ENROLLED
       2016 Legislature                     CS for SB 12, 3rd Engrossed
       
       
       
       
       
       
                                                               201612er
    1  
    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. 39.01, F.S.;
    7         defining a term; amending s. 39.407, F.S.; requiring
    8         assessment findings to be provided to the plan that is
    9         financially responsible for a child’s care in
   10         residential treatment under certain circumstances;
   11         amending s. 394.453, F.S.; revising legislative
   12         intent; amending s. 394.4573, F.S.; requiring the
   13         Department of Children and Families to submit a
   14         certain assessment to the Governor and Legislature by
   15         a specified date; defining and revising terms;
   16         providing essential elements of a coordinated system
   17         of care; providing requirements for the department’s
   18         annual assessment; authorizing the department to award
   19         certain grants; deleting duties and measures of the
   20         department regarding continuity of care management
   21         systems; amending s. 394.461, F.S.; creating a
   22         designated receiving system that functions as a no
   23         wrong-door model, based on certain receiving system
   24         models; authorizing, rather than requiring, the
   25         department to adopt rules to implement the designated
   26         receiving system; repealing s. 394.675, F.S., relating
   27         to the substance abuse and mental health service
   28         system; amending ss. 394.75 and 394.76, F.S.;
   29         conforming provisions and cross-references to changes
   30         made by the act; amending s. 394.4597, F.S.; revising
   31         the prioritization of health care surrogates to be
   32         selected for involuntary patients; specifying certain
   33         persons who are prohibited from being selected as an
   34         individual’s representative; amending s. 394.4598,
   35         F.S.; specifying certain persons who are prohibited
   36         from being appointed as a person’s guardian advocate;
   37         amending s. 394.462, F.S.; requiring that counties
   38         develop and implement transportation plans; providing
   39         requirements for the plans; revising requirements for
   40         transportation to receiving facilities and treatment
   41         facilities; revising exceptions to such requirements;
   42         amending s. 394.467, F.S.; revising criteria for
   43         involuntary inpatient placement; revising criteria for
   44         a procedure for continued involuntary inpatient
   45         services; specifying requirements for a certain waiver
   46         of the patient’s attendance at a hearing; requiring
   47         the court to consider certain testimony and evidence
   48         regarding a patient’s incompetence; amending s.
   49         394.46715, F.S.; revising rulemaking authority of the
   50         department; amending s. 394.4685, F.S.; requiring a
   51         public receiving facility initiating a patient
   52         transfer to a licensed hospital for certain mental
   53         health services to provide notice and transfer patient
   54         records to the hospital; amending s. 394.656, F.S.;
   55         revising the membership of the Criminal Justice,
   56         Mental Health, and Substance Abuse Statewide Grant
   57         Review Committee; providing duties for the committee;
   58         authorizing a not-for-profit community provider or
   59         managing entity to apply for certain grants; revising
   60         eligibility for such grants; defining a term; creating
   61         s. 394.761, F.S.; requiring the agency and the
   62         department to develop a plan for revenue maximization;
   63         providing requirements for the plan; providing duties
   64         for the agency and department relating to the plan;
   65         requiring the plan to be submitted to the Legislature
   66         by a certain date; amending s. 394.879, F.S.;
   67         providing that certain facilities may be in a multi
   68         story building and authorized on certain floors;
   69         requiring the department to develop a plan to create
   70         an option for a single, consolidated license for
   71         certain providers by a specified date; amending s.
   72         394.9082, F.S.; providing a purpose for behavioral
   73         health managing entities; revising definitions;
   74         providing duties of the department; requiring the
   75         department to revise its contracts with managing
   76         entities; providing duties for managing entities;
   77         providing requirements for network accreditation and
   78         systems coordination agreements; providing for
   79         performance measurement and accountability and
   80         enhancements plans; providing a funding mechanism for
   81         managing entities; renaming the Crisis Stabilization
   82         Services Utilization Database as the Acute Care
   83         Services Utilization Database; requiring certain
   84         providers to provide utilization data; deleting
   85         provisions relating to legislative findings and
   86         intent, service delivery strategies, essential
   87         elements, reporting requirements, and rulemaking
   88         authority; amending s. 397.305, F.S.; providing
   89         legislative intent; amending s. 397.311, F.S.;
   90         defining and redefining terms; conforming a cross
   91         reference; amending s. 397.321, F.S.; deleting a
   92         requirement for the department to appoint a substance
   93         abuse impairment coordinator; requiring the department
   94         to develop certain forms, display such forms on its
   95         website, and notify certain entities of the existence
   96         and availability of such forms; amending s. 397.675,
   97         F.S.; revising the criteria for involuntary admissions
   98         due to substance abuse or co-occurring mental health
   99         disorders; amending s. 397.6772, F.S.; requiring law
  100         enforcement officers to use standard forms developed
  101         by the department to execute a certain written report;
  102         amending s. 397.6773, F.S.; revising a cross
  103         reference; amending s. 397.679, F.S.; authorizing
  104         specified licensed professionals to complete a
  105         certificate for the involuntary admission of an
  106         individual; amending s. 397.6791, F.S.; providing a
  107         list of professionals authorized to initiate a
  108         certificate for an emergency assessment or admission
  109         of a person who has a substance abuse disorder;
  110         amending s. 397.6793, F.S.; revising the criteria for
  111         initiation of a certificate for an emergency admission
  112         for a person who is substance abuse impaired; amending
  113         s. 397.6795, F.S.; revising the list of persons
  114         authorized to deliver a person for an emergency
  115         assessment; amending s. 397.681, F.S.; prohibiting the
  116         court from charging a fee for involuntary petitions;
  117         amending s. 397.6811, F.S.; revising the list of
  118         persons authorized to file a petition for an
  119         involuntary assessment and stabilization; amending s.
  120         397.6814, F.S.; prohibiting a fee from being charged
  121         for the filing of a petition for involuntary
  122         assessment and stabilization; amending s. 397.6818,
  123         F.S.; limiting the validity of an order for
  124         involuntary admission to 7 days after it is signed
  125         unless otherwise specified in the order; amending s.
  126         397.6819, F.S.; revising the responsibilities of
  127         service providers who admit an individual for an
  128         involuntary assessment and stabilization; amending s.
  129         397.695, F.S.; authorizing certain persons to file a
  130         petition for involuntary outpatient services of an
  131         individual; providing procedures and requirements for
  132         such petitions; amending s. 397.6951, F.S.; requiring
  133         that certain additional information be included in a
  134         petition for involuntary outpatient services; amending
  135         s. 397.6955, F.S.; requiring a court to fulfill
  136         certain additional duties upon the filing of a
  137         petition for involuntary outpatient services; amending
  138         s. 397.6957, F.S.; providing additional requirements
  139         for a hearing on a petition for involuntary outpatient
  140         services; amending s. 397.697, F.S.; authorizing a
  141         court to make a determination of involuntary
  142         outpatient services; extending the timeframe a
  143         respondent receives certain publicly funded licensed
  144         services; authorizing a court to order a respondent to
  145         undergo treatment through a publicly or privately
  146         funded licensed service provider under certain
  147         circumstances; requiring a copy of the court’s order
  148         to be sent to the managing entity; amending s.
  149         397.6971, F.S.; establishing the requirements for an
  150         early release from involuntary outpatient services;
  151         amending s. 397.6975, F.S.; requiring the court to
  152         appoint certain counsel; providing requirements for
  153         hearings on petitions for continued involuntary
  154         outpatient services; requiring notice of such
  155         hearings; amending s. 397.6977, F.S.; conforming
  156         provisions to changes made by the act; creating s.
  157         397.6978, F.S.; providing for the appointment of
  158         guardian advocates if an individual is found
  159         incompetent to consent to treatment; prohibiting
  160         specified persons from being appointed as an
  161         individual’s guardian advocate; providing requirements
  162         for a facility requesting the appointment of a
  163         guardian advocate; requiring a training course for
  164         guardian advocates; providing requirements for the
  165         training course; providing requirements for the
  166         prioritization of individuals to be selected as
  167         guardian advocates; authorizing certain guardian
  168         advocates to consent to medical treatment; providing
  169         exceptions; providing procedures for the discharge of
  170         a guardian advocate; amending s. 409.967, F.S.;
  171         requiring managed care plans to provide for quality
  172         care; amending s. 409.973, F.S.; providing an
  173         integrated behavioral health initiative; reenacting s.
  174         409.975(6), F.S., relating to provider payment;
  175         providing legislative intent; amending s. 491.0045,
  176         F.S.; revising registration requirements for interns;
  177         repealing s. 394.4674, F.S., relating to the
  178         comprehensive plan and report on the
  179         deinstitutionalization of patients in a treatment
  180         facility; repealing s. 394.4985, F.S., relating to the
  181         implementation of a districtwide information and
  182         referral network; repealing s. 394.745, F.S., relating
  183         to the annual report on the compliance of providers
  184         under contract with the department; repealing s.
  185         397.331, F.S., relating to definitions and legislative
  186         intent; repealing part IX of chapter 397, F.S.,
  187         consisting of ss. 397.801, 397.811, and 397.821, F.S.,
  188         relating to substance abuse impairment coordination,
  189         juvenile substance abuse impairment coordination, and
  190         juvenile substance abuse impairment prevention and
  191         early intervention councils, respectively; repealing
  192         s. 397.901, F.S., relating to prototype juvenile
  193         addictions receiving facilities; repealing s. 397.93,
  194         F.S., relating to target populations for children’s
  195         substance abuse services; repealing s. 397.94, F.S.,
  196         relating to the information and referral network for
  197         children’s substance abuse services; repealing s.
  198         397.951, F.S., relating to substance abuse treatment
  199         and sanctions; repealing s. 397.97, F.S., relating to
  200         demonstration models for children’s substance abuse
  201         services; repealing s. 397.98, F.S., relating to
  202         utilization management for children’s substance abuse
  203         services; amending ss. 39.407, 39.524, 212.055,
  204         394.4599, 394.495, 394.496, 394.9085, 397.321,
  205         397.405, 397.407, 397.416, 397.4871, 409.1678,
  206         409.966, 409.972, 440.102, 744.704, and 960.065, F.S.;
  207         conforming cross-references; requiring the Secretary
  208         of Children and Families to appoint a workgroup on the
  209         use of advance directives for substance use disorders;
  210         requiring a report to the Governor and Legislature by
  211         a specified date; providing for expiration of the
  212         workgroup; amending s. 61.13, F.S.; providing that a
  213         parenting plan that provides for shared parental
  214         responsibility over health care decisions must
  215         authorize either parent to consent to mental health
  216         treatment for the child; amending s. 39.001, F.S.;
  217         conforming provisions to changes made by the act;
  218         amending ss. 39.507 and 39.521, F.S.; providing for
  219         consideration of mental health issues and involvement
  220         in mental health programs in adjudicatory hearings and
  221         orders; providing requirements for certain court
  222         orders; revising the qualifications for administrators
  223         of mental health and substance abuse assessments or
  224         evaluations; amending s. 394.4655, F.S.; defining the
  225         terms “court” and “criminal county court”; providing
  226         for involuntary outpatient services; authorizing
  227         certain licensed physicians and psychiatric nurses to
  228         provide a second opinion regarding a recommendation
  229         for involuntary outpatient services under certain
  230         circumstances; requiring a service provider to
  231         document certain inquiries; requiring the managing
  232         entity to document certain efforts; making technical
  233         changes; amending s. 394.4599, F.S.; conforming
  234         provisions to changes made by the act; amending s.
  235         394.455, F.S.; defining and redefining terms; amending
  236         s. 394.463, F.S.; authorizing circuit or county courts
  237         to enter ex parte orders for involuntary examinations;
  238         requiring a facility to provide copies of ex parte
  239         orders, reports, and certificates to the department,
  240         rather than the Agency for Health Care Administration;
  241         requiring the department to receive certain orders,
  242         certificates, and reports; requiring the department to
  243         receive and maintain copies of certain documents;
  244         prohibiting a person from being held for involuntary
  245         examination for more than a specified period of time;
  246         providing exceptions; requiring certain individuals to
  247         be released to law enforcement custody; providing
  248         exceptions; conforming cross-references; amending s.
  249         394.4615, F.S.; conforming a cross-reference;
  250         providing an appropriation; providing an effective
  251         date.
  252          
  253  Be It Enacted by the Legislature of the State of Florida:
  254  
  255         Section 1. Paragraph (e) is added to subsection (10) of
  256  section 29.004, Florida Statutes, to read:
  257         29.004 State courts system.—For purposes of implementing s.
  258  14, Art. V of the State Constitution, the elements of the state
  259  courts system to be provided from state revenues appropriated by
  260  general law are as follows:
  261         (10) Case management. Case management includes:
  262         (e)Service referral, coordination, monitoring, and
  263  tracking for treatment-based mental health court programs under
  264  chapter 394.
  265  
  266  Case management may not include costs associated with the
  267  application of therapeutic jurisprudence principles by the
  268  courts. Case management also may not include case intake and
  269  records management conducted by the clerk of court.
  270         Section 2. Subsections (65) through (79) of section 39.01,
  271  Florida Statutes, are renumbered as subsections (66) through
  272  (80), respectively, and a new subsection (65) is added to that
  273  section to read:
  274         39.01 Definitions.—When used in this chapter, unless the
  275  context otherwise requires:
  276         (65)“Qualified professional” means a physician or a
  277  physician assistant licensed under chapter 458 or chapter 459; a
  278  psychiatrist licensed under chapter 458 or chapter 459; a
  279  psychologist as defined in s. 490.003(7) or a professional
  280  licensed under chapter 491; or a psychiatric nurse as defined in
  281  s. 394.455.
  282         Section 3. Paragraph (c) of subsection (6) of section
  283  39.407, Florida Statutes, is amended to read:
  284         39.407 Medical, psychiatric, and psychological examination
  285  and treatment of child; physical, mental, or substance abuse
  286  examination of person with or requesting child custody.—
  287         (6) Children who are in the legal custody of the department
  288  may be placed by the department, without prior approval of the
  289  court, in a residential treatment center licensed under s.
  290  394.875 or a hospital licensed under chapter 395 for residential
  291  mental health treatment only pursuant to this section or may be
  292  placed by the court in accordance with an order of involuntary
  293  examination or involuntary placement entered pursuant to s.
  294  394.463 or s. 394.467. All children placed in a residential
  295  treatment program under this subsection must have a guardian ad
  296  litem appointed.
  297         (c) Before a child is admitted under this subsection, the
  298  child shall be assessed for suitability for residential
  299  treatment by a qualified evaluator who has conducted a personal
  300  examination and assessment of the child and has made written
  301  findings that:
  302         1. The child appears to have an emotional disturbance
  303  serious enough to require residential treatment and is
  304  reasonably likely to benefit from the treatment.
  305         2. The child has been provided with a clinically
  306  appropriate explanation of the nature and purpose of the
  307  treatment.
  308         3. All available modalities of treatment less restrictive
  309  than residential treatment have been considered, and a less
  310  restrictive alternative that would offer comparable benefits to
  311  the child is unavailable.
  312  
  313  A copy of the written findings of the evaluation and suitability
  314  assessment must be provided to the department, and to the
  315  guardian ad litem, and, if the child is a member of a Medicaid
  316  managed care plan, to the plan that is financially responsible
  317  for the child’s care in residential treatment, all of whom must
  318  be provided with who shall have the opportunity to discuss the
  319  findings with the evaluator.
  320         Section 4. Section 394.453, Florida Statutes, is amended to
  321  read:
  322         394.453 Legislative intent.—
  323         (1) It is the intent of the Legislature:
  324         (a) To authorize and direct the Department of Children and
  325  Families to evaluate, research, plan, and recommend to the
  326  Governor and the Legislature programs designed to reduce the
  327  occurrence, severity, duration, and disabling aspects of mental,
  328  emotional, and behavioral disorders.
  329         (b)It is the intent of the Legislature That treatment
  330  programs for such disorders shall include, but not be limited
  331  to, comprehensive health, social, educational, and
  332  rehabilitative services to persons requiring intensive short
  333  term and continued treatment in order to encourage them to
  334  assume responsibility for their treatment and recovery. It is
  335  intended that:
  336         1. Such persons be provided with emergency service and
  337  temporary detention for evaluation when required;
  338         2.Such persons that they be admitted to treatment
  339  facilities on a voluntary basis when extended or continuing care
  340  is needed and unavailable in the community;
  341         3.that Involuntary placement be provided only when expert
  342  evaluation determines that it is necessary;
  343         4.that Any involuntary treatment or examination be
  344  accomplished in a setting that which is clinically appropriate
  345  and most likely to facilitate the person’s return to the
  346  community as soon as possible; and
  347         5.that Individual dignity and human rights be guaranteed
  348  to all persons who are admitted to mental health facilities or
  349  who are being held under s. 394.463.
  350         (c)That services provided to persons in this state use the
  351  coordination-of-care principles characteristic of recovery
  352  oriented services and include social support services, such as
  353  housing support, life skills and vocational training, and
  354  employment assistance, necessary for persons with mental health
  355  disorders and co-occurring mental health and substance use
  356  disorders to live successfully in their communities.
  357         (d)That licensed, qualified health professionals be
  358  authorized to practice to the fullest extent of their education
  359  and training in the performance of professional functions
  360  necessary to carry out the intent of this part.
  361         (2)It is the further intent of the Legislature that the
  362  least restrictive means of intervention be employed based on the
  363  individual needs of each person, within the scope of available
  364  services. It is the policy of this state that the use of
  365  restraint and seclusion on clients is justified only as an
  366  emergency safety measure to be used in response to imminent
  367  danger to the client or others. It is, therefore, the intent of
  368  the Legislature to achieve an ongoing reduction in the use of
  369  restraint and seclusion in programs and facilities serving
  370  persons with mental illness.
  371         Section 5. Section 394.4573, Florida Statutes, is amended
  372  to read:
  373         394.4573 Coordinated system of care; annual assessment;
  374  essential elements Continuity of care management system;
  375  measures of performance; system improvement grants; reports.—On
  376  or before December 1 of each year, the department shall submit
  377  to the Governor, the President of the Senate, and the Speaker of
  378  the House of Representatives an assessment of the behavioral
  379  health services in this state. The assessment shall consider, at
  380  a minimum, the extent to which designated receiving systems
  381  function as no-wrong-door models, the availability of treatment
  382  and recovery services that use recovery-oriented and peer
  383  involved approaches, the availability of less-restrictive
  384  services, and the use of evidence-informed practices. The
  385  department’s assessment shall consider, at a minimum, the needs
  386  assessments conducted by the managing entities pursuant to s.
  387  394.9082(5). Beginning in 2017, the department shall compile and
  388  include in the report all plans submitted by managing entities
  389  pursuant to s. 394.9082(8) and the department’s evaluation of
  390  each plan.
  391         (1) As used in For the purposes of this section:
  392         (a)“Care coordination” means the implementation of
  393  deliberate and planned organizational relationships and service
  394  procedures that improve the effectiveness and efficiency of the
  395  behavioral health system by engaging in purposeful interactions
  396  with individuals who are not yet effectively connected with
  397  services to ensure service linkage. Examples of care
  398  coordination activities include development of referral
  399  agreements, shared protocols, and information exchange
  400  procedures. The purpose of care coordination is to enhance the
  401  delivery of treatment services and recovery supports and to
  402  improve outcomes among priority populations.
  403         (b)(a) “Case management” means those direct services
  404  provided to a client in order to assess his or her activities
  405  aimed at assessing client needs, plan, or arrange planning
  406  services, coordinate service providers, link linking the service
  407  system to a client, monitor coordinating the various system
  408  components, monitoring service delivery, and evaluate patient
  409  outcomes to ensure the client is receiving the appropriate
  410  services evaluating the effect of service delivery.
  411         (b)“Case manager” means an individual who works with
  412  clients, and their families and significant others, to provide
  413  case management.
  414         (c)“Client manager” means an employee of the department
  415  who is assigned to specific provider agencies and geographic
  416  areas to ensure that the full range of needed services is
  417  available to clients.
  418         (c)(d) “Coordinated system Continuity of care management
  419  system” means a system that assures, within available resources,
  420  that clients have access to the full array of behavioral and
  421  related services in a region or community offered by all service
  422  providers, whether participating under contract with the
  423  managing entity or by another method of community partnership or
  424  mutual agreement within the mental health services delivery
  425  system.
  426         (d)“No-wrong-door model” means a model for the delivery of
  427  acute care services to persons who have mental health or
  428  substance use disorders, or both, which optimizes access to
  429  care, regardless of the entry point to the behavioral health
  430  care system.
  431         (2) The essential elements of a coordinated system of care
  432  include:
  433         (a)Community interventions, such as prevention, primary
  434  care for behavioral health needs, therapeutic and supportive
  435  services, crisis response services, and diversion programs.
  436         (b)A designated receiving system that consists of one or
  437  more facilities serving a defined geographic area and
  438  responsible for assessment and evaluation, both voluntary and
  439  involuntary, and treatment or triage of patients who have a
  440  mental health or substance use disorder, or co-occurring
  441  disorders.
  442         1.A county or several counties shall plan the designated
  443  receiving system using a process that includes the managing
  444  entity and is open to participation by individuals with
  445  behavioral health needs and their families, service providers,
  446  law enforcement agencies, and other parties. The county or
  447  counties, in collaboration with the managing entity, shall
  448  document the designated receiving system through written
  449  memoranda of agreement or other binding arrangements. The county
  450  or counties and the managing entity shall complete the plan and
  451  implement the designated receiving system by July 1, 2017, and
  452  the county or counties and the managing entity shall review and
  453  update, as necessary, the designated receiving system at least
  454  once every 3 years.
  455         2.To the extent permitted by available resources, the
  456  designated receiving system shall function as a no-wrong-door
  457  model. The designated receiving system may be organized in any
  458  manner which functions as a no-wrong-door model that responds to
  459  individual needs and integrates services among various
  460  providers. Such models include, but are not limited to:
  461         a.A central receiving system that consists of a designated
  462  central receiving facility that serves as a single entry point
  463  for persons with mental health or substance use disorders, or
  464  co-occurring disorders. The central receiving facility shall be
  465  capable of assessment, evaluation, and triage or treatment or
  466  stabilization of persons with mental health or substance use
  467  disorders, or co-occurring disorders.
  468         b.A coordinated receiving system that consists of multiple
  469  entry points that are linked by shared data systems, formal
  470  referral agreements, and cooperative arrangements for care
  471  coordination and case management. Each entry point shall be a
  472  designated receiving facility and shall, within existing
  473  resources, provide or arrange for necessary services following
  474  an initial assessment and evaluation.
  475         c.A tiered receiving system that consists of multiple
  476  entry points, some of which offer only specialized or limited
  477  services. Each service provider shall be classified according to
  478  its capabilities as either a designated receiving facility or
  479  another type of service provider, such as a triage center, a
  480  licensed detoxification facility, or an access center. All
  481  participating service providers shall, within existing
  482  resources, be linked by methods to share data, formal referral
  483  agreements, and cooperative arrangements for care coordination
  484  and case management.
  485  
  486  An accurate inventory of the participating service providers
  487  which specifies the capabilities and limitations of each
  488  provider and its ability to accept patients under the designated
  489  receiving system agreements and the transportation plan
  490  developed pursuant to this section shall be maintained and made
  491  available at all times to all first responders in the service
  492  area.
  493         (c)Transportation in accordance with a plan developed
  494  under s. 394.462.
  495         (d)Crisis services, including mobile response teams,
  496  crisis stabilization units, addiction receiving facilities, and
  497  detoxification facilities.
  498         (e) Case management. Each case manager or person directly
  499  supervising a case manager who provides Medicaid-funded targeted
  500  case management services shall hold a valid certification from a
  501  department-approved credentialing entity as defined in s.
  502  397.311(9) by July 1, 2017, and, thereafter, within 6 months
  503  after hire.
  504         (f)Care coordination that involves coordination with other
  505  local systems and entities, public and private, which are
  506  involved with the individual, such as primary care, child
  507  welfare, behavioral health care, and criminal and juvenile
  508  justice organizations.
  509         (g)Outpatient services.
  510         (h)Residential services.
  511         (i)Hospital inpatient care.
  512         (j)Aftercare and other post-discharge services.
  513         (k)Medication-assisted treatment and medication
  514  management.
  515         (l)Recovery support, including, but not limited to,
  516  support for competitive employment, educational attainment,
  517  independent living skills development, family support and
  518  education, wellness management and self-care, and assistance in
  519  obtaining housing that meets the individual’s needs. Such
  520  housing may include mental health residential treatment
  521  facilities, limited mental health assisted living facilities,
  522  adult family care homes, and supportive housing. Housing
  523  provided using state funds must provide a safe and decent
  524  environment free from abuse and neglect.
  525         (m) Care plans shall assign specific responsibility for
  526  initial and ongoing evaluation of the supervision and support
  527  needs of the individual and the identification of housing that
  528  meets such needs. For purposes of this paragraph, the term
  529  “supervision” means oversight of and assistance with compliance
  530  with the clinical aspects of an individual’s care plan.
  531         (3) SYSTEM IMPROVEMENT GRANTS.—Subject to a specific
  532  appropriation by the Legislature, the department may award
  533  system improvement grants to managing entities based on a
  534  detailed plan to enhance services in accordance with the no
  535  wrong-door model as defined in subsection (1) and to address
  536  specific needs identified in the assessment prepared by the
  537  department pursuant to this section. Such a grant must be
  538  awarded through a performance-based contract that links payments
  539  to the documented and measurable achievement of system
  540  improvements. The department is directed to implement a
  541  continuity of care management system for the provision of mental
  542  health care, through the provision of client and case
  543  management, including clients referred from state treatment
  544  facilities to community mental health facilities. Such system
  545  shall include a network of client managers and case managers
  546  throughout the state designed to:
  547         (a)Reduce the possibility of a client’s admission or
  548  readmission to a state treatment facility.
  549         (b)Provide for the creation or designation of an agency in
  550  each county to provide single intake services for each person
  551  seeking mental health services. Such agency shall provide
  552  information and referral services necessary to ensure that
  553  clients receive the most appropriate and least restrictive form
  554  of care, based on the individual needs of the person seeking
  555  treatment. Such agency shall have a single telephone number,
  556  operating 24 hours per day, 7 days per week, where practicable,
  557  at a central location, where each client will have a central
  558  record.
  559         (c)Advocate on behalf of the client to ensure that all
  560  appropriate services are afforded to the client in a timely and
  561  dignified manner.
  562         (d)Require that any public receiving facility initiating a
  563  patient transfer to a licensed hospital for acute care mental
  564  health services not accessible through the public receiving
  565  facility shall notify the hospital of such transfer and send all
  566  records relating to the emergency psychiatric or medical
  567  condition.
  568         (3)The department is directed to develop and include in
  569  contracts with service providers measures of performance with
  570  regard to goals and objectives as specified in the state plan.
  571  Such measures shall use, to the extent practical, existing data
  572  collection methods and reports and shall not require, as a
  573  result of this subsection, additional reports on the part of
  574  service providers. The department shall plan monitoring visits
  575  of community mental health facilities with other state, federal,
  576  and local governmental and private agencies charged with
  577  monitoring such facilities.
  578         Section 6. Section 394.461, Florida Statutes, is amended to
  579  read:
  580         394.461 Designation of receiving and treatment facilities
  581  and receiving systems.—The department is authorized to designate
  582  and monitor receiving facilities, and treatment facilities, and
  583  receiving systems and may suspend or withdraw such designation
  584  for failure to comply with this part and rules adopted under
  585  this part. Unless designated by the department, facilities are
  586  not permitted to hold or treat involuntary patients under this
  587  part.
  588         (1) RECEIVING FACILITY.—The department may designate any
  589  community facility as a receiving facility. Any other facility
  590  within the state, including a private facility or a federal
  591  facility, may be so designated by the department, provided that
  592  such designation is agreed to by the governing body or authority
  593  of the facility.
  594         (2) TREATMENT FACILITY.—The department may designate any
  595  state-owned, state-operated, or state-supported facility as a
  596  state treatment facility. A civil patient shall not be admitted
  597  to a state treatment facility without previously undergoing a
  598  transfer evaluation. Before a court hearing for involuntary
  599  placement in a state treatment facility, the court shall receive
  600  and consider the information documented in the transfer
  601  evaluation. Any other facility, including a private facility or
  602  a federal facility, may be designated as a treatment facility by
  603  the department, provided that such designation is agreed to by
  604  the appropriate governing body or authority of the facility.
  605         (3) PRIVATE FACILITIES.—Private facilities designated as
  606  receiving and treatment facilities by the department may provide
  607  examination and treatment of involuntary patients, as well as
  608  voluntary patients, and are subject to all the provisions of
  609  this part.
