Florida Senate - 2017 COMMITTEE AMENDMENT
Bill No. SB 1756
Ì375730ÂÎ375730
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
04/03/2017 .
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The Committee on Children, Families, and Elder Affairs (Garcia)
recommended the following:
1 Senate Amendment (with title amendment)
2 Delete everything after the enacting clause
3 and insert:
4 Section 1. Section 394.453, Florida Statutes, is amended to
5 read:
6 394.453 Legislative intent.—
7 (1) It is the intent of the Legislature:
8 (a) To authorize and direct the Department of Children and
9 Families to evaluate, research, plan, and recommend to the
10 Governor and the Legislature programs designed to reduce the
11 occurrence, severity, duration, and disabling aspects of mental,
12 emotional, and behavioral disorders and substance abuse
13 impairment.
14 (b) That treatment programs for such disorders include, but
15 not be limited to, comprehensive health, social, educational,
16 and rehabilitative services for individuals to persons requiring
17 intensive short-term and continued treatment in order to
18 encourage them to assume responsibility for their treatment and
19 recovery. It is intended that:
20 1. Such individuals persons be provided with emergency
21 service and temporary detention for evaluation if when required;
22 2. Such individuals persons be admitted to treatment
23 facilities if on a voluntary basis when extended or continuing
24 care is needed and unavailable in the community;
25 3. Involuntary placement be provided only if when expert
26 evaluation determines it is necessary;
27 4. Any involuntary treatment or examination be accomplished
28 in a setting that is clinically appropriate and most likely to
29 facilitate the individual’s discharge person’s return to the
30 community as soon as possible; and
31 5. Individual Dignity and human rights be guaranteed to all
32 individuals persons who are admitted to mental health facilities
33 or who are being held under s. 394.463.
34 (c) That services provided to individuals persons in this
35 state use the coordination-of-care principles characteristic of
36 recovery-oriented services and include social support services,
37 such as housing support, life skills and vocational training,
38 and employment assistance, necessary for individuals persons
39 with mental health disorders and co-occurring mental health and
40 substance use disorders to live successfully in their
41 communities.
42 (d) That licensed, qualified health professionals be
43 authorized to practice to the fullest extent of their education
44 and training in the performance of professional functions
45 necessary to carry out the intent of this part.
46 (2) It is the policy of this state that the use of
47 restraint and seclusion on clients is justified only as an
48 emergency safety measure to be used in response to imminent
49 danger to the individual client or others. It is, therefore, the
50 intent of the Legislature to achieve an ongoing reduction in the
51 use of restraint and seclusion in programs and facilities
52 serving individuals experiencing persons with mental illness.
53 (3) The Legislature further finds the need for additional
54 psychiatrists to be of critical state concern and recommends the
55 establishment of an additional psychiatry program to be offered
56 by one of Florida’s schools of medicine currently not offering
57 psychiatry. The program shall seek to integrate primary care and
58 psychiatry and other evolving models of care for individuals
59 persons with mental health and substance use disorders.
60 Additionally, the Legislature finds that the use of telemedicine
61 for patient evaluation, case management, and ongoing care will
62 improve management of patient care and reduce costs of
63 transportation.
64 Section 2. Section 394.455, Florida Statutes, is amended to
65 read:
66 394.455 Definitions.—As used in this part, the term:
67 (1) “Access center” means a facility that has medical,
68 mental health, and substance abuse professionals to provide
69 emergency screening and evaluation for mental health or
70 substance abuse disorders and may provide transportation to an
71 appropriate facility if an individual is in need of more
72 intensive services.
73 (2) “Addictions receiving facility” is a secure, acute care
74 facility that, at a minimum, provides emergency screening,
75 evaluation, detoxification, and stabilization services; is
76 operated 24 hours per day, 7 days per week; and is designated by
77 the department to serve individuals found to have substance
78 abuse impairment who qualify for services under this part.
79 (3) “Administrator” means the chief administrative officer
80 of a receiving or treatment facility or his or her designee.
81 (4) “Adult” means an individual who is 18 years of age or
82 older or who has had the disability of nonage removed under
83 chapter 743.
84 (5) “Advance directive” has the same meaning as in s.
85 765.101.
86 (5) “Clinical psychologist” means a psychologist as defined
87 in s. 490.003(7) with 3 years of postdoctoral experience in the
88 practice of clinical psychology, inclusive of the experience
89 required for licensure, or a psychologist employed by a facility
90 operated by the United States Department of Veterans Affairs
91 that qualifies as a receiving or treatment facility under this
92 part.
93 (6) “Clinical record” means all parts of the record
94 required to be maintained and includes all medical records,
95 progress notes, charts, and admission and discharge data, and
96 all other information recorded by facility staff which pertains
97 to an individual’s admission, retention the patient’s
98 hospitalization, or treatment.
99 (7) “Clinical social worker” means a person licensed to
100 practice social work under s. 491.005 or s. 491.006 or a person
101 employed as a clinical social worker by the United States
102 Department of Veterans Affairs or the United States Department
103 of Defense as a clinical social worker under s. 491.005 or s.
104 491.006.
105 (8) “Community facility” means a community service provider
106 that contracts with the department to furnish substance abuse or
107 mental health services under part IV of this chapter.
108 (9) “Community mental health center or clinic” means a
109 publicly funded, not-for-profit center that contracts with the
110 department for the provision of inpatient, outpatient, day
111 treatment, or emergency services.
112 (10) “Court,” unless otherwise specified, means the circuit
113 court.
114 (11) “Department” means the Department of Children and
115 Families.
116 (12) “Designated receiving facility” means a facility
117 approved by the department which may be a public or private
118 hospital, crisis stabilization unit, or addictions receiving
119 facility; which provides, at a minimum, emergency screening,
120 evaluation, and short-term stabilization for mental health or
121 substance abuse disorders; and which may have an agreement with
122 a corresponding facility for transportation and services.
123 (13) “Detoxification facility” means a facility licensed to
124 provide detoxification services under chapter 397.
125 (14) “Electronic means” means a form of telecommunication
126 which requires all parties to maintain visual as well as audio
127 communication when being used to conduct an examination by a
128 qualified professional.
129 (15) “Express and informed consent” means consent
130 voluntarily given in writing, by a competent person, after
131 sufficient explanation and disclosure of the subject matter
132 involved, as documented in the clinical record, to enable the
133 individual or his or her guardian, guardian advocate, or health
134 care surrogate or proxy person to make a knowing and willful
135 decision without any element of force, fraud, deceit, duress, or
136 other form of constraint or coercion. Such consent must be in
137 writing when provided by the individual, but may be provided
138 verbally and documented in the clinical record when the
139 individual’s substitute decisionmaker is unable to reasonably
140 provide it in writing.
141 (16) “Facility” means any hospital, community facility,
142 public or private facility, or receiving or treatment facility
143 providing for the evaluation, diagnosis, care, treatment,
144 training, or hospitalization of individuals persons who appear
145 to have or who have been diagnosed as having a mental illness or
146 substance abuse impairment. The term does not include a program
147 or an entity licensed under chapter 400 or chapter 429.
148 (17) “Government facility” means a facility owned,
149 operated, or administered by the Department of Corrections or
150 the United States Department of Veterans Affairs.
151 (18)(17) “Guardian” means the natural guardian of a minor,
152 or a person appointed by a court to act on behalf of a ward’s
153 person if the ward is a minor or has been adjudicated
154 incapacitated.
155 (19)(18) “Guardian advocate” means a person appointed by a
156 court to make decisions regarding mental health treatment on
157 behalf of an individual a patient who has been found incompetent
158 to consent to treatment pursuant to this part.
159 (20)(19) “Hospital” means a hospital licensed under chapter
160 395 and part II of chapter 408.
161 (21)(20) “Incapacitated” means that an individual a person
162 has been adjudicated incapacitated pursuant to part V of chapter
163 744 and a guardian of the individual person has been appointed.
164 (22)(21) “Incompetent to consent to treatment” means that
165 an individual’s a state in which a person’s judgment is so
166 affected by a mental illness or a substance abuse impairment
167 that he or she lacks the capacity to make a well-reasoned,
168 willful, and knowing decision concerning his or her medical,
169 mental health, or substance abuse treatment.
170 (23) “Individual” means any person who is held or accepted
171 for a mental health examination or treatment.
172 (24)(22) “Involuntary examination” means an examination
173 performed under s. 394.463, s. 397.6772, s. 397.679, s.
174 397.6798, or s. 397.6811 to determine if an individual whether a
175 person qualifies for involuntary services.
176 (25)(23) “Involuntary services” means court-ordered
177 outpatient services or inpatient placement for mental health
178 treatment pursuant to s. 394.4655 or s. 394.467.
179 (26)(24) “Law enforcement officer” has the same meaning as
180 provided in s. 943.10 or a federal or tribal law enforcement
181 officer as defined by federal law.
182 (27)(25) “Marriage and family therapist” means a person
183 licensed to practice marriage and family therapy under s.
184 491.005 or s. 491.006 or a person employed as a marriage and
185 family therapist by the United States Department of Veterans
186 Affairs or the United States Department of Defense.
187 (28)(26) “Mental health counselor” means a person licensed
188 to practice mental health counseling under s. 491.005 or s.
189 491.006 or a person employed as a mental health counselor by the
190 United States Department of Veterans Affairs or the United
191 States Department of Defense.
192 (29)(27) “Mental health overlay program” means a mobile
193 service that provides an independent examination for voluntary
194 admission and a range of supplemental onsite services to an
195 individual who has persons with a mental illness in a
196 residential setting such as a nursing home, an assisted living
197 facility, or an adult family-care home or a nonresidential
198 setting such as an adult day care center. Independent
199 examinations provided through a mental health overlay program
200 must only be provided only under contract with the department
201 for this service or be attached to a public receiving facility
202 that is also a community mental health center.
203 (30)(28) “Mental illness” means an impairment of the mental
204 or emotional processes that exercise conscious control of one’s
205 actions or of the ability to perceive or understand reality,
206 which impairment substantially interferes with the individual’s
207 person’s ability to meet the ordinary demands of living. As used
208 in For the purposes of this part, the term does not include a
209 developmental disability as defined in chapter 393,
210 intoxication, or conditions manifested only by antisocial
211 behavior or substance abuse impairment.
212 (31)(29) “Minor” means an individual who is 17 years of age
213 or younger and who has not had the disability of nonage removed
214 pursuant to s. 743.01 or s. 743.015.
215 (32)(30) “Mobile crisis response service” means a
216 nonresidential crisis service available 24 hours per day, 7 days
217 per week which provides immediate intensive assessments and
218 interventions, including screening for admission into a mental
219 health receiving facility, an addictions receiving facility, or
220 a detoxification facility, for the purpose of identifying
221 appropriate treatment services.
222 (31) “Patient” means any person, with or without a co
223 occurring substance abuse disorder, who is held or accepted for
224 mental health treatment.
225 (33)(32) “Physician” means a medical practitioner licensed
226 under chapter 458 or chapter 459 who has experience in the
227 diagnosis and treatment of mental illness or a physician
228 employed by a facility operated by the United States Department
229 of Veterans Affairs or the United States Department of Defense.
230 (34)(33) “Physician assistant” means a person fully
231 licensed as a physician assistant under chapter 458 or chapter
232 459 or a person employed as a physician assistant by the United
233 States Department of Veterans Affairs or the United States
234 Department of Defense who has experience in the diagnosis and
235 treatment of mental disorders.
236 (35)(34) “Private facility” means a hospital or facility
237 operated by a for-profit or not-for-profit corporation or
238 association which provides mental health or substance abuse
239 services and is not a public facility.
240 (36)(35) “Psychiatric nurse” means an advanced registered
241 nurse practitioner certified under s. 464.012 who has a master’s
242 or doctoral degree in psychiatric nursing, holds a national
243 advanced practice certification as a psychiatric mental health
244 advanced practice nurse, and has 2 years of post-master’s
245 clinical experience under the supervision of a physician or a
246 person employed as a psychiatric nurse by the United States
247 Department of Veterans Affairs or the United States Department
248 of Defense.
249 (37)(36) “Psychiatrist” means a medical practitioner
250 licensed under chapter 458 or chapter 459 for at least 3 years,
251 inclusive of psychiatric residency or a person employed as a
252 psychiatrist by the United States Department of Veterans Affairs
253 or the United States Department of Defense.
254 (38) “Psychologist” means a person defined as a
255 psychologist under s. 490.003 or a person employed as a
256 psychologist by the United States Department of Veterans Affairs
257 or the United States Department of Defense.
258 (39)(37) “Public facility” means a facility that has
259 contracted with the department to provide mental health services
260 to all individuals persons, regardless of ability to pay, and is
261 receiving state funds for such purpose.
262 (40)(38) “Qualified professional” means a physician or a
263 physician assistant licensed under chapter 458 or chapter 459; a
264 psychiatrist licensed under chapter 458 or chapter 459; a
265 psychologist as defined in s. 490.003(7); an advanced registered
266 nurse practitioner licensed under part I of chapter 464; or a
267 psychiatric nurse as defined in this section.
268 (41)(39) “Receiving facility” means a public or private
269 facility or hospital designated by the department to receive and
270 hold individuals on involuntary status or refer, as appropriate,
271 involuntary patients under emergency conditions for mental
272 health or substance abuse evaluation and to provide treatment or
273 transportation to the appropriate service provider. The term
274 does not include a county jail.
275 (42)(40) “Representative” means a person selected pursuant
276 to s. 394.4597(2) to receive notice of proceedings during the
277 time a patient is held in or admitted to a receiving or
278 treatment facility.
279 (43)(41) “Restraint” means:
280 (a) A physical restraint, including any manual method or
281 physical or mechanical device, material, or equipment attached
282 or adjacent to an individual’s body so that he or she cannot
283 easily remove the restraint and which restricts freedom of
284 movement or normal access to one’s body. “Physical restraint”
285 includes the physical holding of an individual a person during a
286 procedure to forcibly administer psychotropic medication.
287 “Physical restraint” does not include physical devices such as
288 orthopedically prescribed appliances, surgical dressings and
289 bandages, supportive body bands, or other physical holding when
290 necessary for routine physical examinations and tests or for
291 purposes of orthopedic, surgical, or other similar medical
292 treatment when used to provide support for the achievement of
293 functional body position or proper balance for protecting an
294 individual or when used to protect a person from falling out of
295 bed.
296 (b) A drug or medication used to control an individual’s a
297 person’s behavior or to restrict his or her freedom of movement
298 which is not part of the standard treatment regimen for an
299 individual having of a person with a diagnosed mental illness.
300
301 (44)(42) “Seclusion” means the physical segregation or
302 involuntary isolation of an individual a person in a room or
303 area from which the individual person is prevented from leaving.
304 The prevention may be by physical barrier or by a staff member
305 who is acting in a manner, or who is physically situated, so as
306 to prevent the individual person from leaving the room or area.
307 As used in For purposes of this part, the term does not mean
308 isolation due to the individual’s a person’s medical condition
309 or symptoms.
310 (45)(43) “Secretary” means the Secretary of Children and
311 Families.
312 (46)(44) “Service provider” means a public or private
313 receiving facility, a facility licensed under chapter 397, a
314 treatment facility, an entity under contract with the department
315 to provide mental health or substance abuse services, a
316 community mental health center or clinic, a psychologist, a
317 clinical social worker, a marriage and family therapist, a
318 mental health counselor, a physician, a psychiatrist, an
319 advanced registered nurse practitioner, a psychiatric nurse, or
320 a substance abuse qualified professional as defined in s. 39.01.
321 (47)(45) “Substance abuse impaired impairment” means a
322 condition involving the use of alcoholic beverages or any
323 psychoactive or mood-altering substance in such a manner that a
324 person has lost the power of self-control and has inflicted or
325 is likely to inflict physical harm on himself, herself, or
326 another.
327 (48) “Substance abuse qualified professional” has the same
328 meaning as in s. 397.311(33).
329 (49)(46) “Transfer evaluation” means the process, as
330 approved by the department, in which the individual by which a
331 person who is being considered for placement in a state
332 treatment facility is evaluated for appropriateness of admission
333 to a treatment such facility. The transfer evaluation shall be
334 conducted by the department, a public receiving facility, or a
335 community mental health center or clinic.
336 (50)(47) “Treatment facility” means a state-owned, state
337 operated, or state-supported hospital, center, or clinic
338 designated by the department for extended treatment and
339 hospitalization of individuals who have a mental illness, beyond
340 that provided for by a receiving facility or a, of persons who
341 have a mental illness, including facilities of the United States
342 Government, and any private facility designated by the
343 department when rendering such services to a person pursuant to
344 the provisions of this part. Patients treated in facilities of
345 the United States Government shall be solely those whose care is
346 the responsibility of the United States Department of Veterans
347 Affairs.
348 (51)(48) “Triage center” means a facility that has medical,
349 mental health, and substance abuse professionals present or on
350 call to provide emergency screening and evaluation for mental
351 health or substance abuse disorders for individuals transported
352 to the center by a law enforcement officer.
353 Section 3. Section 394.457, Florida Statutes, is amended to
354 read:
355 394.457 Operation and administration.—
356 (1) ADMINISTRATION.—The Department of Children and Families
357 is designated the “Mental Health Authority” of Florida. The
358 department and the Agency for Health Care Administration shall
359 exercise executive and administrative supervision over all
360 mental health facilities, programs, and services.
361 (2) RESPONSIBILITIES OF THE DEPARTMENT.—The department is
362 responsible for:
363 (a) The planning, evaluation, and implementation of a
364 complete and comprehensive statewide program of mental health
365 and substance abuse, including community services, receiving and
366 treatment facilities, child services, research, and training as
367 authorized and approved by the Legislature, based on the annual
368 program budget of the department. The department is also
369 responsible for the coordination of efforts with other
370 departments and divisions of the state government, county and
371 municipal governments, and private agencies concerned with and
372 providing mental health or substance abuse services. It is
373 responsible for establishing standards, providing technical
374 assistance, supervising and exercising supervision of mental
375 health and substance abuse programs, and of, and the treatment
376 of individuals patients at, community facilities, other
377 facilities serving individuals for persons who have a mental
378 illness or substance abuse impairment, and any agency or
379 facility providing services under to patients pursuant to this
380 part.
381 (b) The publication and distribution of an information
382 handbook to facilitate the understanding of this part, the
383 policies and procedures involved in the implementation of this
384 part, and the responsibilities of the various service providers
385 of services under this part. Distribution of this handbook may
386 be limited to online electronic distribution. The department may
387 It shall stimulate research by public and private agencies,
388 institutions of higher learning, and hospitals in the interest
389 of the elimination and amelioration of mental illnesses or
390 substance abuse impairments illness.
391 (3) POWER TO CONTRACT.—The department may contract to
392 provide, and be provided with, services and facilities in order
393 to carry out its responsibilities under this part with respect
394 to the following agencies: public and private hospitals;
395 receiving and treatment facilities; clinics; laboratories;
396 departments, divisions, and other units of state government; the
397 state colleges and universities; the community colleges; private
398 colleges and universities; counties, municipalities, and any
399 other political subdivisions governmental unit, including
400 facilities of the United States Government; and any other public
401 or private entity that which provides or needs facilities or
402 services. Baker Act funds for community inpatient, crisis
403 stabilization, short-term residential treatment, and screening
404 services under this part must be allocated to each county
405 pursuant to the department’s funding allocation methodology.
406 Notwithstanding s. 287.057(3)(e), contracts for community-based
407 Baker Act services for inpatient, crisis stabilization, short
408 term residential treatment, and screening provided under this
409 part, other than those with other units of government, to be
410 provided for the department must be awarded using competitive
411 solicitation sealed bids if the county commission of the county
412 receiving the services makes a request to the department
413 department’s district office by January 15 of the contracting
414 year. The department district may not enter into a competitively
415 bid contract under this provision if such action will result in
416 increases of state or local expenditures for Baker Act services
417 within the district. Contracts for these Baker Act services
418 using competitive solicitation sealed bids are effective for 3
419 years. The department shall adopt rules establishing minimum
420 standards for such contracted services and facilities and shall
421 make periodic audits and inspections to assure that the
422 contracted services are provided and meet the standards of the
423 department.
424 (4) APPLICATION FOR AND ACCEPTANCE OF GIFTS AND GRANTS.—The
425 department may apply for and accept any funds, grants, gifts, or
426 services made available to it by any agency or department of the
427 Federal Government or any other public or private agency or
428 person individual in aid of mental health and substance abuse
429 programs. All such moneys must shall be deposited in the State
430 Treasury and shall be disbursed as provided by law.
431 (5) RULES.—The department shall adopt rules:
432 (a) The department shall adopt rules Establishing forms and
433 procedures relating to the rights and privileges of individuals
434 receiving examination or patients seeking mental health
435 treatment from facilities under this part.
436 (b) Implementing and administering The department shall
437 adopt rules necessary for the implementation and administration
438 of the provisions of this part., and A program subject to the
439 provisions of this part may shall not be permitted to operate
440 unless rules designed to ensure the protection of the health,
441 safety, and welfare of the individuals examined and patients
442 treated under through such program have been adopted. Such rules
443 adopted under this subsection must include provisions governing
444 the use of restraint and seclusion which are consistent with
445 recognized best practices and professional judgment; prohibit
446 inherently dangerous restraint or seclusion procedures;
447 establish limitations on the use and duration of restraint and
448 seclusion; establish measures to ensure the safety of program
449 participants and staff during an incident of restraint or
450 seclusion; establish procedures for staff to follow before,
451 during, and after incidents of restraint or seclusion; establish
452 professional qualifications of and training for staff who may
453 order or be engaged in the use of restraint or seclusion; and
454 establish mandatory reporting, data collection, and data
455 dissemination procedures and requirements. Such rules adopted
456 under this subsection must require that each instance of the use
457 of restraint or seclusion be documented in the clinical record
458 of the individual who has been restrained or secluded patient.
