdiction over the case and the parties for the entry
 2809  of such further orders as the circumstances may require. The
 2810  court’s requirements for notification of proposed release must
 2811  be included in the original treatment order.
 2812         (3) An involuntary outpatient services treatment order
 2813  authorizes the licensed service provider to require the
 2814  individual to receive services that undergo such treatment as
 2815  will benefit him or her, including services treatment at any
 2816  licensable service component of a licensed service provider.
 2817         (4) The court may not order involuntary outpatient services
 2818  if the service provider certifies to the court that the
 2819  recommended services are not available. The service provider
 2820  must document notify the managing entity as to the availability
 2821  of the requested services. The managing entity must document
 2822  such efforts to obtain the requested services.
 2823         (5) If the court orders involuntary outpatient services, a
 2824  copy of the order must be sent to the managing entity within 1
 2825  working day after it is received from the court. Documents may
 2826  be submitted electronically though existing data systems, if
 2827  applicable. After the order for outpatient services is issued,
 2828  the service provider and the patient may modify provisions of
 2829  the treatment plan. For any material modification of the
 2830  treatment plan to which the patient or the patient’s guardian
 2831  advocate, if appointed, agrees, the service provider shall send
 2832  notice of the modification to the court. Any material
 2833  modification of the treatment plan which is contested by the
 2834  patient or the guardian advocate, if applicable, must be
 2835  approved or disapproved by the court.
 2836         Section 32. Section 397.6971, Florida Statutes, is amended
 2837  to read:
 2838         397.6971 Early release from involuntary outpatient services
 2839  substance abuse treatment.—
 2840         (1) At any time before prior to the end of the 60-day
 2841  involuntary outpatient services treatment period, or prior to
 2842  the end of any extension granted pursuant to s. 397.6975, an
 2843  individual receiving admitted for involuntary outpatient
 2844  services treatment may be determined eligible for discharge to
 2845  the most appropriate referral or disposition for the individual
 2846  when any of the following apply:
 2847         (a) The individual no longer meets the criteria for
 2848  involuntary admission and has given his or her informed consent
 2849  to be transferred to voluntary treatment status.;
 2850         (b) If the individual was admitted on the grounds of
 2851  likelihood of infliction of physical harm upon himself or
 2852  herself or others, such likelihood no longer exists.; or
 2853         (c) If the individual was admitted on the grounds of need
 2854  for assessment and stabilization or treatment, accompanied by
 2855  inability to make a determination respecting such need, either:
 2856         1. Such inability no longer exists; or
 2857         2. It is evident that further treatment will not bring
 2858  about further significant improvements in the individual’s
 2859  condition.;
 2860         (d) The individual is no longer in need of services.; or
 2861         (e) The director of the service provider determines that
 2862  the individual is beyond the safe management capabilities of the
 2863  provider.
 2864         (2) Whenever a qualified professional determines that an
 2865  individual admitted for involuntary outpatient services
 2866  qualifies treatment is ready for early release under for any of
 2867  the reasons listed in subsection (1), the service provider shall
 2868  immediately discharge the individual, and must notify all
 2869  persons specified by the court in the original treatment order.
 2870         Section 33. Section 397.6975, Florida Statutes, is amended
 2871  to read:
 2872         397.6975 Extension of involuntary outpatient services
 2873  substance abuse treatment period.—
 2874         (1) Whenever a service provider believes that an individual
 2875  who is nearing the scheduled date of his or her release from
 2876  involuntary outpatient services treatment continues to meet the
 2877  criteria for involuntary outpatient services treatment in s.
 2878  397.693, a petition for renewal of the involuntary outpatient
 2879  services treatment order may be filed with the court at least 10
 2880  days before the expiration of the court-ordered outpatient
 2881  services treatment period. The court shall immediately schedule
 2882  a hearing to be held not more than 15 days after filing of the
 2883  petition. The court shall provide the copy of the petition for
 2884  renewal and the notice of the hearing to all parties to the
 2885  proceeding. The hearing is conducted pursuant to s. 397.6957.
 2886         (2) If the court finds that the petition for renewal of the
 2887  involuntary outpatient services treatment order should be
 2888  granted, it may order the respondent to receive undergo
 2889  involuntary outpatient services treatment for a period not to
 2890  exceed an additional 90 days. When the conditions justifying
 2891  involuntary outpatient services treatment no longer exist, the
 2892  individual must be released as provided in s. 397.6971. When the
 2893  conditions justifying involuntary outpatient services treatment
 2894  continue to exist after an additional 90 days of service
 2895  additional treatment, a new petition requesting renewal of the
 2896  involuntary outpatient services treatment order may be filed
 2897  pursuant to this section.
 2898         (3) Within 1 court working day after the filing of a
 2899  petition for continued involuntary outpatient services, the
 2900  court shall appoint the regional conflict counsel to represent
 2901  the respondent, unless the respondent is otherwise represented
 2902  by counsel. The clerk of the court shall immediately notify the
 2903  regional conflict counsel of such appointment. The regional
 2904  conflict counsel shall represent the respondent until the
 2905  petition is dismissed or the court order expires or the
 2906  respondent is discharged from involuntary outpatient services.
 2907  Any attorney representing the respondent shall have access to
 2908  the respondent, witnesses, and records relevant to the
 2909  presentation of the respondent’s case and shall represent the
 2910  interests of the respondent, regardless of the source of payment
 2911  to the attorney.