  610         (4) REPORTING REQUIREMENTS.—
  611         (a) A facility designated as a public receiving or
  612  treatment facility under this section shall report to the
  613  department on an annual basis the following data, unless these
  614  data are currently being submitted to the Agency for Health Care
  615  Administration:
  616         1. Number of licensed beds.
  617         2. Number of contract days.
  618         3. Number of admissions by payor class and diagnoses.
  619         4. Number of bed days by payor class.
  620         5. Average length of stay by payor class.
  621         6. Total revenues by payor class.
  622         (b) For the purposes of this subsection, “payor class”
  623  means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private
  624  pay health insurance, private-pay health maintenance
  625  organization, private preferred provider organization, the
  626  Department of Children and Families, other government programs,
  627  self-pay patients, and charity care.
  628         (c) The data required under this subsection shall be
  629  submitted to the department no later than 90 days following the
  630  end of the facility’s fiscal year. A facility designated as a
  631  public receiving or treatment facility shall submit its initial
  632  report for the 6-month period ending June 30, 2008.
  633         (d) The department shall issue an annual report based on
  634  the data required pursuant to this subsection. The report shall
  635  include individual facilities’ data, as well as statewide
  636  totals. The report shall be submitted to the Governor, the
  637  President of the Senate, and the Speaker of the House of
  638  Representatives.
  639         (5)RECEIVING SYSTEM.—The department shall designate as a
  640  receiving system one or more facilities serving a defined
  641  geographic area developed pursuant to s. 394.4573 which is
  642  responsible for assessment and evaluation, both voluntary and
  643  involuntary, and treatment, stabilization, or triage for
  644  patients who have a mental illness, a substance use disorder, or
  645  co-occurring disorders. Any transportation plans developed
  646  pursuant to s. 394.462 must support the operation of the
  647  receiving system.
  648         (6)(5) RULES.—The department may shall adopt rules relating
  649  to:
  650         (a) Procedures and criteria for receiving and evaluating
  651  facility applications for designation, which may include onsite
  652  facility inspection and evaluation of an applicant’s licensing
  653  status and performance history, as well as consideration of
  654  local service needs.
  655         (b) Minimum standards consistent with this part that a
  656  facility must meet and maintain in order to be designated as a
  657  receiving or treatment facility and procedures for monitoring
  658  continued adherence to such standards.
  659         (c)Procedures and criteria for designating receiving
  660  systems which may include consideration of the adequacy of
  661  services provided by facilities within the receiving system to
  662  meet the needs of the geographic area using available resources.
  663         (d)(c) Procedures for receiving complaints against a
  664  designated facility or designated receiving system and for
  665  initiating inspections and investigations of facilities or
  666  receiving systems alleged to have violated the provisions of
  667  this part or rules adopted under this part.
  668         (e)(d) Procedures and criteria for the suspension or
  669  withdrawal of designation as a receiving facility or receiving
  670  system.
  671         Section 7. Section 394.675, Florida Statutes, is repealed.
  672         Section 8. Subsection (3) and paragraph (b) of subsection
  673  (4) of section 394.75, Florida Statutes, are amended to read:
  674         394.75 State and district substance abuse and mental health
  675  plans.—
  676         (3) The district health and human services board shall
  677  prepare an integrated district substance abuse and mental health
  678  plan. The plan shall be prepared and updated on a schedule
  679  established by the Alcohol, Drug Abuse, and Mental Health
  680  Program Office. The plan shall reflect the needs and program
  681  priorities established by the department and the needs of the
  682  district established under ss. 394.4573 and 394.674 and 394.675.
  683  The plan must list in order of priority the mental health and
  684  the substance abuse treatment needs of the district and must
  685  rank each program separately. The plan shall include:
  686         (a) A record of the total amount of money available in the
  687  district for mental health and substance abuse services.
  688         (b) A description of each service that will be purchased
  689  with state funds.
  690         (c) A record of the amount of money allocated for each
  691  service identified in the plan as being purchased with state
  692  funds.
  693         (d) A record of the total funds allocated to each provider.
  694         (e) A record of the total funds allocated to each provider
  695  by type of service to be purchased with state funds.
  696         (f) Input from community-based persons, organizations, and
  697  agencies interested in substance abuse and mental health
  698  treatment services; local government entities that contribute
  699  funds to the public substance abuse and mental health treatment
  700  systems; and consumers of publicly funded substance abuse and
  701  mental health services, and their family members. The plan must
  702  describe the means by which this local input occurred.
  703  
  704  The plan shall be submitted by the district board to the
  705  district administrator and to the governing bodies for review,
  706  comment, and approval.
  707         (4) The district plan shall:
  708         (b) Provide the means for meeting the needs of the
  709  district’s eligible clients, specified in ss. 394.4573 and
  710  394.674 and 394.675, for substance abuse and mental health
  711  services.
  712         Section 9. Paragraph (a) of subsection (3) of section
  713  394.76, Florida Statutes, is amended to read:
  714         394.76 Financing of district programs and services.—If the
  715  local match funding level is not provided in the General
  716  Appropriations Act or the substantive bill implementing the
  717  General Appropriations Act, such funding level shall be provided
  718  as follows:
  719         (3) The state share of financial participation shall be
  720  determined by the following formula:
  721         (a) The state share of approved program costs shall be a
  722  percentage of the net balance determined by deducting from the
  723  total operating cost of services and programs, as specified in
  724  s. 394.4573 394.675(1), those expenditures which are ineligible
  725  for state participation as provided in subsection (7) and those
  726  ineligible expenditures established by rule of the department
  727  pursuant to s. 394.78.
  728         Section 10. Paragraphs (d) and (e) of subsection (2) of
  729  section 394.4597, Florida Statutes, are amended to read:
  730         394.4597 Persons to be notified; patient’s representative.—
  731         (2) INVOLUNTARY PATIENTS.—
  732         (d) When the receiving or treatment facility selects a
  733  representative, first preference shall be given to a health care
  734  surrogate, if one has been previously selected by the patient.
  735  If the patient has not previously selected a health care
  736  surrogate, the selection, except for good cause documented in
  737  the patient’s clinical record, shall be made from the following
  738  list in the order of listing:
  739         1. The patient’s spouse.
  740         2. An adult child of the patient.
  741         3. A parent of the patient.
  742         4. The adult next of kin of the patient.
  743         5. An adult friend of the patient.
  744         6.The appropriate Florida local advocacy council as
  745  provided in s. 402.166.
  746         (e) The following persons are prohibited from selection as
  747  a patient’s representative:
  748         1.A professional providing clinical services to the
  749  patient under this part.
  750         2.The licensed professional who initiated the involuntary
  751  examination of the patient, if the examination was initiated by
  752  professional certificate.
  753         3.An employee, an administrator, or a board member of the
  754  facility providing the examination of the patient.
  755         4.An employee, an administrator, or a board member of a
  756  treatment facility providing treatment for the patient.
  757         5.A person providing any substantial professional services
  758  to the patient, including clinical services.
  759         6.A creditor of the patient.
  760         7.A person subject to an injunction for protection against
  761  domestic violence under s. 741.30, whether the order of
  762  injunction is temporary or final, and for which the patient was
  763  the petitioner.
  764         8.A person subject to an injunction for protection against
  765  repeat violence, stalking, sexual violence, or dating violence
  766  under s. 784.046, whether the order of injunction is temporary
  767  or final, and for which the patient was the petitioner A
  768  licensed professional providing services to the patient under
  769  this part, an employee of a facility providing direct services
  770  to the patient under this part, a department employee, a person
  771  providing other substantial services to the patient in a
  772  professional or business capacity, or a creditor of the patient
  773  shall not be appointed as the patient’s representative.
  774         Section 11. Subsections (2) through (7) of section
  775  394.4598, Florida Statutes, are renumbered as subsections (3)
  776  through (8), respectively, a new subsection (2) is added to that
  777  section, and present subsections (3) and (4) of that section are
  778  amended, to read:
  779         394.4598 Guardian advocate.—
  780         (2)The following persons are prohibited from appointment
  781  as a patient’s guardian advocate:
  782         (a)A professional providing clinical services to the
  783  patient under this part.
  784         (b)The licensed professional who initiated the involuntary
  785  examination of the patient, if the examination was initiated by
  786  professional certificate.
  787         (c)An employee, an administrator, or a board member of the
  788  facility providing the examination of the patient.
  789         (d)An employee, an administrator, or a board member of a
  790  treatment facility providing treatment of the patient.
  791         (e)A person providing any substantial professional
  792  services, excluding public and professional guardians, to the
  793  patient, including clinical services.
  794         (f)A creditor of the patient.
  795         (g)A person subject to an injunction for protection
  796  against domestic violence under s. 741.30, whether the order of
  797  injunction is temporary or final, and for which the patient was
  798  the petitioner.
  799         (h)A person subject to an injunction for protection
  800  against repeat violence, stalking, sexual violence, or dating
  801  violence under s. 784.046, whether the order of injunction is
  802  temporary or final, and for which the patient was the
  803  petitioner.
  804         (4)(3)In lieu of the training required of guardians
  805  appointed pursuant to chapter 744, Prior to a guardian advocate
  806  must, at a minimum, participate in a 4-hour training course
  807  approved by the court before exercising his or her authority,
  808  the guardian advocate shall attend a training course approved by
  809  the court. At a minimum, this training course, of not less than
  810  4 hours, must include, at minimum, information about the patient
  811  rights, psychotropic medications, the diagnosis of mental
  812  illness, the ethics of medical decisionmaking, and duties of
  813  guardian advocates. This training course shall take the place of
  814  the training required for guardians appointed pursuant to
  815  chapter 744.
  816         (5)(4) The required training course and the information to
  817  be supplied to prospective guardian advocates before prior to
  818  their appointment and the training course for guardian advocates
  819  must be developed and completed through a course developed by
  820  the department, and approved by the chief judge of the circuit
  821  court, and taught by a court-approved organization, which.
  822  Court-approved organizations may include, but is are not limited
  823  to, a community college community or junior colleges, a
  824  guardianship organization guardianship organizations, a and the
  825  local bar association, or The Florida Bar. The training course
  826  may be web-based, provided in video format, or other electronic
  827  means but must be capable of ensuring the identity and
  828  participation of the prospective guardian advocate. The court
  829  may, in its discretion, waive some or all of the training
  830  requirements for guardian advocates or impose additional
  831  requirements. The court shall make its decision on a case-by
  832  case basis and, in making its decision, shall consider the
  833  experience and education of the guardian advocate, the duties
  834  assigned to the guardian advocate, and the needs of the patient.
  835         Section 12. Section 394.462, Florida Statutes, is amended
  836  to read:
  837         394.462 Transportation.—A transportation plan shall be
  838  developed and implemented by each county by July 1, 2017, in
  839  collaboration with the managing entity in accordance with this
  840  section. A county may enter into a memorandum of understanding
  841  with the governing boards of nearby counties to establish a
  842  shared transportation plan. When multiple counties enter into a
  843  memorandum of understanding for this purpose, the counties shall
  844  notify the managing entity and provide it with a copy of the
  845  agreement. The transportation plan shall describe methods of
  846  transport to a facility within the designated receiving system
  847  for individuals subject to involuntary examination under s.
  848  394.463 or involuntary admission under s. 397.6772, s. 397.679,
  849  s. 397.6798, or s. 397.6811, and may identify responsibility for
  850  other transportation to a participating facility when necessary
  851  and agreed to by the facility. The plan may rely on emergency
  852  medical transport services or private transport companies, as
  853  appropriate. The plan shall comply with the transportation
  854  provisions of this section and ss. 397.6772, 397.6795, 397.6822,
  855  and 397.697.
  856         (1) TRANSPORTATION TO A RECEIVING FACILITY.—
  857         (a) Each county shall designate a single law enforcement
  858  agency within the county, or portions thereof, to take a person
  859  into custody upon the entry of an ex parte order or the
  860  execution of a certificate for involuntary examination by an
  861  authorized professional and to transport that person to the
  862  appropriate facility within the designated receiving system
  863  pursuant to a transportation plan or an exception under
  864  subsection (4), or to the nearest receiving facility if neither
  865  apply for examination.
  866         (b)1. The designated law enforcement agency may decline to
  867  transport the person to a receiving facility only if:
  868         a.1. The jurisdiction designated by the county has
  869  contracted on an annual basis with an emergency medical
  870  transport service or private transport company for
  871  transportation of persons to receiving facilities pursuant to
  872  this section at the sole cost of the county; and
  873         b.2. The law enforcement agency and the emergency medical
  874  transport service or private transport company agree that the
  875  continued presence of law enforcement personnel is not necessary
  876  for the safety of the person or others.
  877         2.3. The entity providing transportation jurisdiction
  878  designated by the county may seek reimbursement for
  879  transportation expenses. The party responsible for payment for
  880  such transportation is the person receiving the transportation.
  881  The county shall seek reimbursement from the following sources
  882  in the following order:
  883         a. From a private or public third-party payor an insurance
  884  company, health care corporation, or other source, if the person
  885  receiving the transportation has applicable coverage is covered
  886  by an insurance policy or subscribes to a health care
  887  corporation or other source for payment of such expenses.
  888         b. From the person receiving the transportation.
  889         c. From a financial settlement for medical care, treatment,
  890  hospitalization, or transportation payable or accruing to the
  891  injured party.
  892         (c)(b)A Any company that transports a patient pursuant to
  893  this subsection is considered an independent contractor and is
  894  solely liable for the safe and dignified transport
  895  transportation of the patient. Such company must be insured and
  896  provide no less than $100,000 in liability insurance with
  897  respect to the transport transportation of patients.
  898         (d)(c) Any company that contracts with a governing board of
  899  a county to transport patients shall comply with the applicable
  900  rules of the department to ensure the safety and dignity of the
  901  patients.
  902         (e)(d) When a law enforcement officer takes custody of a
  903  person pursuant to this part, the officer may request assistance
  904  from emergency medical personnel if such assistance is needed
  905  for the safety of the officer or the person in custody.
  906         (f)(e) When a member of a mental health overlay program or
  907  a mobile crisis response service is a professional authorized to
  908  initiate an involuntary examination pursuant to s. 394.463 or s.
  909  397.675 and that professional evaluates a person and determines
  910  that transportation to a receiving facility is needed, the
  911  service, at its discretion, may transport the person to the
  912  facility or may call on the law enforcement agency or other
  913  transportation arrangement best suited to the needs of the
  914  patient.
  915         (g)(f) When any law enforcement officer has custody of a
  916  person based on either noncriminal or minor criminal behavior
  917  that meets the statutory guidelines for involuntary examination
  918  pursuant to s. 394.463 under this part, the law enforcement
  919  officer shall transport the person to the appropriate facility
  920  within the designated receiving system pursuant to a
  921  transportation plan or an exception under subsection (4), or to
  922  the nearest receiving facility if neither apply for examination.
  923  Persons who meet the statutory guidelines for involuntary
  924  admission pursuant to s. 397.675 may also be transported by law
  925  enforcement officers to the extent resources are available and
  926  as otherwise provided by law. Such persons shall be transported
  927  to an appropriate facility within the designated receiving
  928  system pursuant to a transportation plan or an exception under
  929  subsection (4), or to the nearest facility if neither apply.
  930         (h)(g) When any law enforcement officer has arrested a
  931  person for a felony and it appears that the person meets the
  932  statutory guidelines for involuntary examination or placement
  933  under this part, such person must shall first be processed in
  934  the same manner as any other criminal suspect. The law
  935  enforcement agency shall thereafter immediately notify the
  936  appropriate facility within the designated receiving system
  937  pursuant to a transportation plan or an exception under
  938  subsection (4), or to the nearest public receiving facility if
  939  neither apply. The receiving facility, which shall be
  940  responsible for promptly arranging for the examination and
  941  treatment of the person. A receiving facility is not required to
  942  admit a person charged with a crime for whom the facility
  943  determines and documents that it is unable to provide adequate
  944  security, but shall provide mental health examination and
  945  treatment to the person where he or she is held.
  946         (i)(h) If the appropriate law enforcement officer believes
  947  that a person has an emergency medical condition as defined in
  948  s. 395.002, the person may be first transported to a hospital
  949  for emergency medical treatment, regardless of whether the
  950  hospital is a designated receiving facility.
  951         (j)(i) The costs of transportation, evaluation,
  952  hospitalization, and treatment incurred under this subsection by
  953  persons who have been arrested for violations of any state law
  954  or county or municipal ordinance may be recovered as provided in
  955  s. 901.35.
  956         (k)(j)The appropriate facility within the designated
  957  receiving system pursuant to a transportation plan or an
  958  exception under subsection (4), or the nearest receiving
  959  facility if neither apply, must accept persons brought by law
  960  enforcement officers, or an emergency medical transport service
  961  or a private transport company authorized by the county, for
  962  involuntary examination pursuant to s. 394.463.
  963         (l) The appropriate facility within the designated
  964  receiving system pursuant to a transportation plan or an
  965  exception under subsection (4), or the nearest receiving
  966  facility if neither apply, must provide persons brought by law
  967  enforcement officers, or an emergency medical transport service
  968  or a private transport company authorized by the county,
  969  pursuant to s. 397.675, a basic screening or triage sufficient
  970  to refer the person to the appropriate services.
  971         (m)(k) Each law enforcement agency designated pursuant to
  972  paragraph (a) shall establish a policy that develop a memorandum
  973  of understanding with each receiving facility within the law
  974  enforcement agency’s jurisdiction which reflects a single set of
  975  protocols for the safe and secure transportation of the person
  976  and transfer of custody of the person. Each law enforcement
  977  agency shall provide a copy of the protocols to the managing
  978  entity. These protocols must also address crisis intervention
  979  measures.
  980         (n)(l) When a jurisdiction has entered into a contract with
  981  an emergency medical transport service or a private transport
  982  company for transportation of persons to receiving facilities
  983  within the designated receiving system, such service or company
  984  shall be given preference for transportation of persons from
  985  nursing homes, assisted living facilities, adult day care
  986  centers, or adult family-care homes, unless the behavior of the
  987  person being transported is such that transportation by a law
  988  enforcement officer is necessary.
  989         (o)(m)Nothing in This section may not shall be construed
  990  to limit emergency examination and treatment of incapacitated
  991  persons provided in accordance with the provisions of s.
  992  401.445.
  993         (2) TRANSPORTATION TO A TREATMENT FACILITY.—
  994         (a) If neither the patient nor any person legally obligated
  995  or responsible for the patient is able to pay for the expense of
  996  transporting a voluntary or involuntary patient to a treatment
  997  facility, the transportation plan established by the governing
  998  board of the county or counties must specify how in which the
  999  hospitalized patient will be transported to, from, and between
 1000  facilities in a is hospitalized shall arrange for such required
 1001  transportation and shall ensure the safe and dignified manner
 1002  transportation of the patient. The governing board of each
 1003  county is authorized to contract with private transport
 1004  companies for the transportation of such patients to and from a
 1005  treatment facility.
 1006         (b) A Any company that transports a patient pursuant to
 1007  this subsection is considered an independent contractor and is
 1008  solely liable for the safe and dignified transportation of the
 1009  patient. Such company must be insured and provide no less than
 1010  $100,000 in liability insurance with respect to the transport
 1011  transportation of patients.
 1012         (c) A Any company that contracts with one or more counties
 1013  the governing board of a county to transport patients in
 1014  accordance with this section shall comply with the applicable
 1015  rules of the department to ensure the safety and dignity of the
 1016  patients.
 1017         (d) County or municipal law enforcement and correctional
 1018  personnel and equipment may shall not be used to transport
 1019  patients adjudicated incapacitated or found by the court to meet
 1020  the criteria for involuntary placement pursuant to s. 394.467,
 1021  except in small rural counties where there are no cost-efficient
 1022  alternatives.
 1023         (3) TRANSFER OF CUSTODY.—Custody of a person who is
 1024  transported pursuant to this part, along with related
 1025  documentation, shall be relinquished to a responsible individual
 1026  at the appropriate receiving or treatment facility.
 1027         (4) EXCEPTIONS.—An exception to the requirements of this
 1028  section may be granted by the secretary of the department for
 1029  the purposes of improving service coordination or better meeting
 1030  the special needs of individuals. A proposal for an exception
 1031  must be submitted to the department by the district
 1032  administrator after being approved by the governing boards of
 1033  any affected counties, prior to submission to the secretary.
 1034         (a) A proposal for an exception must identify the specific
 1035  provision from which an exception is requested; describe how the
 1036  proposal will be implemented by participating law enforcement
 1037  agencies and transportation authorities; and provide a plan for
 1038  the coordination of services such as case management.
 1039         (b) The exception may be granted only for:
 1040         1. An arrangement centralizing and improving the provision
 1041  of services within a district, which may include an exception to
 1042  the requirement for transportation to the nearest receiving
 1043  facility;
 1044         2. An arrangement by which a facility may provide, in
 1045  addition to required psychiatric or substance use disorder
 1046  services, an environment and services which are uniquely
 1047  tailored to the needs of an identified group of persons with
 1048  special needs, such as persons with hearing impairments or
 1049  visual impairments, or elderly persons with physical frailties;
 1050  or
 1051         3. A specialized transportation system that provides an
 1052  efficient and humane method of transporting patients to
 1053  receiving facilities, among receiving facilities, and to
 1054  treatment facilities.
 1055         (c)Any exception approved pursuant to this subsection
 1056  shall be reviewed and approved every 5 years by the secretary.
 1057  
 1058  The exceptions provided in this subsection shall expire on June
 1059  30, 2017, and no new exceptions shall be granted after that
 1060  date. After June 30, 2017, the transport of a patient to a
 1061  facility that is not the nearest facility must be made pursuant
 1062  to a plan as provided in this section.
 1063         Section 13. Section 394.467, Florida Statutes, is amended
 1064  to read:
 1065         394.467 Involuntary inpatient placement.—
 1066         (1) CRITERIA.—A person may be ordered for placed in
 1067  involuntary inpatient placement for treatment upon a finding of
 1068  the court by clear and convincing evidence that:
 1069         (a) He or she has a mental illness is mentally ill and
 1070  because of his or her mental illness:
 1071         1.a. He or she has refused voluntary inpatient placement
 1072  for treatment after sufficient and conscientious explanation and
 1073  disclosure of the purpose of inpatient placement for treatment;
 1074  or
 1075         b. He or she is unable to determine for himself or herself
 1076  whether inpatient placement is necessary; and
 1077         2.a. He or she is manifestly incapable of surviving alone
 1078  or with the help of willing and responsible family or friends,
 1079  including available alternative services, and, without
 1080  treatment, is likely to suffer from neglect or refuse to care
 1081  for himself or herself, and such neglect or refusal poses a real
 1082  and present threat of substantial harm to his or her well-being;
 1083  or
 1084         b. There is substantial likelihood that in the near future
 1085  he or she will inflict serious bodily harm on self or others
 1086  himself or herself or another person, as evidenced by recent
 1087  behavior causing, attempting, or threatening such harm; and
 1088         (b) All available less restrictive treatment alternatives
 1089  that which would offer an opportunity for improvement of his or
 1090  her condition have been judged to be inappropriate.
 1091         (2) ADMISSION TO A TREATMENT FACILITY.—A patient may be
 1092  retained by a receiving facility or involuntarily placed in a
 1093  treatment facility upon the recommendation of the administrator
 1094  of the receiving facility where the patient has been examined
 1095  and after adherence to the notice and hearing procedures
 1096  provided in s. 394.4599. The recommendation must be supported by
 1097  the opinion of a psychiatrist and the second opinion of a
 1098  clinical psychologist or another psychiatrist, both of whom have
 1099  personally examined the patient within the preceding 72 hours,
 1100  that the criteria for involuntary inpatient placement are met.
 1101  However, in a county that has a population of fewer than 50,000,
 1102  if the administrator certifies that a psychiatrist or clinical
 1103  psychologist is not available to provide the second opinion, the
 1104  second opinion may be provided by a licensed physician who has
 1105  postgraduate training and experience in diagnosis and treatment
 1106  of mental illness and nervous disorders or by a psychiatric
 1107  nurse. Any second opinion authorized in this subsection may be
 1108  conducted through a face-to-face examination, in person, or by
 1109  electronic means. Such recommendation shall be entered on a
 1110  petition for an involuntary inpatient placement certificate that
 1111  authorizes the receiving facility to retain the patient pending
 1112  transfer to a treatment facility or completion of a hearing.
 1113         (3) PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.—The
 1114  administrator of the facility shall file a petition for
 1115  involuntary inpatient placement in the court in the county where
 1116  the patient is located. Upon filing, the clerk of the court
 1117  shall provide copies to the department, the patient, the
 1118  patient’s guardian or representative, and the state attorney and
 1119  public defender of the judicial circuit in which the patient is
 1120  located. A No fee may not shall be charged for the filing of a
 1121  petition under this subsection.
 1122         (4) APPOINTMENT OF COUNSEL.—Within 1 court working day
 1123  after the filing of a petition for involuntary inpatient
 1124  placement, the court shall appoint the public defender to
 1125  represent the person who is the subject of the petition, unless
 1126  the person is otherwise represented by counsel. The clerk of the
 1127  court shall immediately notify the public defender of such
 1128  appointment. Any attorney representing the patient shall have
 1129  access to the patient, witnesses, and records relevant to the
 1130  presentation of the patient’s case and shall represent the
 1131  interests of the patient, regardless of the source of payment to
 1132  the attorney.
 1133         (5) CONTINUANCE OF HEARING.—The patient is entitled, with
 1134  the concurrence of the patient’s counsel, to at least one
 1135  continuance of the hearing. The continuance shall be for a
 1136  period of up to 4 weeks.
 1137         (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.—
 1138         (a)1. The court shall hold the hearing on involuntary
 1139  inpatient placement within 5 court working days, unless a
 1140  continuance is granted.
 1141         2.Except for good cause documented in the court file, the
 1142  hearing must shall be held in the county or the facility, as
 1143  appropriate, where the patient is located, must and shall be as
 1144  convenient to the patient as is may be consistent with orderly
 1145  procedure, and shall be conducted in physical settings not
 1146  likely to be injurious to the patient’s condition. If the court
 1147  finds that the patient’s attendance at the hearing is not
 1148  consistent with the best interests of the patient, and the
 1149  patient’s counsel does not object, the court may waive the
 1150  presence of the patient from all or any portion of the hearing.
 1151  The state attorney for the circuit in which the patient is
 1152  located shall represent the state, rather than the petitioning
 1153  facility administrator, as the real party in interest in the
 1154  proceeding.
 1155         3.2. The court may appoint a general or special magistrate
 1156  to preside at the hearing. One of the professionals who executed
 1157  the petition for involuntary inpatient placement certificate
 1158  shall be a witness. The patient and the patient’s guardian or
 1159  representative shall be informed by the court of the right to an
 1160  independent expert examination. If the patient cannot afford
 1161  such an examination, the court shall ensure that one is
 1162  provided, as otherwise provided for by law provide for one. The
 1163  independent expert’s report is shall be confidential and not
 1164  discoverable, unless the expert is to be called as a witness for
 1165  the patient at the hearing. The testimony in the hearing must be
 1166  given under oath, and the proceedings must be recorded. The
 1167  patient may refuse to testify at the hearing.
 1168         (b) If the court concludes that the patient meets the
 1169  criteria for involuntary inpatient placement, it may shall order
 1170  that the patient be transferred to a treatment facility or, if
 1171  the patient is at a treatment facility, that the patient be
 1172  retained there or be treated at any other appropriate receiving
 1173  or treatment facility, or that the patient receive services from
 1174  a receiving or treatment facility, on an involuntary basis, for
 1175  a period of up to 90 days 6 months. However, any order for
 1176  involuntary mental health services in a treatment facility may
 1177  be for up to 6 months. The order shall specify the nature and
 1178  extent of the patient’s mental illness. The court may not order
 1179  an individual with traumatic brain injury or dementia who lacks
 1180  a co-occurring mental illness to be involuntarily placed in a
 1181  state treatment facility. The facility shall discharge a patient
 1182  any time the patient no longer meets the criteria for
 1183  involuntary inpatient placement, unless the patient has
 1184  transferred to voluntary status.
 1185         (c) If at any time before prior to the conclusion of the
 1186  hearing on involuntary inpatient placement it appears to the
 1187  court that the person does not meet the criteria for involuntary
 1188  inpatient placement under this section, but instead meets the
 1189  criteria for involuntary outpatient services placement, the
 1190  court may order the person evaluated for involuntary outpatient
 1191  services placement pursuant to s. 394.4655. The petition and
 1192  hearing procedures set forth in s. 394.4655 shall apply. If the
 1193  person instead meets the criteria for involuntary assessment,
 1194  protective custody, or involuntary admission pursuant to s.
 1195  397.675, then the court may order the person to be admitted for
 1196  involuntary assessment for a period of 5 days pursuant to s.
 1197  397.6811. Thereafter, all proceedings are shall be governed by
 1198  chapter 397.