459 (c) The department shall adopt rules Establishing minimum
460 standards for services provided by a mental health overlay
461 program or a mobile crisis response service.
462 (6) PERSONNEL.—
463 (a) The department shall, by rule, establish minimum
464 standards of education and experience for professional and
465 technical personnel employed in mental health programs,
466 including members of a mobile crisis response service.
467 (b) The department may shall design and distribute
468 appropriate materials for the orientation and training of
469 persons actively engaged in administering implementing the
470 provisions of this part relating to the involuntary examination
471 and treatment placement of individuals persons who are believed
472 to have a mental illness or substance abuse impairment.
473 (7) PAYMENT FOR CARE OF PATIENTS.—Fees and fee collections
474 for individuals patients in state-owned, state-operated, or
475 state-supported treatment facilities must be in accordance with
476 shall be according to s. 402.33.
477 Section 4. Subsection (1) and paragraph (b) of subsection
478 (2) of section 394.4573, Florida Statutes, are amended to read:
479 394.4573 Coordinated system of care; annual assessment;
480 essential elements; measures of performance; system improvement
481 grants; reports.—On or before December 1 of each year, the
482 department shall submit to the Governor, the President of the
483 Senate, and the Speaker of the House of Representatives an
484 assessment of the behavioral health services in this state. The
485 assessment shall consider, at a minimum, the extent to which
486 designated receiving systems function as no-wrong-door models,
487 the availability of treatment and recovery services that use
488 recovery-oriented and peer-involved approaches, the availability
489 of less-restrictive services, and the use of evidence-informed
490 practices. The department’s assessment shall consider, at a
491 minimum, the needs assessments conducted by the managing
492 entities pursuant to s. 394.9082(5). Beginning in 2017, the
493 department shall compile and include in the report all plans
494 submitted by managing entities pursuant to s. 394.9082(8) and
495 the department’s evaluation of each plan.
496 (1) As used in this section, the term:
497 (a) “Care coordination” means the implementation of
498 deliberate and planned organizational relationships and service
499 procedures that improve the effectiveness and efficiency of the
500 behavioral health system by engaging in purposeful interactions
501 with individuals who are not yet effectively connected with
502 services to ensure service linkage. Examples of care
503 coordination activities include development of referral
504 agreements, shared protocols, and information exchange
505 procedures. The purpose of care coordination is to enhance the
506 delivery of treatment services and recovery supports and to
507 improve outcomes among priority populations.
508 (b) “Case management” means those direct services provided
509 to a client in order to assess his or her needs, plan or arrange
510 services, coordinate service providers, link the service system
511 to a client, monitor service delivery, and evaluate patient
512 outcomes to ensure the client is receiving the appropriate
513 services.
514 (c) “Coordinated system of care” means the full array of
515 behavioral and related services in a region or community offered
516 by all service providers, whether participating under contract
517 with the managing entity or by another method of community
518 partnership or mutual agreement.
519 (d) “No-wrong-door model” means a model for the delivery of
520 acute care services to individuals persons who have mental
521 health or substance use disorders, or both, which optimizes
522 access to care, regardless of the entry point to the behavioral
523 health care system.
524 (2) The essential elements of a coordinated system of care
525 include:
526 (b) A designated receiving system that consists of one or
527 more facilities serving a defined geographic area and
528 responsible for assessment and evaluation, both voluntary and
529 involuntary, and treatment or triage of patients who have a
530 mental health or substance use disorder, or co-occurring
531 disorders.
532 1. A county or several counties shall plan the designated
533 receiving system using a process that includes the managing
534 entity and is open to participation by individuals with
535 behavioral health needs and their families, service providers,
536 law enforcement agencies, and other parties. The county or
537 counties, in collaboration with the managing entity, shall
538 document the designated receiving system through written
539 memoranda of agreement or other binding arrangements. The county
540 or counties and the managing entity shall complete the plan and
541 implement the designated receiving system by July 1, 2017, and
542 the county or counties and the managing entity shall review and
543 update, as necessary, the designated receiving system at least
544 once every 3 years.
545 2. To the extent permitted by available resources, the
546 designated receiving system shall function as a no-wrong-door
547 model. The designated receiving system may be organized in any
548 manner which functions as a no-wrong-door model that responds to
549 individual needs and integrates services among various
550 providers. Such models include, but are not limited to:
551 a. A central receiving system that consists of a designated
552 central receiving facility that serves as a single entry point
553 for individuals persons with mental health or substance use
554 disorders, or co-occurring disorders. The central receiving
555 facility shall be capable of assessment, evaluation, and triage
556 or treatment or stabilization of individuals persons with mental
557 health or substance use disorders, or co-occurring disorders.
558 b. A coordinated receiving system that consists of multiple
559 entry points that are linked by shared data systems, formal
560 referral agreements, and cooperative arrangements for care
561 coordination and case management. Each entry point shall be a
562 designated receiving facility and shall, within existing
563 resources, provide or arrange for necessary services following
564 an initial assessment and evaluation.
565 c. A tiered receiving system that consists of multiple
566 entry points, some of which offer only specialized or limited
567 services. Each service provider shall be classified according to
568 its capabilities as either a designated receiving facility or
569 another type of service provider, such as a triage center, a
570 licensed detoxification facility, or an access center. All
571 participating service providers shall, within existing
572 resources, be linked by methods to share data, formal referral
573 agreements, and cooperative arrangements for care coordination
574 and case management.
575
576 An accurate inventory of the participating service providers
577 which specifies the capabilities and limitations of each
578 provider and its ability to accept patients under the designated
579 receiving system agreements and the transportation plan
580 developed pursuant to this section shall be maintained and made
581 available at all times to all first responders in the service
582 area.
583 Section 5. Section 394.4574, Florida Statutes, is amended
584 to read:
585 394.4574 Responsibilities for coordination of services for
586 a mental health resident with a mental illness who resides in an
587 assisted living facility that holds a limited mental health
588 license.—
589 (1) As used in this section, the term “mental health
590 resident” means an individual who receives social security
591 disability income due to a mental disorder as determined by the
592 Social Security Administration or receives supplemental security
593 income due to a mental disorder as determined by the Social
594 Security Administration and receives optional state
595 supplementation.
596 (2) Medicaid managed care plans are responsible for
597 Medicaid enrolled mental health residents, and managing entities
598 under contract with the department are responsible for mental
599 health residents who are not enrolled in a Medicaid health plan.
600 A Medicaid managed care plan or a managing entity shall ensure
601 that:
602 (a) A mental health resident has been assessed by a
603 psychiatrist, clinical psychologist, clinical social worker, or
604 psychiatric nurse, mental health counselor, marriage and family
605 therapist, or a qualified professional as defined in s.
606 394.455(40) an individual who is supervised by one of these
607 professionals, and determined to be appropriate to reside in an
608 assisted living facility. The documentation must be provided to
609 the administrator of the facility within 30 days after the
610 mental health resident has been admitted to the facility. An
611 evaluation completed upon discharge from a state mental health
612 treatment facility hospital meets the requirements of this
613 subsection related to appropriateness for services placement as
614 a mental health resident if it was completed within 90 days
615 before admission to the facility.
616 (b) A cooperative agreement, as required in s. 429.075, is
617 developed by the mental health or substance abuse care services
618 provider that serves a mental health resident and the
619 administrator of the assisted living facility with a limited
620 mental health license in which the mental health resident is
621 living.
622 (c) The community living support plan, as defined in s.
623 429.02, has been prepared by a mental health resident and his or
624 her mental health case manager in consultation with the
625 administrator of the facility or the administrator’s designee.
626 The plan must be completed and provided to the administrator of
627 the assisted living facility with a limited mental health
628 license in which the mental health resident lives within 30 days
629 after the resident’s admission. The support plan and the
630 agreement may be in one document.
631 (d) The assisted living facility with a limited mental
632 health license is provided with documentation that the
633 individual meets the definition of a mental health resident.
634 (e) The mental health services provider assigns a case
635 manager to each mental health resident for whom the entity is
636 responsible. The case manager shall coordinate the development
637 and implementation of the community living support plan defined
638 in s. 429.02. The plan must be updated at least annually, or
639 when there is a significant change in the resident’s behavioral
640 health status. Each case manager shall keep a record of the date
641 and time of any face-to-face interaction with the resident and
642 make the record available to the responsible entity for
643 inspection. The record must be retained for at least 2 years
644 after the date of the most recent interaction.
645 (f) Consistent monitoring and implementation of community
646 living support plans and cooperative agreements are conducted by
647 the resident’s case manager.
648 (g) Concerns are reported to the appropriate regulatory
649 oversight organization if a regulated provider fails to deliver
650 appropriate services or otherwise acts in a manner that has the
651 potential to result in harm to the resident.
652 (3) The secretary of Children and Families, in consultation
653 with the Agency for Health Care Administration, shall require
654 each regional district administrator to develop, with community
655 input, a detailed annual plan that demonstrates how the regional
656 office, in cooperation with service providers, district will
657 ensure the provision of state-funded mental health and substance
658 abuse treatment services to residents of assisted living
659 facilities that hold a limited mental health license. This plan
660 must be consistent with the substance abuse and mental health
661 district plan developed pursuant to s. 394.75 and must address
662 case management services; access to consumer-operated drop-in
663 centers; access to services during evenings, weekends, and
664 holidays; supervision of the clinical needs of the residents;
665 and access to emergency psychiatric care.
666 Section 6. Section 394.458, Florida Statutes, is amended to
667 read:
668 394.458 Introduction or removal of certain articles
669 unlawful; penalty.—
670 (1)(a) Except as authorized by the facility administrator
671 for a lawful purpose law or as specifically authorized by the
672 person in charge of each hospital providing mental health
673 services under this part, it is unlawful to knowingly and
674 intentionally bring into any facility providing services under
675 this part, or to take or attempt to take or send therefrom, any
676 of the following articles introduce into or upon the grounds of
677 such hospital, or to take or attempt to take or send therefrom,
678 any of the following articles, which are hereby declared to be
679 contraband for the purposes of this section:
680 (a)1. Any intoxicating beverage or beverage which causes or
681 may cause an intoxicating effect;
682 (b)2. Any controlled substance as defined in chapter 893;
683 (c) Any imitation controlled substance as defined in s.
684 817.564; or
685 (d)3. Any firearms or deadly weapon, except for certified
686 law enforcement officers acting in their official capacity.
687 (b) It is unlawful to transmit to, or attempt to transmit
688 to, or cause or attempt to cause to be transmitted to, or
689 received by, any patient of any hospital providing mental health
690 services under this part any article or thing declared by this
691 section to be contraband, at any place which is outside of the
692 grounds of such hospital, except as authorized by law or as
693 specifically authorized by the person in charge of such
694 hospital.
695 (2) A person who violates any provision of this section
696 commits a felony of the third degree, punishable as provided in
697 s. 775.082, s. 775.083, or s. 775.084.
698 (3) A facility providing services under this part shall
699 post at each entry point of the facility a conspicuous notice
700 that includes the text of this section.
701 Section 7. Section 394.459, Florida Statutes, is amended to
702 read:
703 394.459 Rights of individuals receiving mental health
704 treatment and services patients.—
705 (1) RIGHT TO INDIVIDUAL DIGNITY.—It is the policy of this
706 state that the individual dignity of all individuals held for
707 examination or admitted for mental health treatment the patient
708 shall be respected at all times and upon all occasions,
709 including any occasion when the individual patient is taken into
710 custody, held, or transported. Procedures, facilities, vehicles,
711 and restraining devices used utilized for criminals or those
712 accused of a crime may shall not be used in connection with
713 individuals persons who have a mental illness, except for the
714 protection of the individual patient or others. Individuals
715 Persons who have a mental illness but who are not charged with a
716 criminal offense may shall not be detained or incarcerated in
717 the jails of this state. An individual A person who is receiving
718 treatment for mental illness may shall not be deprived of any
719 constitutional rights. However, if such an individual a person
720 is adjudicated incapacitated, his or her rights may be limited
721 to the same extent the rights of any incapacitated individual
722 person are limited by law.
723 (2) RIGHT TO TREATMENT.—An individual held for examination
724 or admitted for mental health treatment:
725 (a) Shall A person shall not be denied treatment for mental
726 illness and services shall not be delayed at a receiving or
727 treatment facility because of inability to pay. However, every
728 reasonable effort to collect appropriate reimbursement for the
729 cost of providing mental health services from individuals to
730 persons able to pay for services, including insurance or third
731 party payers payments, shall be made by facilities providing
732 services under pursuant to this part.
733 (b) Shall be provided It is further the policy of the state
734 that the least restrictive appropriate available treatment be
735 utilized based on the individual’s individual needs and best
736 interests, of the patient and consistent with the optimum
737 improvement of the individual’s patient’s condition.
738 (c) Each person who remains at a receiving or treatment
739 facility for more than 12 hours Shall be given a physical
740 examination by a health practitioner authorized by law to give
741 such examinations and a mental health evaluation by a
742 psychiatrist, psychologist, or psychiatric nurse, in a mental
743 health receiving facility, within 24 hours after arrival at the
744 facility if the individual has not been released or discharged
745 pursuant to s. 394.463(2)(h) or s. 394.469. The physical
746 examination and mental health evaluation must be documented in
747 the clinical record. The physical and mental health examinations
748 shall include efforts to identify indicators and symptoms of
749 substance abuse impairment, substance abuse intoxication, and
750 substance abuse withdrawal, within 24 hours after arrival at
751 such facility.
752 (d) Every patient in a facility Shall be afforded the
753 opportunity to participate in activities designed to enhance
754 self-image and the beneficial effects of other treatments, as
755 determined by the facility.
756 (e) Not more than 5 days after admission to a facility,
757 each patient Shall have and receive an individualized treatment
758 plan in writing which the individual patient has had an
759 opportunity to assist in preparing and to review before prior to
760 its implementation. The plan must shall include a space for the
761 individual’s patient’s comments and signature.
762 (3) RIGHT TO EXPRESS AND INFORMED PATIENT CONSENT.—
763 (a)1. Each individual patient entering treatment shall be
764 asked to give express and informed consent for admission or
765 treatment.
766 (a) If the individual patient has been adjudicated
767 incapacitated or found to be incompetent to consent to
768 treatment, express and informed consent must to treatment shall
769 be sought instead from his or her the patient’s guardian or
770 guardian advocate or health care surrogate or proxy. If the
771 individual patient is a minor, express and informed consent for
772 admission or treatment must be obtained from the minor’s shall
773 also be requested from the patient’s guardian. Express and
774 informed consent for admission or treatment of a patient under
775 18 years of age shall be required from the patient’s guardian,
776 unless the minor is seeking outpatient crisis intervention
777 services under s. 394.4784. Express and informed consent for
778 admission or treatment given by a patient who is under 18 years
779 of age shall not be a condition of admission when the patient’s
780 guardian gives express and informed consent for the patient’s
781 admission pursuant to s. 394.463 or s. 394.467.
782 (b)2. Before giving express and informed consent, the
783 following information shall be provided and explained in plain
784 language to the individual and to his or her patient, or to the
785 patient’s guardian if the individual is an adult patient is 18
786 years of age or older and has been adjudicated incapacitated, or
787 to his or her the patient’s guardian advocate if the individual
788 patient has been found to be incompetent to consent to
789 treatment, to the health care surrogate or proxy, or to both the
790 individual patient and the guardian if the individual patient is
791 a minor;: the reason for admission or treatment; the proposed
792 treatment; the purpose of the treatment to be provided; the
793 common risks, benefits, and side effects thereof; the specific
794 dosage range for the medication, if when applicable; alternative
795 treatment modalities; the approximate length of care; the
796 potential effects of stopping treatment; how treatment will be
797 monitored; and that any consent given for treatment may be
798 revoked orally or in writing before or during the treatment
799 period by the individual receiving treatment patient or by a
800 person who is legally authorized to make health care decisions
801 on the individual’s behalf of the patient.
802 (b) In the case of medical procedures requiring the use of
803 a general anesthetic or electroconvulsive treatment, and prior
804 to performing the procedure, express and informed consent shall
805 be obtained from the patient if the patient is legally
806 competent, from the guardian of a minor patient, from the
807 guardian of a patient who has been adjudicated incapacitated, or
808 from the guardian advocate of the patient if the guardian
809 advocate has been given express court authority to consent to
810 medical procedures or electroconvulsive treatment as provided
811 under s. 394.4598.
812 (c) When the department is the legal guardian of a patient,
813 or is the custodian of a patient whose physician is unwilling to
814 perform a medical procedure, including an electroconvulsive
815 treatment, based solely on the patient’s consent and whose
816 guardian or guardian advocate is unknown or unlocatable, the
817 court shall hold a hearing to determine the medical necessity of
818 the medical procedure. The patient shall be physically present,
819 unless the patient’s medical condition precludes such presence,
820 represented by counsel, and provided the right and opportunity
821 to be confronted with, and to cross-examine, all witnesses
822 alleging the medical necessity of such procedure. In such
823 proceedings, the burden of proof by clear and convincing
824 evidence shall be on the party alleging the medical necessity of
825 the procedure.
826 (d) The administrator of a receiving or treatment facility
827 may, upon the recommendation of the patient’s attending
828 physician, authorize emergency medical treatment, including a
829 surgical procedure, if such treatment is deemed lifesaving, or
830 if the situation threatens serious bodily harm to the patient,
831 and permission of the patient or the patient’s guardian or
832 guardian advocate cannot be obtained.
833 (4) QUALITY OF TREATMENT.—
834 (a) Each individual held for examination, admitted for
835 mental health treatment, or receiving involuntary treatment
836 patient shall receive services that are, including, for a
837 patient placed under s. 394.4655, those services included in the
838 court order which are suited to his or her needs, and which
839 shall be administered skillfully, safely, and humanely with full
840 respect for the individual’s patient’s dignity and personal
841 integrity. Each individual patient shall receive such medical,
842 vocational, social, educational, and rehabilitative services as
843 his or her condition requires in order to live successfully in
844 the community. In order to achieve this goal, the department
845 shall is directed to coordinate its mental health programs with
846 all other programs of the department and other state agencies.
847 (b) Facilities shall develop and maintain, in a form
848 accessible to and readily understandable by individuals held for
849 examination, admitted for mental health treatment, or receiving
850 involuntary treatment patients and consistent with rules adopted
851 by the department, the following:
852 1. Criteria, procedures, and required staff training for
853 the any use of close or elevated levels of supervision;, of
854 restraint, seclusion, or isolation;, or of emergency treatment
855 orders;, and for the use of bodily control and physical
856 management techniques.
857 2. Procedures for documenting, monitoring, and requiring
858 clinical review of all uses of the procedures described in
859 subparagraph 1. and for documenting and requiring review of any
860 incidents resulting in injury to individuals receiving services
861 patients.
862 3. A system for investigating, tracking, managing, and
863 responding to complaints by individuals persons receiving
864 services or persons individuals acting on their behalf.
865 (c) Receiving and treatment facilities shall have written
866 procedures for reporting events that place individuals receiving
867 services at risk of harm. Such events must be reported to the
868 department as soon as reasonably possible after discovery and
869 include, but are not limited to:
870 1. The death, regardless of cause or manner, of an
871 individual examined or treated at a facility that occurs while
872 the individual is at the facility or that occurs within 72 hours
873 after release, if the death is known to the facility
874 administrator.
875 2. An injury sustained, or allegedly sustained, at a
876 facility, by an individual examined or treated at the facility
877 and caused by an accident, self-injury, assault, act of abuse,
878 neglect, or suicide attempt, if the injury requires medical
879 treatment by a licensed health care practitioner in an acute
880 care medical facility.
881 3. The unauthorized departure or absence of an individual
882 from a facility in which he or she has been held for involuntary
883 examination or involuntary treatment.
884 4. A disaster or crisis situation such as a tornado,
885 hurricane, kidnapping, riot, or hostage situation that
886 jeopardizes the health, safety, or welfare of individuals
887 examined or treated in a facility.
888 5. An allegation of sexual battery upon an individual
889 examined or treated in a facility.
890 (d)(c) A facility may not use seclusion or restraint for
891 punishment, in compensation to compensate for inadequate
892 staffing, or for the convenience of staff. Facilities shall
893 ensure that all staff, contractors, and volunteers are made
894 aware of these restrictions on the use of seclusion and
895 restraint and shall make and maintain records which demonstrate
896 that this information has been conveyed to each staff member,
897 contractor, and volunteer individual staff members.
898 (5) COMMUNICATION, ABUSE REPORTING, AND VISITS.—
899 (a) Each individual held for examination or admitted for
900 mental health treatment person receiving services in a facility
901 providing mental health services under this part has the right
902 to communicate freely and privately with persons outside the
903 facility unless it is determined that such communication is
904 likely to be harmful to the individual person or others. Each
905 facility shall make available as soon as reasonably possible to
906 persons receiving services a telephone that allows for free
907 local calls and access to a long-distance service available to
908 the individual as soon as reasonably possible. A facility is not
909 required to pay the costs of an individual’s a patient’s long
910 distance calls. The telephone must shall be readily accessible
911 to the patient and shall be placed so that the individual
912 patient may use it to communicate privately and confidentially.