 2912         (4) Hearings on petitions for continued involuntary
 2913  outpatient services shall be before the circuit court. The court
 2914  may appoint a general or special master to preside at the
 2915  hearing. The procedures for obtaining an order pursuant to this
 2916  section shall be in accordance with s. 397.697.
 2917         (5) Notice of hearing shall be provided to the respondent
 2918  or his or her counsel. The respondent and the respondent’s
 2919  counsel may agree to a period of continued outpatient services
 2920  without a court hearing.
 2921         (6) The same procedure shall be repeated before the
 2922  expiration of each additional period of outpatient services.
 2923         (7) If the respondent has previously been found incompetent
 2924  to consent to treatment, the court shall consider testimony and
 2925  evidence regarding the respondent’s competence.
 2926         Section 34. Section 397.6977, Florida Statutes, is amended
 2927  to read:
 2928         397.6977 Disposition of individual upon completion of
 2929  involuntary outpatient services substance abuse treatment.—At
 2930  the conclusion of the 60-day period of court-ordered involuntary
 2931  outpatient services treatment, the respondent individual is
 2932  automatically discharged unless a motion for renewal of the
 2933  involuntary outpatient services treatment order has been filed
 2934  with the court pursuant to s. 397.6975.
 2935         Section 35. Section 397.6978, Florida Statutes, is created
 2936  to read:
 2937         397.6978 Guardian advocate; patient incompetent to consent;
 2938  substance abuse disorder.
 2939         (1) The administrator of a receiving facility or addictions
 2940  receiving facility may petition the court for the appointment of
 2941  a guardian advocate based upon the opinion of a qualified
 2942  professional that the patient is incompetent to consent to
 2943  treatment. If the court finds that a patient is incompetent to
 2944  consent to treatment and has not been adjudicated incapacitated
 2945  and that a guardian with the authority to consent to mental
 2946  health treatment has not been appointed, it may appoint a
 2947  guardian advocate. The patient has the right to have an attorney
 2948  represent him or her at the hearing. If the person is indigent,
 2949  the court shall appoint the office of the regional conflict
 2950  counsel to represent him or her at the hearing. The patient has
 2951  the right to testify, cross-examine witnesses, and present
 2952  witnesses. The proceeding shall be recorded electronically or
 2953  stenographically, and testimony must be provided under oath. One
 2954  of the qualified professionals authorized to give an opinion in
 2955  support of a petition for involuntary placement, as described in
 2956  s. 397.675 or s. 397.6981, must testify. A guardian advocate
 2957  must meet the qualifications of a guardian contained in part IV
 2958  of chapter 744. The person who is appointed as a guardian
 2959  advocate must agree to the appointment.
 2960         (2) The following persons are prohibited from appointment
 2961  as a patient’s guardian advocate:
 2962         (a) A professional providing clinical services to the
 2963  individual under this part.
 2964         (b) The qualified professional who initiated the
 2965  involuntary examination of the individual, if the examination
 2966  was initiated by a qualified professional’s certificate.
 2967         (c) An employee, an administrator, or a board member of the
 2968  facility providing the examination of the individual.
 2969         (d) An employee, an administrator, or a board member of the
 2970  treatment facility providing treatment of the individual.
 2971         (e) A person providing any substantial professional
 2972  services to the individual, including clinical services.
 2973         (f) A creditor of the individual.
 2974         (g) A person subject to an injunction for protection
 2975  against domestic violence under s. 741.30, whether the order of
 2976  injunction is temporary or final, and for which the individual
 2977  was the petitioner.
 2978         (h) A person subject to an injunction for protection
 2979  against repeat violence, sexual violence, or dating violence
 2980  under s. 784.046, whether the order of injunction is temporary
 2981  or final, and for which the individual was the petitioner.
 2982         (3) A facility requesting appointment of a guardian
 2983  advocate must, before the appointment, provide the prospective
 2984  guardian advocate with information about the duties and
 2985  responsibilities of guardian advocates, including information
 2986  about the ethics of medical decisionmaking. Before asking a
 2987  guardian advocate to give consent to treatment for a patient,
 2988  the facility must provide to the guardian advocate sufficient
 2989  information so that the guardian advocate can decide whether to
 2990  give express and informed consent to the treatment. Such
 2991  information must include information that demonstrates that the
 2992  treatment is essential to the care of the patient and does not
 2993  present an unreasonable risk of serious, hazardous, or
 2994  irreversible side effects. If possible, before giving consent to
 2995  treatment, the guardian advocate must personally meet and talk
 2996  with the patient and the patient’s physician. If that is not
 2997  possible, the discussion may be conducted by telephone. The
 2998  decision of the guardian advocate may be reviewed by the court,
 2999  upon petition of the patient’s attorney, the patient’s family,
 3000  or the facility administrator.
 3001         (4) In lieu of the training required for guardians
 3002  appointed pursuant to chapter 744, a guardian advocate shall
 3003  attend at least a 4-hour training course approved by the court
 3004  before exercising his or her authority. At a minimum, the
 3005  training course must include information about patient rights,
 3006  the diagnosis of substance abuse disorders, the ethics of
 3007  medical decisionmaking, and the duties of guardian advocates.