 1199         (d) At the hearing on involuntary inpatient placement, the
 1200  court shall consider testimony and evidence regarding the
 1201  patient’s competence to consent to treatment. If the court finds
 1202  that the patient is incompetent to consent to treatment, it
 1203  shall appoint a guardian advocate as provided in s. 394.4598.
 1204         (e) The administrator of the petitioning receiving facility
 1205  shall provide a copy of the court order and adequate
 1206  documentation of a patient’s mental illness to the administrator
 1207  of a treatment facility if the whenever a patient is ordered for
 1208  involuntary inpatient placement, whether by civil or criminal
 1209  court. The documentation must shall include any advance
 1210  directives made by the patient, a psychiatric evaluation of the
 1211  patient, and any evaluations of the patient performed by a
 1212  psychiatric nurse, a clinical psychologist, a marriage and
 1213  family therapist, a mental health counselor, or a clinical
 1214  social worker. The administrator of a treatment facility may
 1215  refuse admission to any patient directed to its facilities on an
 1216  involuntary basis, whether by civil or criminal court order, who
 1217  is not accompanied at the same time by adequate orders and
 1218  documentation.
 1219         (7) PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT
 1220  PLACEMENT.—
 1221         (a) Hearings on petitions for continued involuntary
 1222  inpatient placement of an individual placed at any treatment
 1223  facility are shall be administrative hearings and must shall be
 1224  conducted in accordance with the provisions of s. 120.57(1),
 1225  except that any order entered by the administrative law judge is
 1226  shall be final and subject to judicial review in accordance with
 1227  s. 120.68. Orders concerning patients committed after
 1228  successfully pleading not guilty by reason of insanity are shall
 1229  be governed by the provisions of s. 916.15.
 1230         (b) If the patient continues to meet the criteria for
 1231  involuntary inpatient placement and is being treated at a
 1232  treatment facility, the administrator shall, before prior to the
 1233  expiration of the period during which the treatment facility is
 1234  authorized to retain the patient, file a petition requesting
 1235  authorization for continued involuntary inpatient placement. The
 1236  request must shall be accompanied by a statement from the
 1237  patient’s physician, psychiatrist, psychiatric nurse, or
 1238  clinical psychologist justifying the request, a brief
 1239  description of the patient’s treatment during the time he or she
 1240  was involuntarily placed, and an individualized plan of
 1241  continued treatment. Notice of the hearing must shall be
 1242  provided as provided set forth in s. 394.4599. If a patient’s
 1243  attendance at the hearing is voluntarily waived, the
 1244  administrative law judge must determine that the waiver is
 1245  knowing and voluntary before waiving the presence of the patient
 1246  from all or a portion of the hearing. Alternatively, if at the
 1247  hearing the administrative law judge finds that attendance at
 1248  the hearing is not consistent with the best interests of the
 1249  patient, the administrative law judge may waive the presence of
 1250  the patient from all or any portion of the hearing, unless the
 1251  patient, through counsel, objects to the waiver of presence. The
 1252  testimony in the hearing must be under oath, and the proceedings
 1253  must be recorded.
 1254         (c) Unless the patient is otherwise represented or is
 1255  ineligible, he or she shall be represented at the hearing on the
 1256  petition for continued involuntary inpatient placement by the
 1257  public defender of the circuit in which the facility is located.
 1258         (d) If at a hearing it is shown that the patient continues
 1259  to meet the criteria for involuntary inpatient placement, the
 1260  administrative law judge shall sign the order for continued
 1261  involuntary inpatient placement for up to 90 days a period not
 1262  to exceed 6 months. However, any order for involuntary mental
 1263  health services in a treatment facility may be for up to 6
 1264  months. The same procedure shall be repeated before prior to the
 1265  expiration of each additional period the patient is retained.
 1266         (e) If continued involuntary inpatient placement is
 1267  necessary for a patient admitted while serving a criminal
 1268  sentence, but his or her whose sentence is about to expire, or
 1269  for a minor patient involuntarily placed, while a minor but who
 1270  is about to reach the age of 18, the administrator shall
 1271  petition the administrative law judge for an order authorizing
 1272  continued involuntary inpatient placement.
 1273         (f) If the patient has been previously found incompetent to
 1274  consent to treatment, the administrative law judge shall
 1275  consider testimony and evidence regarding the patient’s
 1276  competence. If the administrative law judge finds evidence that
 1277  the patient is now competent to consent to treatment, the
 1278  administrative law judge may issue a recommended order to the
 1279  court that found the patient incompetent to consent to treatment
 1280  that the patient’s competence be restored and that any guardian
 1281  advocate previously appointed be discharged.
 1282         (g)If the patient has been ordered to undergo involuntary
 1283  inpatient placement and has previously been found incompetent to
 1284  consent to treatment, the court shall consider testimony and
 1285  evidence regarding the patient’s incompetence. If the patient’s
 1286  competency to consent to treatment is restored, the discharge of
 1287  the guardian advocate shall be governed by s. 394.4598.
 1288  
 1289  The procedure required in this subsection must be followed
 1290  before the expiration of each additional period the patient is
 1291  involuntarily receiving services.
 1292         (8) RETURN TO FACILITY OF PATIENTS.—If a patient
 1293  involuntarily held When a patient at a treatment facility under
 1294  this part leaves the facility without the administrator’s
 1295  authorization, the administrator may authorize a search for the
 1296  patient and his or her the return of the patient to the
 1297  facility. The administrator may request the assistance of a law
 1298  enforcement agency in this regard the search for and return of
 1299  the patient.
 1300         Section 14. Section 394.46715, Florida Statutes, is amended
 1301  to read:
 1302         394.46715 Rulemaking authority.—The department may adopt
 1303  rules to administer this part Department of Children and
 1304  Families shall have rulemaking authority to implement the
 1305  provisions of ss. 394.455, 394.4598, 394.4615, 394.463,
 1306  394.4655, and 394.467 as amended or created by this act. These
 1307  rules shall be for the purpose of protecting the health, safety,
 1308  and well-being of persons examined, treated, or placed under
 1309  this act.
 1310         Section 15. Subsection (2) of section 394.4685, Florida
 1311  Statutes, is amended to read:
 1312         394.4685 Transfer of patients among facilities.—
 1313         (2) TRANSFER FROM PUBLIC TO PRIVATE FACILITIES.—
 1314         (a) A patient who has been admitted to a public receiving
 1315  or public treatment facility and has requested, either
 1316  personally or through his or her guardian or guardian advocate,
 1317  and is able to pay for treatment in a private facility shall be
 1318  transferred at the patient’s expense to a private facility upon
 1319  acceptance of the patient by the private facility.
 1320         (b)A public receiving facility initiating a patient
 1321  transfer to a licensed hospital for acute care mental health
 1322  services not accessible through the public receiving facility
 1323  shall notify the hospital of such transfer and send the hospital
 1324  all records relating to the emergency psychiatric or medical
 1325  condition.
 1326         Section 16. Section 394.656, Florida Statutes, is amended
 1327  to read:
 1328         394.656 Criminal Justice, Mental Health, and Substance
 1329  Abuse Reinvestment Grant Program.—
 1330         (1) There is created within the Department of Children and
 1331  Families the Criminal Justice, Mental Health, and Substance
 1332  Abuse Reinvestment Grant Program. The purpose of the program is
 1333  to provide funding to counties with which they may use to can
 1334  plan, implement, or expand initiatives that increase public
 1335  safety, avert increased spending on criminal justice, and
 1336  improve the accessibility and effectiveness of treatment
 1337  services for adults and juveniles who have a mental illness,
 1338  substance abuse disorder, or co-occurring mental health and
 1339  substance abuse disorders and who are in, or at risk of
 1340  entering, the criminal or juvenile justice systems.
 1341         (2) The department shall establish a Criminal Justice,
 1342  Mental Health, and Substance Abuse Statewide Grant Review
 1343  Committee. The committee shall include:
 1344         (a) One representative of the Department of Children and
 1345  Families;
 1346         (b) One representative of the Department of Corrections;
 1347         (c) One representative of the Department of Juvenile
 1348  Justice;
 1349         (d) One representative of the Department of Elderly
 1350  Affairs; and
 1351         (e) One representative of the Office of the State Courts
 1352  Administrator;.
 1353         (f)One representative of the Department of Veterans’
 1354  Affairs;
 1355         (g)One representative of the Florida Sheriffs Association;
 1356         (h)One representative of the Florida Police Chiefs
 1357  Association;
 1358         (i)One representative of the Florida Association of
 1359  Counties;
 1360         (j)One representative of the Florida Alcohol and Drug
 1361  Abuse Association;
 1362         (k)One representative of the Florida Association of
 1363  Managing Entities;
 1364         (l)One representative of the Florida Council for Community
 1365  Mental Health;
 1366         (m)One representative of the National Alliance of Mental
 1367  Illness;
 1368         (n)One representative of the Florida Prosecuting Attorneys
 1369  Association;
 1370         (o)One representative of the Florida Public Defender
 1371  Association; and
 1372         (p)One administrator of an assisted living facility that
 1373  holds a limited mental health license.
 1374         (3)The committee shall serve as the advisory body to
 1375  review policy and funding issues that help reduce the impact of
 1376  persons with mental illness and substance abuse disorders on
 1377  communities, criminal justice agencies, and the court system.
 1378  The committee shall advise the department in selecting
 1379  priorities for grants and investing awarded grant moneys.
 1380         (4)The committee must have experience in substance use and
 1381  mental health disorders, community corrections, and law
 1382  enforcement. To the extent possible, the members of the
 1383  committee shall have expertise in grant review writing, grant
 1384  reviewing, and grant application scoring.
 1385         (5)(a)(3)(a) A county, or a not-for-profit community
 1386  provider or managing entity designated by the county planning
 1387  council or committee, as described in s. 394.657, may apply for
 1388  a 1-year planning grant or a 3-year implementation or expansion
 1389  grant. The purpose of the grants is to demonstrate that
 1390  investment in treatment efforts related to mental illness,
 1391  substance abuse disorders, or co-occurring mental health and
 1392  substance abuse disorders results in a reduced demand on the
 1393  resources of the judicial, corrections, juvenile detention, and
 1394  health and social services systems.
 1395         (b) To be eligible to receive a 1-year planning grant or a
 1396  3-year implementation or expansion grant:,
 1397         1. A county applicant must have a county planning council
 1398  or committee that is in compliance with the membership
 1399  requirements set forth in this section.
 1400         2.A not-for-profit community provider or managing entity
 1401  must be designated by the county planning council or committee
 1402  and have written authorization to submit an application. A not
 1403  for-profit community provider or managing entity must have
 1404  written authorization for each submitted application.
 1405         (c)The department may award a 3-year implementation or
 1406  expansion grant to an applicant who has not received a 1-year
 1407  planning grant.
 1408         (d)The department may require an applicant to conduct
 1409  sequential intercept mapping for a project. For purposes of this
 1410  paragraph, the term “sequential intercept mapping” means a
 1411  process for reviewing a local community’s mental health,
 1412  substance abuse, criminal justice, and related systems and
 1413  identifying points of interceptions where interventions may be
 1414  made to prevent an individual with a substance abuse disorder or
 1415  mental illness from deeper involvement in the criminal justice
 1416  system.
 1417         (6)(4) The grant review and selection committee shall
 1418  select the grant recipients and notify the department of
 1419  Children and Families in writing of the recipients’ names of the
 1420  applicants who have been selected by the committee to receive a
 1421  grant. Contingent upon the availability of funds and upon
 1422  notification by the grant review and selection committee of
 1423  those applicants approved to receive planning, implementation,
 1424  or expansion grants, the department of Children and Families may
 1425  transfer funds appropriated for the grant program to a selected
 1426  grant recipient to any county awarded a grant.
 1427         Section 17. Section 394.761, Florida Statutes, is created
 1428  to read:
 1429         394.761Revenue maximization.—
 1430         (1) The agency and the department shall develop a plan to
 1431  obtain federal approval for increasing the availability of
 1432  federal Medicaid funding for behavioral health care. Increased
 1433  funding shall be used to advance the goal of improved
 1434  integration of behavioral health services and primary care
 1435  services for individuals eligible for Medicaid through the
 1436  development and effective implementation of the behavioral
 1437  health system of care as described in s. 394.4573.
 1438         (2) The agency and the department shall identify in the
 1439  plan the amount of general revenue funding appropriated for
 1440  mental health and substance abuse services eligible to be used
 1441  as state Medicaid match. The agency and the department shall
 1442  evaluate alternative uses of increased Medicaid funding,
 1443  including seeking Medicaid eligibility for the severely and
 1444  persistently mentally ill or persons with substance use
 1445  disorders, increased reimbursement rates for behavioral health
 1446  services, adjustments to the capitation rate for Medicaid
 1447  enrollees with chronic mental illness and substance use
 1448  disorders, targeted case management for individuals with
 1449  substance use disorders as a Medicaid-funded service,
 1450  supplemental payments to mental health and substance abuse
 1451  service providers through a designated state health program or
 1452  other mechanisms, and innovative programs to provide incentives
 1453  for improved outcomes for behavioral health conditions. The
 1454  agency and the department shall identify in the plan the
 1455  advantages and disadvantages of each alternative and assess each
 1456  alternative’s potential for achieving improved integration of
 1457  services. The agency and the department shall identify in the
 1458  plan the types of federal approvals necessary to implement each
 1459  alternative and project a timeline for implementation.
 1460         (3) The department, in coordination with the agency and the
 1461  managing entities, shall compile detailed documentation of the
 1462  cost and reimbursements for Medicaid covered services provided
 1463  to Medicaid eligible individuals by providers of behavioral
 1464  health services that are also funded for programs authorized by
 1465  this chapter and chapter 397. The department’s documentation,
 1466  along with a report of general revenue funds supporting
 1467  behavioral health services that are not counted as maintenance
 1468  of effort or match for any other federal program, must be
 1469  submitted to the agency by December 31, 2016.
 1470         (4) If the report presents clear evidence that Medicaid
 1471  reimbursements are less than the costs of providing the
 1472  services, the agency and the department shall request such
 1473  additional trust fund authority as is necessary to draw federal
 1474  Medicaid funds as a match for the documented general revenue
 1475  expenditures supporting covered services delivered to eligible
 1476  individuals. Payment of the federal funds shall be made to
 1477  providers in such a manner as is allowed by federal law and
 1478  regulations.
 1479         (5) The agency and the department shall submit the written
 1480  plan and report required in this section to the President of the
 1481  Senate and the Speaker of the House of Representatives by
 1482  December 31, 2016.
 1483         Section 18. Subsection (5) of section 394.879, Florida
 1484  Statutes, is amended, and subsection (6) is added to that
 1485  section, to read:
 1486         394.879 Rules; enforcement.—
 1487         (5) The agency or the department may not adopt any rule
 1488  governing the design, construction, erection, alteration,
 1489  modification, repair, or demolition of crisis stabilization
 1490  units. It is the intent of the Legislature to preempt that
 1491  function to the Florida Building commission and the State Fire
 1492  Marshal through adoption and maintenance of the Florida Building
 1493  Code and the Florida Fire Prevention Code. However, a crisis
 1494  stabilization unit, a short-term residential treatment facility,
 1495  or an integrated adult mental health crisis stabilization and
 1496  addictions receiving facility that is collocated with a
 1497  centralized receiving facility may be in a multi-story building
 1498  and may be authorized on floors other than the ground floor. The
 1499  agency shall provide technical assistance to the commission and
 1500  the State Fire Marshal in updating the construction standards of
 1501  the Florida Building Code and the Florida Fire Prevention Code
 1502  which govern crisis stabilization units. In addition, the agency
 1503  may enforce the special-occupancy provisions of the Florida
 1504  Building code and the Florida Fire Prevention Code which apply
 1505  to crisis stabilization units in conducting any inspection
 1506  authorized under this part or part II of chapter 408.
 1507         (6)The department and the Agency for Health Care
 1508  Administration shall develop a plan to provide options for a
 1509  single, consolidated license for a provider that offers multiple
 1510  types of either mental health services or substance abuse
 1511  services, or both, regulated under chapters 394 and 397,
 1512  respectively. In the plan, the department and the agency shall
 1513  identify the statutory revisions necessary to accomplish the
 1514  consolidation. To the extent possible, the department and the
 1515  agency shall accomplish such consolidation administratively and
 1516  by rule. The department and the agency shall submit the plan to
 1517  the Governor, the President of the Senate, and the Speaker of
 1518  the House of Representatives by November 1, 2016.
 1519         Section 19. Section 394.9082, Florida Statutes, is amended
 1520  to read:
 1521         (Substantial rewording of section. See
 1522         s. 394.9082, F.S., for present text.)
 1523         394.9082Behavioral health managing entities.—
 1524         (1)INTENT AND PURPOSE.—
 1525         (a)The Legislature finds that untreated behavioral health
 1526  disorders constitute major health problems for residents of this
 1527  state, are a major economic burden to the citizens of this
 1528  state, and substantially increase demands on the state’s
 1529  juvenile and adult criminal justice systems, the child welfare
 1530  system, and health care systems. The Legislature finds that
 1531  behavioral health disorders respond to appropriate treatment,
 1532  rehabilitation, and supportive intervention. The Legislature
 1533  finds that local communities have also made substantial
 1534  investments in behavioral health services, contracting with
 1535  safety net providers who by mandate and mission provide
 1536  specialized services to vulnerable and hard-to-serve populations
 1537  and have strong ties to local public health and public safety
 1538  agencies. The Legislature finds that a regional management
 1539  structure that facilitates a comprehensive and cohesive system
 1540  of coordinated care for behavioral health treatment and
 1541  prevention services will improve access to care, promote service
 1542  continuity, and provide for more efficient and effective
 1543  delivery of substance abuse and mental health services. It is
 1544  the intent of the Legislature that managing entities work to
 1545  create linkages among various services and systems, including
 1546  juvenile justice and adult criminal justice, child welfare,
 1547  housing services, homeless systems of care, and health care.
 1548         (b)The purpose of the behavioral health managing entities
 1549  is to plan, coordinate, and contract for the delivery of
 1550  community mental health and substance abuse services, to improve
 1551  access to care, to promote service continuity, to purchase
 1552  services, and to support efficient and effective delivery of
 1553  services.
 1554         (2)DEFINITIONS.—As used in this section, the term:
 1555         (a)“Behavioral health services” means mental health
 1556  services and substance abuse prevention and treatment services
 1557  as described in this chapter and chapter 397.
 1558         (b)“Coordinated system of care” means the array of mental
 1559  health services and substance abuse services described in s.
 1560  394.4573.
 1561         (c)“Geographic area” means one or more contiguous
 1562  counties, circuits, or regions as described in s. 409.966.
 1563         (d)“Managed behavioral health organization” means a
 1564  Medicaid managed care organization currently under contract with
 1565  the statewide Medicaid managed medical assistance program in
 1566  this state pursuant to part IV of chapter 409, including a
 1567  managed care organization operating as a behavioral health
 1568  specialty plan.
 1569         (e)“Managing entity” means a corporation selected by and
 1570  under contract with the department to manage the daily
 1571  operational delivery of behavioral health services through a
 1572  coordinated system of care.
 1573         (f)“Provider network” means the group of direct service
 1574  providers, facilities, and organizations under contract with a
 1575  managing entity to provide a comprehensive array of emergency,
 1576  acute care, residential, outpatient, recovery support, and
 1577  consumer support services, including prevention services.
 1578         (g)“Subregion” means a distinct portion of a managing
 1579  entity’s geographic region defined by unifying service and
 1580  provider utilization patterns.
 1581         (3)DEPARTMENT DUTIES.—The department shall:
 1582         (a)Contract with organizations to serve as managing
 1583  entities in accordance with the requirements of this section and
 1584  conduct a readiness review of any new managing entities before
 1585  such entities assume their responsibilities.
 1586         (b)Specify data reporting requirements and use of shared
 1587  data systems.
 1588         (c)Define the priority populations that will benefit from
 1589  receiving care coordination. In defining such populations, the
 1590  department shall take into account the availability of resources
 1591  and consider:
 1592         1. The number and duration of involuntary admissions within
 1593  a specified time.
 1594         2. The degree of involvement with the criminal justice
 1595  system and the risk to public safety posed by the individual.
 1596         3. Whether the individual has recently resided in or is
 1597  currently awaiting admission to or discharge from a treatment
 1598  facility as defined in s. 394.455.
 1599         4. The degree of utilization of behavioral health services.
 1600         5. Whether the individual is a parent or caregiver who is
 1601  involved with the child welfare system.
 1602         (d)Support the development and implementation of a
 1603  coordinated system of care by requiring each provider that
 1604  receives state funds for behavioral health services through a
 1605  direct contract with the department to work with the managing
 1606  entity in the provider’s service area to coordinate the
 1607  provision of behavioral health services as part of the contract
 1608  with the department.
 1609         (e)Provide technical assistance to the managing entities.
 1610         (f)Promote the coordination of behavioral health care and
 1611  primary care.
 1612         (g)Facilitate coordination between the managing entity and
 1613  other payors of behavioral health care.
 1614         (h)Develop and provide a unique identifier for clients
 1615  receiving behavioral health services through the managing entity
 1616  to coordinate care.
 1617         (i)Coordinate procedures for the referral and admission of
 1618  patients to, and the discharge of patients from, treatment
 1619  facilities as defined in s. 394.455 and their return to the
 1620  community.
 1621         (j)Ensure that managing entities comply with state and
 1622  federal laws, rules, regulations, and grant requirements.
 1623         (k)Develop rules for the operations of, and the
 1624  requirements that shall be met by, the managing entity, if
 1625  necessary.
 1626         (l)Periodically review contract and reporting requirements
 1627  and reduce costly, duplicative, and unnecessary administrative
 1628  requirements.
 1629         (4)CONTRACT WITH MANAGING ENTITIES.—
 1630         (a)In contracting for services with managing entities
 1631  under this section, the department shall first attempt to
 1632  contract with not-for-profit, community-based organizations with
 1633  competence in managing provider networks serving persons with
 1634  mental health and substance use disorders to serve as managing
 1635  entities.
 1636         (b)The department shall issue an invitation to negotiate
 1637  under s. 287.057 to select an organization to serve as a
 1638  managing entity. If the department receives fewer than two
 1639  responsive bids to the solicitation, the department shall
 1640  reissue the solicitation and managed behavioral health
 1641  organizations shall be eligible to bid and be awarded a
 1642  contract.
 1643         (c)If the managing entity is a not-for-profit, community
 1644  based organization, it must have a governing board that is
 1645  representative. At a minimum, the governing board must include
 1646  consumers and their family members; representatives of local
 1647  government, area law enforcement agencies, health care
 1648  facilities, and community-based care lead agencies; business
 1649  leaders; and providers of substance abuse and mental health
 1650  services as defined in this chapter and chapter 397.
 1651         (d)If the managing entity is a managed behavioral health
 1652  organization, it must establish an advisory board that meets the
 1653  same requirements specified in paragraph (c) for a governing
 1654  board.
 1655         (e)If the department issues an invitation to negotiate
 1656  pursuant to paragraph (b), the department shall consider, at a
 1657  minimum, the following factors:
 1658         1.Experience serving persons with mental health and
 1659  substance use disorders.
 1660         2.Established community partnerships with behavioral
 1661  health care providers.
 1662         3.Demonstrated organizational capabilities for network
 1663  management functions.
 1664         4.Capability to coordinate behavioral health services with
 1665  primary care services.
 1666         5.Willingness to provide recovery-oriented services and
 1667  systems of care and work collaboratively with persons with
 1668  mental health and substance use disorders and their families in
 1669  designing such systems and delivering such services.
 1670         (f)The department’s contracts with managing entities must
 1671  support efficient and effective administration of the behavioral
 1672  health system and ensure accountability for performance.
 1673         (g)A contractor serving as a managing entity shall operate
 1674  under the same data reporting, administrative, and
 1675  administrative rate requirements, regardless of whether it is a
 1676  for-profit or not-for-profit entity.
 1677         (h)The contract must designate the geographic area that
 1678  will be served by the managing entity, which area must be of
 1679  sufficient size in population, funding, and services to allow
 1680  for flexibility and efficiency.
 1681         (i)The contract must require that, when there is a change
 1682  in the managing entity in a geographic area, the managing entity
 1683  work with the department to develop and implement a transition
 1684  plan that ensures continuity of care for patients receiving
 1685  behavioral health services.
 1686         (j)By June 30, 2019, if all other contract requirements
 1687  and performance standards are met and the department determines
 1688  that a managing entity under contract as of July 1, 2016, has
 1689  received network accreditation pursuant to subsection (6), the
 1690  department may continue its contract with the managing entity
 1691  for up to, but not exceeding, 5 years, including any and all
 1692  renewals and extensions. Thereafter, the department must issue a
 1693  competitive solicitation pursuant to paragraph (b).
 1694         (5)MANAGING ENTITY DUTIES.—A managing entity shall:
 1695         (a)Maintain a governing board or, if a managed behavioral
 1696  health organization, an advisory board as provided in paragraph
 1697  (4)(c) or paragraph (4)(d), respectively.
 1698         (b)Conduct a community behavioral health care needs
 1699  assessment every 3 years in the geographic area served by the
 1700  managing entity which identifies needs by subregion. The process
 1701  for conducting the needs assessment shall include an opportunity
 1702  for public participation. The assessment shall include, at a
 1703  minimum, the information the department needs for its annual
 1704  report to the Governor and Legislature pursuant to s. 394.4573.
 1705  The managing entity shall provide the needs assessment to the
 1706  department.
 1707         (c)Determine the optimal array of services to meet the
 1708  needs identified in the community behavioral health care needs
 1709  assessment and expand the scope of services as resources become
 1710  available.
 1711         (d) Promote the development and effective implementation of
 1712  a coordinated system of care pursuant to s. 394.4573.
 1713         (e) Provide assistance to counties to develop a designated
 1714  receiving system pursuant to s. 394.4573 and a transportation
 1715  plan pursuant to s. 394.462.
 1716         (f) Develop strategies to divert persons with mental
 1717  illness or substance use disorders from the criminal and
 1718  juvenile justice systems in collaboration with the court system
 1719  and the Department of Juvenile Justice and to integrate
 1720  behavioral health services with the child welfare system.
 1721         (g) Promote and support care coordination activities that
 1722  will improve outcomes among individuals identified as priority
 1723  populations pursuant to paragraph (3)(c).
 1724         (h)Work independently and collaboratively with
 1725  stakeholders to improve access to and effectiveness, quality,
 1726  and outcomes of behavioral health services. This work may
 1727  include, but is not limited to, facilitating the dissemination
 1728  and use of evidence-informed practices.
 1729         (i)Develop a comprehensive provider network of qualified
 1730  providers to deliver behavioral health services. The managing
 1731  entity is not required to competitively procure network
 1732  providers but shall publicize opportunities to join the provider
 1733  network and evaluate providers in the network to determine if
 1734  they may remain in the network. The managing entity shall
 1735  publish these processes on its website. The managing entity
 1736  shall ensure continuity of care for clients if a provider ceases
 1737  to provide a service or leaves the network.
 1738         (j)As appropriate, develop resources by pursuing third
 1739  party payments for services, applying for grants, assisting
 1740  providers in securing local matching funds and in-kind services,
 1741  and employing any other method needed to ensure that services
 1742  are available and accessible.
 1743         (k)Enter into cooperative agreements with local homeless
 1744  councils and organizations for sharing information about
 1745  clients, available resources, and other data or information for
 1746  addressing the homelessness of persons suffering from a
 1747  behavioral health crisis. All information sharing must comply
 1748  with federal and state privacy and confidentiality laws,
 1749  statutes, and regulations.
 1750         (l)Work collaboratively with public receiving facilities
 1751  and licensed housing providers to establish a network of
 1752  licensed housing resources for mental health consumers that will
 1753  prevent and reduce readmissions to public receiving facilities.
 1754         (m)Monitor network providers’ performance and their
 1755  compliance with contract requirements and federal and state
 1756  laws, rules, regulations, and grant requirements.
 1757         (n)Manage and allocate funds for services to meet federal
 1758  and state laws, rules, and regulations.
 1759         (o)Promote coordination of behavioral health care with
 1760  primary care.
 1761         (p)Implement shared data systems necessary for the
 1762  delivery of coordinated care and integrated services, the
 1763  assessment of managing entity performance and provider
 1764  performance, and the reporting of outcomes and costs of
 1765  services.
 1766         (q)Operate in a transparent manner, providing public
 1767  access to information, notice of meetings, and opportunities for
 1768  public participation in managing entity decisionmaking.
 1769         (r)Establish and maintain effective relationships with
 1770  community stakeholders, including individuals served by the
 1771  behavioral health system of care and their families, local
 1772  governments, and other community organizations that meet the
 1773  needs of individuals with mental illness or substance use
 1774  disorders.
