| 1 | A bill to be entitled |
| 2 | An act relating to mental health; revising part I of ch. |
| 3 | 394, F.S., relating to the Florida Mental Health Act, to |
| 4 | substitute the term "individual" for the terms "person," |
| 5 | "patient," or "client"; amending s. 394.453, F.S.; |
| 6 | conforming terms; amending s. 394.455, F.S.; redefining |
| 7 | terms, defining new terms, and deleting terms; amending s. |
| 8 | 394.457, F.S.; conforming terms; amending s. 394.4572, |
| 9 | F.S.; conforming terms; deleting certain background |
| 10 | screening requirements and exemptions for certain mental |
| 11 | health professionals; amending s. 394.4573, F.S.; |
| 12 | conforming terms; deleting a report requirement relating |
| 13 | to the implementation of staffing standards in state |
| 14 | treatment facilities; amending ss. 394.4574 and 394.458, |
| 15 | F.S.; conforming terms; amending s. 394.459, F.S.; |
| 16 | conforming terms; revising requirements for a physical |
| 17 | examination and psychiatric evaluation and requiring the |
| 18 | examination to be documented in the clinical record; |
| 19 | requiring facilities to provide procedures for reporting |
| 20 | events that place individuals receiving services at risk |
| 21 | of harm; requiring facilities to provide information and |
| 22 | assist individuals with advance directives; amending ss. |
| 23 | 394.4593 and 394.4595, F.S.; conforming terms; amending s. |
| 24 | 394.4597, F.S.; conforming terms; adding a health care |
| 25 | surrogate to list of persons to be noted in the clinical |
| 26 | record; specifying the rights, authority, and |
| 27 | responsibilities of a representative; amending s. |
| 28 | 394.4598, F.S.; conforming terms; requiring a guardian |
| 29 | advocate to make every effort to make the decision the |
| 30 | individual would have made; amending s. 394.4599, F.S.; |
| 31 | conforming terms; adding the health care surrogate or |
| 32 | proxy to list of persons to receive notice of involuntary |
| 33 | admission; repealing s. 394.460, F.S., relating to the |
| 34 | rights of professionals; amending s. 394.461, F.S.; |
| 35 | conforming terms; specifying that only governmental |
| 36 | facilities and other facilities designated by the |
| 37 | Department of Children and Family Services may serve as |
| 38 | receiving and treatment facilities; revising facility data |
| 39 | that must be submitted to the Agency for Health Care |
| 40 | Administration; amending s. 394.4615, F.S.; conforming |
| 41 | terms; adding a health care surrogate or proxy to list of |
| 42 | persons that may waive confidentiality of a clinical |
| 43 | record; providing additional grounds for releasing a |
| 44 | clinical record; amending s. 394.462, F.S.; conforming |
| 45 | terms; providing that a law enforcement officer acting in |
| 46 | good faith may not be held liable for false imprisonment; |
| 47 | specifying when a county or law enforcement agency may be |
| 48 | reimbursed for transportation expenses; authorizing the |
| 49 | Department of Corrections to transport an individual under |
| 50 | certain circumstances; amending s. 394.4625, F.S.; |
| 51 | conforming terms; requiring a minor's assent to voluntary |
| 52 | admission; requiring an individual who has been |
| 53 | voluntarily admitted and charged with a crime to be |
| 54 | returned to the custody of a law enforcement agency after |
| 55 | discharge; amending s. 394.463, F.S.; conforming terms; |
| 56 | requiring an ex parte order for involuntary examination to |
| 57 | be based on specific facts and have occurred within the |
| 58 | last 14 days; providing that a certificate for involuntary |
| 59 | examination is valid only until the individual is |
| 60 | delivered to a receiving facility or for 7 days after the |
| 61 | certificate is executed; providing notification |
| 62 | requirements to guardians of minors who are involuntarily |
| 63 | examined; revising the procedures for holding a person for |
| 64 | involuntary examination and for emergency situations; |
| 65 | requiring an individual charged with a crime who has been |
| 66 | voluntarily or involuntarily admitted to be returned to |
| 67 | the custody of a law enforcement agency after discharge; |
| 68 | amending s. 394.4655, F.S.; conforming terms; revising |
| 69 | criteria for requesting a continuance for a hearing on |
| 70 | involuntary outpatient placement; amending s. 394.467, |
| 71 | F.S.; conforming terms; requiring a facility to send a |
| 72 | copy of the petition for involuntary inpatient placement |
| 73 | to the Agency for Health Care Administration; requiring an |