913 The facility may establish reasonable rules for the use of this
914 telephone which, provided that the rules do not interfere with
915 an individual’s a patient’s access to a telephone to report
916 abuse pursuant to paragraph (e).
917 (b) Each individual patient admitted to a facility under
918 the provisions of this part is shall be allowed to receive,
919 send, and mail sealed, unopened correspondence; and the
920 individual’s no patient’s incoming or outgoing correspondence
921 may not shall be opened, delayed, held, or censored by the
922 facility unless there is reason to believe that it contains
923 items or substances that which may be harmful to the individual
924 patient or others, in which case the administrator may direct
925 reasonable examination of such mail and may regulate the
926 disposition of such items or substances.
927 (c) Each facility shall allow must permit immediate access
928 to an individual held for examination or admitted for mental
929 health treatment any patient, subject to the patient’s right to
930 deny or withdraw consent at any time, by the individual, or by
931 the individual’s patient’s family members, guardian, guardian
932 advocate, health care surrogate or proxy, representative,
933 Florida statewide or local advocacy council, or attorney, unless
934 such access would be detrimental to the individual patient. If
935 the a patient’s right to communicate or to receive visitors is
936 restricted by the facility, written notice of such restriction
937 and the reasons for the restriction shall be served on the
938 individual and the individual’s attorney, patient, the patient’s
939 attorney, and the patient’s guardian, guardian advocate, health
940 care surrogate or proxy, or representative; and such restriction
941 and the reason for the restriction, shall be recorded in on the
942 patient’s clinical record with the reasons therefor. The
943 restriction must of a patient’s right to communicate or to
944 receive visitors shall be reviewed at least every 7 days. The
945 right to communicate or receive visitors may shall not be
946 restricted as a means of punishment. Nothing in This paragraph
947 does not shall be construed to limit the establishment of rules
948 under provisions of paragraph (d).
949 (d) Each facility shall establish reasonable rules
950 governing visitors, visiting hours, and the use of telephones by
951 individuals held for examination or admitted for mental health
952 treatment patients in the least restrictive possible manner. An
953 individual has Patients shall have the right to contact and to
954 receive communication from his or her their attorneys at any
955 reasonable time.
956 (e) Each individual held for examination or admitted for
957 mental health treatment patient receiving mental health
958 treatment in any facility shall have ready access to a telephone
959 in order to report an alleged abuse. The facility staff shall
960 orally and in writing inform each individual patient of the
961 procedure for reporting abuse and shall make every reasonable
962 effort to present the information in a language that the
963 individual patient understands. A written copy of that
964 procedure, including the telephone number of the central abuse
965 hotline and reporting forms, shall be posted in plain view.
966 (f) The department must shall adopt rules providing a
967 procedure for reporting alleged abuse. Facility staff shall be
968 required, as a condition of employment, must to become familiar
969 with the requirements and procedures for the reporting of abuse.
970 (6) CARE AND CUSTODY OF PERSONAL EFFECTS OF PATIENTS.—The
971 rights of an individual held for examination or admitted for
972 mental health treatment A patient’s right to the possession of
973 his or her clothing and personal effects shall be respected. The
974 facility may take temporary custody of such effects if when
975 required for medical and safety reasons. The A patient’s
976 clothing and personal effects shall be inventoried upon their
977 removal into temporary custody. Copies of this inventory shall
978 be given to the individual and his or her patient and to the
979 patient’s guardian, guardian advocate, health care surrogate or
980 proxy, or representative and shall be recorded in the patient’s
981 clinical record. This inventory may be amended upon the request
982 of the individual and his or her patient or the patient’s
983 guardian, guardian advocate, health care surrogate or proxy, or
984 representative. The inventory and any amendments to it must be
985 witnessed by two members of the facility staff and by the
986 individual patient, if able. All of the a patient’s clothing and
987 personal effects held by the facility must shall be returned to
988 the individual patient immediately upon his or her the discharge
989 or transfer of the patient from the facility, unless such return
990 would be detrimental to the individual patient. If personal
991 effects are not returned to the patient, the reason must be
992 documented in the clinical record along with the disposition of
993 the clothing and personal effects, which may be given instead to
994 the individual’s patient’s guardian, guardian advocate, health
995 care surrogate or proxy, or representative. As soon as
996 practicable after an emergency transfer of a patient, the
997 individual’s patient’s clothing and personal effects shall be
998 transferred to the individual’s patient’s new location, together
999 with a copy of the inventory and any amendments, unless an
1000 alternate plan is approved by the individual patient, if he or
1001 she is able, and by his or her the patient’s guardian, guardian
1002 advocate, health care surrogate or proxy, or representative.
1003 (7) VOTING IN PUBLIC ELECTIONS.—An individual held for
1004 examination or admitted for mental health treatment A patient
1005 who is eligible to vote according to the laws of the state has
1006 the right to vote in the primary, and general, and special
1007 elections. The department shall establish rules to enable such
1008 individuals patients to obtain voter registration forms,
1009 applications for vote-by-mail ballots, and vote-by-mail ballots.
1010 (8) HABEAS CORPUS.—
1011 (a) At any time, and without notice, an individual held for
1012 mental health examination or admitted for inpatient treatment in
1013 a person held in a receiving or treatment facility, or a
1014 relative, friend, guardian, guardian advocate, health care
1015 surrogate or proxy, representative, or attorney, or the
1016 department, on behalf of such individual person, may petition
1017 for a writ of habeas corpus to question the cause and legality
1018 of such detention and request that the court order a return to
1019 the writ in accordance with chapter 79. Each individual patient
1020 held in a facility shall receive a written notice of the right
1021 to petition for a writ of habeas corpus.
1022 (b) At any time, and without notice, an individual held for
1023 mental health examination or admitted for inpatient treatment a
1024 person who is a patient in a receiving or treatment facility, or
1025 a relative, friend, guardian, guardian advocate, health care
1026 surrogate or proxy, representative, or attorney, or the
1027 department, on behalf of such individual person, may file a
1028 petition in the circuit court in the county where the individual
1029 patient is being held alleging that he or she the patient is
1030 being unjustly denied a right or privilege granted under this
1031 part herein or that a procedure authorized under this part
1032 herein is being abused. Upon the filing of such a petition, the
1033 court may shall have the authority to conduct a judicial inquiry
1034 and to issue any order needed to correct an abuse of the
1035 provisions of this part.
1036 (c) The administrator of any receiving or treatment
1037 facility receiving a petition under this subsection shall file
1038 the petition with the clerk of the court no later than on the
1039 next court working day.
1040 (d) A No fee may not shall be charged for the filing of a
1041 petition under this subsection.
1042 (9) VIOLATIONS.—The department shall report to the Agency
1043 for Health Care Administration any violation of the rights or
1044 privileges of individuals patients, or of any procedures
1045 provided under this part, by any facility or professional
1046 licensed or regulated under state law by the agency. The agency
1047 is authorized to impose Any sanction authorized for violation of
1048 this part may be imposed, based solely on the investigation and
1049 findings of the department.
1050 (10) LIABILITY FOR VIOLATIONS.—A Any person who violates or
1051 abuses the any rights or privileges of individuals held or
1052 admitted for mental health treatment patients provided under by
1053 this part is liable for damages as determined by law. A Any
1054 person who acts reasonably, in good faith, and without
1055 negligence in compliance with the provisions of this part is
1056 immune from civil or criminal liability for his or her actions
1057 in connection with the preparation or execution of petitions,
1058 applications, certificates, reports, or other documents
1059 initiating admission to a facility or the apprehension,
1060 detention, transportation, examination, admission, diagnosis,
1061 treatment, or discharge of an individual a patient to or from a
1062 facility. However, this section does not relieve any person from
1063 liability if such person commits negligence.
1064 (11) RIGHT TO PARTICIPATE IN TREATMENT AND DISCHARGE
1065 PLANNING.—An individual held for examination or admitted for
1066 mental health treatment The patient shall have the opportunity
1067 to participate in treatment and discharge planning and shall be
1068 notified in writing of his or her right, upon discharge from the
1069 facility, to seek treatment from the professional or agency of
1070 the individual’s patient’s choice.
1071 (12) POSTING OF NOTICE OF RIGHTS OF PATIENTS.—Each facility
1072 shall post a notice that lists and describes listing and
1073 describing, in the language and terminology that the individual
1074 persons to whom the notice is addressed can understand, the
1075 rights provided under in this section. This notice must shall
1076 include a statement that provisions of the federal Americans
1077 with Disabilities Act apply and the name and telephone number of
1078 a person to contact for further information. The This notice
1079 must shall be posted in a place readily accessible to
1080 individuals patients and in a format easily seen by the
1081 individuals served patients. The This notice must shall include
1082 the telephone numbers of Disability Rights Florida, Inc the
1083 Florida local advocacy council and Advocacy Center for Persons
1084 with Disabilities, Inc.
1085 Section 8. Section 394.4593, Florida Statutes, is amended
1086 to read:
1087 394.4593 Sexual misconduct prohibited; reporting required;
1088 penalties.—
1089 (1) As used in this section, the term:
1090 (a) “Employee” means includes any paid staff member,
1091 volunteer, or intern of the department or a service provider
1092 providing services pursuant to this part; any person under
1093 contract with the department or a service provider providing
1094 services pursuant to this part; and any person providing care or
1095 support to an individual a client on behalf of the department or
1096 its service providers.
1097 (b) “Sexual activity” means:
1098 1. Fondling the genital area, groin, inner thighs,
1099 buttocks, or breasts of an individual a person.
1100 2. The oral, anal, or vaginal penetration by or union with
1101 the sexual organ of another or the anal or vaginal penetration
1102 of another by any other object.
1103 3. Intentionally touching in a lewd or lascivious manner
1104 the breasts, genitals, the genital area, or buttocks, or the
1105 clothing covering them, of an individual a person, or forcing or
1106 enticing an individual a person to touch the perpetrator.
1107 4. Intentionally masturbating in the presence of another
1108 individual person.
1109 5. Intentionally exposing the genitals in a lewd or
1110 lascivious manner in the presence of another individual person.
1111 6. Intentionally committing any other sexual act that does
1112 not involve actual physical or sexual contact with another
1113 individual the victim, including, but not limited to,
1114 sadomasochistic abuse, sexual bestiality, or the simulation of
1115 any act involving sexual activity in the presence of the
1116 individual a victim.
1117 (c) “Sexual misconduct” means any sexual activity between
1118 an employee and an individual held or admitted for examination
1119 or treatment pursuant to this part a patient, regardless of the
1120 consent of that individual the patient. The term does not
1121 include an act done for a bona fide medical purpose or an
1122 internal search conducted in the lawful performance of duty by
1123 an employee.
1124 (2) An employee who engages in sexual misconduct with an
1125 individual a patient who:
1126 (a) Is in the custody of the department; or
1127 (b) Resides in a receiving facility or a treatment
1128 facility, as those terms are defined in s. 394.455,
1129
1130 commits a felony of the second degree, punishable as provided in
1131 s. 775.082, s. 775.083, or s. 775.084. An employee may be found
1132 guilty of violating this subsection without having committed the
1133 crime of sexual battery.
1134 (3) The consent of an individual held or admitted for
1135 examination or treatment the patient to sexual activity is not a
1136 defense to prosecution under this section.
1137 (4) This section does not apply to an employee who, at the
1138 time of the sexual activity:
1139 (a) Is legally married to the individual involved in the
1140 sexual activity patient; or
1141 (b) Has no reason to believe that the individual involved
1142 in the sexual activity is held or admitted for examination or
1143 treatment pursuant to this part person with whom the employee
1144 engaged in sexual misconduct is a patient receiving services as
1145 described in subsection (2).
1146 (5) An employee who witnesses sexual misconduct, or who
1147 otherwise knows or has reasonable cause to suspect that a person
1148 has engaged in sexual misconduct, shall immediately report the
1149 incident to the department’s central abuse hotline and to the
1150 appropriate local law enforcement agency. Such employee shall
1151 also prepare, date, and sign an independent report that
1152 specifically describes the nature of the sexual misconduct, the
1153 location and time of the incident, and the persons involved. The
1154 employee shall deliver the report to the supervisor or program
1155 director, who is responsible for providing copies to the
1156 department’s inspector general. The inspector general shall
1157 immediately conduct an appropriate administrative investigation,
1158 and, if there is probable cause to believe that sexual
1159 misconduct has occurred, the inspector general shall notify the
1160 state attorney in the circuit in which the incident occurred.
1161 (6)(a) Any person who is required to make a report under
1162 this section and who knowingly or willfully fails to do so, or
1163 who knowingly or willfully prevents another person from doing
1164 so, commits a misdemeanor of the first degree, punishable as
1165 provided in s. 775.082 or s. 775.083.
1166 (b) Any person who knowingly or willfully submits
1167 inaccurate, incomplete, or untruthful information with respect
1168 to a report required under this section commits a misdemeanor of
1169 the first degree, punishable as provided in s. 775.082 or s.
1170 775.083.
1171 (c) Any person who knowingly or willfully coerces or
1172 threatens any other person with the intent to alter testimony or
1173 a written report regarding an incident of sexual misconduct
1174 commits a felony of the third degree, punishable as provided in
1175 s. 775.082, s. 775.083, or s. 775.084.
1176 (7) The provisions and penalties set forth in this section
1177 are in addition to any other civil, administrative, or criminal
1178 action provided by law which may be applied against an employee.
1179 Section 9. Section 394.4595, Florida Statutes, is repealed.
1180 Section 10. Section 394.4596, Florida Statutes, is created
1181 to read:
1182 394.4596 Federally mandated protection and advocacy system
1183 for individuals with disabilities.—The agency designated by the
1184 governor as the federally mandated protection and advocacy
1185 system for individuals with disabilities has specific access
1186 authority under federal law to facilities, individuals,
1187 information, and records. Any facility defined in s. 394.455(12)
1188 shall allow this agency to exercise access authority provided to
1189 it by state and federal law.
1190 Section 11. Section 394.4597, Florida Statutes, is amended
1191 to read:
1192 394.4597 Persons to be notified; individual’s patient’s
1193 representative.—
1194 (1) VOLUNTARY ADMISSION PATIENTS.—At the time an individual
1195 a patient is voluntarily admitted to a receiving or treatment
1196 facility, the individual shall be asked to identify a person to
1197 be notified in case of an emergency, and the identity and
1198 contact information of that a person to be notified in case of
1199 an emergency shall be entered in the patient’s clinical record.
1200 (2) INVOLUNTARY ADMISSION PATIENTS.—
1201 (a) At the time an individual a patient is admitted to a
1202 facility for involuntary examination or services placement, or
1203 when a petition for involuntary services placement is filed, the
1204 name, address, and telephone number names, addresses, and
1205 telephone numbers of the individual’s patient’s guardian or
1206 guardian advocate, health care surrogate or proxy, or
1207 representative if he or she the patient has no guardian, and the
1208 individual’s patient’s attorney shall be entered in the
1209 patient’s clinical record.
1210 (b) If the individual patient has no guardian, guardian
1211 advocate, health care surrogate, or proxy, he or she the patient
1212 shall be asked to designate a representative. If the individual
1213 patient is unable or unwilling to designate a representative,
1214 the facility shall select a representative.
1215 (c) The individual patient shall be consulted with regard
1216 to the selection of a representative by the receiving or
1217 treatment facility and may shall have authority to request that
1218 the any such representative be replaced.
1219 (d) If When the receiving or treatment facility selects a
1220 representative, first preference shall be given to a health care
1221 surrogate, if one has been previously selected by the patient.
1222 If the individual patient has not previously selected a health
1223 care surrogate, the selection, except for good cause documented
1224 in the patient’s clinical record, shall be made from the
1225 following list in the order of listing:
1226 1. The individual’s patient’s spouse.
1227 2. An adult child of the individual patient.
1228 3. A parent of the individual patient.
1229 4. The adult next of kin of the individual patient.
1230 5. An adult friend of the individual patient.
1231 (e) The following persons are prohibited from selection as
1232 an individual’s a patient’s representative:
1233 1. A professional providing clinical services to the
1234 individual patient under this part.
1235 2. The licensed professional who initiated the involuntary
1236 examination of the individual patient, if the examination was
1237 initiated by professional certificate.
1238 3. An employee, a volunteer, a contractor, an
1239 administrator, or a board member of the facility providing the
1240 examination of the individual patient.
1241 4. An employee, a volunteer, a contractor, an
1242 administrator, or a board member of a treatment facility
1243 providing treatment for the individual patient.
1244 5. A person providing any substantial professional services
1245 to the individual patient, including clinical services.
1246 6. A creditor of the individual patient.
1247 7. A person who is a party subject to an injunction for
1248 protection against domestic violence under s. 741.30, whether
1249 the order of injunction is temporary or final, and for which the
1250 individual patient was the petitioner.
1251 8. A person who is a party subject to an injunction for
1252 protection against repeat violence, stalking, sexual violence,
1253 or dating violence under s. 784.046, whether the order of
1254 injunction is temporary or final, and for which the individual
1255 patient was the petitioner.
1256 (f) The representative selected by the individual or
1257 designated by the facility has the right, authority, and
1258 responsibility to:
1259 1. Receive notice of the individual’s admission;
1260 2. Receive notice of proceedings affecting the individual;
1261 3. Have immediate access to the individual unless such
1262 access is documented to be detrimental to the individual;
1263 4. Receive notice of any restriction of the individual’s
1264 right to communicate or receive visitors;
1265 5. Receive a copy of the inventory of clothing and personal
1266 effects upon the individual’s admission and to request an
1267 amendment to the inventory at any time;
1268 6. Receive disposition of the individual’s clothing and
1269 personal effects if not returned to the individual, or to
1270 approve an alternate plan;
1271 7. Petition on behalf of the individual for a writ of
1272 habeas corpus to question the cause and legality of the
1273 individual’s detention or to allege that the individual is being
1274 unjustly denied a right or privilege granted under this part, or
1275 that a procedure authorized under this part is being abused;
1276 8. Apply for a change of venue for the individual’s
1277 involuntary services placement hearing for the convenience of
1278 the parties or witnesses or because of the individual’s
1279 condition;
1280 9. Receive written notice of any restriction of the
1281 individual’s right to inspect his or her clinical record;
1282 10. Receive notice of the release of the individual from a
1283 receiving facility where an involuntary examination was
1284 performed;
1285 11. Receive a copy of any petition for the individual’s
1286 involuntary services filed with the court; and
1287 12. Be informed by the court of the individual’s right to
1288 an independent expert evaluation pursuant to involuntary
1289 services procedures.
1290 Section 12. Section 394.4598, Florida Statutes, is amended
1291 to read:
1292 394.4598 Guardian advocate.—
1293 (1) The administrator may petition the court for the
1294 appointment of a guardian advocate based upon the opinion of a
1295 psychiatrist that an individual held for examination or admitted
1296 for mental health treatment the patient is incompetent to
1297 consent to treatment. If the court finds that the individual a
1298 patient is incompetent to consent to treatment and has not been
1299 adjudicated incapacitated and a guardian having with the
1300 authority to consent to mental health or substance abuse
1301 treatment has not been appointed, it shall appoint a guardian
1302 advocate. The individual patient has the right to have an
1303 attorney represent him or her at the hearing. If the individual
1304 is not otherwise represented by counsel and person is indigent,
1305 the court shall appoint the office of the public defender to
1306 represent him or her at the hearing. The individual patient has
1307 the right to testify, cross-examine witnesses, and present
1308 witnesses. The proceeding must shall be recorded either
1309 electronically or stenographically, and testimony shall be
1310 provided under oath. One of the professionals authorized to give
1311 an opinion in support of a petition for involuntary services
1312 placement, as described in s. 394.4655 or s. 394.467, shall must
1313 testify. The A guardian advocate shall must meet the
1314 qualifications of a guardian pursuant to contained in part IV of
1315 chapter 744. A person may not be appointed as a guardian
1316 advocate unless he or she agrees, except that a professional
1317 referred to in this part, an employee of the facility providing
1318 direct services to the patient under this part, a departmental
1319 employee, a facility administrator, or member of the Florida
1320 local advocacy council shall not be appointed. A person who is
1321 appointed as a guardian advocate must agree to the appointment.
1322 (2) The following persons are prohibited from being
1323 appointed as an individual’s appointment as a patient’s guardian
1324 advocate:
1325 (a) A professional providing clinical services to the
1326 individual patient under this part.
1327 (b) The licensed professional who initiated the involuntary
1328 examination of the individual patient, if the examination was
1329 initiated by professional certificate.
1330 (c) An employee, a contractor, a volunteer, an
1331 administrator, or a board member of the facility providing the
1332 examination of the individual patient.
1333 (d) An employee, a contractor, a volunteer, an
1334 administrator, or a board member of a treatment facility
1335 providing treatment of the individual patient.
1336 (e) A person providing any substantial professional
1337 services, excluding public and professional guardians, to the
1338 individual patient, including clinical services.
1339 (f) A creditor of the individual patient.
1340 (g) A party person subject to an injunction for protection
1341 against domestic violence under s. 741.30, whether the order of
1342 injunction is temporary or final, and for which the individual
1343 patient was the petitioner.