 3008         (5) The required training course and the information to be
 3009  supplied to prospective guardian advocates before their
 3010  appointment must be developed by the department, approved by the
 3011  chief judge of the circuit court, and taught by a court-approved
 3012  organization, which may include, but need not be limited to, a
 3013  community college, a guardianship organization, a local bar
 3014  association, or The Florida Bar. The training course may be web
 3015  based, provided in video format, or other electronic means but
 3016  must be capable of ensuring the identity and participation of
 3017  the prospective guardian advocate. The court may waive some or
 3018  all of the training requirements for guardian advocates or
 3019  impose additional requirements. The court shall make its
 3020  decision on a case-by-case basis and, in making its decision,
 3021  shall consider the experience and education of the guardian
 3022  advocate, the duties assigned to the guardian advocate, and the
 3023  needs of the patient.
 3024         (6) In selecting a guardian advocate, the court shall give
 3025  preference to the patient’s health care surrogate, if one has
 3026  already been designated by the patient. If the patient has not
 3027  previously designated a health care surrogate, the selection
 3028  shall be made, except for good cause documented in the court
 3029  record, from among the following persons, listed in order of
 3030  priority:
 3031         (a) The patient’s spouse.
 3032         (b) An adult child of the patient.
 3033         (c) A parent of the patient.
 3034         (d) The adult next of kin of the patient.
 3035         (e) An adult friend of the patient.
 3036         (f) An adult trained and willing to serve as the guardian
 3037  advocate for the patient.
 3038         (7) If a guardian with the authority to consent to medical
 3039  treatment has not already been appointed, or if the patient has
 3040  not already designated a health care surrogate, the court may
 3041  authorize the guardian advocate to consent to medical treatment
 3042  as well as substance abuse disorder treatment. Unless otherwise
 3043  limited by the court, a guardian advocate with authority to
 3044  consent to medical treatment has the same authority to make
 3045  health care decisions and is subject to the same restrictions as
 3046  a proxy appointed under part IV of chapter 765. Unless the
 3047  guardian advocate has sought and received express court approval
 3048  in a proceeding separate from the proceeding to determine the
 3049  competence of the patient to consent to medical treatment, the
 3050  guardian advocate may not consent to:
 3051         (a) Abortion.
 3052         (b) Sterilization.
 3053         (c) Electroshock therapy.
 3054         (d) Psychosurgery.
 3055         (e) Experimental treatments that have not been approved by
 3056  a federally approved institutional review board in accordance
 3057  with 45 C.F.R. part 46 or 21 C.F.R. part 56.
 3058  
 3059  The court must base its authorization on evidence that the
 3060  treatment or procedure is essential to the care of the patient
 3061  and that the treatment does not present an unreasonable risk of
 3062  serious, hazardous, or irreversible side effects. In complying
 3063  with this subsection, the court shall follow the procedures set
 3064  forth in subsection (1).
 3065         (8) The guardian advocate shall be discharged when the
 3066  patient is discharged from an order for involuntary outpatient
 3067  services or involuntary inpatient placement or when the patient
 3068  is transferred from involuntary to voluntary status. The court
 3069  or a hearing officer shall consider the competence of the
 3070  patient as provided in subsection (1) and may consider an
 3071  involuntarily placed patient’s competence to consent to
 3072  treatment at any hearing. Upon sufficient evidence, the court
 3073  may restore, or the hearing officer may recommend that the court
 3074  restore, the patient’s competence. A copy of the order restoring
 3075  competence or the certificate of discharge containing the
 3076  restoration of competence shall be provided to the patient and
 3077  the guardian advocate.
 3078         Section 36. Paragraph (a) of subsection (3) of section
 3079  39.407, Florida Statutes, is amended to read:
 3080         39.407 Medical, psychiatric, and psychological examination
 3081  and treatment of child; physical, mental, or substance abuse
 3082  examination of person with or requesting child custody.—
 3083         (3)(a)1. Except as otherwise provided in subparagraph (b)1.
 3084  or paragraph (e), before the department provides psychotropic
 3085  medications to a child in its custody, the prescribing physician
 3086  shall attempt to obtain express and informed consent, as defined
 3087  in s. 394.455(16) s. 394.455(9) and as described in s.
 3088  394.459(3)(a), from the child’s parent or legal guardian. The
 3089  department must take steps necessary to facilitate the inclusion
 3090  of the parent in the child’s consultation with the physician.
 3091  However, if the parental rights of the parent have been
 3092  terminated, the parent’s location or identity is unknown or
 3093  cannot reasonably be ascertained, or the parent declines to give
 3094  express and informed consent, the department may, after
 3095  consultation with the prescribing physician, seek court
 3096  authorization to provide the psychotropic medications to the
 3097  child. Unless parental rights have been terminated and if it is
 3098  possible to do so, the department shall continue to involve the
 3099  parent in the decisionmaking process regarding the provision of
 3100  psychotropic medications. If, at any time, a parent whose
 3101  parental rights have not been terminated provides express and
 3102  informed consent to the provision of a psychotropic medication,
 3103  the requirements of this section that the department seek court
 3104  authorization do not apply to that medication until such time as
 3105  the parent no longer consents.
 3106         2. Any time the department seeks a medical evaluation to
 3107  determine the need to initiate or continue a psychotropic
 3108  medication for a child, the department must provide to the
 3109  evaluating physician all pertinent medical information known to
 3110  the department concerning that child.