 1775         (s)Collaborate with and encourage increased coordination
 1776  between the provider network and other systems, programs, and
 1777  entities, such as the child welfare system, law enforcement
 1778  agencies, the criminal and juvenile justice systems, the
 1779  Medicaid program, offices of the public defender, and offices of
 1780  criminal conflict and civil regional counsel.
 1781         1.Collaboration with the criminal and juvenile justice
 1782  systems shall seek, at a minimum, to divert persons with mental
 1783  illness, substance use disorders, or co-occurring conditions
 1784  from these systems.
 1785         2.Collaboration with the court system shall seek, at a
 1786  minimum, to develop specific written procedures and agreements
 1787  to maximize the use of involuntary outpatient services, reduce
 1788  involuntary inpatient treatment, and increase diversion from the
 1789  criminal and juvenile justice systems.
 1790         3.Collaboration with the child welfare system shall seek,
 1791  at a minimum, to provide effective and timely services to
 1792  parents and caregivers involved in the child welfare system.
 1793         (6)NETWORK ACCREDITATION AND SYSTEMS COORDINATION
 1794  AGREEMENTS.—
 1795         (a)1.The department shall identify acceptable
 1796  accreditations which address coordination within a network and,
 1797  if possible, between the network and major systems and programs
 1798  with which the network interacts, such as the child welfare
 1799  system, the courts system, and the Medicaid program. In
 1800  identifying acceptable accreditations, the department shall
 1801  consider whether the accreditation facilitates integrated
 1802  strategic planning, resource coordination, technology
 1803  integration, performance measurement, and increased value to
 1804  consumers through choice of and access to services, improved
 1805  coordination of services, and effectiveness and efficiency of
 1806  service delivery.
 1807         2.All managing entities under contract with the state by
 1808  July 1, 2016, shall earn accreditation deemed acceptable by the
 1809  department pursuant to subparagraph 1. by June 30, 2019.
 1810  Managing entities whose initial contract with the state is
 1811  executed after July 1, 2016, shall earn network accreditation
 1812  within 3 years after the contract execution date. Pursuant to
 1813  paragraph (4)(j), the department may continue the contract of a
 1814  managing entity under contract as of July 1, 2016, that earns
 1815  the network accreditation within the required timeframe and
 1816  maintains it throughout the contract term.
 1817         (b)If no accreditations are available or deemed acceptable
 1818  pursuant to paragraph (a) which address coordination between the
 1819  provider network and major systems and programs with which the
 1820  provider network interacts, each managing entity shall enter
 1821  into memoranda of understanding which details mechanisms for
 1822  communication and coordination. The managing entity shall enter
 1823  into such memoranda with any community-based care lead agencies,
 1824  circuit courts, county courts, sheriffs’ offices, offices of the
 1825  public defender, offices of criminal conflict and civil regional
 1826  counsel, Medicaid managed medical assistance plans, and homeless
 1827  coalitions in its service area. Each managing entity under
 1828  contract on July 1, 2016, shall enter into such memoranda by
 1829  June 30, 2017, and each managing entity under contract after
 1830  July 1, 2016, shall enter into such memoranda within 1 year
 1831  after its contract execution date.
 1832         (7)PERFORMANCE MEASUREMENT AND ACCOUNTABILITY.-Managing
 1833  entities shall collect and submit data to the department
 1834  regarding persons served, outcomes of persons served, costs of
 1835  services provided through the department’s contract, and other
 1836  data as required by the department. The department shall
 1837  evaluate managing entity performance and the overall progress
 1838  made by the managing entity, together with other systems, in
 1839  meeting the community’s behavioral health needs, based on
 1840  consumer-centered outcome measures that reflect national
 1841  standards, if possible, that can be accurately measured. The
 1842  department shall work with managing entities to establish
 1843  performance standards, including, but not limited to:
 1844         (a)The extent to which individuals in the community
 1845  receive services, including, but not limited to, parents or
 1846  caregivers involved in the child welfare system who need
 1847  behavioral health services.
 1848         (b)The improvement in the overall behavioral health of a
 1849  community.
 1850         (c)The improvement in functioning or progress in the
 1851  recovery of individuals served by the managing entity, as
 1852  determined using person-centered measures tailored to the
 1853  population.
 1854         (d)The success of strategies to:
 1855         1.Divert admissions from acute levels of care, jails,
 1856  prisons, and forensic facilities as measured by, at a minimum,
 1857  the total number and percentage of clients who, during a
 1858  specified period, experience multiple admissions to acute levels
 1859  of care, jails, prisons, or forensic facilities;
 1860         2. Integrate behavioral health services with the child
 1861  welfare system; and
 1862         3.Address the housing needs of individuals being released
 1863  from public receiving facilities who are homeless.
 1864         (e)Consumer and family satisfaction.
 1865         (f)The level of engagement of key community
 1866  constituencies, such as law enforcement agencies, community
 1867  based care lead agencies, juvenile justice agencies, the courts,
 1868  school districts, local government entities, hospitals, and
 1869  other organizations, as appropriate, for the geographical
 1870  service area of the managing entity.
 1871         (8)ENHANCEMENT PLANS.—By September 1 of each year,
 1872  beginning in 2017, each managing entity shall develop and submit
 1873  to the department a description of strategies for enhancing
 1874  services and addressing three to five priority needs in the
 1875  service area. The planning process sponsored by the managing
 1876  entity shall include consumers and their families, community
 1877  based care lead agencies, local governments, law enforcement
 1878  agencies, service providers, community partners and other
 1879  stakeholders. Each strategy must be described in detail and
 1880  accompanied by an implementation plan that specifies action
 1881  steps, identifies responsible parties, and delineates specific
 1882  services that would be purchased, projected costs, the projected
 1883  number of individuals that would be served, and the estimated
 1884  benefits of the services. All or parts of these enhancement
 1885  plans may be included in the department’s annual budget requests
 1886  submitted to the Legislature.
 1887         (9)FUNDING FOR MANAGING ENTITIES.—
 1888         (a)A contract established between the department and a
 1889  managing entity under this section shall be funded by general
 1890  revenue, other applicable state funds, or applicable federal
 1891  funding sources. A managing entity may carry forward documented
 1892  unexpended state funds from one fiscal year to the next, but the
 1893  cumulative amount carried forward may not exceed 8 percent of
 1894  the annual amount of the contract. Any unexpended state funds in
 1895  excess of that percentage shall be returned to the department.
 1896  The funds carried forward may not be used in a way that would
 1897  increase future recurring obligations or for any program or
 1898  service that was not authorized under the existing contract with
 1899  the department. Expenditures of funds carried forward shall be
 1900  separately reported to the department. Any unexpended funds that
 1901  remain at the end of the contract period shall be returned to
 1902  the department. Funds carried forward may be retained through
 1903  contract renewals and new contract procurements as long as the
 1904  same managing entity is retained by the department.
 1905         (b)The method of payment for a fixed-price contract with a
 1906  managing entity shall provide for a 2-month advance payment at
 1907  the beginning of each fiscal year and equal monthly payments
 1908  thereafter.
 1909         (10)ACUTE CARE SERVICES UTILIZATION DATABASE.—The
 1910  department shall develop, implement, and maintain standards
 1911  under which a managing entity shall collect utilization data
 1912  from all public receiving facilities situated within its
 1913  geographical service area and all detoxification and addictions
 1914  receiving facilities under contract with the managing entity. As
 1915  used in this subsection, the term “public receiving facility”
 1916  means an entity that meets the licensure requirements of, and is
 1917  designated by, the department to operate as a public receiving
 1918  facility under s. 394.875 and that is operating as a licensed
 1919  crisis stabilization unit.
 1920         (a)The department shall develop standards and protocols to
 1921  be used for data collection, storage, transmittal, and analysis.
 1922  The standards and protocols shall allow for compatibility of
 1923  data and data transmittal between public receiving facilities,
 1924  detoxification facilities, addictions receiving facilities,
 1925  managing entities, and the department for the implementation,
 1926  and to meet the requirements, of this subsection.
 1927         (b)A managing entity shall require providers specified in
 1928  paragraph (a) to submit data, in real time or at least daily, to
 1929  the managing entity for:
 1930         1.All admissions and discharges of clients receiving
 1931  public receiving facility services who qualify as indigent, as
 1932  defined in s. 394.4787.
 1933         2.All admissions and discharges of clients receiving
 1934  substance abuse services in an addictions receiving facility or
 1935  detoxification facility pursuant to parts IV and V of chapter
 1936  397 who qualify as indigent.
 1937         3.The current active census of total licensed and utilized
 1938  beds, the number of beds purchased by the department, the number
 1939  of clients qualifying as indigent who occupy any of those beds,
 1940  the total number of unoccupied licensed beds, regardless of
 1941  funding, and the number in excess of licensed capacity. Crisis
 1942  units licensed for both adult and child use will report as a
 1943  single unit.
 1944         (c)A managing entity shall require providers specified in
 1945  paragraph (a) to submit data, on a monthly basis, to the
 1946  managing entity which aggregates the daily data submitted under
 1947  paragraph (b). The managing entity shall reconcile the data in
 1948  the monthly submission to the data received by the managing
 1949  entity under paragraph (b) to check for consistency. If the
 1950  monthly aggregate data submitted by a provider under this
 1951  paragraph are inconsistent with the daily data submitted under
 1952  paragraph (b), the managing entity shall consult with the
 1953  provider to make corrections necessary to ensure accurate data.
 1954         (d)A managing entity shall require providers specified in
 1955  paragraph (a) within its provider network to submit data, on an
 1956  annual basis, to the managing entity which aggregates the data
 1957  submitted and reconciled under paragraph (c). The managing
 1958  entity shall reconcile the data in the annual submission to the
 1959  data received and reconciled by the managing entity under
 1960  paragraph (c) to check for consistency. If the annual aggregate
 1961  data submitted by a provider under this paragraph are
 1962  inconsistent with the data received and reconciled under
 1963  paragraph (c), the managing entity shall consult with the
 1964  provider to make corrections necessary to ensure accurate data.
 1965         (e)After ensuring the accuracy of data pursuant to
 1966  paragraphs (c) and (d), the managing entity shall submit the
 1967  data to the department on a monthly and an annual basis. The
 1968  department shall create a statewide database for the data
 1969  described under paragraph (b) and submitted under this paragraph
 1970  for the purpose of analyzing the use of publicly funded crisis
 1971  stabilization services and detoxification and addictions
 1972  receiving services provided on a statewide and an individual
 1973  provider basis.
 1974         Section 20. Subsections (4) through (9) of section 397.305,
 1975  Florida Statutes, are renumbered as subsections (6) though (11),
 1976  respectively, and new subsections (4) and (5) are added to that
 1977  section, to read:
 1978         397.305 Legislative findings, intent, and purpose.—
 1979         (4)It is the intent of the Legislature that licensed,
 1980  qualified health professionals be authorized to practice to the
 1981  full extent of their education and training in the performance
 1982  of professional functions necessary to carry out the intent of
 1983  this chapter.
 1984         (5)It is the intent of the Legislature to establish
 1985  expectations that services provided to persons in this state use
 1986  the coordination-of-care principles characteristic of recovery
 1987  oriented services and include social support services, such as
 1988  housing support, life skills and vocational training, and
 1989  employment assistance necessary for persons who have substance
 1990  use disorders or co-occurring substance use and mental health
 1991  disorders to live successfully in their communities.
 1992         Section 21. Present subsection (19) of section 391.311,
 1993  Florida Statutes, is redesignated as subsection (20), present
 1994  subsections (20) through (45) of that section are redesignated
 1995  as subsections (23) through (48), respectively, new subsections
 1996  (19), (21), and (22) are added to that section, and present
 1997  subsections (30) and (38) of that section are amended, to read:
 1998         397.311 Definitions.—As used in this chapter, except part
 1999  VIII, the term:
 2000         (19)“Incompetent to consent to treatment” means a state in
 2001  which a person’s judgment is so affected by a substance abuse
 2002  impairment that he or she lacks the capacity to make a well
 2003  reasoned, willful, and knowing decision concerning his or her
 2004  medical health, mental health, or substance abuse treatment.
 2005         (21)“Informed consent” means consent voluntarily given in
 2006  writing by a competent person after sufficient explanation and
 2007  disclosure of the subject matter involved to enable the person
 2008  to make a knowing and willful decision without any element of
 2009  force, fraud, deceit, duress, or other form of constraint or
 2010  coercion.
 2011         (22)“Involuntary services” means an array of behavioral
 2012  health services that may be ordered by the court for persons
 2013  with substance abuse impairment or co-occurring substance abuse
 2014  impairment and mental health disorders.
 2015         (33)(30) “Qualified professional” means a physician or a
 2016  physician assistant licensed under chapter 458 or chapter 459; a
 2017  professional licensed under chapter 490 or chapter 491; an
 2018  advanced registered nurse practitioner having a specialty in
 2019  psychiatry licensed under part I of chapter 464; or a person who
 2020  is certified through a department-recognized certification
 2021  process for substance abuse treatment services and who holds, at
 2022  a minimum, a bachelor’s degree. A person who is certified in
 2023  substance abuse treatment services by a state-recognized
 2024  certification process in another state at the time of employment
 2025  with a licensed substance abuse provider in this state may
 2026  perform the functions of a qualified professional as defined in
 2027  this chapter but must meet certification requirements contained
 2028  in this subsection no later than 1 year after his or her date of
 2029  employment.
 2030         (41)(38) “Service component” or “component” means a
 2031  discrete operational entity within a service provider which is
 2032  subject to licensing as defined by rule. Service components
 2033  include prevention, intervention, and clinical treatment
 2034  described in subsection (25) (22).
 2035         Section 22. Subsections (16) through (20) of section
 2036  397.321, Florida Statutes, are renumbered as subsections (15)
 2037  through (19), respectively, present subsection (15) is amended,
 2038  and a new subsection (20) is added to that section, to read:
 2039         397.321 Duties of the department.—The department shall:
 2040         (15)Appoint a substance abuse impairment coordinator to
 2041  represent the department in efforts initiated by the statewide
 2042  substance abuse impairment prevention and treatment coordinator
 2043  established in s. 397.801 and to assist the statewide
 2044  coordinator in fulfilling the responsibilities of that position.
 2045         (20)Develop and prominently display on its website all
 2046  forms necessary for the implementation and administration of
 2047  parts IV and V of this chapter. These forms shall include, but
 2048  are not limited to, a petition for involuntary admission form
 2049  and all related pleading forms, and a form to be used by law
 2050  enforcement agencies pursuant to s. 397.6772. The department
 2051  shall notify law enforcement agencies, the courts, and other
 2052  state agencies of the existence and availability of such forms.
 2053         Section 23. Section 397.675, Florida Statutes, is amended
 2054  to read:
 2055         397.675 Criteria for involuntary admissions, including
 2056  protective custody, emergency admission, and other involuntary
 2057  assessment, involuntary treatment, and alternative involuntary
 2058  assessment for minors, for purposes of assessment and
 2059  stabilization, and for involuntary treatment.—A person meets the
 2060  criteria for involuntary admission if there is good faith reason
 2061  to believe that the person is substance abuse impaired or has a
 2062  co-occurring mental health disorder and, because of such
 2063  impairment or disorder:
 2064         (1) Has lost the power of self-control with respect to
 2065  substance abuse use; and either
 2066         (2)(a) Has inflicted, or threatened or attempted to
 2067  inflict, or unless admitted is likely to inflict, physical harm
 2068  on himself or herself or another; or
 2069         (b) Is in need of substance abuse services and, by reason
 2070  of substance abuse impairment, his or her judgment has been so
 2071  impaired that he or she the person is incapable of appreciating
 2072  his or her need for such services and of making a rational
 2073  decision in that regard, although thereto; however, mere refusal
 2074  to receive such services does not constitute evidence of lack of
 2075  judgment with respect to his or her need for such services; or
 2076         (b)Without care or treatment, is likely to suffer from
 2077  neglect or refuse to care for himself or herself; that such
 2078  neglect or refusal poses a real and present threat of
 2079  substantial harm to his or her well-being; and that it is not
 2080  apparent that such harm may be avoided through the help of
 2081  willing family members or friends or the provision of other
 2082  services, or there is substantial likelihood that the person has
 2083  inflicted, or threatened to or attempted to inflict, or, unless
 2084  admitted, is likely to inflict, physical harm on himself,
 2085  herself, or another.
 2086         Section 24. Subsection (1) of section 397.6772, Florida
 2087  Statutes, is amended to read:
 2088         397.6772 Protective custody without consent.—
 2089         (1) If a person in circumstances which justify protective
 2090  custody as described in s. 397.677 fails or refuses to consent
 2091  to assistance and a law enforcement officer has determined that
 2092  a hospital or a licensed detoxification or addictions receiving
 2093  facility is the most appropriate place for the person, the
 2094  officer may, after giving due consideration to the expressed
 2095  wishes of the person:
 2096         (a) Take the person to a hospital or to a licensed
 2097  detoxification or addictions receiving facility against the
 2098  person’s will but without using unreasonable force. The officer
 2099  shall use the standard form developed by the department pursuant
 2100  to s. 397.321 to execute a written report detailing the
 2101  circumstances under which the person was taken into custody. The
 2102  written report shall be included in the patient’s clinical
 2103  record; or
 2104         (b) In the case of an adult, detain the person for his or
 2105  her own protection in any municipal or county jail or other
 2106  appropriate detention facility.
 2107  
 2108  Such detention is not to be considered an arrest for any
 2109  purpose, and no entry or other record may be made to indicate
 2110  that the person has been detained or charged with any crime. The
 2111  officer in charge of the detention facility must notify the
 2112  nearest appropriate licensed service provider within the first 8
 2113  hours after detention that the person has been detained. It is
 2114  the duty of the detention facility to arrange, as necessary, for
 2115  transportation of the person to an appropriate licensed service
 2116  provider with an available bed. Persons taken into protective
 2117  custody must be assessed by the attending physician within the
 2118  72-hour period and without unnecessary delay, to determine the
 2119  need for further services.
 2120         Section 25. Paragraph (a) of subsection (1) of section
 2121  397.6773, Florida Statutes, is amended to read:
 2122         397.6773 Dispositional alternatives after protective
 2123  custody.—
 2124         (1) An individual who is in protective custody must be
 2125  released by a qualified professional when:
 2126         (a) The individual no longer meets the involuntary
 2127  admission criteria in s. 397.675 397.675(1);
 2128         Section 26. Section 397.679, Florida Statutes, is amended
 2129  to read:
 2130         397.679 Emergency admission; circumstances justifying.—A
 2131  person who meets the criteria for involuntary admission in s.
 2132  397.675 may be admitted to a hospital or to a licensed
 2133  detoxification facility or addictions receiving facility for
 2134  emergency assessment and stabilization, or to a less intensive
 2135  component of a licensed service provider for assessment only,
 2136  upon receipt by the facility of a the physician’s certificate by
 2137  a physician, an advanced registered nurse practitioner, a
 2138  psychiatric nurse, a clinical psychologist, a clinical social
 2139  worker, a marriage and family therapist, a mental health
 2140  counselor, a physician assistant working under the scope of
 2141  practice of the supervising physician, or a master’s-level
 2142  certified addictions professional for substance abuse services,
 2143  if the certificate is specific to substance abuse impairment,
 2144  and the completion of an application for emergency admission.
 2145         Section 27. Section 397.6791, Florida Statutes, is amended
 2146  to read:
 2147         397.6791 Emergency admission; persons who may initiate.—The
 2148  following persons may request a certificate for an emergency
 2149  assessment or admission:
 2150         (1) In the case of an adult, any professional who may issue
 2151  a professional certificate pursuant to s. 397.6793 the
 2152  certifying physician, the person’s spouse or legal guardian, any
 2153  relative of the person, or any other responsible adult who has
 2154  personal knowledge of the person’s substance abuse impairment.
 2155         (2) In the case of a minor, the minor’s parent, legal
 2156  guardian, or legal custodian.
 2157         Section 28. Section 397.6793, Florida Statutes, is amended
 2158  to read:
 2159         397.6793 Professional’s Physician’s certificate for
 2160  emergency admission.—
 2161         (1) A physician, a clinical psychologist, a physician
 2162  assistant working under the scope of practice of the supervising
 2163  physician, a psychiatric nurse, an advanced registered nurse
 2164  practitioner, a mental health counselor, a marriage and family
 2165  therapist, a master’s-level-certified addictions professional
 2166  for substance abuse services, or a clinical social worker may
 2167  execute a professional’s certificate for emergency admission.
 2168  The professional’s physician’s certificate must include the name
 2169  of the person to be admitted, the relationship between the
 2170  person and the professional executing the certificate physician,
 2171  the relationship between the applicant and the professional
 2172  physician, any relationship between the professional physician
 2173  and the licensed service provider, and a statement that the
 2174  person has been examined and assessed within the preceding 5
 2175  days after of the application date, and must include factual
 2176  allegations with respect to the need for emergency admission,
 2177  including:
 2178         (a) The reason for the physician’s belief that the person
 2179  is substance abuse impaired; and
 2180         (b) The reason for the physician’s belief that because of
 2181  such impairment the person has lost the power of self-control
 2182  with respect to substance abuse; and either
 2183         (c)1. The reason for the belief physician believes that,
 2184  without care or treatment, the person is likely to suffer from
 2185  neglect or refuse to care for himself or herself; that such
 2186  neglect or refusal poses a real and present threat of
 2187  substantial harm to his or her well-being; and that it is not
 2188  apparent that such harm may be avoided through the help of
 2189  willing family members or friends or the provision of other
 2190  services, or there is substantial likelihood that the person has
 2191  inflicted or, unless admitted, is likely to inflict, physical
 2192  harm on himself, or herself, or another others unless admitted;
 2193  or
 2194         2. The reason for the belief physician believes that the
 2195  person’s refusal to voluntarily receive care is based on
 2196  judgment so impaired by reason of substance abuse that the
 2197  person is incapable of appreciating his or her need for care and
 2198  of making a rational decision regarding his or her need for
 2199  care.
 2200         (2) The professional’s physician’s certificate must
 2201  recommend the least restrictive type of service that is
 2202  appropriate for the person. The certificate must be signed by
 2203  the professional physician. If other less restrictive means are
 2204  not available, such as voluntary appearance for outpatient
 2205  evaluation, a law enforcement officer shall take the person
 2206  named in the certificate into custody and deliver him or her to
 2207  the appropriate facility for involuntary assessment and
 2208  stabilization.
 2209         (3) A signed copy of the professional’s physician’s
 2210  certificate shall accompany the person, and shall be made a part
 2211  of the person’s clinical record, together with a signed copy of
 2212  the application. The application and the professional’s
 2213  physician’s certificate authorize the involuntary admission of
 2214  the person pursuant to, and subject to the provisions of, ss.
 2215  397.679-397.6797.
 2216         (4) The professional’s certificate is valid for 7 days
 2217  after issuance.
 2218         (5)The professional’s physician’s certificate must
 2219  indicate whether the person requires transportation assistance
 2220  for delivery for emergency admission and specify, pursuant to s.
 2221  397.6795, the type of transportation assistance necessary.
 2222         Section 29. Section 397.6795, Florida Statutes, is amended
 2223  to read:
 2224         397.6795 Transportation-assisted delivery of persons for
 2225  emergency assessment.—An applicant for a person’s emergency
 2226  admission, or the person’s spouse or guardian, or a law
 2227  enforcement officer, or a health officer may deliver a person
 2228  named in the professional’s physician’s certificate for
 2229  emergency admission to a hospital or a licensed detoxification
 2230  facility or addictions receiving facility for emergency
 2231  assessment and stabilization.
 2232         Section 30. Subsection (1) of section 397.681, Florida
 2233  Statutes, is amended to read:
 2234         397.681 Involuntary petitions; general provisions; court
 2235  jurisdiction and right to counsel.—
 2236         (1) JURISDICTION.—The courts have jurisdiction of
 2237  involuntary assessment and stabilization petitions and
 2238  involuntary treatment petitions for substance abuse impaired
 2239  persons, and such petitions must be filed with the clerk of the
 2240  court in the county where the person is located. The clerk of
 2241  the court may not charge a fee for the filing of a petition
 2242  under this section. The chief judge may appoint a general or
 2243  special magistrate to preside over all or part of the
 2244  proceedings. The alleged impaired person is named as the
 2245  respondent.
 2246         Section 31. Subsection (1) of section 397.6811, Florida
 2247  Statutes, is amended to read:
 2248         397.6811 Involuntary assessment and stabilization.—A person
 2249  determined by the court to appear to meet the criteria for
 2250  involuntary admission under s. 397.675 may be admitted for a
 2251  period of 5 days to a hospital or to a licensed detoxification
 2252  facility or addictions receiving facility, for involuntary
 2253  assessment and stabilization or to a less restrictive component
 2254  of a licensed service provider for assessment only upon entry of
 2255  a court order or upon receipt by the licensed service provider
 2256  of a petition. Involuntary assessment and stabilization may be
 2257  initiated by the submission of a petition to the court.
 2258         (1) If the person upon whose behalf the petition is being
 2259  filed is an adult, a petition for involuntary assessment and
 2260  stabilization may be filed by the respondent’s spouse or legal
 2261  guardian, any relative, a private practitioner, the director of
 2262  a licensed service provider or the director’s designee, or an
 2263  adult any three adults who has direct have personal knowledge of
 2264  the respondent’s substance abuse impairment.
 2265         Section 32. Section 397.6814, Florida Statutes, is amended
 2266  to read:
 2267         397.6814 Involuntary assessment and stabilization; contents
 2268  of petition.—A petition for involuntary assessment and
 2269  stabilization must contain the name of the respondent,; the name
 2270  of the applicant or applicants,; the relationship between the
 2271  respondent and the applicant, and; the name of the respondent’s
 2272  attorney, if known, and a statement of the respondent’s ability
 2273  to afford an attorney; and must state facts to support the need
 2274  for involuntary assessment and stabilization, including:
 2275         (1) The reason for the petitioner’s belief that the
 2276  respondent is substance abuse impaired; and
 2277         (2) The reason for the petitioner’s belief that because of
 2278  such impairment the respondent has lost the power of self
 2279  control with respect to substance abuse; and either
 2280         (3)(a) The reason the petitioner believes that the
 2281  respondent has inflicted or is likely to inflict physical harm
 2282  on himself or herself or others unless admitted; or
 2283         (b) The reason the petitioner believes that the
 2284  respondent’s refusal to voluntarily receive care is based on
 2285  judgment so impaired by reason of substance abuse that the
 2286  respondent is incapable of appreciating his or her need for care
 2287  and of making a rational decision regarding that need for care.
 2288  If the respondent has refused to submit to an assessment, such
 2289  refusal must be alleged in the petition.
 2290  
 2291  A fee may not be charged for the filing of a petition pursuant
 2292  to this section.
 2293         Section 33. Subsection (4) is added to section 397.6818,
 2294  Florida Statutes, to read:
 2295         397.6818 Court determination.—At the hearing initiated in
 2296  accordance with s. 397.6811(1), the court shall hear all
 2297  relevant testimony. The respondent must be present unless the
 2298  court has reason to believe that his or her presence is likely
 2299  to be injurious to him or her, in which event the court shall
 2300  appoint a guardian advocate to represent the respondent. The
 2301  respondent has the right to examination by a court-appointed
 2302  qualified professional. After hearing all the evidence, the
 2303  court shall determine whether there is a reasonable basis to
 2304  believe the respondent meets the involuntary admission criteria
 2305  of s. 397.675.
 2306         (4)The order is valid only for the period specified in the
 2307  order or, if a period is not specified, for 7 days after the
 2308  order is signed.
 2309         Section 34. Section 397.6819, Florida Statutes, is amended
 2310  to read:
 2311         397.6819 Involuntary assessment and stabilization;
 2312  responsibility of licensed service provider.—A licensed service
 2313  provider may admit an individual for involuntary assessment and
 2314  stabilization for a period not to exceed 5 days unless a
 2315  petition for involuntary services has been initiated and the
 2316  individual is being retained pursuant to s. 397.6822(3) or a
 2317  request for an extension of time has been filed with the court
 2318  pursuant to s. 397.6821. The assessment of the individual must
 2319  occur within 72 hours be assessed without unnecessary delay by a
 2320  qualified professional. If an assessment is performed by a
 2321  qualified professional who is not a physician, the assessment
 2322  must be reviewed by a physician before the end of the assessment
 2323  period.
 2324         Section 35. Section 397.695, Florida Statutes, is amended
 2325  to read:
 2326         397.695 Involuntary services treatment; persons who may
 2327  petition.—
 2328         (1) If the respondent is an adult, a petition for
 2329  involuntary services treatment may be filed by the respondent’s
 2330  spouse or legal guardian, any relative, a service provider, or
 2331  an adult any three adults who has direct have personal knowledge
 2332  of the respondent’s substance abuse impairment and his or her
 2333  prior course of assessment and treatment.
