| 1 | Representative Simmons offered the following: | 
| 2 | 
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| 3 | Amendment to Amendment (866277) (with title amendment) | 
| 4 | Remove line(s) 97-188 and insert: | 
| 5 | Section 4.  Effective July 1, 2005, paragraph (a) of | 
| 6 | subsection (2) of section 394.463, Florida Statutes, is amended | 
| 7 | to read: | 
| 8 | 394.463  Involuntary examination.-- | 
| 9 | (2)  INVOLUNTARY EXAMINATION.-- | 
| 10 | (a)  An involuntary examination may be initiated by any one | 
| 11 | of the following means: | 
| 12 | 1.  A court may enter an ex parte order stating that a | 
| 13 | person appears to meet the criteria for involuntary examination, | 
| 14 | giving the findings on which that conclusion is based.  The ex | 
| 15 | parte order for involuntary examination must be based on sworn | 
| 16 | testimony, written or oral.  If other less restrictive means are | 
| 17 | not available, such as voluntary appearance for outpatient | 
| 18 | evaluation, a law enforcement officer, or other designated agent | 
| 19 | of the court, shall take the person into custody and deliver him | 
| 20 | or her to the nearest receiving facility for involuntary | 
| 21 | examination.  The order of the court shall be made a part of the | 
| 22 | patient's clinical record.  No fee shall be charged for the | 
| 23 | filing of an order under this subsection.  Any receiving | 
| 24 | facility accepting the patient based on this order must send a | 
| 25 | copy of the order to the Agency for Health Care Administration | 
| 26 | on the next working day.  The order shall be valid only until | 
| 27 | executed or, if not executed, for the period specified in the | 
| 28 | order itself. If no time limit is specified in the order, the | 
| 29 | order shall be valid for 7 days after the date that the order | 
| 30 | was signed. | 
| 31 | 2.  A law enforcement officer shall take a person who | 
| 32 | appears to meet the criteria for involuntary examination into | 
| 33 | custody and deliver the person or have him or her delivered to | 
| 34 | the nearest receiving facility for examination.  The officer | 
| 35 | shall execute a written report detailing the circumstances under | 
| 36 | which the person was taken into custody, and the report shall be | 
| 37 | made a part of the patient's clinical record.  Any receiving | 
| 38 | facility accepting the patient based on this report must send a | 
| 39 | copy of the report to the Agency for Health Care Administration | 
| 40 | on the next working day. | 
| 41 | 3.  A physician, clinical psychologist, psychiatric nurse, | 
| 42 | mental health counselor, or clinical social worker may execute a | 
| 43 | certificate stating that he or she has examined a person within | 
| 44 | the preceding 48 hours and finds that the person appears to meet | 
| 45 | the criteria for involuntary examination and stating the | 
| 46 | observations upon which that conclusion is based. If other less | 
| 47 | restrictive means are not available, such as voluntary | 
| 48 | appearance for outpatient evaluation, a law enforcement officer | 
| 49 | shall take the person named in the certificate into custody and | 
| 50 | deliver him or her to the nearest receiving facility for | 
| 51 | involuntary examination. The law enforcement officer shall | 
| 52 | execute a written report detailing the circumstances under which | 
| 53 | the person was taken into custody. The report and certificate | 
| 54 | shall be made a part of the patient's clinical record. Any | 
| 55 | receiving facility accepting the patient based on this | 
| 56 | certificate must send a copy of the certificate to the Agency | 
| 57 | for Health Care Administration on the next working day. | 
| 58 | Section 5.  Effective January 1, 2005, subsection (1) and | 
| 59 | paragraphs (e), (g), and (i) of subsection (2) of section | 
| 60 | 394.463, Florida Statutes, are amended to read: | 
| 61 | 394.463  Involuntary examination.-- | 
| 62 | (1)  CRITERIA.--A person may be taken to a receiving | 
| 63 | facility for involuntary examination if there is reason to | 
| 64 | believe that the person has a mental illness he or she is | 
| 65 | mentally illand because of his or her mental illness: | 
| 66 | (a)1.  The person has refused voluntary examination after | 
| 67 | conscientious explanation and disclosure of the purpose of the | 
| 68 | examination; or | 
| 69 | 2.  The person is unable to determine for himself or | 
| 70 | herself whether examination is necessary; and | 
| 71 | (b)1.  Without care or treatment, the person is likely to | 
| 72 | suffer from neglect or refuse to care for himself or herself; | 
| 73 | such neglect or refusal poses a real and present threat of | 
| 74 | substantial harm to his or her well-being; and it is not | 
| 75 | apparent that such harm may be avoided through the help of | 
| 76 | willing family members or friends or the provision of other | 
| 77 | services; or | 
| 78 | 2.  There is a substantial likelihood that without care or | 
| 79 | treatment the person will cause serious bodily harm to himself | 
| 80 | or herself or others in the near future, as evidenced by recent | 
| 81 | behavior. | 
| 82 | (2)  INVOLUNTARY EXAMINATION.-- | 
| 83 | (e)  The Agency for Health Care Administration shall | 