 3111         Section 37. Paragraph (e) of subsection (5) of section
 3112  212.055, Florida Statutes, is amended to read:
 3113         212.055 Discretionary sales surtaxes; legislative intent;
 3114  authorization and use of proceeds.—It is the legislative intent
 3115  that any authorization for imposition of a discretionary sales
 3116  surtax shall be published in the Florida Statutes as a
 3117  subsection of this section, irrespective of the duration of the
 3118  levy. Each enactment shall specify the types of counties
 3119  authorized to levy; the rate or rates which may be imposed; the
 3120  maximum length of time the surtax may be imposed, if any; the
 3121  procedure which must be followed to secure voter approval, if
 3122  required; the purpose for which the proceeds may be expended;
 3123  and such other requirements as the Legislature may provide.
 3124  Taxable transactions and administrative procedures shall be as
 3125  provided in s. 212.054.
 3126         (5) COUNTY PUBLIC HOSPITAL SURTAX.—Any county as defined in
 3127  s. 125.011(1) may levy the surtax authorized in this subsection
 3128  pursuant to an ordinance either approved by extraordinary vote
 3129  of the county commission or conditioned to take effect only upon
 3130  approval by a majority vote of the electors of the county voting
 3131  in a referendum. In a county as defined in s. 125.011(1), for
 3132  the purposes of this subsection, “county public general
 3133  hospital” means a general hospital as defined in s. 395.002
 3134  which is owned, operated, maintained, or governed by the county
 3135  or its agency, authority, or public health trust.
 3136         (e) A governing board, agency, or authority shall be
 3137  chartered by the county commission upon this act becoming law.
 3138  The governing board, agency, or authority shall adopt and
 3139  implement a health care plan for indigent health care services.
 3140  The governing board, agency, or authority shall consist of no
 3141  more than seven and no fewer than five members appointed by the
 3142  county commission. The members of the governing board, agency,
 3143  or authority shall be at least 18 years of age and residents of
 3144  the county. No member may be employed by or affiliated with a
 3145  health care provider or the public health trust, agency, or
 3146  authority responsible for the county public general hospital.
 3147  The following community organizations shall each appoint a
 3148  representative to a nominating committee: the South Florida
 3149  Hospital and Healthcare Association, the Miami-Dade County
 3150  Public Health Trust, the Dade County Medical Association, the
 3151  Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade
 3152  County. This committee shall nominate between 10 and 14 county
 3153  citizens for the governing board, agency, or authority. The
 3154  slate shall be presented to the county commission and the county
 3155  commission shall confirm the top five to seven nominees,
 3156  depending on the size of the governing board. Until such time as
 3157  the governing board, agency, or authority is created, the funds
 3158  provided for in subparagraph (d)2. shall be placed in a
 3159  restricted account set aside from other county funds and not
 3160  disbursed by the county for any other purpose.
 3161         1. The plan shall divide the county into a minimum of four
 3162  and maximum of six service areas, with no more than one
 3163  participant hospital per service area. The county public general
 3164  hospital shall be designated as the provider for one of the
 3165  service areas. Services shall be provided through participants’
 3166  primary acute care facilities.
 3167         2. The plan and subsequent amendments to it shall fund a
 3168  defined range of health care services for both indigent persons
 3169  and the medically poor, including primary care, preventive care,
 3170  hospital emergency room care, and hospital care necessary to
 3171  stabilize the patient. For the purposes of this section,
 3172  “stabilization” means stabilization as defined in s. 397.311(42)
 3173  s. 397.311(41). Where consistent with these objectives, the plan
 3174  may include services rendered by physicians, clinics, community
 3175  hospitals, and alternative delivery sites, as well as at least
 3176  one regional referral hospital per service area. The plan shall
 3177  provide that agreements negotiated between the governing board,
 3178  agency, or authority and providers shall recognize hospitals
 3179  that render a disproportionate share of indigent care, provide
 3180  other incentives to promote the delivery of charity care to draw
 3181  down federal funds where appropriate, and require cost
 3182  containment, including, but not limited to, case management.
 3183  From the funds specified in subparagraphs (d)1. and 2. for
 3184  indigent health care services, service providers shall receive
 3185  reimbursement at a Medicaid rate to be determined by the
 3186  governing board, agency, or authority created pursuant to this
 3187  paragraph for the initial emergency room visit, and a per-member
 3188  per-month fee or capitation for those members enrolled in their
 3189  service area, as compensation for the services rendered
 3190  following the initial emergency visit. Except for provisions of
 3191  emergency services, upon determination of eligibility,
 3192  enrollment shall be deemed to have occurred at the time services
 3193  were rendered. The provisions for specific reimbursement of
 3194  emergency services shall be repealed on July 1, 2001, unless
 3195  otherwise reenacted by the Legislature. The capitation amount or
 3196  rate shall be determined before prior to program implementation
 3197  by an independent actuarial consultant. In no event shall such
 3198  reimbursement rates exceed the Medicaid rate. The plan must also
 3199  provide that any hospitals owned and operated by government
 3200  entities on or after the effective date of this act must, as a
 3201  condition of receiving funds under this subsection, afford
 3202  public access equal to that provided under s. 286.011 as to any
 3203  meeting of the governing board, agency, or authority the subject
 3204  of which is budgeting resources for the retention of charity
 3205  care, as that term is defined in the rules of the Agency for
 3206  Health Care Administration. The plan shall also include
 3207  innovative health care programs that provide cost-effective
 3208  alternatives to traditional methods of service and delivery
 3209  funding.