| 74 | attorney representing an individual in involuntary |
| 75 | placement to represent the individual's expressed desires |
| 76 | and be present at all hearings; requiring the state |
| 77 | attorney to participate in all hearings on involuntary |
| 78 | placement; prohibiting continuance requests from parties |
| 79 | other than the individual; requiring the court to also |
| 80 | conduct a hearing on capacity to consent to treatment; |
| 81 | providing for the appointment of a guardian advocate if an |
| 82 | individual is found incompetent; requiring the court to |
| 83 | determine that an individual has knowingly waived his or |
| 84 | her attendance at the hearing; requiring the court to |
| 85 | allow certain testimony at hearings on involuntary |
| 86 | placement if a continuance is granted; requiring the |
| 87 | Division of Administrative Hearings to inform an |
| 88 | individual of his or her right to an independent expert |
| 89 | examination; amending ss. 394.46715 and 394.4672, F.S.; |
| 90 | conforming terms; repealing s. 394.4674, F.S., relating to |
| 91 | a plan and report on the deinstitutionalization of |
| 92 | patients in treatment facilities; amending s. 394.4685, |
| 93 | F.S.; conforming terms; authorizing a public facility to |
| 94 | request the transfer of an individual to a private |
| 95 | facility; amending s. 394.469, F.S.; conforming terms; |
| 96 | requiring a discharged individual who is charged with a |
| 97 | crime to be returned to the custody of a law enforcement |
| 98 | agency; amending ss. 394.473, 394.475, 394.4785, 394.4786, |
| 99 | 394.47865, 394.4787, 394.4788, and 394.4789, F.S.; |
| 100 | conforming terms; amending ss. 39.407, 394.495, 394.496, |
| 101 | 394.9085, 419.001, and 744.704, F.S.; conforming cross- |
| 102 | references; providing an effective date. |
| 103 |
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| 104 | Be It Enacted by the Legislature of the State of Florida: |
| 105 |
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| 106 | Section 1. Section 394.453, Florida Statutes, is amended |
| 107 | to read: |
| 108 | 394.453 Legislative intent.-It is the intent of the |
| 109 | Legislature to authorize and direct the Department of Children |
| 110 | and Family Services to evaluate, research, plan, and recommend |
| 111 | to the Governor and the Legislature programs designed to reduce |
| 112 | the occurrence, severity, duration, and disabling aspects of |
| 113 | mental, emotional, and behavioral disorders. It is the intent of |
| 114 | the Legislature that treatment programs for such disorders shall |
| 115 | include, but not be limited to, comprehensive health, social, |
| 116 | educational, and rehabilitative services for individuals to |
| 117 | persons requiring intensive short-term and continued treatment |
| 118 | in order to encourage them to assume responsibility for their |
| 119 | treatment and recovery. It is intended that such individuals |
| 120 | persons be provided with emergency service and temporary |
| 121 | detention for evaluation if when required; that they be admitted |
| 122 | to treatment facilities if on a voluntary basis when extended or |
| 123 | continuing care is needed and unavailable in the community; that |
| 124 | involuntary placement be provided only if when expert evaluation |
| 125 | determines that it is necessary; that any involuntary treatment |
| 126 | or examination be accomplished in a setting that which is |
| 127 | clinically appropriate and most likely to facilitate the |
| 128 | individual's person's return to the community as soon as |
| 129 | possible; and that individual dignity and human rights be |
| 130 | guaranteed to all individuals persons who are admitted to mental |
| 131 | health facilities or who are being held under s. 394.463. It is |
| 132 | the further intent of the Legislature that the least restrictive |
| 133 | means of intervention be employed based on the individual's |
| 134 | individual needs of each person, within the scope of available |
| 135 | services. It is the policy of this state that the use of |
| 136 | restraint and seclusion on clients is justified only as an |
| 137 | emergency safety measure to be used in response to imminent |
| 138 | danger to the individual client or others. It is, therefore, the |
| 139 | intent of the Legislature to achieve an ongoing reduction in the |
| 140 | use of restraint and seclusion in programs and facilities |
| 141 | serving individuals who have persons with mental illness. |