1344 (h) A party person subject to an injunction for protection
1345 against repeat violence, stalking, sexual violence, or dating
1346 violence under s. 784.046, whether the order of injunction is
1347 temporary or final, and for which the individual patient was the
1348 petitioner.
1349 (3) A facility requesting appointment of a guardian
1350 advocate shall, before must, prior to the appointment, provide
1351 the prospective guardian advocate with information concerning
1352 about the duties and responsibilities of guardian advocates,
1353 including the information about the ethics of medical
1354 decisionmaking. Before asking a guardian advocate to give
1355 consent to treatment for an individual held for examination or
1356 admitted for mental health treatment a patient, the facility
1357 shall provide all disclosures required under s. 394.459(3)(a)2
1358 to the guardian advocate sufficient information so that the
1359 guardian advocate can decide whether to give express and
1360 informed consent to the treatment, including information that
1361 the treatment is essential to the care of the patient, and that
1362 the treatment does not present an unreasonable risk of serious,
1363 hazardous, or irreversible side effects. Before giving consent
1364 to treatment, the guardian advocate shall must meet and talk
1365 with the individual patient and the individual’s patient’s
1366 physician face-to-face in person, if at all possible, and by
1367 telephone, if not. The guardian advocate shall make every effort
1368 to make decisions regarding treatment that he or she believes
1369 the individual would have made under the circumstances if the
1370 individual were capable of making such decision. The decision of
1371 the guardian advocate may be reviewed by the court, upon
1372 petition of the individual’s patient’s attorney, the
1373 individual’s patient’s family, or the facility administrator.
1374 (4) In lieu of the training required of guardians appointed
1375 under pursuant to chapter 744, a guardian advocate must, at a
1376 minimum, complete participate in a 4-hour training course
1377 approved by the court before exercising his or her authority. At
1378 a minimum, this training course must include information
1379 concerning rights of the individual about patient rights,
1380 psychotropic medications, the diagnosis of mental illness, the
1381 ethics of medical decisionmaking, and duties of guardian
1382 advocates.
1383 (5) The required training course and the information
1384 provided to be supplied to prospective guardian advocates before
1385 their appointment must be developed by the department and,
1386 approved by the chief judge of the circuit court, and taught by
1387 a court-approved organization, which may include, but is not
1388 limited to, a community college, a guardianship organization, a
1389 local bar association, or The Florida Bar. The training course
1390 may be web-based, provided in video format, or other electronic
1391 means but must be capable of ensuring the identity and
1392 participation of the prospective guardian advocate. The court
1393 may waive some or all of the training requirements for guardian
1394 advocates or impose additional requirements. The court shall
1395 make its decision on a case-by-case basis and, in making its
1396 decision, shall consider the experience and education of the
1397 guardian advocate, the duties assigned to the guardian advocate,
1398 and the needs of the individual subject to involuntary services
1399 patient.
1400 (6) In selecting a guardian advocate, the court shall give
1401 preference to a health care surrogate, if one has already been
1402 designated by the individual held for examination or admitted
1403 for mental health treatment patient. If the individual patient
1404 has not previously selected a health care surrogate, except for
1405 good cause documented in the court record, the selection shall
1406 be made from the following list in the order of listing:
1407 (a) The individual’s patient’s spouse.
1408 (b) An adult child of the individual patient.
1409 (c) A parent of the individual patient.
1410 (d) The adult next of kin of the individual patient.
1411 (e) An adult friend of the individual patient.
1412 (f) An adult trained and willing to serve as guardian
1413 advocate for the individual patient.
1414 (7) If a guardian having with the authority to consent to
1415 medical treatment has not already been appointed or if the
1416 individual held for examination or admitted for mental health
1417 treatment patient has not already designated a health care
1418 surrogate, the court may authorize the guardian advocate to
1419 consent to medical treatment, as well as mental health and
1420 substance abuse treatment. Unless otherwise limited by the
1421 court, a guardian advocate who has with authority to consent to
1422 medical treatment has shall have the same authority to make
1423 health care decisions and is be subject to the same restrictions
1424 as a proxy appointed under part IV of chapter 765.
1425 (a) Unless the guardian advocate has sought and received
1426 express court approval in proceeding separate from the
1427 proceeding to determine the competence of the individual patient
1428 to consent to medical treatment, the guardian advocate may not
1429 consent to:
1430 1.(a) Abortion.
1431 2.(b) Sterilization.
1432 3.(c) Electroconvulsive treatment.
1433 4.(d) Psychosurgery.
1434 5.(e) Experimental treatments that have not been approved
1435 by a federally approved institutional review board in accordance
1436 with 45 C.F.R. part 46 or 21 C.F.R. part 56.
1437 (b) The court must base its decision on evidence that the
1438 treatment or procedure is essential to the care of the patient
1439 and that the treatment does not present an unreasonable risk of
1440 serious, hazardous, or irreversible side effects. The court
1441 shall follow the procedures set forth in subsection (1) of this
1442 section.
1443 (8) The guardian advocate shall be discharged when the
1444 individual for whom he or she is appointed patient is discharged
1445 from an order for involuntary services outpatient placement or
1446 involuntary inpatient placement or when the individual patient
1447 is transferred from involuntary to voluntary status. The court
1448 or a hearing officer shall consider the competence of the
1449 individual patient pursuant to subsection (1) and may consider
1450 the competence to consent to treatment of an individual on
1451 involuntary status an involuntarily placed patient’s competence
1452 to consent to treatment at any hearing. Upon sufficient
1453 evidence, the court may restore the individual’s, or the hearing
1454 officer may recommend that the court restore, the patient’s
1455 competence. A copy of the order restoring competence or the
1456 certificate of discharge containing the restoration of
1457 competence shall be provided to the individual patient and the
1458 guardian advocate.
1459 Section 13. Paragraphs (c) and (d) of subsection (2) of
1460 section 394.4599, Florida Statutes, are amended to read:
1461 394.4599 Notice.—
1462 (2) INVOLUNTARY ADMISSION.—
1463 (c)1. A receiving facility shall give notice of the
1464 whereabouts of a minor who is being involuntarily held for
1465 examination pursuant to s. 394.463 to the minor’s parent,
1466 guardian, caregiver, or guardian advocate, in person or by
1467 telephone or other form of electronic communication, immediately
1468 after the minor’s arrival at the facility. The facility may
1469 delay notification for no more than 24 hours after the minor’s
1470 arrival if the facility has submitted a report to the central
1471 abuse hotline, pursuant to s. 39.201, based upon knowledge or
1472 suspicion of abuse, abandonment, or neglect and if the facility
1473 deems a delay in notification to be in the minor’s best
1474 interest.
1475 2. The receiving facility shall attempt to notify the
1476 minor’s parent, guardian, caregiver, or guardian advocate until
1477 the receiving facility receives confirmation from the parent,
1478 guardian, caregiver, or guardian advocate, verbally, by
1479 telephone or other form of electronic communication, or by
1480 recorded message, that notification has been received. Attempts
1481 to notify the parent, guardian, caregiver, or guardian advocate
1482 must be repeated at least once every hour during the first 12
1483 hours after the minor’s arrival and once every 24 hours
1484 thereafter and must continue until such confirmation is
1485 received, unless the minor is released at the end of the 72-hour
1486 examination period, or until a petition for involuntary services
1487 is filed with the court pursuant to s. 394.463(2)(f)
1488 394.463(2)(g). The receiving facility may seek assistance from a
1489 law enforcement agency to notify the minor’s parent, guardian,
1490 caregiver, or guardian advocate if the facility has not received
1491 within the first 24 hours after the minor’s arrival a
1492 confirmation by the parent, guardian, caregiver, or guardian
1493 advocate that notification has been received. The receiving
1494 facility must document notification attempts in the minor’s
1495 clinical record.
1496 (d) The written notice of the filing of the petition for
1497 involuntary services for an individual being held must contain
1498 the following:
1499 1. Notice that the petition for:
1500 a. involuntary services inpatient treatment pursuant to s.
1501 394.467 has been filed with the circuit court in the county in
1502 which the individual is hospitalized and the address of such
1503 court; or
1504 b. Involuntary outpatient services pursuant to s. 394.4655
1505 has been filed with the criminal county court, as defined in s.
1506 394.4655(1), or the circuit court, as applicable, in the county
1507 in which the individual is hospitalized and the address of such
1508 court.
1509 2. Notice that the office of the public defender has been
1510 appointed to represent the individual in the proceeding, if the
1511 individual is not otherwise represented by counsel.
1512 3. The date, time, and place of the hearing and the name of
1513 each examining expert and every other person expected to testify
1514 in support of continued detention.
1515 4. Notice that the individual, the individual’s guardian,
1516 guardian advocate, health care surrogate or proxy, or
1517 representative, or the administrator may apply for a change of
1518 venue for the convenience of the parties or witnesses or because
1519 of the condition of the individual.
1520 5. Notice that the individual is entitled to an independent
1521 expert examination and, if the individual cannot afford such an
1522 examination, that the court will provide for one.
1523 Section 14. Section 394.460, Florida Statutes, is repealed.
1524 Section 15. Section 394.461, Florida Statutes, is amended
1525 to read:
1526 394.461 Designation of receiving and treatment facilities
1527 and receiving systems.—The department may is authorized to
1528 designate and monitor receiving facilities, treatment
1529 facilities, and receiving systems and may suspend or withdraw
1530 such designation for failure to comply with this part and rules
1531 adopted under this part. Only governmental facilities and
1532 facilities Unless designated by the department may, facilities
1533 are not permitted to hold or treat individuals on an involuntary
1534 basis patients under this part.
1535 (1) RECEIVING FACILITY.—The department may designate any
1536 community facility as a receiving facility. Any other facility
1537 within the state, including a private facility, as a receiving
1538 facility if or a federal facility, may be so designated by the
1539 department, provided that such designation is agreed to by the
1540 governing body or authority of the facility.
1541 (2) TREATMENT FACILITY.—The department may designate any
1542 state-owned, state-operated, or state-supported facility as a
1543 state treatment facility. An individual may A civil patient
1544 shall not be admitted to a civil state treatment facility
1545 without previously undergoing a transfer evaluation. Before a
1546 court hearing for involuntary services placement in a state
1547 treatment facility, the court shall receive and consider the
1548 information documented in the transfer evaluation. Any other
1549 facility, including a private facility or a governmental federal
1550 facility, may be designated as a treatment facility by the
1551 department, if the provided that such designation is agreed to
1552 by the appropriate governing body or authority of the facility.
1553 (3) GOVERNMENTAL FACILITIES.—Governmental facilities may
1554 provide voluntary and involuntary mental health or substance
1555 abuse examination and treatment for individuals in their care
1556 and custody using the procedures provided in this part and shall
1557 protect the rights of these individuals.
1558 (4)(3) PRIVATE FACILITIES.—Private facilities designated as
1559 receiving and treatment facilities by the department may provide
1560 examination and treatment of individuals on an involuntary or
1561 voluntary basis are subject to involuntary patients, as well as
1562 voluntary patients, and are subject to all the provisions of
1563 this part.
1564 (5)(4) REPORTING REQUIREMENTS.—
1565 (a) A facility designated as a public receiving or
1566 treatment facility under this section shall report to the
1567 department on an annual basis the following data, unless these
1568 data are currently being submitted to the Agency for Health Care
1569 Administration:
1570 1. Number of licensed beds.
1571 2. Number of contract days.
1572 3. Number of admissions by payor class and diagnoses.
1573 4. Number of bed days by payor class.
1574 5. Average length of stay by payor class.
1575 6. Total revenues by payor class.
1576 (b) For the purposes of this subsection, “payor class”
1577 means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private
1578 pay health insurance, private-pay health maintenance
1579 organization, private preferred provider organization, the
1580 Department of Children and Families, other government programs,
1581 self-pay individuals patients, and charity care.
1582 (c) The data required under this subsection shall be
1583 submitted to the department within no later than 90 days after
1584 following the end of the facility’s fiscal year. A facility
1585 designated as a public receiving or treatment facility shall
1586 submit its initial report for the 6-month period ending June 30,
1587 2008.
1588 (d) The department shall issue an annual report based on
1589 the data collected required pursuant to this subsection, which
1590 must include data by facility. The report shall include
1591 individual facilities’ data, as well as statewide totals. The
1592 report shall be submitted to the Governor, the President of the
1593 Senate, and the Speaker of the House of Representatives.
1594 (6)(5) RECEIVING SYSTEM.—The department shall designate as
1595 a receiving system one or more facilities serving a defined
1596 geographic area developed pursuant to s. 394.4573 which is
1597 responsible for assessment and evaluation, both voluntary and
1598 involuntary, and treatment, stabilization, or triage for
1599 patients who have a mental illness, a substance use disorder, or
1600 co-occurring disorders. Any transportation plans developed
1601 pursuant to s. 394.462 must support the operation of the
1602 receiving system.
1603 (7)(6) RULES.—The department may adopt rules relating to:
1604 (a) Procedures and criteria for receiving and evaluating
1605 facility applications for designation as a receiving or
1606 treatment facility, which may include an onsite facility
1607 inspection and evaluation of an applicant’s licensing status and
1608 performance history, as well as consideration of local service
1609 needs.
1610 (b) Minimum standards consistent with this part which that
1611 a facility must meet and maintain in order to be designated as a
1612 receiving or treatment facility and procedures for monitoring
1613 continued adherence to such standards.
1614 (c) Procedures and criteria for designating receiving
1615 systems which may include consideration of the adequacy of
1616 services provided by facilities within the receiving system to
1617 meet the needs of the geographic area using available resources.
1618 (d) Procedures for receiving complaints against a
1619 designated facility or designated receiving system and for
1620 initiating inspections and investigations of facilities or
1621 receiving systems alleged to have violated the provisions of
1622 this part or rules adopted under this part.
1623 (e) Procedures and criteria for the suspension or
1624 withdrawal of designation as a receiving or treatment facility
1625 or receiving system.
1626 Section 16. Section 394.4615, Florida Statutes, is amended
1627 to read:
1628 394.4615 Clinical records; confidentiality.—
1629 (1) A clinical record shall be maintained for each
1630 individual held for examination or admitted for treatment under
1631 this part patient. The record must shall include data pertaining
1632 to admission and such other information as may be required under
1633 rules of the department. A clinical record is confidential and
1634 exempt from the provisions of s. 119.07(1). Unless waived by the
1635 express and informed consent of the individual, his or her, by
1636 the patient or the patient’s guardian or guardian advocate, his
1637 or her health care surrogate or proxy, or, if the patient is
1638 deceased, by his or her the patient’s personal representative or
1639 the family member who stands next in line of intestate
1640 succession, the confidential status of the clinical record is
1641 shall not be lost by either authorized or unauthorized
1642 disclosure to any person, organization, or agency.
1643 (2) The clinical record of an individual held for
1644 examination or admitted for treatment under this part shall be
1645 released if when:
1646 (a) The individual patient or the individual’s patient’s
1647 guardian, guardian advocate, or health care surrogate or proxy
1648 authorizes the release. The guardian, or guardian advocate, or
1649 health care surrogate or proxy, shall be provided access to the
1650 appropriate clinical records of the patient. The individual
1651 patient or the individual’s patient’s guardian, or guardian
1652 advocate, health care surrogate or proxy may authorize the
1653 release of information and clinical records to appropriate
1654 persons to ensure the continuity of the individual’s patient’s
1655 health care or mental health care.
1656 (b) The individual patient is represented by counsel and
1657 the records are needed by such the patient’s counsel for
1658 adequate representation.
1659 (c) The court orders such release. In determining whether
1660 there is good cause for disclosure, the court shall weigh the
1661 need for the information to be disclosed against the possible
1662 harm of disclosure to the individual person to whom such
1663 information pertains.
1664 (d) The individual patient is committed to, or is to be
1665 returned to, the Department of Corrections from the Department
1666 of Children and Families, and the Department of Corrections
1667 requests the such records. The These records shall be furnished
1668 without charge to the Department of Corrections.
1669 (3) Information from the clinical record may be released if
1670 in the following circumstances:
1671 (a) The individual When a patient has declared an intention
1672 to harm self or others other persons. If the When such
1673 declaration has been made, the administrator may authorize the
1674 release of sufficient information to prevent harm provide
1675 adequate warning to the person threatened with harm by the
1676 patient.
1677 (b) When The administrator of the facility or secretary of
1678 the department deems that release to a qualified researcher as
1679 defined in administrative rule, an aftercare treatment provider,
1680 or an employee or agent of the department is necessary for
1681 treatment of the individual patient, maintenance of adequate
1682 records, compilation of treatment data, aftercare planning, or
1683 evaluation of programs.
1684 (c) The information is necessary for the purpose of
1685 determining whether an individual a person meets the criteria
1686 for involuntary services. In such circumstances outpatient
1687 placement or for preparing the proposed treatment plan pursuant
1688 to s. 394.4655, the clinical record may be released to the state
1689 attorney, the public defender or the individual’s patient’s
1690 private legal counsel, the court, and to the appropriate mental
1691 health professionals, including the service provider identified
1692 in s. 394.4655(7)(b)2., in accordance with state and federal
1693 law.
1694 (4) Information from clinical records may be used for
1695 statistical and research purposes if the information is
1696 abstracted in such a way as to protect the identity of
1697 individuals served and meets the requirements of department
1698 rules.
1699 (5) Information from clinical records may be used by the
1700 Agency for Health Care Administration and, the department, and
1701 the Florida advocacy councils for the purpose of monitoring
1702 facility activity and investigating complaints concerning
1703 facilities.
1704 (6) Clinical records relating to a Medicaid recipient shall
1705 be furnished to the Medicaid Fraud Control Unit in the
1706 Department of Legal Affairs, upon request.
1707 (7) Any person, agency, or entity receiving information
1708 pursuant to this section shall maintain such information as
1709 confidential and exempt from the provisions of s. 119.07(1).
1710 (8) Any facility or private mental health practitioner who
1711 acts in good faith in releasing information pursuant to this
1712 section is not subject to civil or criminal liability for such
1713 release.
1714 (9) Nothing in This section does not is intended to
1715 prohibit the parent or next of kin of an individual who is held
1716 for examination or admitted for treatment under this part a
1717 person who is held in or treated under a mental health facility
1718 or program from requesting and receiving information limited to
1719 a summary of that individual’s person’s treatment plan and
1720 current physical and mental condition. Release of such
1721 information must shall be in accordance with the code of ethics
1722 of the profession involved.
1723 (10) An individual held for examination or admitted for
1724 treatment Patients shall have reasonable access to his or her
1725 their clinical records, unless such access is determined by the
1726 individual’s patient’s physician to be harmful to the individual
1727 patient. If the individual’s patient’s right to inspect his or
1728 her clinical record is restricted by the facility, written
1729 notice of the such restriction must shall be given to the
1730 individual and his or her patient and the patient’s guardian,
1731 guardian advocate, attorney, health care surrogate or proxy, or
1732 and representative. In addition, the restriction must shall be
1733 recorded in the clinical record, together with the reasons for
1734 it. The restriction expires of a patient’s right to inspect his
1735 or her clinical record shall expire after 7 days but may be
1736 renewed, after review, for subsequent 7-day periods.
1737 (11) Any person who fraudulently alters, defaces, or
1738 falsifies the clinical record of an individual any person
1739 receiving mental health services in a facility subject to this
1740 part, or causes or procures any of these offenses to be
1741 committed, commits a misdemeanor of the second degree,
1742 punishable as provided in s. 775.082 or s. 775.083.
1743 Section 17. Section 394.462, Florida Statutes, is amended
1744 to read:
1745 394.462 Transportation.—A transportation plan shall be
1746 developed and implemented by each county by July 1, 2017, in
1747 collaboration with the managing entity in accordance with this
1748 section. A county may enter into a memorandum of understanding
1749 with the governing boards of nearby counties to establish a
1750 shared transportation plan. When multiple counties enter into a
1751 memorandum of understanding for this purpose, the counties shall
1752 notify the managing entity and provide it with a copy of the
1753 agreement. The transportation plan shall describe methods of
1754 transport to a facility within the designated receiving system
1755 for individuals subject to involuntary examination under s.
1756 394.463 or involuntary admission under s. 397.6772, s. 397.679,
1757 s. 397.6798, or s. 397.6811, and may identify responsibility for
1758 other transportation to a participating facility when necessary
1759 and agreed to by the facility. The plan may rely on emergency
1760 medical transport services or private transport companies, as
1761 appropriate. The plan shall comply with the transportation
1762 provisions of this section and ss. 397.6772, 397.6795, 397.6822,
1763 and 397.697.
1764 (1) TRANSPORTATION TO A RECEIVING FACILITY.—
1765 (a) Each county shall designate a single law enforcement
1766 agency within the county, or portions thereof, to take an
1767 individual a person into custody upon the entry of an ex parte
1768 order or the execution of a certificate for involuntary
1769 examination by an authorized qualified professional and to
1770 transport that person to the appropriate facility, excluding a
1771 governmental facility, within the designated receiving system
1772 pursuant to a transportation plan or an exception under
1773 subsection (4), or to the nearest receiving facility if neither
1774 apply. However, if the law enforcement officer providing
1775 transportation believes that the individual is eligible for
1776 services provided by the United States Department of Veterans
1777 Affairs, the officer may transport the individual to a facility
1778 operated by the United States Department of Veterans Affairs.
1779 (b) A law enforcement officer acting in good faith pursuant
1780 to this part may not be held criminally or civilly liable for
1781 false imprisonment.