 3210         3. The plan’s benefits shall be made available to all
 3211  county residents currently eligible to receive health care
 3212  services as indigents or medically poor as defined in paragraph
 3213  (4)(d).
 3214         4. Eligible residents who participate in the health care
 3215  plan shall receive coverage for a period of 12 months or the
 3216  period extending from the time of enrollment to the end of the
 3217  current fiscal year, per enrollment period, whichever is less.
 3218         5. At the end of each fiscal year, the governing board,
 3219  agency, or authority shall prepare an audit that reviews the
 3220  budget of the plan, delivery of services, and quality of
 3221  services, and makes recommendations to increase the plan’s
 3222  efficiency. The audit shall take into account participant
 3223  hospital satisfaction with the plan and assess the amount of
 3224  poststabilization patient transfers requested, and accepted or
 3225  denied, by the county public general hospital.
 3226         Section 38. Paragraph (c) of subsection (2) of section
 3227  394.4599, Florida Statutes, is amended to read:
 3228         394.4599 Notice.—
 3229         (2) INVOLUNTARY ADMISSION.—
 3230         (c)1. A receiving facility shall give notice of the
 3231  whereabouts of a minor who is being involuntarily held for
 3232  examination pursuant to s. 394.463 to the minor’s parent,
 3233  guardian, caregiver, or guardian advocate, in person or by
 3234  telephone or other form of electronic communication, immediately
 3235  after the minor’s arrival at the facility. The facility may
 3236  delay notification for no more than 24 hours after the minor’s
 3237  arrival if the facility has submitted a report to the central
 3238  abuse hotline, pursuant to s. 39.201, based upon knowledge or
 3239  suspicion of abuse, abandonment, or neglect and if the facility
 3240  deems a delay in notification to be in the minor’s best
 3241  interest.
 3242         2. The receiving facility shall attempt to notify the
 3243  minor’s parent, guardian, caregiver, or guardian advocate until
 3244  the receiving facility receives confirmation from the parent,
 3245  guardian, caregiver, or guardian advocate, verbally, by
 3246  telephone or other form of electronic communication, or by
 3247  recorded message, that notification has been received. Attempts
 3248  to notify the parent, guardian, caregiver, or guardian advocate
 3249  must be repeated at least once every hour during the first 12
 3250  hours after the minor’s arrival and once every 24 hours
 3251  thereafter and must continue until such confirmation is
 3252  received, unless the minor is released at the end of the 72-hour
 3253  examination period, or until a petition for involuntary services
 3254  placement is filed with the court pursuant to s. 394.463(2)(g)
 3255  s. 394.463(2)(i). The receiving facility may seek assistance
 3256  from a law enforcement agency to notify the minor’s parent,
 3257  guardian, caregiver, or guardian advocate if the facility has
 3258  not received within the first 24 hours after the minor’s arrival
 3259  a confirmation by the parent, guardian, caregiver, or guardian
 3260  advocate that notification has been received. The receiving
 3261  facility must document notification attempts in the minor’s
 3262  clinical record.
 3263         Section 39. Subsection (3) of section 394.495, Florida
 3264  Statutes, is amended to read:
 3265         394.495 Child and adolescent mental health system of care;
 3266  programs and services.—
 3267         (3) Assessments must be performed by:
 3268         (a) A professional as defined in s. 394.455(6), (8), (34),
 3269  (37), or (38) s. 394.455(2), (4), (21), (23), or (24);
 3270         (b) A professional licensed under chapter 491; or
 3271         (c) A person who is under the direct supervision of a
 3272  professional as defined in s. 394.455(6), (8), (34), (37), or
 3273  (38) s. 394.455(2), (4), (21), (23), or (24) or a professional
 3274  licensed under chapter 491.
 3275         Section 40. Subsection (5) of section 394.496, Florida
 3276  Statutes, is amended to read:
 3277         394.496 Service planning.—
 3278         (5) A professional as defined in s. 394.455(6), (8), (34),
 3279  (37), or (38) s. 394.455(2), (4), (21), (23), or (24) or a
 3280  professional licensed under chapter 491 must be included among
 3281  those persons developing the services plan.
 3282         Section 41. Subsection (6) of section 394.9085, Florida
 3283  Statutes, is amended to read:
 3284         394.9085 Behavioral provider liability.—
 3285         (6) For purposes of this section, the terms “detoxification
 3286  services,” “addictions receiving facility,” and “receiving
 3287  facility” have the same meanings as those provided in ss.
 3288  397.311(23)(a)4., 397.311(23)(a)1., and 394.455(41) ss.
 3289  397.311(22)(a)4., 397.311(22)(a)1., and 394.455(26),
 3290  respectively.
 3291         Section 42. Subsection (8) of section 397.405, Florida
 3292  Statutes, is amended to read:
 3293         397.405 Exemptions from licensure.—The following are exempt
 3294  from the licensing provisions of this chapter:
 3295         (8) A legally cognizable church or nonprofit religious
 3296  organization or denomination providing substance abuse services,
 3297  including prevention services, which are solely religious,
 3298  spiritual, or ecclesiastical in nature. A church or nonprofit
 3299  religious organization or denomination providing any of the
 3300  licensed service components itemized under s. 397.311(23) s.