| 142 | Section 2. Section 394.455, Florida Statutes, is amended |
| 143 | to read: |
| 144 | 394.455 Definitions.-As used in this part, unless the |
| 145 | context clearly requires otherwise, the term: |
| 146 | (1) "Administrator" means the chief administrative officer |
| 147 | of a receiving or treatment facility or his or her designee. |
| 148 | (2) "Adult" means an individual who is 18 years of age or |
| 149 | older or who has had the disability of nonage removed pursuant |
| 150 | to s. 743.01 or s. 743.015. |
| 151 | (3) "Advance directive" has the same meaning as in s. |
| 152 | 765.101. |
| 153 | (4)(2) "Clinical psychologist" means a psychologist as |
| 154 | defined in s. 490.003 490.003(7) with 3 years of postdoctoral |
| 155 | experience in the practice of clinical psychology, inclusive of |
| 156 | the experience required for licensure, or a psychologist |
| 157 | employed by a facility operated by the United States Department |
| 158 | of Veterans Affairs or the United States Department of Defense |
| 159 | that qualifies as a receiving or treatment facility under this |
| 160 | part. |
| 161 | (5)(3) "Clinical record" means all parts of the record |
| 162 | required to be maintained and includes all medical records, |
| 163 | progress notes, charts, and admission and discharge data, and |
| 164 | all other information recorded by a facility staff which |
| 165 | pertains to an individual's the patient's hospitalization or |
| 166 | treatment. |
| 167 | (6)(4) "Clinical social worker" has the same meaning as in |
| 168 | s. 491.003 means a person licensed as a clinical social worker |
| 169 | under chapter 491. |
| 170 | (7)(5) "Community facility" means a any community service |
| 171 | provider contracting with the department to furnish substance |
| 172 | abuse or mental health services under part IV of this chapter. |
| 173 | (8)(6) "Community mental health center or clinic" means a |
| 174 | publicly funded, not-for-profit center that which contracts with |
| 175 | the department for the provision of inpatient, outpatient, day |
| 176 | treatment, or emergency services. |
| 177 | (9)(7) "Court," unless otherwise specified, means the |
| 178 | circuit court. |
| 179 | (10)(8) "Department" means the Department of Children and |
| 180 | Family Services. |
| 181 | (11) "Electronic means" means a form of telecommunication |
| 182 | that requires all parties to maintain visual as well as audio |
| 183 | communication. |
| 184 | (12)(9) "Express and informed consent" means consent |
| 185 | voluntarily given in writing, by a competent individual person, |
| 186 | after sufficient explanation and disclosure of the subject |
| 187 | matter involved to enable the individual person to make a |
| 188 | knowing and willful decision without any element of force, |
| 189 | fraud, deceit, duress, or other form of constraint or coercion. |
| 190 | (13)(10) "Facility" means a any hospital, community |
| 191 | facility, public or private facility, or receiving or treatment |
| 192 | facility providing for the evaluation, diagnosis, care, |
| 193 | treatment, training, or hospitalization of individuals persons |
| 194 | who appear to have a mental illness or who have been diagnosed |
| 195 | as having a mental illness. The term "Facility" does not include |
| 196 | a any program or entity licensed under pursuant to chapter 400 |
| 197 | or chapter 429. |
| 198 | (14) "Government facility" means a facility owned, |
| 199 | operated, or administered by the Department of Corrections or |
| 200 | the United States Department of Veterans Affairs. |
| 201 | (15)(11) "Guardian" means the natural guardian of a minor, |
| 202 | or a person appointed by a court to act on behalf of a ward's |
| 203 | person if the ward is a minor or has been adjudicated |
| 204 | incapacitated. |
| 205 | (16)(12) "Guardian advocate" means a person appointed by a |
| 206 | court to make decisions regarding mental health treatment on |
| 207 | behalf of an individual a patient who has been found incompetent |
| 208 | to consent to treatment pursuant to this part. The guardian |
| 209 | advocate may be granted specific additional powers by written |
| 210 | order of the court, as provided in this part. |
| 211 | (17)(13) "Hospital" means a hospital facility as defined |
| 212 | in s. 395.002 and licensed under chapter 395 and part II of |
| 213 | chapter 408. |
| 214 | (18)(14) "Incapacitated" means that an individual a person |
| 215 | has been adjudicated incapacitated pursuant to part V of chapter |
| 216 | 744 and a guardian of the person has been appointed. |