 2334         (2) If the respondent is a minor, a petition for
 2335  involuntary treatment may be filed by a parent, legal guardian,
 2336  or service provider.
 2337         Section 36. Section 397.6951, Florida Statutes, is amended
 2338  to read:
 2339         397.6951 Contents of petition for involuntary services
 2340  treatment.—A petition for involuntary services treatment must
 2341  contain the name of the respondent to be admitted; the name of
 2342  the petitioner or petitioners; the relationship between the
 2343  respondent and the petitioner; the name of the respondent’s
 2344  attorney, if known, and a statement of the petitioner’s
 2345  knowledge of the respondent’s ability to afford an attorney; the
 2346  findings and recommendations of the assessment performed by the
 2347  qualified professional; and the factual allegations presented by
 2348  the petitioner establishing the need for involuntary outpatient
 2349  services. The factual allegations must demonstrate treatment,
 2350  including:
 2351         (1) The reason for the petitioner’s belief that the
 2352  respondent is substance abuse impaired; and
 2353         (2) The reason for the petitioner’s belief that because of
 2354  such impairment the respondent has lost the power of self
 2355  control with respect to substance abuse; and either
 2356         (3)(a) The reason the petitioner believes that the
 2357  respondent has inflicted or is likely to inflict physical harm
 2358  on himself or herself or others unless the court orders the
 2359  involuntary services admitted; or
 2360         (b) The reason the petitioner believes that the
 2361  respondent’s refusal to voluntarily receive care is based on
 2362  judgment so impaired by reason of substance abuse that the
 2363  respondent is incapable of appreciating his or her need for care
 2364  and of making a rational decision regarding that need for care.
 2365         Section 37. Section 397.6955, Florida Statutes, is amended
 2366  to read:
 2367         397.6955 Duties of court upon filing of petition for
 2368  involuntary services treatment.—
 2369         (1) Upon the filing of a petition for the involuntary
 2370  services for treatment of a substance abuse impaired person with
 2371  the clerk of the court, the court shall immediately determine
 2372  whether the respondent is represented by an attorney or whether
 2373  the appointment of counsel for the respondent is appropriate. If
 2374  the court appoints counsel for the person, the clerk of the
 2375  court shall immediately notify the office of criminal conflict
 2376  and civil regional counsel, created pursuant to s. 27.511, of
 2377  the appointment. The office of criminal conflict and civil
 2378  regional counsel shall represent the person until the petition
 2379  is dismissed, the court order expires, or the person is
 2380  discharged from involuntary services. An attorney that
 2381  represents the person named in the petition shall have access to
 2382  the person, witnesses, and records relevant to the presentation
 2383  of the person’s case and shall represent the interests of the
 2384  person, regardless of the source of payment to the attorney.
 2385         (2) The court shall schedule a hearing to be held on the
 2386  petition within 5 10 days unless a continuance is granted. The
 2387  court may appoint a magistrate to preside at the hearing.
 2388         (3) A copy of the petition and notice of the hearing must
 2389  be provided to the respondent; the respondent’s parent,
 2390  guardian, or legal custodian, in the case of a minor; the
 2391  respondent’s attorney, if known; the petitioner; the
 2392  respondent’s spouse or guardian, if applicable; and such other
 2393  persons as the court may direct. If the respondent is a minor, a
 2394  copy of the petition and notice of the hearing must be and have
 2395  such petition and order personally delivered to the respondent
 2396  if he or she is a minor. The court shall also issue a summons to
 2397  the person whose admission is sought.
 2398         Section 38. Section 397.6957, Florida Statutes, is amended
 2399  to read:
 2400         397.6957 Hearing on petition for involuntary services
 2401  treatment.—
 2402         (1) At a hearing on a petition for involuntary services
 2403  treatment, the court shall hear and review all relevant
 2404  evidence, including the review of results of the assessment
 2405  completed by the qualified professional in connection with the
 2406  respondent’s protective custody, emergency admission,
 2407  involuntary assessment, or alternative involuntary admission.
 2408  The respondent must be present unless the court finds that his
 2409  or her presence is likely to be injurious to himself or herself
 2410  or others, in which event the court must appoint a guardian
 2411  advocate to act in behalf of the respondent throughout the
 2412  proceedings.
 2413         (2) The petitioner has the burden of proving by clear and
 2414  convincing evidence that:
 2415         (a) The respondent is substance abuse impaired and has a
 2416  history of lack of compliance with treatment for substance
 2417  abuse;, and
 2418         (b) Because of such impairment the respondent is unlikely
 2419  to voluntarily participate in the recommended services or is
 2420  unable to determine for himself or herself whether services are
 2421  necessary the respondent has lost the power of self-control with
 2422  respect to substance abuse; and: either
 2423         1. Without services, the respondent is likely to suffer
 2424  from neglect or refuse to care for himself or herself; that such
 2425  neglect or refusal poses a real and present threat of
 2426  substantial harm to his or her well-being; and that there is a
 2427  substantial likelihood that without services the respondent will
 2428  cause serious bodily harm to himself, herself, or another in the
 2429  near future, as evidenced by recent behavior The respondent has
 2430  inflicted or is likely to inflict physical harm on himself or
 2431  herself or others unless admitted; or
 2432         2. The respondent’s refusal to voluntarily receive care is
 2433  based on judgment so impaired by reason of substance abuse that
 2434  the respondent is incapable of appreciating his or her need for
 2435  care and of making a rational decision regarding that need for
 2436  care.
 2437         (3)One of the qualified professionals who executed the
 2438  involuntary services certificate must be a witness. The court
 2439  shall allow testimony from individuals, including family
 2440  members, deemed by the court to be relevant under state law,
 2441  regarding the respondent’s prior history and how that prior
 2442  history relates to the person’s current condition. The testimony
 2443  in the hearing must be under oath, and the proceedings must be
 2444  recorded. The patient may refuse to testify at the hearing.
 2445         (4)(3) At the conclusion of the hearing the court shall
 2446  either dismiss the petition or order the respondent to receive
 2447  undergo involuntary services from his or her substance abuse
 2448  treatment, with the respondent’s chosen licensed service
 2449  provider if to deliver the involuntary substance abuse treatment
 2450  where possible and appropriate.
 2451         Section 39. Section 397.697, Florida Statutes, is amended
 2452  to read:
 2453         397.697 Court determination; effect of court order for
 2454  involuntary services substance abuse treatment.—
 2455         (1) When the court finds that the conditions for
 2456  involuntary services substance abuse treatment have been proved
 2457  by clear and convincing evidence, it may order the respondent to
 2458  receive undergo involuntary services from treatment by a
 2459  publicly funded licensed service provider for a period not to
 2460  exceed 90 60 days. The court may also order a respondent to
 2461  undergo treatment through a privately funded licensed service
 2462  provider if the respondent has the ability to pay for the
 2463  treatment, or if any person on the respondent’s behalf
 2464  voluntarily demonstrates a willingness and an ability to pay for
 2465  the treatment. If the court finds it necessary, it may direct
 2466  the sheriff to take the respondent into custody and deliver him
 2467  or her to the licensed service provider specified in the court
 2468  order, or to the nearest appropriate licensed service provider,
 2469  for involuntary services treatment. When the conditions
 2470  justifying involuntary services treatment no longer exist, the
 2471  individual must be released as provided in s. 397.6971. When the
 2472  conditions justifying involuntary services treatment are
 2473  expected to exist after 90 60 days of services treatment, a
 2474  renewal of the involuntary services treatment order may be
 2475  requested pursuant to s. 397.6975 before prior to the end of the
 2476  90-day 60-day period.
 2477         (2) In all cases resulting in an order for involuntary
 2478  services substance abuse treatment, the court shall retain
 2479  jurisdiction over the case and the parties for the entry of such
 2480  further orders as the circumstances may require. The court’s
 2481  requirements for notification of proposed release must be
 2482  included in the original treatment order.
 2483         (3) An involuntary services treatment order authorizes the
 2484  licensed service provider to require the individual to receive
 2485  services that undergo such treatment as will benefit him or her,
 2486  including services treatment at any licensable service component
 2487  of a licensed service provider.
 2488         (4)If the court orders involuntary services, a copy of the
 2489  order must be sent to the managing entity within 1 working day
 2490  after it is received from the court. Documents may be submitted
 2491  electronically though existing data systems, if applicable.
 2492         Section 40. Section 397.6971, Florida Statutes, is amended
 2493  to read:
 2494         397.6971 Early release from involuntary services substance
 2495  abuse treatment.—
 2496         (1) At any time before prior to the end of the 90-day 60
 2497  day involuntary services treatment period, or before prior to
 2498  the end of any extension granted pursuant to s. 397.6975, an
 2499  individual receiving admitted for involuntary services treatment
 2500  may be determined eligible for discharge to the most appropriate
 2501  referral or disposition for the individual when any of the
 2502  following apply:
 2503         (a) The individual no longer meets the criteria for
 2504  involuntary admission and has given his or her informed consent
 2505  to be transferred to voluntary treatment status.;
 2506         (b) If the individual was admitted on the grounds of
 2507  likelihood of infliction of physical harm upon himself or
 2508  herself or others, such likelihood no longer exists.; or
 2509         (c) If the individual was admitted on the grounds of need
 2510  for assessment and stabilization or treatment, accompanied by
 2511  inability to make a determination respecting such need, either:
 2512         1. Such inability no longer exists; or
 2513         2. It is evident that further treatment will not bring
 2514  about further significant improvements in the individual’s
 2515  condition.;
 2516         (d) The individual is no longer in need of services.; or
 2517         (e) The director of the service provider determines that
 2518  the individual is beyond the safe management capabilities of the
 2519  provider.
 2520         (2) Whenever a qualified professional determines that an
 2521  individual admitted for involuntary services qualifies treatment
 2522  is ready for early release under for any of the reasons listed
 2523  in subsection (1), the service provider shall immediately
 2524  discharge the individual, and must notify all persons specified
 2525  by the court in the original treatment order.
 2526         Section 41. Section 397.6975, Florida Statutes, is amended
 2527  to read:
 2528         397.6975 Extension of involuntary services substance abuse
 2529  treatment period.—
 2530         (1) Whenever a service provider believes that an individual
 2531  who is nearing the scheduled date of his or her release from
 2532  involuntary services treatment continues to meet the criteria
 2533  for involuntary services treatment in s. 397.693, a petition for
 2534  renewal of the involuntary services treatment order may be filed
 2535  with the court at least 10 days before the expiration of the
 2536  court-ordered services treatment period. The court shall
 2537  immediately schedule a hearing to be held not more than 15 days
 2538  after filing of the petition. The court shall provide the copy
 2539  of the petition for renewal and the notice of the hearing to all
 2540  parties to the proceeding. The hearing is conducted pursuant to
 2541  s. 397.6957.
 2542         (2) If the court finds that the petition for renewal of the
 2543  involuntary services treatment order should be granted, it may
 2544  order the respondent to receive undergo involuntary services
 2545  treatment for a period not to exceed an additional 90 days. When
 2546  the conditions justifying involuntary services treatment no
 2547  longer exist, the individual must be released as provided in s.
 2548  397.6971. When the conditions justifying involuntary services
 2549  treatment continue to exist after an additional 90 days of
 2550  service additional treatment, a new petition requesting renewal
 2551  of the involuntary services treatment order may be filed
 2552  pursuant to this section.
 2553         (3)Within 1 court working day after the filing of a
 2554  petition for continued involuntary services, the court shall
 2555  appoint the office of criminal conflict and civil regional
 2556  counsel to represent the respondent, unless the respondent is
 2557  otherwise represented by counsel. The clerk of the court shall
 2558  immediately notify the office of criminal conflict and civil
 2559  regional counsel of such appointment. The office of criminal
 2560  conflict and civil regional counsel shall represent the
 2561  respondent until the petition is dismissed or the court order
 2562  expires or the respondent is discharged from involuntary
 2563  services. Any attorney representing the respondent shall have
 2564  access to the respondent, witnesses, and records relevant to the
 2565  presentation of the respondent’s case and shall represent the
 2566  interests of the respondent, regardless of the source of payment
 2567  to the attorney.
 2568         (4)Hearings on petitions for continued involuntary
 2569  services shall be before the circuit court. The court may
 2570  appoint a magistrate to preside at the hearing. The procedures
 2571  for obtaining an order pursuant to this section shall be in
 2572  accordance with s. 397.697.
 2573         (5)Notice of hearing shall be provided to the respondent
 2574  or his or her counsel. The respondent and the respondent’s
 2575  counsel may agree to a period of continued involuntary services
 2576  without a court hearing.
 2577         (6)The same procedure shall be repeated before the
 2578  expiration of each additional period of involuntary services.
 2579         (7)If the respondent has previously been found incompetent
 2580  to consent to treatment, the court shall consider testimony and
 2581  evidence regarding the respondent’s competence.
 2582         Section 42. Section 397.6977, Florida Statutes, is amended
 2583  to read:
 2584         397.6977 Disposition of individual upon completion of
 2585  involuntary services substance abuse treatment.—At the
 2586  conclusion of the 90-day 60-day period of court-ordered
 2587  involuntary services treatment, the respondent individual is
 2588  automatically discharged unless a motion for renewal of the
 2589  involuntary services treatment order has been filed with the
 2590  court pursuant to s. 397.6975.
 2591         Section 43. Section 397.6978, Florida Statutes, is created
 2592  to read:
 2593         397.6978Guardian advocate; patient incompetent to consent;
 2594  substance abuse disorder.—
 2595         (1)The administrator of a receiving facility or an
 2596  addictions receiving facility may petition the court for the
 2597  appointment of a guardian advocate based upon the opinion of a
 2598  qualified professional that the patient is incompetent to
 2599  consent to treatment. If the court finds that a patient is
 2600  incompetent to consent to treatment and has not been adjudicated
 2601  incapacitated and that a guardian with the authority to consent
 2602  to substance abuse treatment has not been appointed, it may
 2603  appoint a guardian advocate. The patient has the right to have
 2604  an attorney represent him or her at the hearing. If the person
 2605  is indigent, the court shall appoint the office of criminal
 2606  conflict and civil regional counsel to represent him or her at
 2607  the hearing. The patient has the right to testify, cross-examine
 2608  witnesses, and present witnesses. The proceeding shall be
 2609  recorded electronically or stenographically, and testimony must
 2610  be provided under oath. One of the qualified professionals
 2611  authorized to give an opinion in support of a petition for
 2612  involuntary services, as described in s. 397.693, must testify.
 2613  A guardian advocate must meet the qualifications of a guardian
 2614  contained in part IV of chapter 744. The person who is appointed
 2615  as a guardian advocate must agree to the appointment.
 2616         (2)The following persons are prohibited from appointment
 2617  as a patient’s guardian advocate:
 2618         (a)A professional providing clinical services to the
 2619  individual under this part.
 2620         (b)The qualified professional who initiated the
 2621  involuntary examination of the individual, if the examination
 2622  was initiated by a qualified professional’s certificate.
 2623         (c)An employee, an administrator, or a board member of the
 2624  facility providing the examination of the individual.
 2625         (d)An employee, an administrator, or a board member of the
 2626  treatment facility providing treatment of the individual.
 2627         (e)A person providing any substantial professional
 2628  services, excluding public guardians or professional guardians,
 2629  to the individual, including clinical services.
 2630         (f)A creditor of the individual.
 2631         (g)A person subject to an injunction for protection
 2632  against domestic violence under s. 741.30, whether the order of
 2633  injunction is temporary or final, and for which the individual
 2634  was the petitioner.
 2635         (h)A person subject to an injunction for protection
 2636  against repeat violence, stalking, sexual violence, or dating
 2637  violence under s. 784.046, whether the order of injunction is
 2638  temporary or final, and for which the individual was the
 2639  petitioner.
 2640         (3)A facility requesting appointment of a guardian
 2641  advocate must, before the appointment, provide the prospective
 2642  guardian advocate with information about the duties and
 2643  responsibilities of guardian advocates, including information
 2644  about the ethics of medical decisionmaking. Before asking a
 2645  guardian advocate to give consent to treatment for a patient,
 2646  the facility must provide to the guardian advocate sufficient
 2647  information so that the guardian advocate can decide whether to
 2648  give express and informed consent to the treatment. Such
 2649  information must include information that demonstrates that the
 2650  treatment is essential to the care of the patient and does not
 2651  present an unreasonable risk of serious, hazardous, or
 2652  irreversible side effects. If possible, before giving consent to
 2653  treatment, the guardian advocate must personally meet and talk
 2654  with the patient and the patient’s physician. If that is not
 2655  possible, the discussion may be conducted by telephone. The
 2656  decision of the guardian advocate may be reviewed by the court,
 2657  upon petition of the patient’s attorney, the patient’s family,
 2658  or the facility administrator.
 2659         (4)In lieu of the training required for guardians
 2660  appointed pursuant to chapter 744, a guardian advocate shall
 2661  attend at least a 4-hour training course approved by the court
 2662  before exercising his or her authority. At a minimum, the
 2663  training course must include information about patient rights,
 2664  the diagnosis of substance abuse disorders, the ethics of
 2665  medical decisionmaking, and the duties of guardian advocates.
 2666         (5)The required training course and the information to be
 2667  supplied to prospective guardian advocates before their
 2668  appointment must be developed by the department, approved by the
 2669  chief judge of the circuit court, and taught by a court-approved
 2670  organization, which may include, but need not be limited to, a
 2671  community college, a guardianship organization, a local bar
 2672  association, or The Florida Bar. The training course may be web
 2673  based, provided in video format, or provided in other electronic
 2674  means but must be capable of ensuring the identity and
 2675  participation of the prospective guardian advocate. The court
 2676  may waive some or all of the training requirements for guardian
 2677  advocates or impose additional requirements. The court shall
 2678  make its decision on a case-by-case basis and, in making its
 2679  decision, shall consider the experience and education of the
 2680  guardian advocate, the duties assigned to the guardian advocate,
 2681  and the needs of the patient.
 2682         (6)In selecting a guardian advocate, the court shall give
 2683  preference to the patient’s health care surrogate, if one has
 2684  already been designated by the patient. If the patient has not
 2685  previously designated a health care surrogate, the selection
 2686  shall be made, except for good cause documented in the court
 2687  record, from among the following persons, listed in order of
 2688  priority:
 2689         (a)The spouse of the patient.
 2690         (b)An adult child of the patient.
 2691         (c)A parent of the patient.
 2692         (d)The adult next of kin of the patient.
 2693         (e)An adult friend of the patient.
 2694         (f)An adult trained and willing to serve as the guardian
 2695  advocate for the patient.
 2696         (7)If a guardian with the authority to consent to medical
 2697  treatment has not already been appointed, or if the patient has
 2698  not already designated a health care surrogate, the court may
 2699  authorize the guardian advocate to consent to medical treatment
 2700  as well as substance abuse disorder treatment. Unless otherwise
 2701  limited by the court, a guardian advocate with authority to
 2702  consent to medical treatment has the same authority to make
 2703  health care decisions and is subject to the same restrictions as
 2704  a proxy appointed under part IV of chapter 765. Unless the
 2705  guardian advocate has sought and received express court approval
 2706  in a proceeding separate from the proceeding to determine the
 2707  competence of the patient to consent to medical treatment, the
 2708  guardian advocate may not consent to:
 2709         (a)Abortion.
 2710         (b)Sterilization.
 2711         (c)Electroshock therapy.
 2712         (d)Psychosurgery.
 2713         (e)Experimental treatments that have not been approved by
 2714  a federally approved institutional review board in accordance
 2715  with 45 C.F.R. part 46 or 21 C.F.R. part 56.
 2716  
 2717  The court must base its authorization on evidence that the
 2718  treatment or procedure is essential to the care of the patient
 2719  and that the treatment does not present an unreasonable risk of
 2720  serious, hazardous, or irreversible side effects. In complying
 2721  with this subsection, the court shall follow the procedures set
 2722  forth in subsection (1).
 2723         (8)The guardian advocate shall be discharged when the
 2724  patient is discharged from an order for involuntary services or
 2725  when the patient is transferred from involuntary to voluntary
 2726  status. The court or a hearing officer shall consider the
 2727  competence of the patient as provided in subsection (1) and may
 2728  consider an involuntarily placed patient’s competence to consent
 2729  to services at any hearing. Upon sufficient evidence, the court
 2730  may restore, or the magistrate may recommend that the court
 2731  restore, the patient’s competence. A copy of the order restoring
 2732  competence or the certificate of discharge containing the
 2733  restoration of competence shall be provided to the patient and
 2734  the guardian advocate.
 2735         Section 44. Paragraphs (d) through (m) of subsection (2) of
 2736  section 409.967, Florida Statutes, are redesignated as
 2737  paragraphs (e) through (n), respectively, and a new paragraph
 2738  (d) is added to that subsection, to read:
 2739         409.967 Managed care plan accountability.—
 2740         (2) The agency shall establish such contract requirements
 2741  as are necessary for the operation of the statewide managed care
 2742  program. In addition to any other provisions the agency may deem
 2743  necessary, the contract must require:
 2744         (d)Quality care.—Managed care plans shall provide, or
 2745  contract for the provision of, care coordination to facilitate
 2746  the appropriate delivery of behavioral health care services in
 2747  the least restrictive setting with treatment and recovery
 2748  capabilities that address the needs of the patient. Services
 2749  shall be provided in a manner that integrates behavioral health
 2750  services and primary care. Plans shall be required to achieve
 2751  specific behavioral health outcome standards, established by the
 2752  agency in consultation with the department.
 2753         Section 45. Subsection (5) is added to section 409.973,
 2754  Florida Statutes, to read:
 2755         409.973 Benefits.—
 2756         (5)INTEGRATED BEHAVIORAL HEALTH INITIATIVE.—Each plan
 2757  operating in the managed medical assistance program shall work
 2758  with the managing entity in its service area to establish
 2759  specific organizational supports and protocols that enhance the
 2760  integration and coordination of primary care and behavioral
 2761  health services for Medicaid recipients. Progress in this
 2762  initiative shall be measured using the integration framework and
 2763  core measures developed by the Agency for Healthcare Research
 2764  and Quality.
 2765         Section 46. Notwithstanding the amendment made to s.
 2766  409.975(6), Florida Statutes, by HB 5101, 1st Eng., 2016 Regular
 2767  Session, subsection (6) of section 409.975, Florida Statutes, is
 2768  reenacted to read:
 2769         409.975 Managed care plan accountability.—In addition to
 2770  the requirements of s. 409.967, plans and providers
 2771  participating in the managed medical assistance program shall
 2772  comply with the requirements of this section.
 2773         (6) PROVIDER PAYMENT.—Managed care plans and hospitals
 2774  shall negotiate mutually acceptable rates, methods, and terms of
 2775  payment. For rates, methods, and terms of payment negotiated
 2776  after the contract between the agency and the plan is executed,
 2777  plans shall pay hospitals, at a minimum, the rate the agency
 2778  would have paid on the first day of the contract between the
 2779  provider and the plan. Such payments to hospitals may not exceed
 2780  120 percent of the rate the agency would have paid on the first
 2781  day of the contract between the provider and the plan, unless
 2782  specifically approved by the agency. Payment rates may be
 2783  updated periodically.
 2784         Section 47. It is the intent of the Legislature that the
 2785  reenactment of s. 409.975(6), Florida Statutes, shall control
 2786  over the amendment to that subsection made by HB 5101, 1st Eng.,
 2787  2016 Regular Session, regardless of the order in which they are
 2788  enacted.
 2789         Section 48. Section 491.0045, Florida Statutes, is amended
 2790  to read:
 2791         491.0045 Intern registration; requirements.—
 2792         (1) Effective January 1, 1998, An individual who has not
 2793  satisfied intends to practice in Florida to satisfy the
 2794  postgraduate or post-master’s level experience requirements, as
 2795  specified in s. 491.005(1)(c), (3)(c), or (4)(c), must register
 2796  as an intern in the profession for which he or she is seeking
 2797  licensure before prior to commencing the post-master’s
 2798  experience requirement or an individual who intends to satisfy
 2799  part of the required graduate-level practicum, internship, or
 2800  field experience, outside the academic arena for any profession,
 2801  must register as an intern in the profession for which he or she
 2802  is seeking licensure before prior to commencing the practicum,
 2803  internship, or field experience.
 2804         (2) The department shall register as a clinical social
 2805  worker intern, marriage and family therapist intern, or mental
 2806  health counselor intern each applicant who the board certifies
 2807  has:
 2808         (a) Completed the application form and remitted a
 2809  nonrefundable application fee not to exceed $200, as set by
 2810  board rule;
 2811         (b)1. Completed the education requirements as specified in
 2812  s. 491.005(1)(c), (3)(c), or (4)(c) for the profession for which
 2813  he or she is applying for licensure, if needed; and
 2814         2. Submitted an acceptable supervision plan, as determined
 2815  by the board, for meeting the practicum, internship, or field
 2816  work required for licensure that was not satisfied in his or her
 2817  graduate program.
 2818         (c) Identified a qualified supervisor.
 2819         (3) An individual registered under this section must remain
 2820  under supervision while practicing under registered intern
 2821  status until he or she is in receipt of a license or a letter
 2822  from the department stating that he or she is licensed to
 2823  practice the profession for which he or she applied.
 2824         (4)An individual who has applied for intern registration
 2825  on or before December 31, 2001, and has satisfied the education
 2826  requirements of s. 491.005 that are in effect through December
 2827  31, 2000, will have met the educational requirements for
 2828  licensure for the profession for which he or she has applied.
 2829         (4)(5)An individual who fails Individuals who have
 2830  commenced the experience requirement as specified in s.
 2831  491.005(1)(c), (3)(c), or (4)(c) but failed to register as
 2832  required by subsection (1) shall register with the department
 2833  before January 1, 2000. Individuals who fail to comply with this
 2834  section may subsection shall not be granted a license under this
 2835  chapter, and any time spent by the individual completing the
 2836  experience requirement as specified in s. 491.005(1)(c), (3)(c),
 2837  or (4)(c) before prior to registering as an intern does shall
 2838  not count toward completion of the such requirement.
 2839         (5)An intern registration is valid for 5 years.
 2840         (6)A registration issued on or before March 31, 2017,
 2841  expires March 31, 2022, and may not be renewed or reissued. Any
 2842  registration issued after March 31, 2017, expires 60 months
 2843  after the date it is issued. A subsequent intern registration
 2844  may not be issued unless the candidate has passed the theory and
 2845  practice examination described in s. 491.005(1)(d), (3)(d), and
 2846  (4)(d).
 2847         (7)An individual who has held a provisional license issued
 2848  by the board may not apply for an intern registration in the
 2849  same profession.
 2850         Section 49. Section 394.4674, Florida Statutes, is
 2851  repealed.
 2852         Section 50. Section 394.4985, Florida Statutes, is
 2853  repealed.
 2854         Section 51. Section 394.745, Florida Statutes, is repealed.
 2855         Section 52. Section 397.331, Florida Statutes, is repealed.
 2856         Section 53. Section 397.801, Florida Statutes, is repealed.
 2857         Section 54. Section 397.811, Florida Statutes, is repealed.
 2858         Section 55. Section 397.821, Florida Statutes, is repealed.
 2859         Section 56. Section 397.901, Florida Statutes, is repealed.
 2860         Section 57. Section 397.93, Florida Statutes, is repealed.
 2861         Section 58. Section 397.94, Florida Statutes, is repealed.
 2862         Section 59. Section 397.951, Florida Statutes, is repealed.
 2863         Section 60. Section 397.97, Florida Statutes, is repealed.
 2864         Section 61. Section 397.98, Florida Statutes, is repealed.
 2865         Section 62. Paragraph (a) of subsection (3) of section
 2866  39.407, Florida Statutes, is amended to read:
 2867         39.407 Medical, psychiatric, and psychological examination
 2868  and treatment of child; physical, mental, or substance abuse
 2869  examination of person with or requesting child custody.—
 2870         (3)(a)1. Except as otherwise provided in subparagraph (b)1.
 2871  or paragraph (e), before the department provides psychotropic
 2872  medications to a child in its custody, the prescribing physician
 2873  shall attempt to obtain express and informed consent, as defined
 2874  in s. 394.455(15) s. 394.455(9) and as described in s.
 2875  394.459(3)(a), from the child’s parent or legal guardian. The
 2876  department must take steps necessary to facilitate the inclusion
 2877  of the parent in the child’s consultation with the physician.