 3301  397.311(22) is not exempt from substance abuse licensure but
 3302  retains its exemption with respect to all services which are
 3303  solely religious, spiritual, or ecclesiastical in nature.
 3304  
 3305  The exemptions from licensure in this section do not apply to
 3306  any service provider that receives an appropriation, grant, or
 3307  contract from the state to operate as a service provider as
 3308  defined in this chapter or to any substance abuse program
 3309  regulated pursuant to s. 397.406. Furthermore, this chapter may
 3310  not be construed to limit the practice of a physician or
 3311  physician assistant licensed under chapter 458 or chapter 459, a
 3312  psychologist licensed under chapter 490, a psychotherapist
 3313  licensed under chapter 491, or an advanced registered nurse
 3314  practitioner licensed under part I of chapter 464, who provides
 3315  substance abuse treatment, so long as the physician, physician
 3316  assistant, psychologist, psychotherapist, or advanced registered
 3317  nurse practitioner does not represent to the public that he or
 3318  she is a licensed service provider and does not provide services
 3319  to individuals pursuant to part V of this chapter. Failure to
 3320  comply with any requirement necessary to maintain an exempt
 3321  status under this section is a misdemeanor of the first degree,
 3322  punishable as provided in s. 775.082 or s. 775.083.
 3323         Section 43. Subsections (1) and (5) of section 397.407,
 3324  Florida Statutes, are amended to read:
 3325         397.407 Licensure process; fees.—
 3326         (1) The department shall establish the licensure process to
 3327  include fees and categories of licenses and must prescribe a fee
 3328  range that is based, at least in part, on the number and
 3329  complexity of programs listed in s. 397.311(23) s. 397.311(22)
 3330  which are operated by a licensee. The fees from the licensure of
 3331  service components are sufficient to cover at least 50 percent
 3332  of the costs of regulating the service components. The
 3333  department shall specify a fee range for public and privately
 3334  funded licensed service providers. Fees for privately funded
 3335  licensed service providers must exceed the fees for publicly
 3336  funded licensed service providers.
 3337         (5) The department may issue probationary, regular, and
 3338  interim licenses. The department shall issue one license for
 3339  each service component that is operated by a service provider
 3340  and defined pursuant to s. 397.311(23) s. 397.311(22). The
 3341  license is valid only for the specific service components listed
 3342  for each specific location identified on the license. The
 3343  licensed service provider shall apply for a new license at least
 3344  60 days before the addition of any service components or 30 days
 3345  before the relocation of any of its service sites. Provision of
 3346  service components or delivery of services at a location not
 3347  identified on the license may be considered an unlicensed
 3348  operation that authorizes the department to seek an injunction
 3349  against operation as provided in s. 397.401, in addition to
 3350  other sanctions authorized by s. 397.415. Probationary and
 3351  regular licenses may be issued only after all required
 3352  information has been submitted. A license may not be
 3353  transferred. As used in this subsection, the term “transfer”
 3354  includes, but is not limited to, the transfer of a majority of
 3355  the ownership interest in the licensed entity or transfer of
 3356  responsibilities under the license to another entity by
 3357  contractual arrangement.
 3358         Section 44. Section 397.416, Florida Statutes, is amended
 3359  to read:
 3360         397.416 Substance abuse treatment services; qualified
 3361  professional.—Notwithstanding any other provision of law, a
 3362  person who was certified through a certification process
 3363  recognized by the former Department of Health and Rehabilitative
 3364  Services before January 1, 1995, may perform the duties of a
 3365  qualified professional with respect to substance abuse treatment
 3366  services as defined in this chapter, and need not meet the
 3367  certification requirements contained in s. 397.311(31) s.
 3368  397.311(30).
 3369         Section 45. Paragraph (b) of subsection (1) of section
 3370  409.972, Florida Statutes, is amended to read:
 3371         409.972 Mandatory and voluntary enrollment.—
 3372         (1) The following Medicaid-eligible persons are exempt from
 3373  mandatory managed care enrollment required by s. 409.965, and
 3374  may voluntarily choose to participate in the managed medical
 3375  assistance program:
 3376         (b) Medicaid recipients residing in residential commitment
 3377  facilities operated through the Department of Juvenile Justice
 3378  or a mental health treatment facility facilities as defined in
 3379  s. 394.455(50) by s. 394.455(32).
 3380         Section 46. Paragraphs (d) and (g) of subsection (1) of
 3381  section 440.102, Florida Statutes, are amended to read:
 3382         440.102 Drug-free workplace program requirements.—The
 3383  following provisions apply to a drug-free workplace program
 3384  implemented pursuant to law or to rules adopted by the Agency
 3385  for Health Care Administration:
 3386         (1) DEFINITIONS.—Except where the context otherwise
 3387  requires, as used in this act:
 3388         (d) “Drug rehabilitation program” means a service provider,
 3389  established pursuant to s. 397.311(40) s. 397.311(39), that
 3390  provides confidential, timely, and expert identification,
 3391  assessment, and resolution of employee drug abuse.