1782 (c)(b)1. The designated law enforcement agency may decline
1783 to transport the individual person to a receiving facility only
1784 if:
1785 1.a. The county or jurisdiction designated by the county
1786 has contracted on an annual basis with an emergency medical
1787 transport service or private transport company for
1788 transportation of individuals persons to receiving facilities.
1789 pursuant to this section at the sole cost of the county; and
1790 2.b. The law enforcement agency and the emergency medical
1791 transport service or private transport company agree that the
1792 continued presence of law enforcement personnel is not necessary
1793 for the safety of the individual being transported person or
1794 others.
1795 3.2. The entity providing transportation may seek
1796 reimbursement for transportation expenses. The party responsible
1797 for payment for such transportation is the person receiving the
1798 transportation. The county shall seek reimbursement from the
1799 following sources in the following order:
1800 a. From a private or public third-party payor, if the
1801 individual being transported person receiving the transportation
1802 has applicable coverage.
1803 b. From the individual being transported person receiving
1804 the transportation.
1805 c. From a financial settlement for medical care, treatment,
1806 hospitalization, or transportation payable or accruing to the
1807 injured party.
1808 (d)(c) A company that transports an individual a patient
1809 pursuant to this subsection is considered an independent
1810 contractor and is solely liable for the safe and dignified
1811 transport of the individual patient. The Such company must be
1812 insured and maintain at least provide no less than $100,000 in
1813 liability insurance with respect to such the transport of
1814 patients.
1815 (d) Any company that contracts with a governing board of a
1816 county to transport patients shall comply with the applicable
1817 rules of the department to ensure the safety and dignity of
1818 patients.
1819 (e) If When a law enforcement officer takes custody of an
1820 individual a person pursuant to this part, the officer may
1821 request assistance from emergency medical personnel if the such
1822 assistance is needed for the safety of the officer or the
1823 individual person in custody.
1824 (f) If When a member of a mental health overlay program or
1825 a mobile crisis response service who is a professional
1826 authorized to initiate an involuntary examination pursuant to s.
1827 394.463 or s. 397.675 and that professional evaluates an
1828 individual a person and determines that transportation to a
1829 receiving facility is needed, the service, at its discretion,
1830 may transport the individual person to the facility or may call
1831 on the law enforcement agency or other transportation
1832 arrangement best suited to the needs of the individual being
1833 transported patient.
1834 (g) If a When any law enforcement officer has custody of an
1835 individual a person based on a misdemeanor or a felony, other
1836 than a forcible felony as defined in s. 776.08, who either
1837 noncriminal or minor criminal behavior that meets the statutory
1838 guidelines for involuntary examination pursuant to s. 394.463,
1839 the law enforcement officer shall transport the individual
1840 person to the appropriate facility within the designated
1841 receiving system pursuant to a transportation plan or an
1842 exception under subsection (4), or to the nearest receiving
1843 facility if neither apply. Individuals Persons who meet the
1844 statutory guidelines for involuntary admission pursuant to s.
1845 397.675 may also be transported by law enforcement officers to
1846 the extent resources are available and as otherwise provided by
1847 law. Such persons shall be transported to an appropriate
1848 facility within the designated receiving system pursuant to a
1849 transportation plan or an exception under subsection (4), or to
1850 the nearest facility if neither apply.
1851 (h) If a When any law enforcement officer has arrested an
1852 individual a person for a forcible felony, as defined in s.
1853 776.08, and it appears that the individual person meets the
1854 criteria statutory guidelines for involuntary examination or
1855 placement under this part, the individual such person must first
1856 be processed in the same manner as any other criminal suspect.
1857 The law enforcement agency shall thereafter immediately notify
1858 the appropriate facility within the designated receiving system
1859 pursuant to a transportation plan or an exception under
1860 subsection (4), or to the nearest receiving facility if neither
1861 apply. The receiving facility shall be responsible for promptly
1862 arranging for the examination and treatment of the individual
1863 person. A receiving facility is not required to admit an
1864 individual a person charged with a crime for whom the facility
1865 determines and documents that it is unable to provide adequate
1866 security, but shall provide examination and treatment to the
1867 individual person where he or she is held.
1868 (i) If the appropriate law enforcement officer believes
1869 that an individual a person has an emergency medical condition
1870 as defined in s. 395.002, the individual person may be first
1871 transported to a hospital for emergency medical treatment,
1872 regardless of whether the hospital is a designated receiving
1873 facility.
1874 (j) The costs of transportation, evaluation,
1875 hospitalization, and treatment incurred under this subsection by
1876 an individual who was persons who have been arrested for a
1877 violation violations of any state law or county or municipal
1878 ordinance may be recovered as provided in s. 901.35.
1879 (k) The appropriate facility within the designated
1880 receiving system pursuant to a transportation plan or an
1881 exception under subsection (4), or the nearest receiving
1882 facility if neither apply, must accept an individual persons
1883 brought by law enforcement officers, or an emergency medical
1884 transport service or a private transport company authorized by
1885 the county, for involuntary examination pursuant to s. 394.463.
1886 The original of the form initiating the involuntary examination
1887 is not required for a receiving facility to accept such an
1888 individual or for transfers from one facility to another.
1889 (l) The appropriate facility within the designated
1890 receiving system pursuant to a transportation plan or an
1891 exception under subsection (4), or the nearest receiving
1892 facility if neither apply, must provide persons brought by law
1893 enforcement officers, or an emergency medical transport service
1894 or a private transport company authorized by the county,
1895 pursuant to s. 397.675, a basic screening or triage sufficient
1896 to refer the person to the appropriate services.
1897 (m) Each law enforcement agency designated pursuant to
1898 paragraph (a) shall establish a policy that reflects a single
1899 set of protocols for the safe and secure transportation and
1900 transfer of custody of the individual person. Each law
1901 enforcement agency shall provide a copy of the protocols to the
1902 managing entity.
1903 (n) If When a jurisdiction has entered into a contract with
1904 an emergency medical transport service or a private transport
1905 company for transportation of individuals persons to facilities
1906 within the designated receiving system, such service or company
1907 shall be given preference for transportation of individuals
1908 persons from nursing homes, assisted living facilities, adult
1909 day care centers, or adult family-care homes, unless the
1910 behavior of the individual person being transported is such that
1911 transportation by a law enforcement officer is necessary.
1912 (o) This section does not may not be construed to limit
1913 emergency examination and treatment of incapacitated persons
1914 provided in accordance with s. 401.445.
1915 (p) A law enforcement officer may transport an individual
1916 who appears to meet the criteria for voluntary admission under
1917 s. 394.4625(1)(a) to a receiving facility at the individual’s
1918 request.
1919 (2) TRANSPORTATION TO A TREATMENT FACILITY.—
1920 (a) If the individual held for examination or admitted for
1921 treatment under this part or neither the patient nor any person
1922 legally obligated or responsible for the individual patient is
1923 not able to pay for the expense of transporting an individual a
1924 voluntary or involuntary patient to a treatment facility, the
1925 transportation plan established by the governing board of the
1926 county or counties must specify how the hospitalized patient
1927 will be transported to, from, and between facilities in a safe
1928 and dignified manner.
1929 (b) A company that transports an individual a patient
1930 pursuant to this subsection is considered an independent
1931 contractor and is solely liable for the safe and dignified
1932 transportation of the individual patient. The Such company must
1933 be insured and provide at least no less than $100,000 in
1934 liability insurance for such with respect to the transport of
1935 patients.
1936 (c) A company that contracts with one or more counties to
1937 transport patients in accordance with this section shall comply
1938 with the applicable rules of the department to ensure the safety
1939 and dignity of patients.
1940 (d) County or municipal law enforcement and correctional
1941 personnel and equipment may not be used to transport an
1942 individual patients adjudicated incapacitated or found by the
1943 court to meet the criteria for involuntary services under
1944 placement pursuant to s. 394.467, except in small rural counties
1945 where there are no cost-efficient alternatives.
1946 (3) TRANSFER OF CUSTODY.—Custody of an individual a person
1947 who is transported pursuant to this part and, along with related
1948 documentation, shall be relinquished to a responsible person
1949 individual at the appropriate receiving or treatment facility.
1950 (4) EXCEPTIONS.—An exception to the requirements of this
1951 section may be granted by the secretary of the department for
1952 the purposes of improving service coordination or better meeting
1953 the special needs of individuals. A proposal for an exception
1954 shall must be submitted to the department after being approved
1955 by the governing boards of any affected counties.
1956 (a) A proposal for an exception must identify the specific
1957 provision from which an exception is requested; describe how the
1958 proposal will be implemented by participating law enforcement
1959 agencies and transportation authorities; and provide a plan for
1960 the coordination of services.
1961 (b) An The exception may be granted only for:
1962 1. An arrangement centralizing and improving the provision
1963 of services within a county, circuit, or local area district,
1964 which may include an exception to the requirement for
1965 transportation to the nearest receiving facility;
1966 2. An arrangement whereby by which a facility may provide,
1967 in addition to required psychiatric or substance use disorder
1968 services, an environment and services that which are uniquely
1969 tailored to the needs of an identified group of individuals who
1970 have persons with special needs, such as persons who have with
1971 hearing impairments or visual impairments, or elderly persons
1972 who have with physical frailties; or
1973 3. A specialized transportation system that provides an
1974 efficient and humane method of transporting individuals patients
1975 to and among receiving facilities, among receiving facilities,
1976 and to treatment facilities.
1977
1978 The exceptions provided in this subsection shall expire on June
1979 30, 2017, and no new exceptions shall be granted after that
1980 date. After June 30, 2017, the transport of a patient to a
1981 facility that is not the nearest facility must be made pursuant
1982 to a plan as provided in this section.
1983 Section 18. Section 394.4625, Florida Statutes, is amended
1984 to read:
1985 394.4625 Voluntary admissions.—
1986 (1) EXAMINATION AND TREATMENT AUTHORITY TO RECEIVE
1987 PATIENTS.—
1988 (a) In order to be admitted to a facility on a voluntary
1989 basis:
1990 1. An individual must show evidence of mental illness.
1991 2. An individual must be suitable for treatment by the
1992 facility.
1993 3. An adult must provide express and informed consent, and
1994 must be competent to do so.
1995 4. A minor may only be admitted on the basis of the express
1996 and informed consent of the minor’s guardian in conjunction with
1997 the assent of the minor.
1998 a. The assent of the minor is an affirmative agreement by
1999 the minor to remain at the facility for examination or
2000 treatment. Mere failure to object is not assent.
2001 b. The minor’s assent must be verified through a clinical
2002 assessment that is documented in the clinical record and
2003 conducted within 12 hours after arrival at the facility by a
2004 licensed professional authorized to initiate an involuntary
2005 examination pursuant to s. 394.463.
2006 c. In verifying the minor’s assent, the examining
2007 professional must first provide the minor with an explanation as
2008 to why the minor will be examined and treated, what the minor
2009 can expect while in the facility, and when the minor may expect
2010 to be released, using language that is appropriate to the
2011 minor’s age, experience, maturity, and condition. The examining
2012 professional must determine and document that the minor is able
2013 to understand this information.
2014 d. Unless the minor’s assent is verified pursuant to this
2015 section, a petition for involuntary services must be filed with
2016 the court or the minor must be released to his or her guardian
2017 within 24 hours after arrival A facility may receive for
2018 observation, diagnosis, or treatment any person 18 years of age
2019 or older making application by express and informed consent for
2020 admission or any person age 17 or under for whom such
2021 application is made by his or her guardian. If found to show
2022 evidence of mental illness, to be competent to provide express
2023 and informed consent, and to be suitable for treatment, such
2024 person 18 years of age or older may be admitted to the facility.
2025 A person age 17 or under may be admitted only after a hearing to
2026 verify the voluntariness of the consent.
2027 (b) A mental health overlay program or a mobile crisis
2028 response service or a licensed professional who is authorized to
2029 initiate an involuntary examination pursuant to s. 394.463 and
2030 is employed by a community mental health center or clinic shall
2031 must, pursuant to district procedure approved by the respective
2032 district administrator, conduct an initial assessment of the
2033 ability of the following individuals persons to give express and
2034 informed consent to treatment before such individuals persons
2035 may be admitted voluntarily:
2036 1. An individual A person 60 years of age or older for whom
2037 transfer is being sought from a nursing home, assisted living
2038 facility, adult day care center, or adult family-care home, if
2039 the individual when such person has been diagnosed with as
2040 suffering from dementia.
2041 2. An individual A person 60 years of age or older for whom
2042 transfer is being sought from a nursing home pursuant to s.
2043 400.0255(11) 400.0255(12).
2044 3. An individual who resides in a facility licensed under
2045 chapter 400 or chapter 429 A person for whom all decisions
2046 concerning medical treatment are currently being lawfully made
2047 by a the health care surrogate or proxy designated under chapter
2048 765.
2049 (c) If When an initial assessment of the ability of an
2050 individual a person to give express and informed consent to
2051 treatment is required under this part section, and a mobile
2052 crisis response service does not respond to the request for an
2053 assessment within 2 hours after the request is made or informs
2054 the requesting facility that it will not be able to respond
2055 within 2 hours after the request is made, the requesting
2056 facility may arrange for assessment by a any licensed
2057 professional authorized to initiate an involuntary examination
2058 under pursuant to s. 394.463. The professional may not be who is
2059 not employed by, or under contract with, or and does not have a
2060 financial interest in, either the facility initiating the
2061 transfer or the receiving facility to which the transfer may be
2062 made and may not have a financial interest in the outcome of the
2063 assessment.
2064 (d) A facility may not admit an individual on voluntary
2065 status or transfer an individual to voluntary status as a
2066 voluntary patient a person who has been adjudicated
2067 incapacitated, unless the condition of incapacity has been
2068 judicially removed, except when a court authorized a legal
2069 guardian in adherence to s. 744.3725. If a facility admits an
2070 individual on voluntary status who is later determined to have
2071 been adjudicated incapacitated, the facility shall discharge the
2072 individual or transfer the individual to involuntary status
2073 unless there is a court order pursuant to s. 744.3725 as a
2074 voluntary patient a person who is later determined to have been
2075 adjudicated incapacitated, and the condition of incapacity had
2076 not been removed by the time of the admission, the facility must
2077 either discharge the patient or transfer the patient to
2078 involuntary status.
2079 (e) The health care surrogate or proxy of an individual on
2080 voluntary status a voluntary patient may not consent to the
2081 provision of mental health treatment for that individual the
2082 patient. An individual on voluntary status A voluntary patient
2083 who is unwilling or unable to provide express and informed
2084 consent to mental health treatment must either be discharged or
2085 transferred to involuntary status.
2086 (f) Within 24 hours after an individual’s voluntary
2087 admission, a physician or psychologist admission of a voluntary
2088 patient, the admitting physician shall document in the patient’s
2089 clinical record whether the individual that the patient is able
2090 to give express and informed consent for admission. If the
2091 individual patient is not able to give express and informed
2092 consent for admission, the facility must shall either discharge
2093 the patient or transfer the individual patient to involuntary
2094 status pursuant to subsection (5).
2095 (2) RELEASE OR DISCHARGE OF VOLUNTARY PATIENTS.—
2096 (a) A facility shall discharge an individual on voluntary
2097 status who a voluntary patient:
2098 1. Who Has sufficiently improved so that retention in the
2099 facility is no longer clinically appropriate desirable. The
2100 individual A patient may also be discharged to the care of a
2101 community facility.
2102 2. Has revoked Who revokes consent to admission or requests
2103 discharge. The individual or his or her A voluntary patient or a
2104 relative, friend, or attorney of the patient may request
2105 discharge either orally or in writing at any time following
2106 admission to the facility. The patient must be discharged within
2107 24 hours after of the request, unless the request is rescinded
2108 or the individual patient is transferred to involuntary status
2109 pursuant to this section. The 24-hour time period may be
2110 extended by a treatment facility if when necessary for adequate
2111 discharge planning, but may shall not exceed 3 days excluding
2112 exclusive of weekends and holidays. If the individual patient,
2113 or another on the individual’s patient’s behalf, makes an oral
2114 request for discharge to a staff member, the such request must
2115 shall be immediately entered in the patient’s clinical record.
2116 If the request for discharge is made by a person other than the
2117 individual patient, the discharge may be conditioned upon the
2118 individual’s express and informed consent of the patient.
2119 (b) An individual on voluntary status A voluntary patient
2120 who has been admitted to a facility and who refuses to consent
2121 to or revokes consent to treatment must shall be discharged
2122 within 24 hours after such refusal or revocation, unless he or
2123 she is transferred to involuntary status pursuant to this
2124 section or unless the refusal or revocation is freely and
2125 voluntarily rescinded by the individual patient.
2126 (c) An individual on voluntary status who is currently
2127 charged with a crime shall be discharged to the custody of a law
2128 enforcement officer upon release or discharge from a facility,
2129 unless the individual has been released from law enforcement
2130 custody by posting of a bond, by a pretrial conditional release,
2131 or by other judicial release.
2132 (3) NOTICE OF RIGHT TO DISCHARGE.—At the time of admission
2133 and at least every 6 months thereafter, an individual on
2134 voluntary status a voluntary patient shall be notified in
2135 writing of his or her right to apply for a discharge.
2136 (4) TRANSFER TO VOLUNTARY STATUS.—An involuntary patient
2137 who applies to be transferred to voluntary status shall be
2138 transferred to voluntary status immediately, unless the
2139 individual has been ordered to involuntary services patient has
2140 been charged with a crime, or has been involuntarily placed for
2141 treatment by a court pursuant to s. 394.467 and continues to
2142 meet the criteria for involuntary placement. When transfer to
2143 voluntary status occurs, notice shall be given as provided in s.
2144 394.4599.
2145 (5) TRANSFER TO INVOLUNTARY STATUS.—If an individual on
2146 voluntary status When a voluntary patient, or an authorized
2147 person on the individual’s patient’s behalf, makes a request for
2148 discharge, the request for discharge, unless freely and
2149 voluntarily rescinded, must be communicated to a physician,
2150 clinical psychologist, or psychiatrist as quickly as possible,
2151 but within not later than 12 hours after the request is made. If
2152 the individual patient meets the criteria for involuntary
2153 services, the individual must be transferred to a designated
2154 receiving facility or governmental facility and the
2155 administrator of the receiving or governmental facility where
2156 the individual is held placement, the administrator of the
2157 facility must file with the court a petition for involuntary
2158 services placement, within 2 court working days after the
2159 request for discharge is made. If the petition is not filed
2160 within 2 court working days, the individual must patient shall
2161 be discharged. Pending the filing of the petition, the
2162 individual patient may be held and emergency mental health
2163 treatment rendered in the least restrictive manner, upon the
2164 written order of a physician, if it is determined that such
2165 treatment is necessary for the safety of the individual patient
2166 or others.
2167 Section 19. Section 394.463, Florida Statutes, is amended
2168 to read:
2169 394.463 Involuntary examination.—
2170 (1) CRITERIA.—An individual may be subject to A person may
2171 be taken to a receiving facility for involuntary examination if
2172 there is reason to believe that he or she the person has a
2173 mental illness and because of this his or her mental illness:
2174 (a)1. The individual person has refused voluntary
2175 examination after conscientious explanation and disclosure of
2176 the purpose of the examination; or
2177 2. The individual person is unable to determine for himself
2178 or herself whether examination is necessary; and
2179 (b)1. Without care or treatment:,
2180 1. The individual person is likely to suffer from neglect
2181 or refuse to care for himself or herself; such neglect or
2182 refusal poses a real and present threat of substantial harm to
2183 his or her well-being; and it is not apparent that the such harm
2184 may be avoided through the help of willing family members or
2185 friends or the provision of other services; or
2186 2. There is a substantial likelihood that individual
2187 without care or treatment the person will cause serious bodily
2188 harm to self himself or herself or others in the near future, as
2189 evidenced by recent behavior.
2190 (2) INVOLUNTARY EXAMINATION.—
2191 (a) An involuntary examination may be initiated by any one
2192 of the following means:
2193 1. A circuit or county court may enter an ex parte order
2194 stating that an individual a person appears to meet the criteria
2195 for involuntary examination and specifying the findings on which
2196 that conclusion is based. The ex parte order for involuntary
2197 examination must be based on written or oral sworn testimony
2198 that includes specific facts that support the findings. If other
2199 less restrictive means are not available, such as voluntary
2200 appearance for outpatient evaluation, a law enforcement officer,
2201 or other designated agent of the court, shall take the
2202 individual person into custody and deliver him or her to an
2203 appropriate, or the nearest, facility within the designated
2204 receiving system pursuant to s. 394.462 for involuntary
2205 examination. The order of the court order must shall be made a
2206 part of the patient’s clinical record. A fee may not be charged
2207 for the filing of a petition an order under this subsection. A
2208 facility accepting the individual patient based on the this
2209 order must send a copy of the order to the department the next
2210 working day. The order may be submitted electronically through
2211 existing data systems, if available. The order is shall be valid
2212 only until the individual person is delivered to the facility or
2213 for the period specified in the order itself, whichever comes
2214 first. If a no time limit is not specified in the order, the
2215 order is shall be valid for 7 days after the date it that the
2216 order was signed.