 2878  However, if the parental rights of the parent have been
 2879  terminated, the parent’s location or identity is unknown or
 2880  cannot reasonably be ascertained, or the parent declines to give
 2881  express and informed consent, the department may, after
 2882  consultation with the prescribing physician, seek court
 2883  authorization to provide the psychotropic medications to the
 2884  child. Unless parental rights have been terminated and if it is
 2885  possible to do so, the department shall continue to involve the
 2886  parent in the decisionmaking process regarding the provision of
 2887  psychotropic medications. If, at any time, a parent whose
 2888  parental rights have not been terminated provides express and
 2889  informed consent to the provision of a psychotropic medication,
 2890  the requirements of this section that the department seek court
 2891  authorization do not apply to that medication until such time as
 2892  the parent no longer consents.
 2893         2. Any time the department seeks a medical evaluation to
 2894  determine the need to initiate or continue a psychotropic
 2895  medication for a child, the department must provide to the
 2896  evaluating physician all pertinent medical information known to
 2897  the department concerning that child.
 2898         Section 63. Subsection (1) of section 39.524, Florida
 2899  Statutes, is amended to read:
 2900         39.524 Safe-harbor placement.—
 2901         (1) Except as provided in s. 39.407 or s. 985.801, a
 2902  dependent child 6 years of age or older who has been found to be
 2903  a victim of sexual exploitation as defined in s. 39.01(70)(g) s.
 2904  39.01(69)(g) must be assessed for placement in a safe house or
 2905  safe foster home as provided in s. 409.1678 using the initial
 2906  screening and assessment instruments provided in s. 409.1754(1).
 2907  If such placement is determined to be appropriate for the child
 2908  as a result of this assessment, the child may be placed in a
 2909  safe house or safe foster home, if one is available. However,
 2910  the child may be placed in another setting, if the other setting
 2911  is more appropriate to the child’s needs or if a safe house or
 2912  safe foster home is unavailable, as long as the child’s
 2913  behaviors are managed so as not to endanger other children
 2914  served in that setting.
 2915         Section 64. Paragraph (e) of subsection (5) of section
 2916  212.055, Florida Statutes, is amended to read:
 2917         212.055 Discretionary sales surtaxes; legislative intent;
 2918  authorization and use of proceeds.—It is the legislative intent
 2919  that any authorization for imposition of a discretionary sales
 2920  surtax shall be published in the Florida Statutes as a
 2921  subsection of this section, irrespective of the duration of the
 2922  levy. Each enactment shall specify the types of counties
 2923  authorized to levy; the rate or rates which may be imposed; the
 2924  maximum length of time the surtax may be imposed, if any; the
 2925  procedure which must be followed to secure voter approval, if
 2926  required; the purpose for which the proceeds may be expended;
 2927  and such other requirements as the Legislature may provide.
 2928  Taxable transactions and administrative procedures shall be as
 2929  provided in s. 212.054.
 2930         (5) COUNTY PUBLIC HOSPITAL SURTAX.—Any county as defined in
 2931  s. 125.011(1) may levy the surtax authorized in this subsection
 2932  pursuant to an ordinance either approved by extraordinary vote
 2933  of the county commission or conditioned to take effect only upon
 2934  approval by a majority vote of the electors of the county voting
 2935  in a referendum. In a county as defined in s. 125.011(1), for
 2936  the purposes of this subsection, “county public general
 2937  hospital” means a general hospital as defined in s. 395.002
 2938  which is owned, operated, maintained, or governed by the county
 2939  or its agency, authority, or public health trust.
 2940         (e) A governing board, agency, or authority shall be
 2941  chartered by the county commission upon this act becoming law.
 2942  The governing board, agency, or authority shall adopt and
 2943  implement a health care plan for indigent health care services.
 2944  The governing board, agency, or authority shall consist of no
 2945  more than seven and no fewer than five members appointed by the
 2946  county commission. The members of the governing board, agency,
 2947  or authority shall be at least 18 years of age and residents of
 2948  the county. No member may be employed by or affiliated with a
 2949  health care provider or the public health trust, agency, or
 2950  authority responsible for the county public general hospital.
 2951  The following community organizations shall each appoint a
 2952  representative to a nominating committee: the South Florida
 2953  Hospital and Healthcare Association, the Miami-Dade County
 2954  Public Health Trust, the Dade County Medical Association, the
 2955  Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade
 2956  County. This committee shall nominate between 10 and 14 county
 2957  citizens for the governing board, agency, or authority. The
 2958  slate shall be presented to the county commission and the county
 2959  commission shall confirm the top five to seven nominees,
 2960  depending on the size of the governing board. Until such time as
 2961  the governing board, agency, or authority is created, the funds
 2962  provided for in subparagraph (d)2. shall be placed in a
 2963  restricted account set aside from other county funds and not
 2964  disbursed by the county for any other purpose.
 2965         1. The plan shall divide the county into a minimum of four
 2966  and maximum of six service areas, with no more than one
 2967  participant hospital per service area. The county public general
 2968  hospital shall be designated as the provider for one of the
 2969  service areas. Services shall be provided through participants’
 2970  primary acute care facilities.
 2971         2. The plan and subsequent amendments to it shall fund a
 2972  defined range of health care services for both indigent persons
 2973  and the medically poor, including primary care, preventive care,
 2974  hospital emergency room care, and hospital care necessary to
 2975  stabilize the patient. For the purposes of this section,
 2976  “stabilization” means stabilization as defined in s. 397.311(44)
 2977  s. 397.311(41). Where consistent with these objectives, the plan
 2978  may include services rendered by physicians, clinics, community
 2979  hospitals, and alternative delivery sites, as well as at least
 2980  one regional referral hospital per service area. The plan shall
 2981  provide that agreements negotiated between the governing board,
 2982  agency, or authority and providers shall recognize hospitals
 2983  that render a disproportionate share of indigent care, provide
 2984  other incentives to promote the delivery of charity care to draw
 2985  down federal funds where appropriate, and require cost
 2986  containment, including, but not limited to, case management.
 2987  From the funds specified in subparagraphs (d)1. and 2. for
 2988  indigent health care services, service providers shall receive
 2989  reimbursement at a Medicaid rate to be determined by the
 2990  governing board, agency, or authority created pursuant to this
 2991  paragraph for the initial emergency room visit, and a per-member
 2992  per-month fee or capitation for those members enrolled in their
 2993  service area, as compensation for the services rendered
 2994  following the initial emergency visit. Except for provisions of
 2995  emergency services, upon determination of eligibility,
 2996  enrollment shall be deemed to have occurred at the time services
 2997  were rendered. The provisions for specific reimbursement of
 2998  emergency services shall be repealed on July 1, 2001, unless
 2999  otherwise reenacted by the Legislature. The capitation amount or
 3000  rate shall be determined before prior to program implementation
 3001  by an independent actuarial consultant. In no event shall such
 3002  reimbursement rates exceed the Medicaid rate. The plan must also
 3003  provide that any hospitals owned and operated by government
 3004  entities on or after the effective date of this act must, as a
 3005  condition of receiving funds under this subsection, afford
 3006  public access equal to that provided under s. 286.011 as to any
 3007  meeting of the governing board, agency, or authority the subject
 3008  of which is budgeting resources for the retention of charity
 3009  care, as that term is defined in the rules of the Agency for
 3010  Health Care Administration. The plan shall also include
 3011  innovative health care programs that provide cost-effective
 3012  alternatives to traditional methods of service and delivery
 3013  funding.
 3014         3. The plan’s benefits shall be made available to all
 3015  county residents currently eligible to receive health care
 3016  services as indigents or medically poor as defined in paragraph
 3017  (4)(d).
 3018         4. Eligible residents who participate in the health care
 3019  plan shall receive coverage for a period of 12 months or the
 3020  period extending from the time of enrollment to the end of the
 3021  current fiscal year, per enrollment period, whichever is less.
 3022         5. At the end of each fiscal year, the governing board,
 3023  agency, or authority shall prepare an audit that reviews the
 3024  budget of the plan, delivery of services, and quality of
 3025  services, and makes recommendations to increase the plan’s
 3026  efficiency. The audit shall take into account participant
 3027  hospital satisfaction with the plan and assess the amount of
 3028  poststabilization patient transfers requested, and accepted or
 3029  denied, by the county public general hospital.
 3030         Section 65. Paragraph (c) of subsection (2) of section
 3031  394.4599, Florida Statutes, is amended to read:
 3032         394.4599 Notice.—
 3033         (2) INVOLUNTARY ADMISSION.—
 3034         (c)1. A receiving facility shall give notice of the
 3035  whereabouts of a minor who is being involuntarily held for
 3036  examination pursuant to s. 394.463 to the minor’s parent,
 3037  guardian, caregiver, or guardian advocate, in person or by
 3038  telephone or other form of electronic communication, immediately
 3039  after the minor’s arrival at the facility. The facility may
 3040  delay notification for no more than 24 hours after the minor’s
 3041  arrival if the facility has submitted a report to the central
 3042  abuse hotline, pursuant to s. 39.201, based upon knowledge or
 3043  suspicion of abuse, abandonment, or neglect and if the facility
 3044  deems a delay in notification to be in the minor’s best
 3045  interest.
 3046         2. The receiving facility shall attempt to notify the
 3047  minor’s parent, guardian, caregiver, or guardian advocate until
 3048  the receiving facility receives confirmation from the parent,
 3049  guardian, caregiver, or guardian advocate, verbally, by
 3050  telephone or other form of electronic communication, or by
 3051  recorded message, that notification has been received. Attempts
 3052  to notify the parent, guardian, caregiver, or guardian advocate
 3053  must be repeated at least once every hour during the first 12
 3054  hours after the minor’s arrival and once every 24 hours
 3055  thereafter and must continue until such confirmation is
 3056  received, unless the minor is released at the end of the 72-hour
 3057  examination period, or until a petition for involuntary services
 3058  placement is filed with the court pursuant to s. 394.463(2)(g)
 3059  s. 394.463(2)(i). The receiving facility may seek assistance
 3060  from a law enforcement agency to notify the minor’s parent,
 3061  guardian, caregiver, or guardian advocate if the facility has
 3062  not received within the first 24 hours after the minor’s arrival
 3063  a confirmation by the parent, guardian, caregiver, or guardian
 3064  advocate that notification has been received. The receiving
 3065  facility must document notification attempts in the minor’s
 3066  clinical record.
 3067         Section 66. Subsection (3) and paragraph (p) of subsection
 3068  (4) of section 394.495, Florida Statutes, are amended to read:
 3069         394.495 Child and adolescent mental health system of care;
 3070  programs and services.—
 3071         (3) Assessments must be performed by:
 3072         (a) A professional as defined in s. 394.455(5), (7), (32),
 3073  (35), or (36) s. 394.455(2), (4), (21), (23), or (24);
 3074         (b) A professional licensed under chapter 491; or
 3075         (c) A person who is under the direct supervision of a
 3076  qualified professional as defined in s. 394.455(5), (7), (32),
 3077  (35), or (36) s. 394.455(2), (4), (21), (23), or (24) or a
 3078  professional licensed under chapter 491.
 3079         (4) The array of services may include, but is not limited
 3080  to:
 3081         (p) Trauma-informed services for children who have suffered
 3082  sexual exploitation as defined in s. 39.01(70)(g) s.
 3083  39.01(69)(g).
 3084         Section 67. Subsection (5) of section 394.496, Florida
 3085  Statutes, is amended to read:
 3086         394.496 Service planning.—
 3087         (5) A professional as defined in s. 394.455(5), (7), (32),
 3088  (35), or (36) s. 394.455(2), (4), (21), (23), or (24) or a
 3089  professional licensed under chapter 491 must be included among
 3090  those persons developing the services plan.
 3091         Section 68. Subsection (6) of section 394.9085, Florida
 3092  Statutes, is amended to read:
 3093         394.9085 Behavioral provider liability.—
 3094         (6) For purposes of this section, the terms “detoxification
 3095  services,” “addictions receiving facility,” and “receiving
 3096  facility” have the same meanings as those provided in ss.
 3097  397.311(25)(a)4., 397.311(25)(a)1., and 394.455(39) ss.
 3098  397.311(22)(a)4., 397.311(22)(a)1., and 394.455(26),
 3099  respectively.
 3100         Section 69. Subsections (16) through (20) of section
 3101  397.321, Florida Statutes, are renumbered as subsections (15)
 3102  through (19), respectively, and present subsection (15) of that
 3103  section is amended, to read:
 3104         397.321 Duties of the department.—The department shall:
 3105         (15)Appoint a substance abuse impairment coordinator to
 3106  represent the department in efforts initiated by the statewide
 3107  substance abuse impairment prevention and treatment coordinator
 3108  established in s. 397.801 and to assist the statewide
 3109  coordinator in fulfilling the responsibilities of that position.
 3110         Section 70. Subsection (8) of section 397.405, Florida
 3111  Statutes, is amended to read:
 3112         397.405 Exemptions from licensure.—The following are exempt
 3113  from the licensing provisions of this chapter:
 3114         (8) A legally cognizable church or nonprofit religious
 3115  organization or denomination providing substance abuse services,
 3116  including prevention services, which are solely religious,
 3117  spiritual, or ecclesiastical in nature. A church or nonprofit
 3118  religious organization or denomination providing any of the
 3119  licensed service components itemized under s. 397.311(25) s.
 3120  397.311(22) is not exempt from substance abuse licensure but
 3121  retains its exemption with respect to all services which are
 3122  solely religious, spiritual, or ecclesiastical in nature.
 3123  
 3124  The exemptions from licensure in this section do not apply to
 3125  any service provider that receives an appropriation, grant, or
 3126  contract from the state to operate as a service provider as
 3127  defined in this chapter or to any substance abuse program
 3128  regulated pursuant to s. 397.406. Furthermore, this chapter may
 3129  not be construed to limit the practice of a physician or
 3130  physician assistant licensed under chapter 458 or chapter 459, a
 3131  psychologist licensed under chapter 490, a psychotherapist
 3132  licensed under chapter 491, or an advanced registered nurse
 3133  practitioner licensed under part I of chapter 464, who provides
 3134  substance abuse treatment, so long as the physician, physician
 3135  assistant, psychologist, psychotherapist, or advanced registered
 3136  nurse practitioner does not represent to the public that he or
 3137  she is a licensed service provider and does not provide services
 3138  to individuals pursuant to part V of this chapter. Failure to
 3139  comply with any requirement necessary to maintain an exempt
 3140  status under this section is a misdemeanor of the first degree,
 3141  punishable as provided in s. 775.082 or s. 775.083.
 3142         Section 71. Subsections (1) and (5) of section 397.407,
 3143  Florida Statutes, are amended to read:
 3144         397.407 Licensure process; fees.—
 3145         (1) The department shall establish the licensure process to
 3146  include fees and categories of licenses and must prescribe a fee
 3147  range that is based, at least in part, on the number and
 3148  complexity of programs listed in s. 397.311(25) s. 397.311(22)
 3149  which are operated by a licensee. The fees from the licensure of
 3150  service components are sufficient to cover at least 50 percent
 3151  of the costs of regulating the service components. The
 3152  department shall specify a fee range for public and privately
 3153  funded licensed service providers. Fees for privately funded
 3154  licensed service providers must exceed the fees for publicly
 3155  funded licensed service providers.
 3156         (5) The department may issue probationary, regular, and
 3157  interim licenses. The department shall issue one license for
 3158  each service component that is operated by a service provider
 3159  and defined pursuant to s. 397.311(25) s. 397.311(22). The
 3160  license is valid only for the specific service components listed
 3161  for each specific location identified on the license. The
 3162  licensed service provider shall apply for a new license at least
 3163  60 days before the addition of any service components or 30 days
 3164  before the relocation of any of its service sites. Provision of
 3165  service components or delivery of services at a location not
 3166  identified on the license may be considered an unlicensed
 3167  operation that authorizes the department to seek an injunction
 3168  against operation as provided in s. 397.401, in addition to
 3169  other sanctions authorized by s. 397.415. Probationary and
 3170  regular licenses may be issued only after all required
 3171  information has been submitted. A license may not be
 3172  transferred. As used in this subsection, the term “transfer”
 3173  includes, but is not limited to, the transfer of a majority of
 3174  the ownership interest in the licensed entity or transfer of
 3175  responsibilities under the license to another entity by
 3176  contractual arrangement.
 3177         Section 72. Section 397.416, Florida Statutes, is amended
 3178  to read:
 3179         397.416 Substance abuse treatment services; qualified
 3180  professional.—Notwithstanding any other provision of law, a
 3181  person who was certified through a certification process
 3182  recognized by the former Department of Health and Rehabilitative
 3183  Services before January 1, 1995, may perform the duties of a
 3184  qualified professional with respect to substance abuse treatment
 3185  services as defined in this chapter, and need not meet the
 3186  certification requirements contained in s. 397.311(33) s.
 3187  397.311(30).
 3188         Section 73. Subsection (2) of section 397.4871, Florida
 3189  Statutes, is amended to read:
 3190         397.4871 Recovery residence administrator certification.—
 3191         (2) The department shall approve at least one credentialing
 3192  entity by December 1, 2015, for the purpose of developing and
 3193  administering a voluntary credentialing program for
 3194  administrators. The department shall approve any credentialing
 3195  entity that the department endorses pursuant to s. 397.321(15)
 3196  s. 397.321(16) if the credentialing entity also meets the
 3197  requirements of this section. The approved credentialing entity
 3198  shall:
 3199         (a) Establish recovery residence administrator core
 3200  competencies, certification requirements, testing instruments,
 3201  and recertification requirements.
 3202         (b) Establish a process to administer the certification
 3203  application, award, and maintenance processes.
 3204         (c) Develop and administer:
 3205         1. A code of ethics and disciplinary process.
 3206         2. Biennial continuing education requirements and annual
 3207  certification renewal requirements.
 3208         3. An education provider program to approve training
 3209  entities that are qualified to provide precertification training
 3210  to applicants and continuing education opportunities to
 3211  certified persons.
 3212         Section 74. Paragraph (c) of subsection (1) and paragraphs
 3213  (a) and (b) of subsection (6) of section 409.1678, Florida
 3214  Statutes, are amended to read:
 3215         409.1678 Specialized residential options for children who
 3216  are victims of sexual exploitation.—
 3217         (1) DEFINITIONS.—As used in this section, the term:
 3218         (c) “Sexually exploited child” means a child who has
 3219  suffered sexual exploitation as defined in s. 39.01(70)(g) s.
 3220  39.01(69)(g) and is ineligible for relief and benefits under the
 3221  federal Trafficking Victims Protection Act, 22 U.S.C. ss. 7101
 3222  et seq.
 3223         (6) LOCATION INFORMATION.—
 3224         (a) Information about the location of a safe house, safe
 3225  foster home, or other residential facility serving victims of
 3226  sexual exploitation, as defined in s. 39.01(70)(g) s.
 3227  39.01(69)(g), which is held by an agency, as defined in s.
 3228  119.011, is confidential and exempt from s. 119.07(1) and s.
 3229  24(a), Art. I of the State Constitution. This exemption applies
 3230  to such confidential and exempt information held by an agency
 3231  before, on, or after the effective date of the exemption.
 3232         (b) Information about the location of a safe house, safe
 3233  foster home, or other residential facility serving victims of
 3234  sexual exploitation, as defined in s. 39.01(70)(g) s.
 3235  39.01(69)(g), may be provided to an agency, as defined in s.
 3236  119.011, as necessary to maintain health and safety standards
 3237  and to address emergency situations in the safe house, safe
 3238  foster home, or other residential facility.
 3239         Section 75. Paragraph (e) of subsection (3) of section
 3240  409.966, Florida Statutes, is amended to read:
 3241         409.966 Eligible plans; selection.—
 3242         (3) QUALITY SELECTION CRITERIA.—
 3243         (e) To ensure managed care plan participation in Regions 1
 3244  and 2, the agency shall award an additional contract to each
 3245  plan with a contract award in Region 1 or Region 2. Such
 3246  contract shall be in any other region in which the plan
 3247  submitted a responsive bid and negotiates a rate acceptable to
 3248  the agency. If a plan that is awarded an additional contract
 3249  pursuant to this paragraph is subject to penalties pursuant to
 3250  s. 409.967(2)(i) s. 409.967(2)(h) for activities in Region 1 or
 3251  Region 2, the additional contract is automatically terminated
 3252  180 days after the imposition of the penalties. The plan must
 3253  reimburse the agency for the cost of enrollment changes and
 3254  other transition activities.
 3255         Section 76. Paragraph (b) of subsection (1) of section
 3256  409.972, Florida Statutes, is amended to read:
 3257         409.972 Mandatory and voluntary enrollment.—
 3258         (1) The following Medicaid-eligible persons are exempt from
 3259  mandatory managed care enrollment required by s. 409.965, and
 3260  may voluntarily choose to participate in the managed medical
 3261  assistance program:
 3262         (b) Medicaid recipients residing in residential commitment
 3263  facilities operated through the Department of Juvenile Justice
 3264  or a mental health treatment facility facilities as defined in
 3265  s. 394.455(47) by s. 394.455(32).
 3266         Section 77. Paragraphs (d) and (g) of subsection (1) of
 3267  section 440.102, Florida Statutes, are amended to read:
 3268         440.102 Drug-free workplace program requirements.—The
 3269  following provisions apply to a drug-free workplace program
 3270  implemented pursuant to law or to rules adopted by the Agency
 3271  for Health Care Administration:
 3272         (1) DEFINITIONS.—Except where the context otherwise
 3273  requires, as used in this act:
 3274         (d) “Drug rehabilitation program” means a service provider,
 3275  established pursuant to s. 397.311(42) s. 397.311(39), that
 3276  provides confidential, timely, and expert identification,
 3277  assessment, and resolution of employee drug abuse.
 3278         (g) “Employee assistance program” means an established
 3279  program capable of providing expert assessment of employee
 3280  personal concerns; confidential and timely identification
 3281  services with regard to employee drug abuse; referrals of
 3282  employees for appropriate diagnosis, treatment, and assistance;
 3283  and followup services for employees who participate in the
 3284  program or require monitoring after returning to work. If, in
 3285  addition to the above activities, an employee assistance program
 3286  provides diagnostic and treatment services, these services shall
 3287  in all cases be provided by service providers pursuant to s.
 3288  397.311(42) s. 397.311(39).
 3289         Section 78. Subsection (7) of section 744.704, Florida
 3290  Statutes, is amended to read:
 3291         744.704 Powers and duties.—
 3292         (7) A public guardian may shall not commit a ward to a
 3293  mental health treatment facility, as defined in s. 394.455(47)
 3294  s. 394.455(32), without an involuntary placement proceeding as
 3295  provided by law.
 3296         Section 79. Subsection (5) of section 960.065, Florida
 3297  Statutes, is amended to read:
 3298         960.065 Eligibility for awards.—
 3299         (5) A person is not ineligible for an award pursuant to
 3300  paragraph (2)(a), paragraph (2)(b), or paragraph (2)(c) if that
 3301  person is a victim of sexual exploitation of a child as defined
 3302  in s. 39.01(70)(g) s. 39.01(69)(g).
 3303         Section 80. The Secretary of Children and Families shall
 3304  appoint a workgroup to consider the feasibility of individuals
 3305  using advance directives to express the treatment wishes for
 3306  substance use disorders. The workgroup shall be composed of
 3307  individuals with expertise in the treatment of substance use
 3308  disorders. The workgroup must review the use of advance
 3309  directives in mental health, the use of advance directives for
 3310  substance use disorders in other states, and the use of similar
 3311  legal instruments to express the treatment wishes of individuals
 3312  suffering from substance use disorders. The workgroup shall
 3313  provide a report to the Governor, the President of the Senate,
 3314  and the Speaker of the House of Representatives by January 1,
 3315  2017. The report must include recommendations on the feasibility
 3316  of using advance directives for individuals with substance use
 3317  disorders and recommendations for any revisions to state laws or
 3318  agency rules. The members of the workgroup are not entitled to
 3319  reimbursement from the Department of Children and Families for
 3320  travel for workgroup meetings unless they are employees of the
 3321  department. This section expires on May 6, 2017.
 3322         Section 81. Paragraph (b) of subsection (2) of section
 3323  61.13, Florida Statutes, is amended to read:
 3324         61.13 Support of children; parenting and time-sharing;
 3325  powers of court.—
 3326         (2)
 3327         (b) A parenting plan approved by the court must, at a
 3328  minimum:,
 3329         1. Describe in adequate detail how the parents will share
 3330  and be responsible for the daily tasks associated with the
 3331  upbringing of the child;
 3332         2.Include the time-sharing schedule arrangements that
 3333  specify the time that the minor child will spend with each
 3334  parent;
 3335         3.Designate a designation of who will be responsible for:
 3336         a. Any and all forms of health care. If the court orders
 3337  shared parental responsibility over health care decisions, the
 3338  parenting plan must provide that either parent may consent to
 3339  mental health treatment for the child.
 3340         b. School-related matters, including the address to be used
 3341  for school-boundary determination and registration., and
 3342         c. Other activities; and
 3343         4.Describe in adequate detail the methods and technologies
 3344  that the parents will use to communicate with the child.
 3345         Section 82. Subsection (6) of section 39.001, Florida
 3346  Statutes, is amended to read:
 3347         39.001 Purposes and intent; personnel standards and
 3348  screening.—
 3349         (6) MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES.—
 3350         (a) The Legislature recognizes that early referral and
 3351  comprehensive treatment can help combat mental illnesses and
 3352  substance abuse disorders in families and that treatment is
 3353  cost-effective.
 3354         (b) The Legislature establishes the following goals for the
 3355  state related to mental illness and substance abuse treatment
 3356  services in the dependency process:
 3357         1. To ensure the safety of children.
 3358         2. To prevent and remediate the consequences of mental
 3359  illnesses and substance abuse disorders on families involved in
 3360  protective supervision or foster care and reduce the occurrences
 3361  of mental illnesses and substance abuse disorders, including
 3362  alcohol abuse or related disorders, for families who are at risk
 3363  of being involved in protective supervision or foster care.
 3364         3. To expedite permanency for children and reunify healthy,
 3365  intact families, when appropriate.
 3366         4. To support families in recovery.
 3367         (c) The Legislature finds that children in the care of the
 3368  state’s dependency system need appropriate health care services,
 3369  that the impact of mental illnesses and substance abuse
 3370  disorders on health indicates the need for health care services
 3371  to include treatment for mental health and substance abuse
 3372  disorders for services to children and parents, where
 3373  appropriate, and that it is in the state’s best interest that
 3374  such children be provided the services they need to enable them
 3375  to become and remain independent of state care. In order to
 3376  provide these services, the state’s dependency system must have
 3377  the ability to identify and provide appropriate intervention and
 3378  treatment for children with personal or family-related mental
 3379  illness and substance abuse problems.
 3380         (d) It is the intent of the Legislature to encourage the
 3381  use of the mental health court program model established under
 3382  chapter 394 and the drug court program model established under
 3383  by s. 397.334 and authorize courts to assess children and
 3384  persons who have custody or are requesting custody of children
 3385  where good cause is shown to identify and address mental
 3386  illnesses and substance abuse disorders problems as the court
 3387  deems appropriate at every stage of the dependency process.
 3388  Participation in treatment, including a mental health court
 3389  program or a treatment-based drug court program, may be required
 3390  by the court following adjudication. Participation in assessment
 3391  and treatment before prior to adjudication is shall be
 3392  voluntary, except as provided in s. 39.407(16).
 3393         (e) It is therefore the purpose of the Legislature to
 3394  provide authority for the state to contract with mental health
 3395  service providers and community substance abuse treatment
 3396  providers for the development and operation of specialized
 3397  support and overlay services for the dependency system, which
 3398  will be fully implemented and used as resources permit.
 3399         (f) Participation in a mental health court program or a the
 3400  treatment-based drug court program does not divest any public or
 3401  private agency of its responsibility for a child or adult, but
 3402  is intended to enable these agencies to better meet their needs
 3403  through shared responsibility and resources.
 3404         Section 83. Subsection (10) of section 39.507, Florida
 3405  Statutes, is amended to read:
 3406         39.507 Adjudicatory hearings; orders of adjudication.—
 3407         (10) After an adjudication of dependency, or a finding of
 3408  dependency in which where adjudication is withheld, the court
 3409  may order a person who has custody or is requesting custody of
 3410  the child to submit to a mental health or substance abuse
 3411  disorder assessment or evaluation. The order may be made only
 3412  upon good cause shown and pursuant to notice and procedural
 3413  requirements provided under the Florida Rules of Juvenile
 3414  Procedure. The assessment or evaluation must be administered by
 3415  an appropriate a qualified professional, as defined in s. 39.01
 3416  or s. 397.311. The court may also require such person to
 3417  participate in and comply with treatment and services identified
 3418  as necessary, including, when appropriate and available,
 3419  participation in and compliance with a mental health court
 3420  program established under chapter 394 or a treatment-based drug
 3421  court program established under s. 397.334. In addition to
 3422  supervision by the department, the court, including the mental
 3423  health court program or treatment-based drug court program, may
 3424  oversee the progress and compliance with treatment by a person
 3425  who has custody or is requesting custody of the child. The court
 3426  may impose appropriate available sanctions for noncompliance
 3427  upon a person who has custody or is requesting custody of the
 3428  child or make a finding of noncompliance for consideration in
 3429  determining whether an alternative placement of the child is in
 3430  the child’s best interests. Any order entered under this
 3431  subsection may be made only upon good cause shown. This
 3432  subsection does not authorize placement of a child with a person
 3433  seeking custody, other than the parent or legal custodian, who
 3434  requires mental health or substance abuse disorder treatment.