 3392         (g) “Employee assistance program” means an established
 3393  program capable of providing expert assessment of employee
 3394  personal concerns; confidential and timely identification
 3395  services with regard to employee drug abuse; referrals of
 3396  employees for appropriate diagnosis, treatment, and assistance;
 3397  and followup services for employees who participate in the
 3398  program or require monitoring after returning to work. If, in
 3399  addition to the above activities, an employee assistance program
 3400  provides diagnostic and treatment services, these services shall
 3401  in all cases be provided by service providers pursuant to s.
 3402  397.311(40) s. 397.311(39).
 3403         Section 47. Subsection (7) of section 744.704, Florida
 3404  Statutes, is amended to read:
 3405         744.704 Powers and duties.—
 3406         (7) A public guardian may shall not commit a ward to a
 3407  mental health treatment facility, as defined in s. 394.455(50)
 3408  s. 394.455(32), without an involuntary placement proceeding as
 3409  provided by law.
 3410         Section 48. Paragraph (a) of subsection (2) of section
 3411  790.065, Florida Statutes, is amended to read:
 3412         790.065 Sale and delivery of firearms.—
 3413         (2) Upon receipt of a request for a criminal history record
 3414  check, the Department of Law Enforcement shall, during the
 3415  licensee’s call or by return call, forthwith:
 3416         (a) Review any records available to determine if the
 3417  potential buyer or transferee:
 3418         1. Has been convicted of a felony and is prohibited from
 3419  receipt or possession of a firearm pursuant to s. 790.23;
 3420         2. Has been convicted of a misdemeanor crime of domestic
 3421  violence, and therefore is prohibited from purchasing a firearm;
 3422         3. Has had adjudication of guilt withheld or imposition of
 3423  sentence suspended on any felony or misdemeanor crime of
 3424  domestic violence unless 3 years have elapsed since probation or
 3425  any other conditions set by the court have been fulfilled or
 3426  expunction has occurred; or
 3427         4. Has been adjudicated mentally defective or has been
 3428  committed to a mental institution by a court or as provided in
 3429  sub-sub-subparagraph b.(II), and as a result is prohibited by
 3430  state or federal law from purchasing a firearm.
 3431         a. As used in this subparagraph, “adjudicated mentally
 3432  defective” means a determination by a court that a person, as a
 3433  result of marked subnormal intelligence, or mental illness,
 3434  incompetency, condition, or disease, is a danger to himself or
 3435  herself or to others or lacks the mental capacity to contract or
 3436  manage his or her own affairs. The phrase includes a judicial
 3437  finding of incapacity under s. 744.331(6)(a), an acquittal by
 3438  reason of insanity of a person charged with a criminal offense,
 3439  and a judicial finding that a criminal defendant is not
 3440  competent to stand trial.
 3441         b. As used in this subparagraph, “committed to a mental
 3442  institution” means:
 3443         (I) Involuntary commitment, commitment for mental
 3444  defectiveness or mental illness, and commitment for substance
 3445  abuse. The phrase includes involuntary inpatient placement as
 3446  defined in s. 394.467, involuntary outpatient services placement
 3447  as defined in s. 394.4655, involuntary assessment and
 3448  stabilization under s. 397.6818, and involuntary substance abuse
 3449  treatment under s. 397.6957, but does not include a person in a
 3450  mental institution for observation or discharged from a mental
 3451  institution based upon the initial review by the physician or a
 3452  voluntary admission to a mental institution; or
 3453         (II) Notwithstanding sub-sub-subparagraph (I), voluntary
 3454  admission to a mental institution for outpatient or inpatient
 3455  treatment of a person who had an involuntary examination under
 3456  s. 394.463, where each of the following conditions have been
 3457  met:
 3458         (A) An examining physician found that the person is an
 3459  imminent danger to himself or herself or others.
 3460         (B) The examining physician certified that if the person
 3461  did not agree to voluntary treatment, a petition for involuntary
 3462  outpatient or inpatient services treatment would have been filed
 3463  under s. 394.463(2)(g) s. 394.463(2)(i)4., or the examining
 3464  physician certified that a petition was filed and the person
 3465  subsequently agreed to voluntary treatment before prior to a
 3466  court hearing on the petition.
 3467         (C) Before agreeing to voluntary treatment, the person
 3468  received written notice of that finding and certification, and
 3469  written notice that as a result of such finding, he or she may
 3470  be prohibited from purchasing a firearm, and may not be eligible
 3471  to apply for or retain a concealed weapon or firearms license
 3472  under s. 790.06 and the person acknowledged such notice in
 3473  writing, in substantially the following form:
 3474  
 3475         “I understand that the doctor who examined me believes
 3476         I am a danger to myself or to others. I understand
 3477         that if I do not agree to voluntary treatment, a
 3478         petition will be filed in court to require me to
 3479         receive involuntary treatment. I understand that if
 3480         that petition is filed, I have the right to contest
 3481         it. In the event a petition has been filed, I
 3482         understand that I can subsequently agree to voluntary
 3483         treatment prior to a court hearing. I understand that
 3484         by agreeing to voluntary treatment in either of these
 3485         situations, I may be prohibited from buying firearms
 3486         and from applying for or retaining a concealed weapons
 3487         or firearms license until I apply for and receive
 3488         relief from that restriction under Florida law.”
 3489  
 3490         (D) A judge or a magistrate has, pursuant to sub-sub
 3491  subparagraph c.(II), reviewed the record of the finding,
 3492  certification, notice, and written acknowledgment classifying
 3493  the person as an imminent danger to himself or herself or
 3494  others, and ordered that such record be submitted to the
 3495  department.