2217 2. A law enforcement officer shall take an individual a
2218 person who appears to meet the criteria for involuntary
2219 examination into custody and deliver or arrange for the delivery
2220 of the individual the person or have him or her delivered to an
2221 appropriate, or the nearest, facility within the designated
2222 receiving system pursuant to s. 394.462 for examination. The
2223 officer shall complete execute a written report detailing the
2224 circumstances under which the individual person was taken into
2225 custody, which must be made a part of the patient’s clinical
2226 record. A Any facility accepting the individual patient based on
2227 this report must send a copy of the report to the department the
2228 next working day.
2229 3. A physician, clinical psychologist, psychiatric nurse,
2230 mental health counselor, marriage and family therapist, or
2231 clinical social worker, advanced registered nurse practitioner,
2232 or physician assistant may execute a certificate stating that he
2233 or she has examined the individual a person within the preceding
2234 48 hours and finds that the individual person appears to meet
2235 the criteria for involuntary examination and stating his or her
2236 the observations upon which that conclusion is based. If other
2237 less restrictive means, such as voluntary appearance for
2238 outpatient evaluation, are not available, a law enforcement
2239 officer shall take into custody the individual person named in
2240 the certificate and deliver him or her to the appropriate, or
2241 nearest, facility within the designated receiving system
2242 pursuant to s. 394.462 for involuntary examination. A law
2243 enforcement officer may only take an individual into custody on
2244 the basis of a certificate within 7 calendar days after the
2245 certificate is signed. The law enforcement officer shall execute
2246 a written report detailing the circumstances under which the
2247 individual person was taken into custody. The report and
2248 certificate shall be made a part of the patient’s clinical
2249 record. A Any facility accepting the individual patient based on
2250 the this certificate must send a copy of the certificate to the
2251 department the next working day. The document may be submitted
2252 electronically through existing data systems, if applicable.
2253 (b) A law enforcement officer who initiates an involuntary
2254 examination of an individual pursuant to subparagraph (a)2., or
2255 a professional who initiates an involuntary examination of an
2256 individual pursuant to subparagraph (a)3., may notify the
2257 individual’s guardian, representative, or health care surrogate
2258 or proxy of such examination. A receiving facility accepting an
2259 individual for involuntary examination shall make and document
2260 immediate attempts to notify the individual’s guardian,
2261 representative, or health care surrogate or proxy upon the
2262 individual’s arrival.
2263 (c)(b) An individual A person may not be removed from any
2264 program or residential services placement licensed under chapter
2265 400 or chapter 429 and transported to a receiving facility for
2266 involuntary examination unless an ex parte order, a professional
2267 certificate, or a law enforcement officer’s report is first
2268 prepared. If the condition of the individual person is such that
2269 preparation of a law enforcement officer’s report is not
2270 practicable before removal, the report must shall be completed
2271 as soon as possible after removal, but in any case before the
2272 individual person is transported to a receiving facility. A
2273 facility admitting an individual a person for involuntary
2274 examination who is not accompanied by the required ex parte
2275 order, professional certificate, or law enforcement officer’s
2276 report must shall notify the department of the such admission by
2277 certified mail or by e-mail, if available, by the next working
2278 day. The provisions of this paragraph do not apply when
2279 transportation is provided by the patient’s family or guardian.
2280 (c) A law enforcement officer acting in accordance with an
2281 ex parte order issued pursuant to this subsection may serve and
2282 execute such order on any day of the week, at any time of the
2283 day or night.
2284 (d) A law enforcement officer acting in accordance with an
2285 ex parte order issued pursuant to this subsection may use such
2286 reasonable physical force as is necessary to gain entry to the
2287 premises, and any dwellings, buildings, or other structures
2288 located on the premises, and to take custody of the person who
2289 is the subject of the ex parte order.
2290 (d)(e) The department shall receive and maintain the
2291 copies of ex parte petitions and orders for involuntary
2292 examinations pursuant to this section, involuntary services
2293 petitions and orders, involuntary outpatient services orders
2294 issued pursuant to s. 394.4655, involuntary inpatient placement
2295 orders issued pursuant to s. 394.467, professional certificates,
2296 and law enforcement officers’ reports. These documents are shall
2297 be considered part of the clinical record, governed by the
2298 provisions of s. 394.4615. These documents shall be used to
2299 prepare annual reports analyzing the data obtained from these
2300 documents, without information identifying individuals held for
2301 examination or admitted for treatment patients, and shall
2302 provide copies of reports to the department, the President of
2303 the Senate, the Speaker of the House of Representatives, and the
2304 minority leaders of the Senate and the House of Representatives.
2305 (e)(f) An individual held for examination A patient shall
2306 be examined by a physician, or a clinical psychologist, or by a
2307 psychiatric nurse performing within the framework of an
2308 established protocol with a psychiatrist at a facility without
2309 unnecessary delay to determine if the criteria for involuntary
2310 services are met. Emergency treatment may be provided upon the
2311 order of a physician if the physician determines that such
2312 treatment is necessary for the safety of the individual patient
2313 or others. The individual patient may not be released by the
2314 receiving facility or its contractor without the documented
2315 approval of a psychiatrist or a clinical psychologist or, if the
2316 receiving facility is owned or operated by a hospital or health
2317 system, the release may also be approved by a psychiatric nurse
2318 performing within the framework of an established protocol with
2319 a psychiatrist, or an attending emergency department physician
2320 with experience in the diagnosis and treatment of mental illness
2321 after completion of an involuntary examination pursuant to this
2322 subsection. A psychiatric nurse may not approve the release of a
2323 patient if the involuntary examination was initiated by a
2324 psychiatrist unless the release is approved by the initiating
2325 psychiatrist.
2326 (f)(g) Within the 72-hour examination period or, if the 72
2327 hours ends on a weekend or holiday, no later than the next
2328 working day thereafter, one of the following actions must be
2329 taken, based on the individual needs of the patient:
2330 1. The patient shall be released, unless he or she is
2331 charged with a crime, in which case the patient shall be
2332 returned to the custody of a law enforcement officer;
2333 2. The patient shall be released, subject to the provisions
2334 of subparagraph 1., for voluntary outpatient treatment;
2335 3. The patient, unless he or she is charged with a crime,
2336 shall be asked to give express and informed consent to placement
2337 as a voluntary patient and, if such consent is given, the
2338 patient shall be admitted as a voluntary patient; or
2339 4. A petition for involuntary services shall be filed in
2340 the circuit court if inpatient treatment is deemed necessary or
2341 with the criminal county court, as defined in s. 394.4655(1), as
2342 applicable. When inpatient treatment is deemed necessary, the
2343 least restrictive treatment consistent with the optimum
2344 improvement of the patient’s condition shall be made available.
2345 When a petition is to be filed for involuntary outpatient
2346 placement, it shall be filed by one of the petitioners specified
2347 in s. 394.4655(4)(a). A petition for involuntary inpatient
2348 placement shall be filed by the facility administrator.
2349 (g)(h) If an individual A person for whom an involuntary
2350 examination has been initiated who is also being evaluated or
2351 treated at a hospital for an emergency medical condition as
2352 defined specified in s. 395.002, the involuntary examination
2353 must be examined by a facility within 72 hours. The 72-hour
2354 period begins when the individual patient arrives at the
2355 hospital and ceases when a the attending physician documents
2356 that the individual patient has an emergency medical condition.
2357 The 72-hour period resumes when the physician documents that the
2358 emergency medical condition has stabilized or does not exist. If
2359 the patient is examined at a hospital providing emergency
2360 medical services by a professional qualified to perform an
2361 involuntary examination and is found as a result of that
2362 examination not to meet the criteria for involuntary outpatient
2363 services pursuant to s. 394.4655(2) or involuntary inpatient
2364 placement pursuant to s. 394.467(1), the patient may be offered
2365 voluntary services or placement, if appropriate, or released
2366 directly from the hospital providing emergency medical services.
2367 The finding by the professional that the patient has been
2368 examined and does not meet the criteria for involuntary
2369 inpatient services or involuntary outpatient placement must be
2370 entered into the patient’s clinical record. This paragraph is
2371 not intended to prevent A hospital providing emergency medical
2372 services may transfer an individual from appropriately
2373 transferring a patient to another hospital before stabilization
2374 if the requirements of s. 395.1041(3)(c) are have been met.
2375 (i) One of the following must occur within 12 hours after a
2376 the patient’s attending physician documents that the
2377 individual’s patient’s medical condition has stabilized or that
2378 an emergency medical condition has been stabilized or does not
2379 exist:
2380 1. The individual shall be examined by a physician,
2381 psychiatric nurse, or psychologist and, if found not to meet the
2382 criteria for involuntary examination pursuant to this section,
2383 shall be released directly from the hospital providing the
2384 emergency medical services. The results of the examination,
2385 including the final disposition, shall be entered into the
2386 clinical record patient must be examined by a facility and
2387 released; or
2388 2. The individual shall be transferred to a receiving
2389 facility for examination if patient must be transferred to a
2390 designated facility in which appropriate medical and mental
2391 health treatment is available. However, the receiving facility
2392 must be notified of the transfer within 2 hours after the
2393 individual’s patient’s condition has been stabilized or after
2394 determination that an emergency medical condition does not
2395 exist.
2396 (3) NOTICE OF RELEASE.—Notice of the release shall be given
2397 to the individual’s patient’s guardian, health care surrogate or
2398 proxy, or representative, to any person who executed a
2399 certificate admitting the patient to the receiving facility, and
2400 to any court that ordered the individual’s examination which
2401 ordered the patient’s evaluation.
2402 Section 20. Section 394.467, Florida Statutes, is amended
2403 to read:
2404 394.467 Involuntary inpatient placement.—
2405 (1) CRITERIA.—An individual A person may be ordered for
2406 involuntary inpatient placement for treatment upon a finding of
2407 the court by clear and convincing evidence that:
2408 (a) He or she has a mental illness and because of his or
2409 her mental illness:
2410 1.a. He or she has refused voluntary inpatient placement
2411 for treatment after sufficient and conscientious explanation and
2412 disclosure of the purpose of inpatient placement for treatment;
2413 or
2414 b. He or she is unable to determine for himself or herself
2415 whether inpatient placement is necessary; and
2416 2.a. He or she is incapable of surviving alone or with the
2417 help of willing and responsible family or friends, including
2418 available alternative services, and, without treatment, is
2419 likely to suffer from neglect or refuse to care for himself or
2420 herself, and such neglect or refusal poses a real and present
2421 threat of substantial harm to his or her well-being; or
2422 b. There is substantial likelihood that in the near future
2423 he or she will inflict serious bodily harm on self or others, as
2424 evidenced by recent behavior causing, attempting, or threatening
2425 such harm; and
2426 (b) All available less restrictive treatment alternatives
2427 that would offer an opportunity for improvement of his or her
2428 condition have been judged to be inappropriate.
2429 (2) ADMISSION TO A TREATMENT FACILITY.—An individual A
2430 patient may be retained by a facility or involuntarily ordered
2431 placed in a treatment facility upon the recommendation of the
2432 administrator of the facility where the individual patient has
2433 been examined and after adherence to the notice and hearing
2434 procedures provided in s. 394.4599. The recommendation must be
2435 supported by the opinion of a psychiatrist and the second
2436 opinion of a clinical psychologist or another psychiatrist, both
2437 of whom have personally examined the individual patient within
2438 the preceding 72 hours, that the criteria for involuntary
2439 inpatient placement are met. However, if the administrator
2440 certifies that a psychiatrist or clinical psychologist is not
2441 available to provide the second opinion, the second opinion may
2442 be provided by a licensed physician who has postgraduate
2443 training and experience in diagnosis and treatment of mental
2444 illness or by a psychiatric nurse. Any opinion authorized in
2445 this subsection may be conducted through a face-to-face
2446 examination, in person, or by electronic means. Such
2447 recommendation shall be entered on a petition for involuntary
2448 inpatient placement certificate that authorizes the facility to
2449 retain the individual being held patient pending transfer to a
2450 treatment facility or completion of a hearing.
2451 (3) PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.—
2452 (a) The administrator of the receiving facility shall file
2453 a petition for involuntary inpatient placement in the court in
2454 the county where the individual patient is located. Upon filing,
2455 the clerk of the court shall provide copies to the department,
2456 the individual, his or her patient, the patient’s guardian,
2457 guardian advocate, health care surrogate or proxy, or
2458 representative, and the state attorney and public defender of
2459 the judicial circuit in which the individual patient is located.
2460 A fee may not be charged for the filing of a petition under this
2461 subsection.
2462 (b) A receiving or treatment facility filing a petition for
2463 involuntary inpatient placement shall send a copy of the
2464 petition to the Department of Children and Families by the next
2465 working day.
2466 (4) APPOINTMENT OF COUNSEL.—
2467 Within 1 court working day after the filing of a petition
2468 for involuntary inpatient placement, the court shall appoint the
2469 public defender to represent the individual person who is the
2470 subject of the petition, unless the person is otherwise
2471 represented by counsel. The clerk of the court shall immediately
2472 notify the public defender of the such appointment. Any attorney
2473 representing the individual patient shall have access to the
2474 individual patient, witnesses, and records relevant to the
2475 presentation of the individual’s patient’s case and shall
2476 represent the interests of the individual patient, regardless of
2477 the source of payment to the attorney.
2478 (5) CONTINUANCE OF HEARING.—The individual patient is
2479 entitled, with the concurrence of the individual’s patient’s
2480 counsel, to at least one continuance of the hearing for up to 4
2481 weeks.
2482 (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.—
2483 (a)1. The court shall hold the hearing on involuntary
2484 services inpatient placement within 5 court working days after
2485 the petition is filed, unless a continuance is granted.
2486 2. Except for good cause documented in the court file,
2487 which may be demonstrated by administrative order of the court,
2488 the hearing must be held in the receiving or treatment facility
2489 where the individual is located. If the hearing cannot be held
2490 in the receiving or treatment facility, it must be held in a
2491 location convenient to the individual as is consistent with
2492 orderly procedure, and which is not likely to be injurious to
2493 the individual’s county or the facility, as appropriate, where
2494 the patient is located, must be as convenient to the patient as
2495 is consistent with orderly procedure, and shall be conducted in
2496 physical settings not likely to be injurious to the patient’s
2497 condition. If the court finds that the individual’s patient’s
2498 attendance at the hearing is not consistent with the best
2499 interests of the individual patient, and the individual’s
2500 patient’s counsel does not object, the court may waive the
2501 presence of the individual patient from all or any portion of
2502 the hearing. Alternatively, if the individual wishes to
2503 voluntarily waive his or her attendance at the hearing, the
2504 court must determine that the individual’s waiver is knowing,
2505 intelligent, and voluntary before waiving the presence of the
2506 individual from all or any portion of the hearing. The state
2507 attorney for the circuit in which the patient is located shall
2508 represent the state, rather than the petitioning facility
2509 administrator, as the real party in interest in the proceeding.
2510 3. The court may appoint a magistrate to preside at the
2511 hearing. One of the professionals who executed the petition for
2512 involuntary inpatient placement certificate shall be a witness.
2513 The court shall ensure that the individual and his or her
2514 guardian, guardian advocate, health care surrogate or proxy, or
2515 representative are informed patient and the patient’s guardian
2516 or representative shall be informed by the court of the right to
2517 an independent expert examination. If the individual patient
2518 cannot afford such an examination, the court shall ensure that
2519 one is provided, as otherwise provided for by law. The
2520 independent expert’s report is confidential and not
2521 discoverable, unless the expert is to be called as a witness for
2522 the individual patient at the hearing. The testimony in the
2523 hearing must be given under oath, and the proceedings must be
2524 recorded. The individual patient may refuse to testify at the
2525 hearing.
2526 (b) If the court concludes that the individual patient
2527 meets the criteria for involuntary services inpatient placement,
2528 it may order that the individual patient be transferred to a
2529 treatment facility or, if the individual patient is at a
2530 treatment facility, that the individual patient be retained
2531 there or be treated at any other appropriate facility, or that
2532 the individual patient receive services, on an involuntary
2533 basis, for up to 90 days. However, any order for involuntary
2534 mental health services in a treatment facility may be for up to
2535 6 months. The order must shall specify the nature and extent of
2536 the individual’s patient’s mental illness. The court may not
2537 order an individual with traumatic brain injury or dementia who
2538 lacks a co-occurring mental illness to be involuntarily placed
2539 in a state treatment facility. The facility shall discharge the
2540 individual a patient any time the individual patient no longer
2541 meets the criteria for involuntary inpatient placement, unless
2542 the individual patient has transferred to voluntary status.
2543 (c) If at any time before the conclusion of the hearing on
2544 involuntary inpatient placement it appears to the court that the
2545 individual person does not meet the criteria for involuntary
2546 inpatient placement under this section, but instead meets the
2547 criteria for involuntary outpatient services, the court may
2548 order the person evaluated for involuntary outpatient services
2549 pursuant to s. 394.4655. The petition and hearing procedures set
2550 forth in s. 394.4655 shall apply. If the person instead meets
2551 the criteria for involuntary assessment, protective custody, or
2552 involuntary admission pursuant to s. 397.675, then the court may
2553 order the person to be admitted for involuntary assessment for a
2554 period of 5 days pursuant to s. 397.6811. Thereafter, all
2555 proceedings are governed by chapter 397.
2556 (f)(d) At the hearing on involuntary inpatient placement,
2557 the court shall consider testimony and evidence regarding the
2558 individual’s patient’s competence to consent to treatment. If
2559 the court finds that the individual patient is incompetent to
2560 consent to treatment, it shall appoint a guardian advocate as
2561 provided in s. 394.4598.
2562 (g)(e) The administrator of the petitioning facility shall
2563 provide a copy of the court order and adequate documentation of
2564 an individual’s a patient’s mental illness to the administrator
2565 of a treatment facility if the individual patient is ordered for
2566 involuntary inpatient placement, whether by civil or criminal
2567 court. The documentation must include any advance directives
2568 made by the individual patient, a psychiatric evaluation of the
2569 individual patient, and any evaluations of the individual
2570 patient performed by a psychiatric nurse, a clinical
2571 psychologist, a marriage and family therapist, a mental health
2572 counselor, or a clinical social worker. The administrator of a
2573 treatment facility may refuse admission to an individual any
2574 patient directed to its facilities on an involuntary basis,
2575 whether by civil or criminal court order, who is not accompanied
2576 by adequate orders and documentation.
2577 (7) PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT
2578 PLACEMENT.—
2579 (a) Hearings on petitions for continued involuntary
2580 inpatient placement of an individual placed at any treatment
2581 facility are administrative hearings and must be conducted in
2582 accordance with s. 120.57(1), except that any order entered by
2583 the administrative law judge is final and subject to judicial
2584 review in accordance with s. 120.68. Orders concerning
2585 individuals patients committed after successfully pleading not
2586 guilty by reason of insanity are governed by s. 916.15.
2587 1.(b) If the individual patient continues to meet the
2588 criteria for involuntary inpatient placement and is being
2589 treated at a treatment facility, the administrator shall, before
2590 the expiration of the period the treatment facility is
2591 authorized to retain the individual patient, file a petition
2592 requesting authorization for continued involuntary inpatient
2593 placement. The request must be accompanied by a statement from
2594 the individual’s patient’s physician, psychiatrist, psychiatric
2595 nurse, or clinical psychologist justifying the request, a brief
2596 description of the individual’s patient’s treatment during the
2597 time he or she was involuntarily placed, and an individualized
2598 plan of continued treatment. Notice of the hearing must be
2599 provided as provided in accordance with s. 394.4599. If an
2600 individual’s attendance at the hearing is voluntarily waived,
2601 the administrative law judge must determine that the waiver is
2602 knowing, intelligent, and voluntary before waiving the presence
2603 of the individual from all or a portion of the hearing.
2604 Alternatively, if an individual’s a patient’s attendance at the
2605 hearing is voluntarily waived, the administrative law judge must
2606 determine that the waiver is knowing and voluntary before
2607 waiving the presence of the individual patient from all or a
2608 portion of the hearing. Alternatively, if at the hearing the
2609 administrative law judge finds that attendance at the hearing is
2610 not consistent with the individual’s best interests of the
2611 patient, the administrative law judge may waive the presence of
2612 the individual patient from all or any portion of the hearing,
2613 unless the individual patient, through counsel, objects to the
2614 waiver of presence. The testimony in the hearing must be under
2615 oath, and the proceedings must be recorded.
2616 2.(c) Unless the individual patient is otherwise
2617 represented or is ineligible, he or she shall be represented at
2618 the hearing on the petition for continued involuntary inpatient
2619 placement by the public defender of the circuit in which the
2620 facility is located.
2621 3. The Division of Administrative Hearings shall ensure
2622 that the individual who is the subject of the petition and his
2623 or her guardian, guardian advocate, health care surrogate or
2624 proxy, or representative are informed of the individual’s right
2625 to an independent expert examination. If the individual cannot
2626 afford such an examination, the court shall ensure that one is
2627 provided as otherwise provided for by law.
2628 4.(d) If at a hearing it is shown that the individual
2629 patient continues to meet the criteria for involuntary inpatient
2630 placement, the administrative law judge shall sign the order for
2631 continued involuntary inpatient placement for up to 90 days.
2632 However, any order for involuntary mental health services in a
2633 treatment facility may be for up to 6 months. The same procedure
2634 must shall be repeated before the expiration of each additional
2635 period the individual patient is retained.
2636 5.(e) If continued involuntary inpatient placement is
2637 necessary for an individual a patient admitted while serving a
2638 criminal sentence, but his or her sentence is about to expire,
2639 or for a minor involuntarily placed, but who is about to reach
2640 the age of 18, the administrator shall petition the
2641 administrative law judge for an order authorizing continued
2642 involuntary inpatient placement.