 3435         Section 84. Paragraph (b) of subsection (1) of section
 3436  39.521, Florida Statutes, is amended to read:
 3437         39.521 Disposition hearings; powers of disposition.—
 3438         (1) A disposition hearing shall be conducted by the court,
 3439  if the court finds that the facts alleged in the petition for
 3440  dependency were proven in the adjudicatory hearing, or if the
 3441  parents or legal custodians have consented to the finding of
 3442  dependency or admitted the allegations in the petition, have
 3443  failed to appear for the arraignment hearing after proper
 3444  notice, or have not been located despite a diligent search
 3445  having been conducted.
 3446         (b) When any child is adjudicated by a court to be
 3447  dependent, the court having jurisdiction of the child has the
 3448  power by order to:
 3449         1. Require the parent and, when appropriate, the legal
 3450  custodian and the child to participate in treatment and services
 3451  identified as necessary. The court may require the person who
 3452  has custody or who is requesting custody of the child to submit
 3453  to a mental health or substance abuse disorder assessment or
 3454  evaluation. The order may be made only upon good cause shown and
 3455  pursuant to notice and procedural requirements provided under
 3456  the Florida Rules of Juvenile Procedure. The mental health
 3457  assessment or evaluation must be administered by a qualified
 3458  professional, as defined in s. 39.01, and the substance abuse
 3459  assessment or evaluation must be administered by a qualified
 3460  professional as defined in s. 397.311. The court may also
 3461  require such person to participate in and comply with treatment
 3462  and services identified as necessary, including, when
 3463  appropriate and available, participation in and compliance with
 3464  a mental health court program established under chapter 394 or a
 3465  treatment-based drug court program established under s. 397.334.
 3466  In addition to supervision by the department, the court,
 3467  including the mental health court program or the treatment-based
 3468  drug court program, may oversee the progress and compliance with
 3469  treatment by a person who has custody or is requesting custody
 3470  of the child. The court may impose appropriate available
 3471  sanctions for noncompliance upon a person who has custody or is
 3472  requesting custody of the child or make a finding of
 3473  noncompliance for consideration in determining whether an
 3474  alternative placement of the child is in the child’s best
 3475  interests. Any order entered under this subparagraph may be made
 3476  only upon good cause shown. This subparagraph does not authorize
 3477  placement of a child with a person seeking custody of the child,
 3478  other than the child’s parent or legal custodian, who requires
 3479  mental health or substance abuse disorder treatment.
 3480         2. Require, if the court deems necessary, the parties to
 3481  participate in dependency mediation.
 3482         3. Require placement of the child either under the
 3483  protective supervision of an authorized agent of the department
 3484  in the home of one or both of the child’s parents or in the home
 3485  of a relative of the child or another adult approved by the
 3486  court, or in the custody of the department. Protective
 3487  supervision continues until the court terminates it or until the
 3488  child reaches the age of 18, whichever date is first. Protective
 3489  supervision shall be terminated by the court whenever the court
 3490  determines that permanency has been achieved for the child,
 3491  whether with a parent, another relative, or a legal custodian,
 3492  and that protective supervision is no longer needed. The
 3493  termination of supervision may be with or without retaining
 3494  jurisdiction, at the court’s discretion, and shall in either
 3495  case be considered a permanency option for the child. The order
 3496  terminating supervision by the department must shall set forth
 3497  the powers of the custodian of the child and shall include the
 3498  powers ordinarily granted to a guardian of the person of a minor
 3499  unless otherwise specified. Upon the court’s termination of
 3500  supervision by the department, no further judicial reviews are
 3501  not required if, so long as permanency has been established for
 3502  the child.
 3503         Section 85. Section 394.4655, Florida Statutes, is amended
 3504  to read:
 3505         394.4655 Involuntary outpatient services placement.—
 3506         (1)DEFINITIONS.—As used in this section, the term:
 3507         (a)“Court” means a circuit court or a criminal county
 3508  court.
 3509         (b)“Criminal county court” means a county court exercising
 3510  its original jurisdiction in a misdemeanor case under s. 34.01.
 3511         (2)(1) CRITERIA FOR INVOLUNTARY OUTPATIENT SERVICES
 3512  PLACEMENT.—A person may be ordered to involuntary outpatient
 3513  services placement upon a finding of the court, by clear and
 3514  convincing evidence, that the person meets all of the following
 3515  criteria by clear and convincing evidence:
 3516         (a) The person is 18 years of age or older.;
 3517         (b) The person has a mental illness.;
 3518         (c) The person is unlikely to survive safely in the
 3519  community without supervision, based on a clinical
 3520  determination.;
 3521         (d) The person has a history of lack of compliance with
 3522  treatment for mental illness.;
 3523         (e) The person has:
 3524         1. At least twice within the immediately preceding 36
 3525  months been involuntarily admitted to a receiving or treatment
 3526  facility as defined in s. 394.455, or has received mental health
 3527  services in a forensic or correctional facility. The 36-month
 3528  period does not include any period during which the person was
 3529  admitted or incarcerated; or
 3530         2. Engaged in one or more acts of serious violent behavior
 3531  toward self or others, or attempts at serious bodily harm to
 3532  himself or herself or others, within the preceding 36 months.;
 3533         (f) The person is, as a result of his or her mental
 3534  illness, unlikely to voluntarily participate in the recommended
 3535  treatment plan and either he or she has refused voluntary
 3536  services placement for treatment after sufficient and
 3537  conscientious explanation and disclosure of why the services are
 3538  necessary purpose of placement for treatment or he or she is
 3539  unable to determine for himself or herself whether services are
 3540  placement is necessary.;
 3541         (g) In view of the person’s treatment history and current
 3542  behavior, the person is in need of involuntary outpatient
 3543  services placement in order to prevent a relapse or
 3544  deterioration that would be likely to result in serious bodily
 3545  harm to himself or herself or others, or a substantial harm to
 3546  his or her well-being as set forth in s. 394.463(1).;
 3547         (h) It is likely that the person will benefit from
 3548  involuntary outpatient services. placement; and
 3549         (i) All available, less restrictive alternatives that would
 3550  offer an opportunity for improvement of his or her condition
 3551  have been judged to be inappropriate or unavailable.
 3552         (3)(2) INVOLUNTARY OUTPATIENT SERVICES PLACEMENT.—
 3553         (a)1. A patient who is being recommended for involuntary
 3554  outpatient services placement by the administrator of the
 3555  receiving facility where the patient has been examined may be
 3556  retained by the facility after adherence to the notice
 3557  procedures provided in s. 394.4599. The recommendation must be
 3558  supported by the opinion of a psychiatrist and the second
 3559  opinion of a clinical psychologist or another psychiatrist, both
 3560  of whom have personally examined the patient within the
 3561  preceding 72 hours, that the criteria for involuntary outpatient
 3562  services placement are met. However, in a county having a
 3563  population of fewer than 50,000, if the administrator certifies
 3564  that a psychiatrist or clinical psychologist is not available to
 3565  provide the second opinion, the second opinion may be provided
 3566  by a licensed physician who has postgraduate training and
 3567  experience in diagnosis and treatment of mental illness, a
 3568  physician assistant who has at least 3 years’ experience and is
 3569  supervised by such licensed physician or a psychiatrist, a
 3570  clinical social worker, and nervous disorders or by a
 3571  psychiatric nurse. Any second opinion authorized in this
 3572  subparagraph may be conducted through a face-to-face
 3573  examination, in person or by electronic means. Such
 3574  recommendation must be entered on an involuntary outpatient
 3575  services placement certificate that authorizes the receiving
 3576  facility to retain the patient pending completion of a hearing.
 3577  The certificate must shall be made a part of the patient’s
 3578  clinical record.
 3579         2. If the patient has been stabilized and no longer meets
 3580  the criteria for involuntary examination pursuant to s.
 3581  394.463(1), the patient must be released from the receiving
 3582  facility while awaiting the hearing for involuntary outpatient
 3583  services placement. Before filing a petition for involuntary
 3584  outpatient services treatment, the administrator of the a
 3585  receiving facility or a designated department representative
 3586  must identify the service provider that will have primary
 3587  responsibility for service provision under an order for
 3588  involuntary outpatient services placement, unless the person is
 3589  otherwise participating in outpatient psychiatric treatment and
 3590  is not in need of public financing for that treatment, in which
 3591  case the individual, if eligible, may be ordered to involuntary
 3592  treatment pursuant to the existing psychiatric treatment
 3593  relationship.
 3594         3. The service provider shall prepare a written proposed
 3595  treatment plan in consultation with the patient or the patient’s
 3596  guardian advocate, if appointed, for the court’s consideration
 3597  for inclusion in the involuntary outpatient services placement
 3598  order that addresses the nature and extent of the mental illness
 3599  and any co-occurring substance use disorder that necessitate
 3600  involuntary outpatient services. The treatment plan must specify
 3601  the likely level of care, including the use of medication, and
 3602  anticipated discharge criteria for terminating involuntary
 3603  outpatient services. The service provider shall also provide a
 3604  copy of the proposed treatment plan to the patient and the
 3605  administrator of the receiving facility. The treatment plan must
 3606  specify the nature and extent of the patient’s mental illness,
 3607  address the reduction of symptoms that necessitate involuntary
 3608  outpatient placement, and include measurable goals and
 3609  objectives for the services and treatment that are provided to
 3610  treat the person’s mental illness and assist the person in
 3611  living and functioning in the community or to prevent a relapse
 3612  or deterioration. Service providers may select and supervise
 3613  other individuals to implement specific aspects of the treatment
 3614  plan. The services in the treatment plan must be deemed
 3615  clinically appropriate by a physician, clinical psychologist,
 3616  psychiatric nurse, mental health counselor, marriage and family
 3617  therapist, or clinical social worker who consults with, or is
 3618  employed or contracted by, the service provider. The service
 3619  provider must certify to the court in the proposed treatment
 3620  plan whether sufficient services for improvement and
 3621  stabilization are currently available and whether the service
 3622  provider agrees to provide those services. If the service
 3623  provider certifies that the services in the proposed treatment
 3624  plan are not available, the petitioner may not file the
 3625  petition. The service provider must notify the managing entity
 3626  if the requested services are not available. The managing entity
 3627  must document such efforts to obtain the requested services.
 3628         (b) If a patient in involuntary inpatient placement meets
 3629  the criteria for involuntary outpatient services placement, the
 3630  administrator of the treatment facility may, before the
 3631  expiration of the period during which the treatment facility is
 3632  authorized to retain the patient, recommend involuntary
 3633  outpatient services placement. The recommendation must be
 3634  supported by the opinion of a psychiatrist and the second
 3635  opinion of a clinical psychologist or another psychiatrist, both
 3636  of whom have personally examined the patient within the
 3637  preceding 72 hours, that the criteria for involuntary outpatient
 3638  services placement are met. However, in a county having a
 3639  population of fewer than 50,000, if the administrator certifies
 3640  that a psychiatrist or clinical psychologist is not available to
 3641  provide the second opinion, the second opinion may be provided
 3642  by a licensed physician who has postgraduate training and
 3643  experience in diagnosis and treatment of mental illness, a
 3644  physician assistant who has at least three years’ experience and
 3645  is supervised by such licensed physician or a psychiatrist, a
 3646  clinical social worker, and nervous disorders or by a
 3647  psychiatric nurse. Any second opinion authorized in this
 3648  subparagraph may be conducted through a face-to-face
 3649  examination, in person or by electronic means. Such
 3650  recommendation must be entered on an involuntary outpatient
 3651  services placement certificate, and the certificate must be made
 3652  a part of the patient’s clinical record.
 3653         (c)1. The administrator of the treatment facility shall
 3654  provide a copy of the involuntary outpatient services placement
 3655  certificate and a copy of the state mental health discharge form
 3656  to the managing entity a department representative in the county
 3657  where the patient will be residing. For persons who are leaving
 3658  a state mental health treatment facility, the petition for
 3659  involuntary outpatient services placement must be filed in the
 3660  county where the patient will be residing.
 3661         2. The service provider that will have primary
 3662  responsibility for service provision shall be identified by the
 3663  designated department representative before prior to the order
 3664  for involuntary outpatient services placement and must, before
 3665  prior to filing a petition for involuntary outpatient services
 3666  placement, certify to the court whether the services recommended
 3667  in the patient’s discharge plan are available in the local
 3668  community and whether the service provider agrees to provide
 3669  those services. The service provider must develop with the
 3670  patient, or the patient’s guardian advocate, if appointed, a
 3671  treatment or service plan that addresses the needs identified in
 3672  the discharge plan. The plan must be deemed to be clinically
 3673  appropriate by a physician, clinical psychologist, psychiatric
 3674  nurse, mental health counselor, marriage and family therapist,
 3675  or clinical social worker, as defined in this chapter, who
 3676  consults with, or is employed or contracted by, the service
 3677  provider.
 3678         3. If the service provider certifies that the services in
 3679  the proposed treatment or service plan are not available, the
 3680  petitioner may not file the petition. The service provider must
 3681  notify the managing entity if the requested services are not
 3682  available. The managing entity must document such efforts to
 3683  obtain the requested services.
 3684         (4)(3) PETITION FOR INVOLUNTARY OUTPATIENT SERVICES
 3685  PLACEMENT.—
 3686         (a) A petition for involuntary outpatient services
 3687  placement may be filed by:
 3688         1. The administrator of a receiving facility; or
 3689         2. The administrator of a treatment facility.
 3690         (b) Each required criterion for involuntary outpatient
 3691  services placement must be alleged and substantiated in the
 3692  petition for involuntary outpatient services placement. A copy
 3693  of the certificate recommending involuntary outpatient services
 3694  placement completed by a qualified professional specified in
 3695  subsection (3) (2) must be attached to the petition. A copy of
 3696  the proposed treatment plan must be attached to the petition.
 3697  Before the petition is filed, the service provider shall certify
 3698  that the services in the proposed treatment plan are available.
 3699  If the necessary services are not available in the patient’s
 3700  local community to respond to the person’s individual needs, the
 3701  petition may not be filed. The service provider must notify the
 3702  managing entity if the requested services are not available. The
 3703  managing entity must document such efforts to obtain the
 3704  requested services.
 3705         (c) The petition for involuntary outpatient services
 3706  placement must be filed in the county where the patient is
 3707  located, unless the patient is being placed from a state
 3708  treatment facility, in which case the petition must be filed in
 3709  the county where the patient will reside. When the petition has
 3710  been filed, the clerk of the court shall provide copies of the
 3711  petition and the proposed treatment plan to the department, the
 3712  managing entity, the patient, the patient’s guardian or
 3713  representative, the state attorney, and the public defender or
 3714  the patient’s private counsel. A fee may not be charged for
 3715  filing a petition under this subsection.
 3716         (5)(4) APPOINTMENT OF COUNSEL.—Within 1 court working day
 3717  after the filing of a petition for involuntary outpatient
 3718  services placement, the court shall appoint the public defender
 3719  to represent the person who is the subject of the petition,
 3720  unless the person is otherwise represented by counsel. The clerk
 3721  of the court shall immediately notify the public defender of the
 3722  appointment. The public defender shall represent the person
 3723  until the petition is dismissed, the court order expires, or the
 3724  patient is discharged from involuntary outpatient services
 3725  placement. An attorney who represents the patient must be
 3726  provided shall have access to the patient, witnesses, and
 3727  records relevant to the presentation of the patient’s case and
 3728  shall represent the interests of the patient, regardless of the
 3729  source of payment to the attorney.
 3730         (6)(5) CONTINUANCE OF HEARING.—The patient is entitled,
 3731  with the concurrence of the patient’s counsel, to at least one
 3732  continuance of the hearing. The continuance shall be for a
 3733  period of up to 4 weeks.
 3734         (7)(6) HEARING ON INVOLUNTARY OUTPATIENT SERVICES
 3735  PLACEMENT.—
 3736         (a)1. The court shall hold the hearing on involuntary
 3737  outpatient services placement within 5 working days after the
 3738  filing of the petition, unless a continuance is granted. The
 3739  hearing must shall be held in the county where the petition is
 3740  filed, must shall be as convenient to the patient as is
 3741  consistent with orderly procedure, and must shall be conducted
 3742  in physical settings not likely to be injurious to the patient’s
 3743  condition. If the court finds that the patient’s attendance at
 3744  the hearing is not consistent with the best interests of the
 3745  patient and if the patient’s counsel does not object, the court
 3746  may waive the presence of the patient from all or any portion of
 3747  the hearing. The state attorney for the circuit in which the
 3748  patient is located shall represent the state, rather than the
 3749  petitioner, as the real party in interest in the proceeding.
 3750         2. The court may appoint a magistrate master to preside at
 3751  the hearing. One of the professionals who executed the
 3752  involuntary outpatient services placement certificate shall be a
 3753  witness. The patient and the patient’s guardian or
 3754  representative shall be informed by the court of the right to an
 3755  independent expert examination. If the patient cannot afford
 3756  such an examination, the court shall ensure that one is
 3757  provided, as otherwise provided by law provide for one. The
 3758  independent expert’s report is shall be confidential and not
 3759  discoverable, unless the expert is to be called as a witness for
 3760  the patient at the hearing. The court shall allow testimony from
 3761  individuals, including family members, deemed by the court to be
 3762  relevant under state law, regarding the person’s prior history
 3763  and how that prior history relates to the person’s current
 3764  condition. The testimony in the hearing must be given under
 3765  oath, and the proceedings must be recorded. The patient may
 3766  refuse to testify at the hearing.
 3767         (b)1. If the court concludes that the patient meets the
 3768  criteria for involuntary outpatient services placement pursuant
 3769  to subsection (2) (1), the court shall issue an order for
 3770  involuntary outpatient services placement. The court order shall
 3771  be for a period of up to 90 days 6 months. The order must
 3772  specify the nature and extent of the patient’s mental illness.
 3773  The order of the court and the treatment plan must shall be made
 3774  part of the patient’s clinical record. The service provider
 3775  shall discharge a patient from involuntary outpatient services
 3776  placement when the order expires or any time the patient no
 3777  longer meets the criteria for involuntary placement. Upon
 3778  discharge, the service provider shall send a certificate of
 3779  discharge to the court.
 3780         2. The court may not order the department or the service
 3781  provider to provide services if the program or service is not
 3782  available in the patient’s local community, if there is no space
 3783  available in the program or service for the patient, or if
 3784  funding is not available for the program or service. The service
 3785  provider must notify the managing entity if the requested
 3786  services are not available. The managing entity must document
 3787  such efforts to obtain the requested services. A copy of the
 3788  order must be sent to the managing entity Agency for Health Care
 3789  Administration by the service provider within 1 working day
 3790  after it is received from the court. The order may be submitted
 3791  electronically through existing data systems. After the
 3792  placement order for involuntary services is issued, the service
 3793  provider and the patient may modify provisions of the treatment
 3794  plan. For any material modification of the treatment plan to
 3795  which the patient or, if one is appointed, the patient’s
 3796  guardian advocate agrees, if appointed, does agree, the service
 3797  provider shall send notice of the modification to the court. Any
 3798  material modifications of the treatment plan which are contested
 3799  by the patient or the patient’s guardian advocate, if applicable
 3800  appointed, must be approved or disapproved by the court
 3801  consistent with subsection (3) (2).
 3802         3. If, in the clinical judgment of a physician, the patient
 3803  has failed or has refused to comply with the treatment ordered
 3804  by the court, and, in the clinical judgment of the physician,
 3805  efforts were made to solicit compliance and the patient may meet
 3806  the criteria for involuntary examination, a person may be
 3807  brought to a receiving facility pursuant to s. 394.463. If,
 3808  after examination, the patient does not meet the criteria for
 3809  involuntary inpatient placement pursuant to s. 394.467, the
 3810  patient must be discharged from the receiving facility. The
 3811  involuntary outpatient services placement order shall remain in
 3812  effect unless the service provider determines that the patient
 3813  no longer meets the criteria for involuntary outpatient services
 3814  placement or until the order expires. The service provider must
 3815  determine whether modifications should be made to the existing
 3816  treatment plan and must attempt to continue to engage the
 3817  patient in treatment. For any material modification of the
 3818  treatment plan to which the patient or the patient’s guardian
 3819  advocate, if applicable appointed, agrees does agree, the
 3820  service provider shall send notice of the modification to the
 3821  court. Any material modifications of the treatment plan which
 3822  are contested by the patient or the patient’s guardian advocate,
 3823  if applicable appointed, must be approved or disapproved by the
 3824  court consistent with subsection (3) (2).
 3825         (c) If, at any time before the conclusion of the initial
 3826  hearing on involuntary outpatient services placement, it appears
 3827  to the court that the person does not meet the criteria for
 3828  involuntary outpatient services placement under this section
 3829  but, instead, meets the criteria for involuntary inpatient
 3830  placement, the court may order the person admitted for
 3831  involuntary inpatient examination under s. 394.463. If the
 3832  person instead meets the criteria for involuntary assessment,
 3833  protective custody, or involuntary admission pursuant to s.
 3834  397.675, the court may order the person to be admitted for
 3835  involuntary assessment for a period of 5 days pursuant to s.
 3836  397.6811. Thereafter, all proceedings are shall be governed by
 3837  chapter 397.
 3838         (d) At the hearing on involuntary outpatient services
 3839  placement, the court shall consider testimony and evidence
 3840  regarding the patient’s competence to consent to services
 3841  treatment. If the court finds that the patient is incompetent to
 3842  consent to treatment, it shall appoint a guardian advocate as
 3843  provided in s. 394.4598. The guardian advocate shall be
 3844  appointed or discharged in accordance with s. 394.4598.
 3845         (e) The administrator of the receiving facility or the
 3846  designated department representative shall provide a copy of the
 3847  court order and adequate documentation of a patient’s mental
 3848  illness to the service provider for involuntary outpatient
 3849  services placement. Such documentation must include any advance
 3850  directives made by the patient, a psychiatric evaluation of the
 3851  patient, and any evaluations of the patient performed by a
 3852  clinical psychologist or a clinical social worker.
 3853         (8)(7) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT
 3854  SERVICES PLACEMENT.—
 3855         (a)1. If the person continues to meet the criteria for
 3856  involuntary outpatient services placement, the service provider
 3857  shall, at least 10 days before the expiration of the period
 3858  during which the treatment is ordered for the person, file in
 3859  the circuit court that issued the order for involuntary
 3860  outpatient services a petition for continued involuntary
 3861  outpatient services placement. The court shall immediately
 3862  schedule a hearing on the petition to be held within 15 days
 3863  after the petition is filed.
 3864         2. The existing involuntary outpatient services placement
 3865  order remains in effect until disposition on the petition for
 3866  continued involuntary outpatient services placement.
 3867         3. A certificate shall be attached to the petition which
 3868  includes a statement from the person’s physician or clinical
 3869  psychologist justifying the request, a brief description of the
 3870  patient’s treatment during the time he or she was receiving
 3871  involuntary services involuntarily placed, and an individualized
 3872  plan of continued treatment.
 3873         4. The service provider shall develop the individualized
 3874  plan of continued treatment in consultation with the patient or
 3875  the patient’s guardian advocate, if applicable appointed. When
 3876  the petition has been filed, the clerk of the court shall
 3877  provide copies of the certificate and the individualized plan of
 3878  continued services treatment to the department, the patient, the
 3879  patient’s guardian advocate, the state attorney, and the
 3880  patient’s private counsel or the public defender.
 3881         (b) Within 1 court working day after the filing of a
 3882  petition for continued involuntary outpatient services
 3883  placement, the court shall appoint the public defender to
 3884  represent the person who is the subject of the petition, unless
 3885  the person is otherwise represented by counsel. The clerk of the
 3886  court shall immediately notify the public defender of such
 3887  appointment. The public defender shall represent the person
 3888  until the petition is dismissed or the court order expires or
 3889  the patient is discharged from involuntary outpatient services
 3890  placement. Any attorney representing the patient shall have
 3891  access to the patient, witnesses, and records relevant to the
 3892  presentation of the patient’s case and shall represent the
 3893  interests of the patient, regardless of the source of payment to
 3894  the attorney.
 3895         (c) Hearings on petitions for continued involuntary
 3896  outpatient services must placement shall be before the circuit
 3897  court that issued the order for involuntary outpatient services.
 3898  The court may appoint a magistrate master to preside at the
 3899  hearing. The procedures for obtaining an order pursuant to this
 3900  paragraph must meet the requirements of shall be in accordance
 3901  with subsection (7) (6), except that the time period included in
 3902  paragraph (2)(e) (1)(e) is not applicable in determining the
 3903  appropriateness of additional periods of involuntary outpatient
 3904  placement.
 3905         (d) Notice of the hearing must shall be provided as set
 3906  forth in s. 394.4599. The patient and the patient’s attorney may
 3907  agree to a period of continued outpatient services placement
 3908  without a court hearing.
 3909         (e) The same procedure must shall be repeated before the
 3910  expiration of each additional period the patient is placed in
 3911  treatment.
 3912         (f) If the patient has previously been found incompetent to
 3913  consent to treatment, the court shall consider testimony and
 3914  evidence regarding the patient’s competence. Section 394.4598
 3915  governs the discharge of the guardian advocate if the patient’s
 3916  competency to consent to treatment has been restored.
 3917         Section 86. Paragraphs (c) and (d) of subsection (2) of
 3918  section 394.4599, Florida Statutes, are amended to read:
 3919         394.4599 Notice.—
 3920         (2) INVOLUNTARY ADMISSION.—
 3921         (c)1. A receiving facility shall give notice of the
 3922  whereabouts of a minor who is being involuntarily held for
 3923  examination pursuant to s. 394.463 to the minor’s parent,
 3924  guardian, caregiver, or guardian advocate, in person or by
 3925  telephone or other form of electronic communication, immediately
 3926  after the minor’s arrival at the facility. The facility may
 3927  delay notification for no more than 24 hours after the minor’s
 3928  arrival if the facility has submitted a report to the central
 3929  abuse hotline, pursuant to s. 39.201, based upon knowledge or
 3930  suspicion of abuse, abandonment, or neglect and if the facility
 3931  deems a delay in notification to be in the minor’s best
 3932  interest.
 3933         2. The receiving facility shall attempt to notify the
 3934  minor’s parent, guardian, caregiver, or guardian advocate until
 3935  the receiving facility receives confirmation from the parent,
 3936  guardian, caregiver, or guardian advocate, verbally, by
 3937  telephone or other form of electronic communication, or by
 3938  recorded message, that notification has been received. Attempts
 3939  to notify the parent, guardian, caregiver, or guardian advocate
 3940  must be repeated at least once every hour during the first 12
 3941  hours after the minor’s arrival and once every 24 hours
 3942  thereafter and must continue until such confirmation is
 3943  received, unless the minor is released at the end of the 72-hour
 3944  examination period, or until a petition for involuntary services
 3945  placement is filed with the court pursuant to s. 394.463(2)(g)
 3946  s. 394.463(2)(i). The receiving facility may seek assistance
 3947  from a law enforcement agency to notify the minor’s parent,
 3948  guardian, caregiver, or guardian advocate if the facility has
 3949  not received within the first 24 hours after the minor’s arrival
 3950  a confirmation by the parent, guardian, caregiver, or guardian
 3951  advocate that notification has been received. The receiving
 3952  facility must document notification attempts in the minor’s
 3953  clinical record.
 3954         (d) The written notice of the filing of the petition for
 3955  involuntary services for placement of an individual being held
 3956  must contain the following:
 3957         1. Notice that the petition for:
 3958         a.Involuntary inpatient treatment pursuant to s. 394.467
 3959  has been filed with the circuit court in the county in which the
 3960  individual is hospitalized and the address of such court; or
 3961         b.Involuntary outpatient services pursuant to s. 394.4655
 3962  has been filed with the criminal county court, as defined in s.
 3963  394.4655(1), or the circuit court, as applicable, in the county
 3964  in which the individual is hospitalized and the address of such
 3965  court.
 3966         2. Notice that the office of the public defender has been
 3967  appointed to represent the individual in the proceeding, if the
 3968  individual is not otherwise represented by counsel.
 3969         3. The date, time, and place of the hearing and the name of
 3970  each examining expert and every other person expected to testify
 3971  in support of continued detention.