 3496         c. In order to check for these conditions, the department
 3497  shall compile and maintain an automated database of persons who
 3498  are prohibited from purchasing a firearm based on court records
 3499  of adjudications of mental defectiveness or commitments to
 3500  mental institutions.
 3501         (I) Except as provided in sub-sub-subparagraph (II), clerks
 3502  of court shall submit these records to the department within 1
 3503  month after the rendition of the adjudication or commitment.
 3504  Reports shall be submitted in an automated format. The reports
 3505  must, at a minimum, include the name, along with any known alias
 3506  or former name, the sex, and the date of birth of the subject.
 3507         (II) For persons committed to a mental institution pursuant
 3508  to sub-sub-subparagraph b.(II), within 24 hours after the
 3509  person’s agreement to voluntary admission, a record of the
 3510  finding, certification, notice, and written acknowledgment must
 3511  be filed by the administrator of the receiving or treatment
 3512  facility, as defined in s. 394.455, with the clerk of the court
 3513  for the county in which the involuntary examination under s.
 3514  394.463 occurred. No fee shall be charged for the filing under
 3515  this sub-sub-subparagraph. The clerk must present the records to
 3516  a judge or magistrate within 24 hours after receipt of the
 3517  records. A judge or magistrate is required and has the lawful
 3518  authority to review the records ex parte and, if the judge or
 3519  magistrate determines that the record supports the classifying
 3520  of the person as an imminent danger to himself or herself or
 3521  others, to order that the record be submitted to the department.
 3522  If a judge or magistrate orders the submittal of the record to
 3523  the department, the record must be submitted to the department
 3524  within 24 hours.
 3525         d. A person who has been adjudicated mentally defective or
 3526  committed to a mental institution, as those terms are defined in
 3527  this paragraph, may petition the circuit court that made the
 3528  adjudication or commitment, or the court that ordered that the
 3529  record be submitted to the department pursuant to sub-sub
 3530  subparagraph c.(II), for relief from the firearm disabilities
 3531  imposed by such adjudication or commitment. A copy of the
 3532  petition shall be served on the state attorney for the county in
 3533  which the person was adjudicated or committed. The state
 3534  attorney may object to and present evidence relevant to the
 3535  relief sought by the petition. The hearing on the petition may
 3536  be open or closed as the petitioner may choose. The petitioner
 3537  may present evidence and subpoena witnesses to appear at the
 3538  hearing on the petition. The petitioner may confront and cross
 3539  examine witnesses called by the state attorney. A record of the
 3540  hearing shall be made by a certified court reporter or by court
 3541  approved electronic means. The court shall make written findings
 3542  of fact and conclusions of law on the issues before it and issue
 3543  a final order. The court shall grant the relief requested in the
 3544  petition if the court finds, based on the evidence presented
 3545  with respect to the petitioner’s reputation, the petitioner’s
 3546  mental health record and, if applicable, criminal history
 3547  record, the circumstances surrounding the firearm disability,
 3548  and any other evidence in the record, that the petitioner will
 3549  not be likely to act in a manner that is dangerous to public
 3550  safety and that granting the relief would not be contrary to the
 3551  public interest. If the final order denies relief, the
 3552  petitioner may not petition again for relief from firearm
 3553  disabilities until 1 year after the date of the final order. The
 3554  petitioner may seek judicial review of a final order denying
 3555  relief in the district court of appeal having jurisdiction over
 3556  the court that issued the order. The review shall be conducted
 3557  de novo. Relief from a firearm disability granted under this
 3558  sub-subparagraph has no effect on the loss of civil rights,
 3559  including firearm rights, for any reason other than the
 3560  particular adjudication of mental defectiveness or commitment to
 3561  a mental institution from which relief is granted.
 3562         e. Upon receipt of proper notice of relief from firearm
 3563  disabilities granted under sub-subparagraph d., the department
 3564  shall delete any mental health record of the person granted
 3565  relief from the automated database of persons who are prohibited
 3566  from purchasing a firearm based on court records of
 3567  adjudications of mental defectiveness or commitments to mental
 3568  institutions.
 3569         f. The department is authorized to disclose data collected
 3570  pursuant to this subparagraph to agencies of the Federal
 3571  Government and other states for use exclusively in determining
 3572  the lawfulness of a firearm sale or transfer. The department is
 3573  also authorized to disclose this data to the Department of
 3574  Agriculture and Consumer Services for purposes of determining
 3575  eligibility for issuance of a concealed weapons or concealed
 3576  firearms license and for determining whether a basis exists for
 3577  revoking or suspending a previously issued license pursuant to
 3578  s. 790.06(10). When a potential buyer or transferee appeals a
 3579  nonapproval based on these records, the clerks of court and
 3580  mental institutions shall, upon request by the department,
 3581  provide information to help determine whether the potential
 3582  buyer or transferee is the same person as the subject of the
 3583  record. Photographs and any other data that could confirm or
 3584  negate identity must be made available to the department for
 3585  such purposes, notwithstanding any other provision of state law
 3586  to the contrary. Any such information that is made confidential
 3587  or exempt from disclosure by law shall retain such confidential
 3588  or exempt status when transferred to the department.
 3589         Section 49. This act shall take effect July 1, 2016.