| 84 | receive and maintain the copies of ex parte orders, involuntary | 
| 85 | outpatient placement orders issued pursuant to s. 394.4655, | 
| 86 | involuntary inpatient placement orders issued pursuant to s. | 
| 87 | 394.467, professional certificates, and law enforcement | 
| 88 | officers' reports.  These documents shall be considered part of | 
| 89 | the clinical record, governed by the provisions of s. 394.4615. | 
| 90 | The agency shall prepare annual reports analyzing the data | 
| 91 | obtained from these documents, without information identifying | 
| 92 | patients, and shall provide copies of reports to the department, | 
| 93 | the President of the Senate, the Speaker of the House of | 
| 94 | Representatives, and the minority leaders of the Senate and the | 
| 95 | House of Representatives. | 
| 96 | (g)  A person for whom an involuntary examination has been | 
| 97 | initiated who is being evaluated or treated at a hospital for an | 
| 98 | emergency medical condition specified in s. 395.002 must be | 
| 99 | examined by a receiving facility within 72 hours.  The 72-hour | 
| 100 | period begins when the patient arrives at the hospital and | 
| 101 | ceases when the attending physician documents that the patient | 
| 102 | has an emergency medical condition. If the patient is examined | 
| 103 | at a hospital providing emergency medical services by a | 
| 104 | professional qualified to perform an involuntary examination and | 
| 105 | is found as a result of that examination not to meet the | 
| 106 | criteria for involuntary outpatient placement pursuant to s. | 
| 107 | 394.4655(1) or involuntary inpatient placement pursuant to s. | 
| 108 | 394.467(1), the patient may be offered voluntary placement, if | 
| 109 | appropriate, or released directly from the hospital providing | 
| 110 | emergency medical services.  The finding by the professional | 
| 111 | that the patient has been examined and does not meet the | 
| 112 | criteria for involuntary inpatient placement or involuntary | 
| 113 | outpatient placement must be entered into the patient's clinical | 
| 114 | record. Nothing in this paragraph is intended to prevent a | 
| 115 | hospital providing emergency medical services from appropriately | 
| 116 | transferring a patient to another hospital prior to | 
| 117 | stabilization, provided the requirements of s. 395.1041(3)(c) | 
| 118 | have been met. | 
| 119 | (i)  Within the 72-hour examination period or, if the 72 | 
| 120 | hours ends on a weekend or holiday, no later than the next | 
| 121 | working day thereafter, one of the following actions must be | 
| 122 | taken, based on the individual needs of the patient: | 
| 123 | 1.  The patient shall be released, unless he or she is | 
| 124 | charged with a crime, in which case the patient shall be | 
| 125 | returned to the custody of a law enforcement officer; | 
| 126 | 2.  The patient shall be released, subject to the | 
| 127 | provisions of subparagraph 1., for voluntary outpatient | 
| 128 | treatment; | 
| 129 | 3.  The patient, unless he or she is charged with a crime, | 
| 130 | shall be asked to give express and informed consent to placement | 
| 131 | as a voluntary patient, and, if such consent is given, the | 
| 132 | patient shall be admitted as a voluntary patient; or | 
| 133 | 4.  A petition for involuntary placement shall be filed in | 
| 134 | the circuit appropriatecourtby the facility administratorwhen | 
| 135 | outpatient or inpatient treatment is deemed necessary. When | 
| 136 | inpatient treatment is deemed necessary ; in which case, the | 
| 137 | least restrictive treatment consistent with the optimum | 
| 138 | improvement of the patient's condition shall be made available. | 
| 139 | When a petition is to be filed for involuntary outpatient | 
| 140 | placement, it shall be filed by one of the petitioners specified | 
| 141 | in s. 394.4655(3)(a). A petition for involuntary inpatient | 
| 142 | placement shall be filed by the facility administrator. | 
| 143 | 
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| 144 | 
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| 145 | ================ T I T L E  A M E N D M E N T ============= | 
| 146 | Remove lines 760-774 and insert: | 
| 147 | 394.463, F.S.; adding mental health counselors to the | 
| 148 | persons who can initiate an involuntary examination; | 
| 149 | revising criteria for an involuntary examination; revising | 
| 150 | requirements for filing a petition for involuntary | 
| 151 | placement; creating s. 394.4655, F.S.; providing for | 
| 152 | involuntary outpatient placement; providing criteria; | 
| 153 | providing procedures; providing for a voluntary | 
| 154 | examination for outpatient placement; providing for a | 
| 155 | petition for involuntary outpatient placement; requiring | 
| 156 | the appointment of counsel; providing for a continuance of | 
| 157 | hearing; providing procedures for the hearing on | 
| 158 | involuntary outpatient placement; providing a procedure | 
| 159 | for continued involuntary outpatient placement; amending | 
| 160 | s. 394.467, F.S., relating to involuntary placement; | 
| 161 | conforming terminology to changes made by the act; | 
| 162 | providing for rulemaking authority; providing for | 
| 163 | severability; providing effective dates. |