2643 6.(f) If the individual patient has been previously found
2644 incompetent to consent to treatment, the administrative law
2645 judge shall consider testimony and evidence regarding the
2646 individual’s patient’s competence. If the administrative law
2647 judge finds evidence that the individual patient is now
2648 competent to consent to treatment, the administrative law judge
2649 may issue a recommended order to the court that found the
2650 individual patient incompetent to consent to treatment that the
2651 individual’s patient’s competence be restored and that any
2652 guardian advocate previously appointed be discharged.
2653 7.(g) If the individual patient has been ordered to undergo
2654 involuntary inpatient placement and has previously been found
2655 incompetent to consent to treatment, the court shall consider
2656 testimony and evidence regarding the individual’s patient’s
2657 incompetence. If the individual’s patient’s competency to
2658 consent to treatment is restored, the discharge of the guardian
2659 advocate shall be governed by s. 394.4598.
2660
2661 The procedure required in this paragraph subsection must be
2662 followed before the expiration of each additional period the
2663 individual is patient is involuntarily receiving involuntary
2664 services.
2665 (8) RETURN TO FACILITY.—If an individual a patient
2666 involuntarily held at a treatment facility under this part
2667 leaves the facility without the administrator’s authorization,
2668 the administrator may authorize a search for the individual
2669 patient and his or her return to the facility. The administrator
2670 may request the assistance of a law enforcement agency in this
2671 regard.
2672 Section 21. Section 394.46715, Florida Statutes, is amended
2673 to read:
2674 394.46715 Rulemaking authority.—The department may adopt
2675 rules to administer this part.
2676 Section 22. Section 394.4672, Florida Statutes, is amended
2677 to read:
2678 394.4672 Procedure for placement of veteran with federal
2679 agency.—
2680 (1) A facility owned, operated, or administered by the
2681 United States Department of Veterans Affairs that provides
2682 mental health services shall have authority as granted by the
2683 Department of Veterans’ Affairs to:
2684 (a) Initiate and conduct involuntary examination pursuant
2685 to s. 394.463.
2686 (b) Provide voluntary admission and treatment pursuant to
2687 s. 394.4625.
2688 (c) Petition for involuntary placement pursuant to s.
2689 394.467.
2690 (2)(1) If the court determines that an individual meets the
2691 criteria for involuntary placementand he or she Whenever it is
2692 determined by the court that a person meets the criteria for
2693 involuntary placement and it appears that such person is
2694 eligible for care or treatment by the United States Department
2695 of Veterans Affairs or other agency of the United States
2696 Government, the court, upon receipt of documentation a
2697 certificate from the United States Department of Veterans
2698 Affairs or another such other agency showing that facilities are
2699 available and that the individual person is eligible for care or
2700 treatment therein, may place that individual person with the
2701 United States Department of Veterans Affairs or other federal
2702 agency. The individual person whose placement is sought shall be
2703 personally served with notice of the pending placement
2704 proceeding in the manner as provided in this part., and nothing
2705 in This section does not shall affect the individual’s his or
2706 her right to appear and be heard in the proceeding. Upon being
2707 placed, the individual is placement, the person shall be subject
2708 to the rules and regulations of the United States Department of
2709 Veterans Affairs or other federal agency.
2710 (3)(2) The judgment or order of placement by a court of
2711 competent jurisdiction of another state or of the District of
2712 Columbia, which places an individual placing a person with the
2713 United States Department of Veterans Affairs or other federal
2714 agency for care or treatment, has, shall have the same force and
2715 effect in this state as in the jurisdiction of the court
2716 entering the judgment or making the order.; and The courts of
2717 the placing state or of the District of Columbia shall retain be
2718 deemed to have retained jurisdiction over the individual of the
2719 person so placed. Consent is hereby given to the application of
2720 the law of the placing state or district with respect to the
2721 authority of the chief officer of any facility of the United
2722 States Department of Veterans Affairs or other federal agency
2723 operated in this state to retain custody or to transfer, parole,
2724 or discharge the individual person.
2725 (4)(3) Upon receipt of documentation from a certificate of
2726 the United States Department of Veterans Affairs or another such
2727 other federal agency that facilities are available for the care
2728 or treatment of individuals who have mental illness and that the
2729 individual mentally ill persons and that the person is eligible
2730 for that care or treatment, the administrator of the receiving
2731 or treatment facility may cause the transfer of that individual
2732 person to the United States Department of Veterans Affairs or
2733 other federal agency. Upon effecting such transfer, the
2734 committing court shall be notified by the transferring agency.
2735 An individual may not be transferred No person shall be
2736 transferred to the United States Department of Veterans Affairs
2737 or other federal agency if he or she is confined pursuant to the
2738 conviction of any felony or misdemeanor or if he or she has been
2739 acquitted of the charge solely on the ground of insanity, unless
2740 before prior to transfer the court placing the individual such
2741 person enters an order for the transfer after appropriate motion
2742 and hearing and without objection by the United States
2743 Department of Veterans Affairs.
2744 (5)(4) An individual Any person transferred as provided in
2745 this section shall be deemed to be placed with the United States
2746 Department of Veterans Affairs or other federal agency pursuant
2747 to the original order placement.
2748 Section 23. Section 394.4685, Florida Statutes, is amended
2749 to read:
2750 394.4685 Transfer of patients among facilities.—
2751 (1) TRANSFER BETWEEN PUBLIC FACILITIES.—
2752 (a) An individual A patient who has been admitted to a
2753 public receiving facility, or his or her the family member,
2754 guardian, or guardian advocate, or health care surrogate or
2755 proxy of such patient, may request the transfer of the
2756 individual patient to another public receiving facility. An
2757 individual A patient who has been admitted to a public treatment
2758 facility, or his or her the family member, guardian, or guardian
2759 advocate, or health care surrogate or proxy of such patient, may
2760 request the transfer of the individual patient to another public
2761 treatment facility. Depending on the medical treatment or mental
2762 health treatment needs of the individual patient and the
2763 availability of appropriate facility resources, the individual
2764 patient may be transferred at the discretion of the department.
2765 If the department approves the transfer of an individual on
2766 involuntary status, notice in accordance with involuntary
2767 patient, notice according to the provisions of s. 394.4599 must
2768 be given before shall be given prior to the transfer by the
2769 transferring facility. The department shall respond to the
2770 request for transfer within 2 working days after receipt of the
2771 request by the facility administrator.
2772 (b) If When required by the medical treatment or mental
2773 health treatment needs of the individual patient or the
2774 efficient use utilization of a public receiving or public
2775 treatment facility, an individual a patient may be transferred
2776 from one receiving facility to another, or from one treatment
2777 facility to another, at the department’s discretion, or, with
2778 the express and informed consent of the individual or the
2779 individual’s guardian, guardian advocate, or health care
2780 surrogate or proxy patient or the patient’s guardian or guardian
2781 advocate, to a facility in another state. Notice in accordance
2782 with according to the provisions of s. 394.4599 must shall be
2783 given before prior to the transfer by the transferring facility.
2784 If prior notice is not possible, notice of the transfer shall be
2785 provided as soon as practicable after the transfer.
2786 (2) TRANSFER FROM PUBLIC TO PRIVATE FACILITIES.—
2787 (a) An individual A patient who has been admitted to a
2788 public receiving or public treatment facility and has requested,
2789 either personally or through his or her guardian, or guardian
2790 advocate, or health care surrogate or proxy, and is able to pay
2791 for treatment in a private facility shall be transferred at the
2792 individual’s patient’s expense to a private facility upon
2793 acceptance of the individual patient by the private facility.
2794 (b) A public receiving facility initiating the a patient
2795 transfer of an individual to a licensed hospital for acute care
2796 mental health services not accessible through the public
2797 receiving facility shall notify the hospital of such transfer
2798 and send the hospital all records relating to the emergency
2799 psychiatric or medical condition.
2800 (3) TRANSFER FROM PRIVATE TO PUBLIC FACILITIES.—
2801 (a) An individual or the individual’s A patient or the
2802 patient’s guardian, or guardian advocate, or health care
2803 surrogate or proxy may request the transfer of the individual
2804 patient from a private to a public facility, and the individual
2805 patient may be so transferred upon acceptance of the individual
2806 patient by the public facility.
2807 (b) A private facility may request the transfer of an
2808 individual a patient from the facility to a public facility, and
2809 the individual patient may be so transferred upon acceptance of
2810 the individual patient by the public facility. The cost of such
2811 transfer is shall be the responsibility of the transferring
2812 facility.
2813 (c) A public facility must respond to a request for the
2814 transfer of an individual a patient within 24 hours 2 working
2815 days after receipt of the request.
2816 (4) TRANSFER BETWEEN PRIVATE FACILITIES.—
2817 (a) An individual being held A patient in a private
2818 facility or his or her the patient’s guardian, or guardian
2819 advocate, or health care surrogate or proxy may request the
2820 transfer of the individual patient to another private facility
2821 at any time, and the individual patient shall be transferred
2822 upon acceptance of the individual patient by the facility to
2823 which transfer is sought.
2824 (b) A private facility may request the transfer of an
2825 individual from the facility to another private facility, and
2826 the individual may be transferred upon acceptance of the
2827 individual by the facility to which the individual is being
2828 transferred.
2829 Section 24. Section 394.469, Florida Statutes, is amended
2830 to read:
2831 394.469 Discharge from of involuntary placement patients.—
2832 (1) POWER TO DISCHARGE.—At any time an individual a patient
2833 is found to no longer meet the criteria for involuntary
2834 placement, the administrator shall:
2835 (a) Discharge the individual patient, unless the patient is
2836 under a criminal charge, in which case the patient shall be
2837 transferred to the custody of the appropriate law enforcement
2838 officer;
2839 (b) Transfer the individual patient to voluntary status on
2840 the administrator’s his or her own authority or at the
2841 individual’s patient’s request, unless the individual is patient
2842 is under criminal charge or adjudicated incapacitated;
2843 (c) Discharge the individual to the custody of a law
2844 enforcement officer, if the individual is currently charged with
2845 any crime and has not been released from law enforcement custody
2846 by posting of a bond, or by a pretrial conditional release or by
2847 other judicial release; or
2848 (d)(c) Place an improved individual patient, except
2849 individuals described in paragraph (c) a patient under a
2850 criminal charge, on convalescent status in the care of a
2851 community facility.
2852 (2) NOTICE.—Notice of discharge or transfer of an
2853 individual must be provided in accordance with a patient shall
2854 be given as provided in s. 394.4599.
2855 Section 25. Section 394.473, Florida Statutes, is amended
2856 to read:
2857 394.473 Attorney Attorney’s fee; expert witness fee.—
2858 (1) In the case of an indigent person for whom An attorney
2859 is appointed to represent an individual pursuant to the
2860 provisions of this part, the attorney shall be compensated by
2861 the state pursuant to s. 27.5304. A public defender appointed to
2862 represent an indigent individual may not In the case of an
2863 indigent person, the court may appoint a public defender. The
2864 public defender shall receive no additional compensation other
2865 than that usually paid his or her office.
2866 (2) If an indigent individual’s case requires In the case
2867 of an indigent person for whom expert testimony is required in a
2868 court hearing pursuant to the provisions of this part act, the
2869 expert shall be compensated by the state pursuant to s. 27.5303
2870 or s. 27.5304, as applicable, unless the expert, except one who
2871 is classified as a full-time employee of the state or who is
2872 receiving remuneration from the state for his or her time in
2873 attendance at the hearing, shall be compensated by the state
2874 pursuant to s. 27.5304.
2875 Section 26. Section 394.475, Florida Statutes, is amended
2876 to read:
2877 394.475 Acceptance, examination, and involuntary services
2878 placement of Florida residents from out-of-state mental health
2879 authorities.—
2880 (1) Upon the request of the state mental health authority
2881 of another state, the department may is authorized to accept an
2882 individual as a patient, for up to a period of not more than 15
2883 days, a person who is and has been a bona fide resident of this
2884 state for at least a period of not less than 1 year.
2885 (2) An individual Any person received pursuant to
2886 subsection (1) shall be examined by the staff of the state
2887 facility where the individual such patient has been admitted
2888 accepted, which examination shall be completed during the 15-day
2889 period.
2890 (3) If, upon examination, the individual such a person
2891 requires continued involuntary services placement, a petition
2892 for a hearing regarding involuntary services placement shall be
2893 filed with the court of the county where wherein the treatment
2894 facility receiving the individual patient is located or the
2895 county where the individual patient is a resident.
2896 (4) During the pendency of the examination period and the
2897 pendency of the involuntary services placement proceedings, an
2898 individual such person may continue to be held in the treatment
2899 facility unless the court having jurisdiction enters an order to
2900 the contrary.
2901 Section 27. Section 394.4785, Florida Statutes, is amended
2902 to read:
2903 394.4785 Children and adolescents; admission and placement
2904 in mental health facilities.—
2905 (1) A child or adolescent as defined as a minor in s.
2906 394.455(31) in s. 394.492 may not be admitted to a state-owned
2907 or state-operated mental health treatment facility. A minor
2908 child may be admitted pursuant to s. 394.4625, s. 394.463, or s.
2909 394.467 to a crisis stabilization unit or a residential
2910 treatment center licensed under this chapter or a hospital
2911 licensed under chapter 395. The treatment center, unit, or
2912 hospital must provide the least restrictive available treatment
2913 that is appropriate to the individual needs of the minor child
2914 or adolescent and must adhere to the guiding principles, system
2915 of care, and service planning provisions of contained in part
2916 III of this chapter.
2917 (2) A minor who is younger than 14 years of age person
2918 under the age of 14 who is admitted to a any hospital licensed
2919 pursuant to chapter 395 may not be admitted to a bed in a room
2920 or ward with an adult patient in a mental health unit or share
2921 common areas with an adult patient in a mental health unit.
2922 However, a minor person 14 years of age or older may be admitted
2923 to a bed in a room or ward in the mental health unit with an
2924 adult if a the admitting physician documents in the clinical
2925 case record that the services are such placement is medically
2926 indicated or for reasons of safety. The Such placement shall be
2927 reviewed by a the attending physician or a designee or on-call
2928 physician each day and documented in the clinical case record.
2929 Section 28. Section 394.4786, Florida Statutes, is
2930 repealed.
2931 Section 29. Section 394.47865, Florida Statutes, is
2932 repealed.
2933 Section 30. Section 394.4787, Florida Statutes, is
2934 repealed.
2935 Section 31. Section 394.4788, Florida Statutes, is
2936 repealed.
2937 Section 32. Section 394.4789, Florida Statutes, is
2938 repealed.
2939 Section 33. Paragraph (a) of subsection (5) of section
2940 20.425, Florida Statutes, is amended to read:
2941 20.425 Agency for Health Care Administration; trust funds.
2942 The following trust funds shall be administered by the Agency
2943 for Health Care Administration:
2944 (5) Public Medical Assistance Trust Fund.
2945 (a) Funds to be credited to and uses of the trust fund
2946 shall be administered in accordance with s. the provisions of
2947 ss. 394.4786 and 409.918.
2948 Section 34. Paragraph (a) of subsection (3) and subsection
2949 (6) of section 39.407, Florida Statutes, are amended to read:
2950 39.407 Medical, psychiatric, and psychological examination
2951 and treatment of child; physical, mental, or substance abuse
2952 examination of person with or requesting child custody.—
2953 (3)(a)1. Except as otherwise provided in subparagraph (b)1.
2954 or paragraph (e), before the department provides psychotropic
2955 medications to a child in its custody, the prescribing physician
2956 shall attempt to obtain express and informed consent, as defined
2957 in s. 394.455(15) and as described in s. 394.459(3)(a), from the
2958 child’s parent or legal guardian. The department must take steps
2959 necessary to facilitate the inclusion of the parent in the
2960 child’s consultation with the physician. However, if the
2961 parental rights of the parent have been terminated, the parent’s
2962 location or identity is unknown or cannot reasonably be
2963 ascertained, or the parent declines to give express and informed
2964 consent, the department may, after consultation with the
2965 prescribing physician, seek court authorization to provide the
2966 psychotropic medications to the child. Unless parental rights
2967 have been terminated and if it is possible to do so, the
2968 department shall continue to involve the parent in the
2969 decisionmaking process regarding the provision of psychotropic
2970 medications. If, at any time, a parent whose parental rights
2971 have not been terminated provides express and informed consent
2972 to the provision of a psychotropic medication, the requirements
2973 of this section that the department seek court authorization do
2974 not apply to that medication until such time as the parent no
2975 longer consents.
2976 2. Any time the department seeks a medical evaluation to
2977 determine the need to initiate or continue a psychotropic
2978 medication for a child, the department must provide to the
2979 evaluating physician all pertinent medical information known to
2980 the department concerning that child.
2981 (6) Children who are in the legal custody of the department
2982 may be placed by the department, without prior approval of the
2983 court, in a residential treatment center licensed under s.
2984 394.875 or a hospital licensed under chapter 395 for residential
2985 mental health treatment only pursuant to this section or may be
2986 placed by the court in accordance with an order of involuntary
2987 examination or involuntary services placement entered pursuant
2988 to s. 394.463 or s. 394.467. All children placed in a
2989 residential treatment program under this subsection must have a
2990 guardian ad litem appointed.
2991 (a) As used in this subsection, the term:
2992 1. “Residential treatment” means placement for observation,
2993 diagnosis, or treatment of an emotional disturbance in a
2994 residential treatment center licensed under s. 394.875 or a
2995 hospital licensed under chapter 395.
2996 2. “Least restrictive alternative” means the treatment and
2997 conditions of treatment that, separately and in combination, are
2998 no more intrusive or restrictive of freedom than reasonably
2999 necessary to achieve a substantial therapeutic benefit or to
3000 protect the child or adolescent or others from physical injury.
3001 3. “Suitable for residential treatment” or “suitability”
3002 means a determination concerning a child or adolescent with an
3003 emotional disturbance as defined in s. 394.492(5) or a serious
3004 emotional disturbance as defined in s. 394.492(6) that each of
3005 the following criteria is met:
3006 a. The child requires residential treatment.
3007 b. The child is in need of a residential treatment program
3008 and is expected to benefit from mental health treatment.
3009 c. An appropriate, less restrictive alternative to
3010 residential treatment is unavailable.
3011 (b) Whenever the department believes that a child in its
3012 legal custody is emotionally disturbed and may need residential
3013 treatment, an examination and suitability assessment must be
3014 conducted by a qualified evaluator who is appointed by the
3015 Agency for Health Care Administration. This suitability
3016 assessment must be completed before the placement of the child
3017 in a residential treatment center for emotionally disturbed
3018 children and adolescents or a hospital. The qualified evaluator
3019 must be a psychiatrist or a psychologist licensed in Florida who
3020 has at least 3 years of experience in the diagnosis and
3021 treatment of serious emotional disturbances in children and
3022 adolescents and who has no actual or perceived conflict of
3023 interest with any inpatient facility or residential treatment
3024 center or program.
3025 (c) Before a child is admitted under this subsection, the
3026 child shall be assessed for suitability for residential
3027 treatment by a qualified evaluator who has conducted a personal
3028 examination and assessment of the child and has made written
3029 findings that:
3030 1. The child appears to have an emotional disturbance
3031 serious enough to require residential treatment and is
3032 reasonably likely to benefit from the treatment.
3033 2. The child has been provided with a clinically
3034 appropriate explanation of the nature and purpose of the
3035 treatment.
3036 3. All available modalities of treatment less restrictive
3037 than residential treatment have been considered, and a less
3038 restrictive alternative that would offer comparable benefits to
3039 the child is unavailable.
3040
3041 A copy of the written findings of the evaluation and suitability
3042 assessment must be provided to the department, to the guardian
3043 ad litem, and, if the child is a member of a Medicaid managed
3044 care plan, to the plan that is financially responsible for the
3045 child’s care in residential treatment, all of whom must be
3046 provided with the opportunity to discuss the findings with the
3047 evaluator.
3048 (d) Immediately upon placing a child in a residential
3049 treatment program under this section, the department must notify
3050 the guardian ad litem and the court having jurisdiction over the
3051 child and must provide the guardian ad litem and the court with
3052 a copy of the assessment by the qualified evaluator.
3053 (e) Within 10 days after the admission of a child to a
3054 residential treatment program, the director of the residential
3055 treatment program or the director’s designee must ensure that an
3056 individualized plan of treatment has been prepared by the
3057 program and has been explained to the child, to the department,
3058 and to the guardian ad litem, and submitted to the department.
3059 The child must be involved in the preparation of the plan to the
3060 maximum feasible extent consistent with his or her ability to
3061 understand and participate, and the guardian ad litem and the
3062 child’s foster parents must be involved to the maximum extent
3063 consistent with the child’s treatment needs. The plan must
3064 include a preliminary plan for residential treatment and
3065 aftercare upon completion of residential treatment. The plan
3066 must include specific behavioral and emotional goals against
3067 which the success of the residential treatment may be measured.
3068 A copy of the plan must be provided to the child, to the
3069 guardian ad litem, and to the department.
3070 (f) Within 30 days after admission, the residential
3071 treatment program must review the appropriateness and
3072 suitability of the child’s placement in the program. The
3073 residential treatment program must determine whether the child
3074 is receiving benefit toward the treatment goals and whether the
3075 child could be treated in a less restrictive treatment program.