 3972         4. Notice that the individual, the individual’s guardian,
 3973  guardian advocate, health care surrogate or proxy, or
 3974  representative, or the administrator may apply for a change of
 3975  venue for the convenience of the parties or witnesses or because
 3976  of the condition of the individual.
 3977         5. Notice that the individual is entitled to an independent
 3978  expert examination and, if the individual cannot afford such an
 3979  examination, that the court will provide for one.
 3980         Section 87. Section 394.455, Florida Statutes, is amended
 3981  to read:
 3982         394.455 Definitions.—As used in this part, unless the
 3983  context clearly requires otherwise, the term:
 3984         (1)“Access center” means a facility that has medical,
 3985  mental health, and substance abuse professionals to provide
 3986  emergency screening and evaluation for mental health or
 3987  substance abuse disorders and may provide transportation to an
 3988  appropriate facility if an individual is in need of more
 3989  intensive services.
 3990         (2)“Addictions receiving facility” is a secure, acute care
 3991  facility that, at a minimum, provides emergency screening,
 3992  evaluation, detoxification, and stabilization services; is
 3993  operated 24 hours per day, 7 days per week; and is designated by
 3994  the department to serve individuals found to have substance
 3995  abuse impairment who qualify for services under this part.
 3996         (3)(1) “Administrator” means the chief administrative
 3997  officer of a receiving or treatment facility or his or her
 3998  designee.
 3999         (4)“Adult” means an individual who is 18 years of age or
 4000  older or who has had the disability of nonage removed under
 4001  chapter 743.
 4002         (5)(2) “Clinical psychologist” means a psychologist as
 4003  defined in s. 490.003(7) with 3 years of postdoctoral experience
 4004  in the practice of clinical psychology, inclusive of the
 4005  experience required for licensure, or a psychologist employed by
 4006  a facility operated by the United States Department of Veterans
 4007  Affairs that qualifies as a receiving or treatment facility
 4008  under this part.
 4009         (6)(3) “Clinical record” means all parts of the record
 4010  required to be maintained and includes all medical records,
 4011  progress notes, charts, and admission and discharge data, and
 4012  all other information recorded by a facility staff which
 4013  pertains to the patient’s hospitalization or treatment.
 4014         (7)(4) “Clinical social worker” means a person licensed as
 4015  a clinical social worker under s. 491.005 or s. 491.006 chapter
 4016  491.
 4017         (8)(5) “Community facility” means a any community service
 4018  provider that contracts contracting with the department to
 4019  furnish substance abuse or mental health services under part IV
 4020  of this chapter.
 4021         (9)(6) “Community mental health center or clinic” means a
 4022  publicly funded, not-for-profit center that which contracts with
 4023  the department for the provision of inpatient, outpatient, day
 4024  treatment, or emergency services.
 4025         (10)(7) “Court,” unless otherwise specified, means the
 4026  circuit court.
 4027         (11)(8) “Department” means the Department of Children and
 4028  Families.
 4029         (12)“Designated receiving facility” means a facility
 4030  approved by the department which may be a public or private
 4031  hospital, crisis stabilization unit, or addictions receiving
 4032  facility; which provides, at a minimum, emergency screening,
 4033  evaluation, and short-term stabilization for mental health or
 4034  substance abuse disorders; and which may have an agreement with
 4035  a corresponding facility for transportation and services.
 4036         (13)“Detoxification facility” means a facility licensed to
 4037  provide detoxification services under chapter 397.
 4038         (14)“Electronic means” means a form of telecommunication
 4039  which requires all parties to maintain visual as well as audio
 4040  communication when being used to conduct an examination by a
 4041  qualified professional.
 4042         (15)(9) “Express and informed consent” means consent
 4043  voluntarily given in writing, by a competent person, after
 4044  sufficient explanation and disclosure of the subject matter
 4045  involved to enable the person to make a knowing and willful
 4046  decision without any element of force, fraud, deceit, duress, or
 4047  other form of constraint or coercion.
 4048         (16)(10) “Facility” means any hospital, community facility,
 4049  public or private facility, or receiving or treatment facility
 4050  providing for the evaluation, diagnosis, care, treatment,
 4051  training, or hospitalization of persons who appear to have a
 4052  mental illness or who have been diagnosed as having a mental
 4053  illness or substance abuse impairment. The term “Facility” does
 4054  not include a any program or an entity licensed under pursuant
 4055  to chapter 400 or chapter 429.
 4056         (17)(11) “Guardian” means the natural guardian of a minor,
 4057  or a person appointed by a court to act on behalf of a ward’s
 4058  person if the ward is a minor or has been adjudicated
 4059  incapacitated.
 4060         (18)(12) “Guardian advocate” means a person appointed by a
 4061  court to make decisions regarding mental health treatment on
 4062  behalf of a patient who has been found incompetent to consent to
 4063  treatment pursuant to this part. The guardian advocate may be
 4064  granted specific additional powers by written order of the
 4065  court, as provided in this part.
 4066         (19)(13) “Hospital” means a hospital facility as defined in
 4067  s. 395.002 and licensed under chapter 395 and part II of chapter
 4068  408.
 4069         (20)(14) “Incapacitated” means that a person has been
 4070  adjudicated incapacitated pursuant to part V of chapter 744 and
 4071  a guardian of the person has been appointed.
 4072         (21)(15) “Incompetent to consent to treatment” means a
 4073  state in which that a person’s judgment is so affected by a his
 4074  or her mental illness or a substance abuse impairment that he or
 4075  she the person lacks the capacity to make a well-reasoned,
 4076  willful, and knowing decision concerning his or her medical, or
 4077  mental health, or substance abuse treatment.
 4078         (22)“Involuntary examination” means an examination
 4079  performed under s. 394.463, s. 397.6772, s. 397.679, s.
 4080  397.6798, or s. 397.6811 to determine whether a person qualifies
 4081  for involuntary services.
 4082         (23)“Involuntary services” means court-ordered outpatient
 4083  services or inpatient placement for mental health treatment
 4084  pursuant to s. 394.4655 or s. 394.467.
 4085         (24)(16) “Law enforcement officer” has the same meaning as
 4086  provided means a law enforcement officer as defined in s.
 4087  943.10.
 4088         (25)“Marriage and family therapist” means a person
 4089  licensed to practice marriage and family therapy under s.
 4090  491.005 or s. 491.006.
 4091         (26)“Mental health counselor” means a person licensed to
 4092  practice mental health counseling under s. 491.005 or s.
 4093  491.006.
 4094         (27)(17) “Mental health overlay program” means a mobile
 4095  service that which provides an independent examination for
 4096  voluntary admission admissions and a range of supplemental
 4097  onsite services to persons with a mental illness in a
 4098  residential setting such as a nursing home, an assisted living
 4099  facility, or an adult family-care home, or a nonresidential
 4100  setting such as an adult day care center. Independent
 4101  examinations provided pursuant to this part through a mental
 4102  health overlay program must only be provided under contract with
 4103  the department for this service or be attached to a public
 4104  receiving facility that is also a community mental health
 4105  center.
 4106         (28)(18) “Mental illness” means an impairment of the mental
 4107  or emotional processes that exercise conscious control of one’s
 4108  actions or of the ability to perceive or understand reality,
 4109  which impairment substantially interferes with the person’s
 4110  ability to meet the ordinary demands of living. For the purposes
 4111  of this part, the term does not include a developmental
 4112  disability as defined in chapter 393, intoxication, or
 4113  conditions manifested only by antisocial behavior or substance
 4114  abuse impairment.
 4115         (29)“Minor” means an individual who is 17 years of age or
 4116  younger and who has not had the disability of nonage removed
 4117  pursuant to s. 743.01 or s. 743.015.
 4118         (30)(19) “Mobile crisis response service” means a
 4119  nonresidential crisis service attached to a public receiving
 4120  facility and available 24 hours per a day, 7 days per a week,
 4121  through which provides immediate intensive assessments and
 4122  interventions, including screening for admission into a mental
 4123  health receiving facility, an addictions receiving facility, or
 4124  a detoxification facility, take place for the purpose of
 4125  identifying appropriate treatment services.
 4126         (31)(20) “Patient” means any person, with or without a co
 4127  occurring substance abuse disorder, who is held or accepted for
 4128  mental health treatment.
 4129         (32)(21) “Physician” means a medical practitioner licensed
 4130  under chapter 458 or chapter 459 who has experience in the
 4131  diagnosis and treatment of mental illness and nervous disorders
 4132  or a physician employed by a facility operated by the United
 4133  States Department of Veterans Affairs or the United States
 4134  Department of Defense which qualifies as a receiving or
 4135  treatment facility under this part.
 4136         (33)“Physician assistant” means a person licensed under
 4137  chapter 458 or chapter 459 who has experience in the diagnosis
 4138  and treatment of mental disorders.
 4139         (34)(22) “Private facility” means a any hospital or
 4140  facility operated by a for-profit or not-for-profit corporation
 4141  or association which that provides mental health or substance
 4142  abuse services and is not a public facility.
 4143         (35)(23) “Psychiatric nurse” means an advanced registered
 4144  nurse practitioner certified under s. 464.012 who has a master’s
 4145  or doctoral degree in psychiatric nursing, holds a national
 4146  advanced practice certification as a psychiatric mental health
 4147  advanced practice nurse, and has 2 years of post-master’s
 4148  clinical experience under the supervision of a physician.
 4149         (36)(24) “Psychiatrist” means a medical practitioner
 4150  licensed under chapter 458 or chapter 459 who has primarily
 4151  diagnosed and treated mental and nervous disorders for at least
 4152  a period of not less than 3 years, inclusive of psychiatric
 4153  residency.
 4154         (37)(25) “Public facility” means a any facility that has
 4155  contracted with the department to provide mental health services
 4156  to all persons, regardless of their ability to pay, and is
 4157  receiving state funds for such purpose.
 4158         (38)“Qualified professional” means a physician or a
 4159  physician assistant licensed under chapter 458 or chapter 459; a
 4160  psychiatrist licensed under chapter 458 or chapter 459; a
 4161  psychologist as defined in s. 490.003(7); or a psychiatric nurse
 4162  as defined in s. 394.455.
 4163         (39)(26) “Receiving facility” means a any public or private
 4164  facility or hospital designated by the department to receive and
 4165  hold or refer, as appropriate, involuntary patients under
 4166  emergency conditions or for mental health or substance abuse
 4167  psychiatric evaluation and to provide short-term treatment or
 4168  transportation to the appropriate service provider. The term
 4169  does not include a county jail.
 4170         (40)(27) “Representative” means a person selected to
 4171  receive notice of proceedings during the time a patient is held
 4172  in or admitted to a receiving or treatment facility.
 4173         (41)(28)(a) “Restraint” means: a physical device, method,
 4174  or drug used to control behavior.
 4175         (a) A physical restraint, including is any manual method or
 4176  physical or mechanical device, material, or equipment attached
 4177  or adjacent to an the individual’s body so that he or she cannot
 4178  easily remove the restraint and which restricts freedom of
 4179  movement or normal access to one’s body. “Physical restraint”
 4180  includes the physical holding of a person during a procedure to
 4181  forcibly administer psychotropic medication. “Physical
 4182  restraint” does not include physical devices such as
 4183  orthopedically prescribed appliances, surgical dressings and
 4184  bandages, supportive body bands, or other physical holding when
 4185  necessary for routine physical examinations and tests or for
 4186  purposes of orthopedic, surgical, or other similar medical
 4187  treatment when used to provide support for the achievement of
 4188  functional body position or proper balance or when used to
 4189  protect a person from falling out of bed.
 4190         (b) A drug or used as a restraint is a medication used to
 4191  control a the person’s behavior or to restrict his or her
 4192  freedom of movement which and is not part of the standard
 4193  treatment regimen of a person with a diagnosed mental illness
 4194  who is a client of the department. Physically holding a person
 4195  during a procedure to forcibly administer psychotropic
 4196  medication is a physical restraint.
 4197         (c)Restraint does not include physical devices, such as
 4198  orthopedically prescribed appliances, surgical dressings and
 4199  bandages, supportive body bands, or other physical holding when
 4200  necessary for routine physical examinations and tests; or for
 4201  purposes of orthopedic, surgical, or other similar medical
 4202  treatment; when used to provide support for the achievement of
 4203  functional body position or proper balance; or when used to
 4204  protect a person from falling out of bed.
 4205         (42)(29) “Seclusion” means the physical segregation of a
 4206  person in any fashion or involuntary isolation of a person in a
 4207  room or area from which the person is prevented from leaving.
 4208  The prevention may be by physical barrier or by a staff member
 4209  who is acting in a manner, or who is physically situated, so as
 4210  to prevent the person from leaving the room or area. For
 4211  purposes of this part chapter, the term does not mean isolation
 4212  due to a person’s medical condition or symptoms.
 4213         (43)(30) “Secretary” means the Secretary of Children and
 4214  Families.
 4215         (44)“Service provider” means a receiving facility, a
 4216  facility licensed under chapter 397, a treatment facility, an
 4217  entity under contract with the department to provide mental
 4218  health or substance abuse services, a community mental health
 4219  center or clinic, a psychologist, a clinical social worker, a
 4220  marriage and family therapist, a mental health counselor, a
 4221  physician, a psychiatrist, an advanced registered nurse
 4222  practitioner, a psychiatric nurse, or a qualified professional
 4223  as defined in s. 39.01.
 4224         (45)“Substance abuse impairment” means a condition
 4225  involving the use of alcoholic beverages or any psychoactive or
 4226  mood-altering substance in such a manner that a person has lost
 4227  the power of self-control and has inflicted or is likely to
 4228  inflict physical harm on himself, herself, or another.
 4229         (46)(31) “Transfer evaluation” means the process by which,
 4230  as approved by the appropriate district office of the
 4231  department, whereby a person who is being considered for
 4232  placement in a state treatment facility is first evaluated for
 4233  appropriateness of admission to such the facility by a
 4234  community-based public receiving facility or by a community
 4235  mental health center or clinic if the public receiving facility
 4236  is not a community mental health center or clinic.
 4237         (47)(32) “Treatment facility” means a any state-owned,
 4238  state-operated, or state-supported hospital, center, or clinic
 4239  designated by the department for extended treatment and
 4240  hospitalization, beyond that provided for by a receiving
 4241  facility, of persons who have a mental illness, including
 4242  facilities of the United States Government, and any private
 4243  facility designated by the department when rendering such
 4244  services to a person pursuant to the provisions of this part.
 4245  Patients treated in facilities of the United States Government
 4246  shall be solely those whose care is the responsibility of the
 4247  United States Department of Veterans Affairs.
 4248         (48)“Triage center” means a facility that has medical,
 4249  mental health, and substance abuse professionals present or on
 4250  call to provide emergency screening and evaluation for mental
 4251  health or substance abuse disorders for individuals transported
 4252  to the center by a law enforcement officer.
 4253         (33)“Service provider” means any public or private
 4254  receiving facility, an entity under contract with the Department
 4255  of Children and Families to provide mental health services, a
 4256  clinical psychologist, a clinical social worker, a marriage and
 4257  family therapist, a mental health counselor, a physician, a
 4258  psychiatric nurse as defined in subsection (23), or a community
 4259  mental health center or clinic as defined in this part.
 4260         (34)“Involuntary examination” means an examination
 4261  performed under s. 394.463 to determine if an individual
 4262  qualifies for involuntary inpatient treatment under s.
 4263  394.467(1) or involuntary outpatient treatment under s.
 4264  394.4655(1).
 4265         (35)“Involuntary placement” means either involuntary
 4266  outpatient treatment pursuant to s. 394.4655 or involuntary
 4267  inpatient treatment pursuant to s. 394.467.
 4268         (36)“Marriage and family therapist” means a person
 4269  licensed as a marriage and family therapist under chapter 491.
 4270         (37)“Mental health counselor” means a person licensed as a
 4271  mental health counselor under chapter 491.
 4272         (38)“Electronic means” means a form of telecommunication
 4273  that requires all parties to maintain visual as well as audio
 4274  communication.
 4275         Section 88. Subsection (2) of section 394.463, Florida
 4276  Statutes, is amended to read:
 4277         394.463 Involuntary examination.—
 4278         (2) INVOLUNTARY EXAMINATION.—
 4279         (a) An involuntary examination may be initiated by any one
 4280  of the following means:
 4281         1. A circuit or county court may enter an ex parte order
 4282  stating that a person appears to meet the criteria for
 4283  involuntary examination and specifying, giving the findings on
 4284  which that conclusion is based. The ex parte order for
 4285  involuntary examination must be based on written or oral sworn
 4286  testimony that includes specific facts that support the
 4287  findings, written or oral. If other less restrictive means are
 4288  not available, such as voluntary appearance for outpatient
 4289  evaluation, a law enforcement officer, or other designated agent
 4290  of the court, shall take the person into custody and deliver him
 4291  or her to an appropriate, or the nearest, receiving facility
 4292  within the designated receiving system pursuant to s. 394.462
 4293  for involuntary examination. The order of the court shall be
 4294  made a part of the patient’s clinical record. A No fee may not
 4295  shall be charged for the filing of an order under this
 4296  subsection. A Any receiving facility accepting the patient based
 4297  on this order must send a copy of the order to the department
 4298  Agency for Health Care Administration on the next working day.
 4299  The order may be submitted electronically through existing data
 4300  systems, if available. The order shall be valid only until the
 4301  person is delivered to the facility or executed or, if not
 4302  executed, for the period specified in the order itself,
 4303  whichever comes first. If no time limit is specified in the
 4304  order, the order shall be valid for 7 days after the date that
 4305  the order was signed.
 4306         2. A law enforcement officer shall take a person who
 4307  appears to meet the criteria for involuntary examination into
 4308  custody and deliver the person or have him or her delivered to
 4309  an appropriate, or the nearest, receiving facility within the
 4310  designated receiving system pursuant to s. 394.462 for
 4311  examination. The officer shall execute a written report
 4312  detailing the circumstances under which the person was taken
 4313  into custody, which must and the report shall be made a part of
 4314  the patient’s clinical record. Any receiving facility accepting
 4315  the patient based on this report must send a copy of the report
 4316  to the department Agency for Health Care Administration on the
 4317  next working day.
 4318         3. A physician, clinical psychologist, psychiatric nurse,
 4319  mental health counselor, marriage and family therapist, or
 4320  clinical social worker may execute a certificate stating that he
 4321  or she has examined a person within the preceding 48 hours and
 4322  finds that the person appears to meet the criteria for
 4323  involuntary examination and stating the observations upon which
 4324  that conclusion is based. If other less restrictive means, such
 4325  as voluntary appearance for outpatient evaluation, are not
 4326  available, such as voluntary appearance for outpatient
 4327  evaluation, a law enforcement officer shall take into custody
 4328  the person named in the certificate into custody and deliver him
 4329  or her to the appropriate, or nearest, receiving facility within
 4330  the designated receiving system pursuant to s. 394.462 for
 4331  involuntary examination. The law enforcement officer shall
 4332  execute a written report detailing the circumstances under which
 4333  the person was taken into custody. The report and certificate
 4334  shall be made a part of the patient’s clinical record. Any
 4335  receiving facility accepting the patient based on this
 4336  certificate must send a copy of the certificate to the
 4337  department Agency for Health Care Administration on the next
 4338  working day. The document may be submitted electronically
 4339  through existing data systems, if applicable.
 4340         (b) A person may shall not be removed from any program or
 4341  residential placement licensed under chapter 400 or chapter 429
 4342  and transported to a receiving facility for involuntary
 4343  examination unless an ex parte order, a professional
 4344  certificate, or a law enforcement officer’s report is first
 4345  prepared. If the condition of the person is such that
 4346  preparation of a law enforcement officer’s report is not
 4347  practicable before removal, the report shall be completed as
 4348  soon as possible after removal, but in any case before the
 4349  person is transported to a receiving facility. A receiving
 4350  facility admitting a person for involuntary examination who is
 4351  not accompanied by the required ex parte order, professional
 4352  certificate, or law enforcement officer’s report shall notify
 4353  the department Agency for Health Care Administration of such
 4354  admission by certified mail or by e-mail, if available, by no
 4355  later than the next working day. The provisions of this
 4356  paragraph do not apply when transportation is provided by the
 4357  patient’s family or guardian.
 4358         (c) A law enforcement officer acting in accordance with an
 4359  ex parte order issued pursuant to this subsection may serve and
 4360  execute such order on any day of the week, at any time of the
 4361  day or night.
 4362         (d) A law enforcement officer acting in accordance with an
 4363  ex parte order issued pursuant to this subsection may use such
 4364  reasonable physical force as is necessary to gain entry to the
 4365  premises, and any dwellings, buildings, or other structures
 4366  located on the premises, and to take custody of the person who
 4367  is the subject of the ex parte order.
 4368         (e) The department Agency for Health Care Administration
 4369  shall receive and maintain the copies of ex parte orders,
 4370  involuntary outpatient services placement orders issued pursuant
 4371  to s. 394.4655, involuntary inpatient placement orders issued
 4372  pursuant to s. 394.467, professional certificates, and law
 4373  enforcement officers’ reports. These documents shall be
 4374  considered part of the clinical record, governed by the
 4375  provisions of s. 394.4615. These documents shall be used to The
 4376  agency shall prepare annual reports analyzing the data obtained
 4377  from these documents, without information identifying patients,
 4378  and shall provide copies of reports to the department, the
 4379  President of the Senate, the Speaker of the House of
 4380  Representatives, and the minority leaders of the Senate and the
 4381  House of Representatives.
 4382         (f) A patient shall be examined by a physician or, a
 4383  clinical psychologist, or by a psychiatric nurse performing
 4384  within the framework of an established protocol with a
 4385  psychiatrist at a receiving facility without unnecessary delay
 4386  to determine if the criteria for involuntary services are met.
 4387  Emergency treatment may be provided and may, upon the order of a
 4388  physician if the physician determines, be given emergency
 4389  treatment if it is determined that such treatment is necessary
 4390  for the safety of the patient or others. The patient may not be
 4391  released by the receiving facility or its contractor without the
 4392  documented approval of a psychiatrist or a clinical psychologist
 4393  or, if the receiving facility is owned or operated by a hospital
 4394  or health system, the release may also be approved by a
 4395  psychiatric nurse performing within the framework of an
 4396  established protocol with a psychiatrist, or an attending
 4397  emergency department physician with experience in the diagnosis
 4398  and treatment of mental illness and nervous disorders and after
 4399  completion of an involuntary examination pursuant to this
 4400  subsection. A psychiatric nurse may not approve the release of a
 4401  patient if the involuntary examination was initiated by a
 4402  psychiatrist unless the release is approved by the initiating
 4403  psychiatrist. However, a patient may not be held in a receiving
 4404  facility for involuntary examination longer than 72 hours.
 4405         (g)Within the 72-hour examination period or, if the 72
 4406  hours ends on a weekend or holiday, no later than the next
 4407  working day thereafter, one of the following actions must be
 4408  taken, based on the individual needs of the patient:
 4409         1.The patient shall be released, unless he or she is
 4410  charged with a crime, in which case the patient shall be
 4411  returned to the custody of a law enforcement officer;
 4412         2.The patient shall be released, subject to the provisions
 4413  of subparagraph 1., for voluntary outpatient treatment;
 4414         3.The patient, unless he or she is charged with a crime,
 4415  shall be asked to give express and informed consent to placement
 4416  as a voluntary patient and, if such consent is given, the
 4417  patient shall be admitted as a voluntary patient; or
 4418         4.A petition for involuntary services shall be filed in
 4419  the circuit court if inpatient treatment is deemed necessary or
 4420  with the criminal county court, as defined in s. 394.4655(1), as
 4421  applicable. When inpatient treatment is deemed necessary, the
 4422  least restrictive treatment consistent with the optimum
 4423  improvement of the patient’s condition shall be made available.
 4424  When a petition is to be filed for involuntary outpatient
 4425  placement, it shall be filed by one of the petitioners specified
 4426  in s. 394.4655(4)(a). A petition for involuntary inpatient
 4427  placement shall be filed by the facility administrator.
 4428         (h)(g) A person for whom an involuntary examination has
 4429  been initiated who is being evaluated or treated at a hospital
 4430  for an emergency medical condition specified in s. 395.002 must
 4431  be examined by a receiving facility within 72 hours. The 72-hour
 4432  period begins when the patient arrives at the hospital and
 4433  ceases when the attending physician documents that the patient
 4434  has an emergency medical condition. If the patient is examined
 4435  at a hospital providing emergency medical services by a
 4436  professional qualified to perform an involuntary examination and
 4437  is found as a result of that examination not to meet the
 4438  criteria for involuntary outpatient services placement pursuant
 4439  to s. 394.4655(2) 394.4655(1) or involuntary inpatient placement
 4440  pursuant to s. 394.467(1), the patient may be offered voluntary
 4441  services or placement, if appropriate, or released directly from
 4442  the hospital providing emergency medical services. The finding
 4443  by the professional that the patient has been examined and does
 4444  not meet the criteria for involuntary inpatient services
 4445  placement or involuntary outpatient placement must be entered
 4446  into the patient’s clinical record. Nothing in This paragraph is
 4447  not intended to prevent a hospital providing emergency medical
 4448  services from appropriately transferring a patient to another
 4449  hospital before prior to stabilization if, provided the
 4450  requirements of s. 395.1041(3)(c) have been met.
 4451         (i)(h) One of the following must occur within 12 hours
 4452  after the patient’s attending physician documents that the
 4453  patient’s medical condition has stabilized or that an emergency
 4454  medical condition does not exist:
 4455         1. The patient must be examined by a designated receiving
 4456  facility and released; or
 4457         2. The patient must be transferred to a designated
 4458  receiving facility in which appropriate medical treatment is
 4459  available. However, the receiving facility must be notified of
 4460  the transfer within 2 hours after the patient’s condition has
 4461  been stabilized or after determination that an emergency medical
 4462  condition does not exist.
 4463         (i)Within the 72-hour examination period or, if the 72
 4464  hours ends on a weekend or holiday, no later than the next
 4465  working day thereafter, one of the following actions must be
 4466  taken, based on the individual needs of the patient:
 4467         1.The patient shall be released, unless he or she is
 4468  charged with a crime, in which case the patient shall be
 4469  returned to the custody of a law enforcement officer;
 4470         2.The patient shall be released, subject to the provisions
 4471  of subparagraph 1., for voluntary outpatient treatment;
 4472         3.The patient, unless he or she is charged with a crime,
 4473  shall be asked to give express and informed consent to placement
 4474  as a voluntary patient, and, if such consent is given, the
 4475  patient shall be admitted as a voluntary patient; or
 4476         4.A petition for involuntary placement shall be filed in
 4477  the circuit court when outpatient or inpatient treatment is
 4478  deemed necessary. When inpatient treatment is deemed necessary,
 4479  the least restrictive treatment consistent with the optimum
 4480  improvement of the patient’s condition shall be made available.
 4481  When a petition is to be filed for involuntary outpatient
 4482  placement, it shall be filed by one of the petitioners specified
 4483  in s. 394.4655(3)(a). A petition for involuntary inpatient
 4484  placement shall be filed by the facility administrator.
 4485         Section 89. Subsection (3) of section 394.4615, Florida
 4486  Statutes, is amended to read:
 4487         394.4615 Clinical records; confidentiality.—
 4488         (3) Information from the clinical record may be released in
 4489  the following circumstances:
 4490         (a) When a patient has declared an intention to harm other
 4491  persons. When such declaration has been made, the administrator
 4492  may authorize the release of sufficient information to provide
 4493  adequate warning to the person threatened with harm by the
 4494  patient.
 4495         (b) When the administrator of the facility or secretary of
 4496  the department deems release to a qualified researcher as
 4497  defined in administrative rule, an aftercare treatment provider,
 4498  or an employee or agent of the department is necessary for
 4499  treatment of the patient, maintenance of adequate records,
 4500  compilation of treatment data, aftercare planning, or evaluation
 4501  of programs.
 4502  
 4503  For the purpose of determining whether a person meets the
 4504  criteria for involuntary outpatient placement or for preparing
 4505  the proposed treatment plan pursuant to s. 394.4655, the
 4506  clinical record may be released to the state attorney, the
 4507  public defender or the patient’s private legal counsel, the
 4508  court, and to the appropriate mental health professionals,
 4509  including the service provider identified in s. 394.4655(7)(b)2.
 4510  394.4655(6)(b)2., in accordance with state and federal law.
 4511         Section 90. For the 2016-2017 fiscal year, the sum of
 4512  $400,000 in nonrecurring funds is appropriated from the
 4513  Operations and Maintenance Trust Fund to the Department of
 4514  Children and Families for the purpose of modifying the existing
 4515  crisis stabilization database to collect and analyze data and
 4516  information pursuant to s. 397.321, Florida Statutes, as amended
 4517  by this act.
 4518         Section 91. This act shall take effect July 1, 2016.