3076 The residential treatment program shall prepare a written report
3077 of its findings and submit the report to the guardian ad litem
3078 and to the department. The department must submit the report to
3079 the court. The report must include a discharge plan for the
3080 child. The residential treatment program must continue to
3081 evaluate the child’s treatment progress every 30 days thereafter
3082 and must include its findings in a written report submitted to
3083 the department. The department may not reimburse a facility
3084 until the facility has submitted every written report that is
3085 due.
3086 (g)1. The department must submit, at the beginning of each
3087 month, to the court having jurisdiction over the child, a
3088 written report regarding the child’s progress toward achieving
3089 the goals specified in the individualized plan of treatment.
3090 2. The court must conduct a hearing to review the status of
3091 the child’s residential treatment plan no later than 3 months
3092 after the child’s admission to the residential treatment
3093 program. An independent review of the child’s progress toward
3094 achieving the goals and objectives of the treatment plan must be
3095 completed by a qualified evaluator and submitted to the court
3096 before its 3-month review.
3097 3. For any child in residential treatment at the time a
3098 judicial review is held pursuant to s. 39.701, the child’s
3099 continued placement in residential treatment must be a subject
3100 of the judicial review.
3101 4. If at any time the court determines that the child is
3102 not suitable for continued residential treatment, the court
3103 shall order the department to place the child in the least
3104 restrictive setting that is best suited to meet his or her
3105 needs.
3106 (h) After the initial 3-month review, the court must
3107 conduct a review of the child’s residential treatment plan every
3108 90 days.
3109 (i) The department must adopt rules for implementing
3110 timeframes for the completion of suitability assessments by
3111 qualified evaluators and a procedure that includes timeframes
3112 for completing the 3-month independent review by the qualified
3113 evaluators of the child’s progress toward achieving the goals
3114 and objectives of the treatment plan which review must be
3115 submitted to the court. The Agency for Health Care
3116 Administration must adopt rules for the registration of
3117 qualified evaluators, the procedure for selecting the evaluators
3118 to conduct the reviews required under this section, and a
3119 reasonable, cost-efficient fee schedule for qualified
3120 evaluators.
3121 Section 35. Subsections (5) and (6) of section 394.492,
3122 Florida Statutes, are amended to read:
3123 394.492 Definitions.—As used in ss. 394.490-394.497, the
3124 term:
3125 (5) “Child or adolescent who has an emotional disturbance”
3126 means a person under 18 years of age who is diagnosed with a
3127 mental, emotional, or behavioral disorder of sufficient duration
3128 to meet one of the diagnostic categories specified in the most
3129 recent edition of the Diagnostic and Statistical Manual of the
3130 American Psychiatric Association, but who does not exhibit
3131 behaviors that substantially interfere with or limit his or her
3132 role or ability to function in the family, school, or community.
3133 The emotional disturbance must not be considered to be a
3134 temporary response to a stressful situation. The term does not
3135 include a child or adolescent who meets the criteria for
3136 involuntary placement under s. 394.467(1).
3137 (6) “Child or adolescent who has a serious emotional
3138 disturbance or mental illness” means a person under 18 years of
3139 age who:
3140 (a) Is diagnosed as having a mental, emotional, or
3141 behavioral disorder that meets one of the diagnostic categories
3142 specified in the most recent edition of the Diagnostic and
3143 Statistical Manual of Mental Disorders of the American
3144 Psychiatric Association; and
3145 (b) Exhibits behaviors that substantially interfere with or
3146 limit his or her role or ability to function in the family,
3147 school, or community, which behaviors are not considered to be a
3148 temporary response to a stressful situation.
3149
3150 The term includes a child or adolescent who meets the criteria
3151 for involuntary placement under s. 394.467(1).
3152 Section 36. Paragraphs (a) and (c) of subsection (3) of
3153 section 394.495, Florida Statutes, are amended to read:
3154 394.495 Child and adolescent mental health system of care;
3155 programs and services.—
3156 (3) Assessments must be performed by:
3157 (a) A professional as defined in s. 394.455(7), (33), (36),
3158 or (37) 394.455(5), (7), (32), (35), or (36);
3159 (c) A person who is under the direct supervision of a
3160 qualified professional as defined in s. 394.455(7), (33), (36),
3161 or (37) 394.455(5), (7), (32), (35), or (36) or a professional
3162 licensed under chapter 491.
3163 Section 37. Subsection (5) of section 394.496, Florida
3164 Statutes, is amended to read:
3165 394.496 Service planning.—
3166 (5) A professional as defined in s. 394.455(7), (33), (36),
3167 or (37) 394.455(5), (7), (32), (35), or (36) or a professional
3168 licensed under chapter 491 must be included among those persons
3169 developing the services plan.
3170 Section 38. Subsection (6) of section 394.9085, Florida
3171 Statutes, is amended to read:
3172 394.9085 Behavioral provider liability.—
3173 (6) For purposes of this section, the terms “detoxification
3174 services,” “addictions receiving facility,” and “receiving
3175 facility” have the same meanings as those provided in ss.
3176 397.311(25)(a)4., 397.311(25)(a)1., and 394.455(41) 394.455(39),
3177 respectively.
3178 Section 39. Paragraph (b) of subsection (1) of section
3179 409.972, Florida Statutes, is amended to read:
3180 409.972 Mandatory and voluntary enrollment.—
3181 (1) The following Medicaid-eligible persons are exempt from
3182 mandatory managed care enrollment required by s. 409.965, and
3183 may voluntarily choose to participate in the managed medical
3184 assistance program:
3185 (b) Medicaid recipients residing in residential commitment
3186 facilities operated through the Department of Juvenile Justice
3187 or a treatment facility as defined in s. 394.455(51)
3188 394.455(47).
3189 Section 40. Subsection (7) of section 744.2007, Florida
3190 Statutes, is amended to read:
3191 744.2007 Powers and duties.—
3192 (7) A public guardian may not commit a ward to a treatment
3193 facility, as defined in s. 394.455(51) 394.455(47), without an
3194 involuntary placement proceeding as provided by law.
3195 Section 41. Paragraph (a) of subsection (2) of section
3196 790.065, Florida Statutes, is amended to read:
3197 790.065 Sale and delivery of firearms.—
3198 (2) Upon receipt of a request for a criminal history record
3199 check, the Department of Law Enforcement shall, during the
3200 licensee’s call or by return call, forthwith:
3201 (a) Review any records available to determine if the
3202 potential buyer or transferee:
3203 1. Has been convicted of a felony and is prohibited from
3204 receipt or possession of a firearm pursuant to s. 790.23;
3205 2. Has been convicted of a misdemeanor crime of domestic
3206 violence, and therefore is prohibited from purchasing a firearm;
3207 3. Has had adjudication of guilt withheld or imposition of
3208 sentence suspended on any felony or misdemeanor crime of
3209 domestic violence unless 3 years have elapsed since probation or
3210 any other conditions set by the court have been fulfilled or
3211 expunction has occurred; or
3212 4. Has been adjudicated mentally defective or has been
3213 committed to a mental institution by a court or as provided in
3214 sub-sub-subparagraph b.(II), and as a result is prohibited by
3215 state or federal law from purchasing a firearm.
3216 a. As used in this subparagraph, “adjudicated mentally
3217 defective” means a determination by a court that a person, as a
3218 result of marked subnormal intelligence, or mental illness,
3219 incompetency, condition, or disease, is a danger to himself or
3220 herself or to others or lacks the mental capacity to contract or
3221 manage his or her own affairs. The phrase includes a judicial
3222 finding of incapacity under s. 744.331(6)(a), an acquittal by
3223 reason of insanity of a person charged with a criminal offense,
3224 and a judicial finding that a criminal defendant is not
3225 competent to stand trial.
3226 b. As used in this subparagraph, “committed to a mental
3227 institution” means:
3228 (I) Involuntary commitment, commitment for mental
3229 defectiveness or mental illness, and commitment for substance
3230 abuse. The phrase includes involuntary services inpatient
3231 placement as defined in s. 394.467, involuntary outpatient
3232 placement as defined in s. 394.4655, involuntary assessment and
3233 stabilization under s. 397.6818, and involuntary substance abuse
3234 treatment under s. 397.6957, but does not include a person in a
3235 mental institution for observation or discharged from a mental
3236 institution based upon the initial review by the physician or a
3237 voluntary admission to a mental institution; or
3238 (II) Notwithstanding sub-sub-subparagraph (I), voluntary
3239 admission to a mental institution for outpatient or inpatient
3240 treatment of a person who had an involuntary examination under
3241 s. 394.463, where each of the following conditions have been
3242 met:
3243 (A) An examining physician found that the person is an
3244 imminent danger to himself or herself or others.
3245 (B) The examining physician certified that if the person
3246 did not agree to voluntary treatment, a petition for involuntary
3247 outpatient or inpatient treatment would have been filed under s.
3248 394.463(2)(f)3. 394.463(2)(i)4., or the examining physician
3249 certified that a petition was filed and the person subsequently
3250 agreed to voluntary treatment prior to a court hearing on the
3251 petition.
3252 (C) Before agreeing to voluntary treatment, the person
3253 received written notice of that finding and certification, and
3254 written notice that as a result of such finding, he or she may
3255 be prohibited from purchasing a firearm, and may not be eligible
3256 to apply for or retain a concealed weapon or firearms license
3257 under s. 790.06 and the person acknowledged such notice in
3258 writing, in substantially the following form:
3259 “I understand that the doctor who examined me believes I am a
3260 danger to myself or to others. I understand that if I do not
3261 agree to voluntary treatment, a petition will be filed in court
3262 to require me to receive involuntary treatment. I understand
3263 that if that petition is filed, I have the right to contest it.
3264 In the event a petition has been filed, I understand that I can
3265 subsequently agree to voluntary treatment prior to a court
3266 hearing. I understand that by agreeing to voluntary treatment in
3267 either of these situations, I may be prohibited from buying
3268 firearms and from applying for or retaining a concealed weapons
3269 or firearms license until I apply for and receive relief from
3270 that restriction under Florida law.”
3271 (D) A judge or a magistrate has, pursuant to sub-sub
3272 subparagraph c.(II), reviewed the record of the finding,
3273 certification, notice, and written acknowledgment classifying
3274 the person as an imminent danger to himself or herself or
3275 others, and ordered that such record be submitted to the
3276 department.
3277 c. In order to check for these conditions, the department
3278 shall compile and maintain an automated database of persons who
3279 are prohibited from purchasing a firearm based on court records
3280 of adjudications of mental defectiveness or commitments to
3281 mental institutions.
3282 (I) Except as provided in sub-sub-subparagraph (II), clerks
3283 of court shall submit these records to the department within 1
3284 month after the rendition of the adjudication or commitment.
3285 Reports shall be submitted in an automated format. The reports
3286 must, at a minimum, include the name, along with any known alias
3287 or former name, the sex, and the date of birth of the subject.
3288 (II) For persons committed to a mental institution pursuant
3289 to sub-sub-subparagraph b.(II), within 24 hours after the
3290 person’s agreement to voluntary admission, a record of the
3291 finding, certification, notice, and written acknowledgment must
3292 be filed by the administrator of the receiving or treatment
3293 facility, as defined in s. 394.455, with the clerk of the court
3294 for the county in which the involuntary examination under s.
3295 394.463 occurred. No fee shall be charged for the filing under
3296 this sub-sub-subparagraph. The clerk must present the records to
3297 a judge or magistrate within 24 hours after receipt of the
3298 records. A judge or magistrate is required and has the lawful
3299 authority to review the records ex parte and, if the judge or
3300 magistrate determines that the record supports the classifying
3301 of the person as an imminent danger to himself or herself or
3302 others, to order that the record be submitted to the department.
3303 If a judge or magistrate orders the submittal of the record to
3304 the department, the record must be submitted to the department
3305 within 24 hours.
3306 d. A person who has been adjudicated mentally defective or
3307 committed to a mental institution, as those terms are defined in
3308 this paragraph, may petition the court that made the
3309 adjudication or commitment, or the court that ordered that the
3310 record be submitted to the department pursuant to sub-sub
3311 subparagraph c.(II), for relief from the firearm disabilities
3312 imposed by such adjudication or commitment. A copy of the
3313 petition shall be served on the state attorney for the county in
3314 which the person was adjudicated or committed. The state
3315 attorney may object to and present evidence relevant to the
3316 relief sought by the petition. The hearing on the petition may
3317 be open or closed as the petitioner may choose. The petitioner
3318 may present evidence and subpoena witnesses to appear at the
3319 hearing on the petition. The petitioner may confront and cross
3320 examine witnesses called by the state attorney. A record of the
3321 hearing shall be made by a certified court reporter or by court
3322 approved electronic means. The court shall make written findings
3323 of fact and conclusions of law on the issues before it and issue
3324 a final order. The court shall grant the relief requested in the
3325 petition if the court finds, based on the evidence presented
3326 with respect to the petitioner’s reputation, the petitioner’s
3327 mental health record and, if applicable, criminal history
3328 record, the circumstances surrounding the firearm disability,
3329 and any other evidence in the record, that the petitioner will
3330 not be likely to act in a manner that is dangerous to public
3331 safety and that granting the relief would not be contrary to the
3332 public interest. If the final order denies relief, the
3333 petitioner may not petition again for relief from firearm
3334 disabilities until 1 year after the date of the final order. The
3335 petitioner may seek judicial review of a final order denying
3336 relief in the district court of appeal having jurisdiction over
3337 the court that issued the order. The review shall be conducted
3338 de novo. Relief from a firearm disability granted under this
3339 sub-subparagraph has no effect on the loss of civil rights,
3340 including firearm rights, for any reason other than the
3341 particular adjudication of mental defectiveness or commitment to
3342 a mental institution from which relief is granted.
3343 e. Upon receipt of proper notice of relief from firearm
3344 disabilities granted under sub-subparagraph d., the department
3345 shall delete any mental health record of the person granted
3346 relief from the automated database of persons who are prohibited
3347 from purchasing a firearm based on court records of
3348 adjudications of mental defectiveness or commitments to mental
3349 institutions.
3350 f. The department is authorized to disclose data collected
3351 pursuant to this subparagraph to agencies of the Federal
3352 Government and other states for use exclusively in determining
3353 the lawfulness of a firearm sale or transfer. The department is
3354 also authorized to disclose this data to the Department of
3355 Agriculture and Consumer Services for purposes of determining
3356 eligibility for issuance of a concealed weapons or concealed
3357 firearms license and for determining whether a basis exists for
3358 revoking or suspending a previously issued license pursuant to
3359 s. 790.06(10). When a potential buyer or transferee appeals a
3360 nonapproval based on these records, the clerks of court and
3361 mental institutions shall, upon request by the department,
3362 provide information to help determine whether the potential
3363 buyer or transferee is the same person as the subject of the
3364 record. Photographs and any other data that could confirm or
3365 negate identity must be made available to the department for
3366 such purposes, notwithstanding any other provision of state law
3367 to the contrary. Any such information that is made confidential
3368 or exempt from disclosure by law shall retain such confidential
3369 or exempt status when transferred to the department.
3370 Section 42. Subsection (1) of section 945.46, Florida
3371 Statutes, is amended to read:
3372 945.46 Initiation of involuntary placement proceedings with
3373 respect to a mentally ill inmate scheduled for release.—
3374 (1) If an inmate who is receiving mental health treatment
3375 in the department is scheduled for release through expiration of
3376 sentence or any other means, but continues to be mentally ill
3377 and in need of care and treatment, as defined in s. 945.42, the
3378 warden is authorized to initiate procedures for involuntary
3379 placement pursuant to s. 394.467, 60 days prior to such release.
3380 Section 43. This act shall take effect July 1, 2017.
3381
3382 ================= T I T L E A M E N D M E N T ================
3383 And the title is amended as follows:
3384 Delete everything before the enacting clause
3385 and insert:
3386 A bill to be entitled
3387 An act relating to examination and treatment of
3388 individuals with mental illness; amending s. 394.453,
3389 F.S.; revising legislative intent; amending s.
3390 394.455, F.S.; providing, revising, and deleting
3391 definitions; amending s. 394.457, F.S.; providing
3392 responsibilities of the Department of Children and
3393 Families for a comprehensive statewide mental health
3394 and substance abuse program; amending s. 394.4573,
3395 F.S.; conforming terminology; amending s. 394.4574,
3396 F.S.; providing for additional professionals to assess
3397 a resident with a mental illness who resides in an
3398 assisted living facility; amending s. 394.458, F.S.;
3399 prohibiting the introduction or removal of certain
3400 articles at a facility providing mental health
3401 services; requiring such facilities to post a notice
3402 thereof; amending s. 394.459, F.S.; revising rights of
3403 individuals receiving mental health treatment and
3404 services to provide for the use of health care
3405 surrogates or proxies to make decisions; revising
3406 requirements relating to express and informed consent
3407 and liability for violations; requiring service
3408 providers to provide information concerning advance
3409 directives; amending s. 394.4593, F.S.; expanding the
3410 definition of the term “employee” to include staff,
3411 volunteers, and interns employed by a service provider
3412 for purposes of reporting sexual misconduct; repealing
3413 s. 394.4595, F.S., relating to the Florida statewide
3414 and local advocacy councils and access to patients and
3415 records; creating s. 394.4596, F.S.; requiring
3416 designated receiving facilities to permit access
3417 authority to an agency designated by the Governor to
3418 serve as the federally mandated protection and
3419 advocacy system for individuals with disabilities;
3420 amending s. 394.4597, F.S.; providing rights and
3421 responsibilities of the representative of an
3422 individual admitted to a facility for involuntary
3423 examination or services; amending s. 394.4598, F.S.;
3424 specifying certain persons who are prohibited from
3425 being appointed as a guardian advocate; providing
3426 duties of a guardian advocate; amending s. 394.4599,
3427 F.S.; revising requirements for a certain notice
3428 related to involuntary admission; repealing s.
3429 394.460, F.S., relating to rights of professionals;
3430 amending s. 394.461, F.S.; authorizing governmental
3431 facilities to provide voluntary and involuntary mental
3432 health and substance abuse examinations and treatment
3433 under certain conditions; providing additional
3434 facility reporting requirements; amending s. 394.4615,
3435 F.S., relating to confidentiality of clinical records;
3436 providing additional circumstances in which
3437 information from a clinical record may be released;
3438 amending s. 394.462, F.S.; revising requirements for
3439 transportation to receiving facilities and treatment
3440 facilities; providing for a law enforcement officer to
3441 transport an individual to a United States Department
3442 of Veterans Affairs facility under certain
3443 circumstances; providing immunity from liability;
3444 deleting obsolete provisions; amending s. 394.4625,
3445 F.S.; revising criteria for voluntary admission to,
3446 and release or discharge from, a facility for
3447 examination and treatment; revising criteria for a
3448 determination of neglect to include mental and
3449 physical harm; requiring certain individuals charged
3450 with a crime to be discharged to the custody of a law
3451 enforcement officer under certain circumstances;
3452 amending s. 394.463, F.S.; requiring certain persons
3453 initiating an involuntary examination to provide
3454 notice to the individual’s guardian, representative,
3455 or health care surrogate or proxy; revising a holding
3456 period for involuntary examination; amending s.
3457 394.467, F.S.; revising provisions relating to
3458 admission to a facility for involuntary services;
3459 authorizing the state attorney to represent the state
3460 in certain proceedings relating to a petition for
3461 involuntary services; granting the state attorney
3462 access to certain clinical records and witnesses;
3463 providing conditions for a continuance of the hearing;
3464 requiring the Division of Administrative Hearings to
3465 advise certain parties representing the individual of
3466 the right to an independent examination in continued
3467 involuntary services proceedings; amending s.
3468 394.46715, F.S.; providing purpose of department
3469 rules; amending s. 394.4672, F.S.; authorizing
3470 facilities of the United States Department of Veterans
3471 Affairs to provide certain mental health services;
3472 amending s. 394.4685, F.S.; revising provisions
3473 governing transfer of individuals between and among
3474 public and private facilities; amending s. 394.469,
3475 F.S.; authorizing the discharge of an individual from
3476 involuntary services into the custody of a law
3477 enforcement officer under certain conditions; amending
3478 s. 394.473, F.S.; revising provisions relating to
3479 compensation of attorneys and expert witnesses in
3480 cases involving indigent individuals; amending s.
3481 394.475, F.S.; conforming terminology; amending s.
3482 394.4785, F.S.; defining the term “minor” for purposes
3483 of admission into a mental health facility; repealing
3484 s. 394.4595, F.S., relating to access to patients and
3485 patients’ records by members of the Florida statewide
3486 and local advocacy councils; repealing s. 394.460,
3487 F.S., relating to the rights of professionals;
3488 repealing s. 394.4655, F.S., relating to involuntary
3489 outpatient services; repealing s. 394.4786, F.S.,
3490 relating to legislative intent; repealing s.
3491 394.47865, F.S., relating to the privatization of
3492 South Florida State Hospital; repealing s. 394.4787,
3493 F.S., relating to definitions; repealing s. 394.4788,
3494 F.S., relating to use of certain PMATF funds for the
3495 purchase of acute care mental health services;
3496 repealing s. 394.4789, F.S., relating to the
3497 establishment of a referral process and eligibility
3498 determination; amending ss. 20.425, 39.407, 394.4599,
3499 394.492, 394.495, 394.496, 394.9082, 394.9085,
3500 409.972, 744.2007, 790.065, and 945.46, F.S.;
3501 conforming references and cross-references; providing
3502 an effective date.