| 217 | (19)(15) "Incompetent to consent to treatment" means that |
| 218 | an individual's a person's judgment is so affected by his or her |
| 219 | mental illness that he or she the person lacks the capacity to |
| 220 | make a well-reasoned, willful, and knowing decision concerning |
| 221 | his or her medical or mental health treatment. |
| 222 | (20) "Involuntary examination" means an examination |
| 223 | performed under s. 394.463 to determine if an individual |
| 224 | qualifies for involuntary inpatient treatment under s. 394.467 |
| 225 | or involuntary outpatient treatment under s. 394.4655. |
| 226 | (21) "Involuntary placement" means involuntary outpatient |
| 227 | treatment pursuant to s. 394.4655 or involuntary inpatient |
| 228 | treatment pursuant to s. 394.467. |
| 229 | (22)(16) "Law enforcement officer" has the same meaning as |
| 230 | means a law enforcement officer as defined in s. 943.10. |
| 231 | (23) "Marriage and family therapist" has the same meaning |
| 232 | as in s. 491.003. |
| 233 | (24) "Mental health counselor" has the same meaning as in |
| 234 | s. 491.003. |
| 235 | (25)(17) "Mental health overlay program" means a mobile |
| 236 | service that which provides an independent examination for |
| 237 | voluntary admission admissions and a range of supplemental |
| 238 | onsite services to an individual who has persons with a mental |
| 239 | illness in a residential setting such as a nursing home, |
| 240 | assisted living facility, adult family-care home, or a |
| 241 | nonresidential setting such as an adult day care center. |
| 242 | Independent examinations provided pursuant to this part through |
| 243 | a mental health overlay program must only be provided only under |
| 244 | contract with the department for this service or be attached to |
| 245 | a public receiving facility that is also a community mental |
| 246 | health center. |
| 247 | (26)(18) "Mental illness" means an impairment of the |
| 248 | mental or emotional processes that exercise conscious control of |
| 249 | one's actions or of the ability to perceive or understand |
| 250 | reality, which impairment substantially interferes with the a |
| 251 | person's ability to meet the ordinary demands of living, |
| 252 | regardless of etiology. For the purposes of this part, the term |
| 253 | does not include a retardation or developmental disability as |
| 254 | defined in chapter 393, intoxication, brain injury, dementia, or |
| 255 | conditions manifested only by antisocial behavior or substance |
| 256 | abuse impairment. |
| 257 | (27) "Minor" means an individual who is 17 years of age or |
| 258 | younger and who has not had the disabilities of nonage removed |
| 259 | pursuant to s. 743.01 or s. 743.015. |
| 260 | (28)(19) "Mobile crisis response service" means a |
| 261 | nonresidential crisis service attached to a public receiving |
| 262 | facility and available 24 hours a day, 7 days a week, through |
| 263 | which provides immediate intensive assessments and |
| 264 | interventions, including screening for admission into a |
| 265 | receiving facility, take place for the purpose of identifying |
| 266 | appropriate treatment services. |
| 267 | (20) "Patient" means any person who is held or accepted |
| 268 | for mental health treatment. |
| 269 | (29)(21) "Physician" means a medical practitioner licensed |
| 270 | under chapter 458 or chapter 459 who has experience in the |
| 271 | diagnosis and treatment of mental and nervous disorders or a |
| 272 | physician employed by a facility operated by the United States |
| 273 | Department of Veterans Affairs or the United States Department |
| 274 | of Defense which qualifies as a receiving or treatment facility |
| 275 | under this part. |
| 276 | (30) "Physician assistant" means a person licensed as a |
| 277 | physician assistant under chapter 458 or chapter 459. |
| 278 | (31)(22) "Private facility" means any hospital or facility |
| 279 | operated by a for-profit or not-for-profit corporation or |
| 280 | association that provides mental health services and is not a |
| 281 | public facility. |
| 282 | (32)(23) "Psychiatric nurse" means an advanced a |
| 283 | registered nurse practitioner licensed under part I of chapter |
| 284 | 464 who has a national advanced practice certification from an |
| 285 | approved nursing specialty board and a collaborative practice |
| 286 | agreement with a psychiatrist on file with the Board of Nursing |
| 287 | master's degree or a doctorate in psychiatric nursing and 2 |
| 288 | years of post-master's clinical experience under the supervision |
| 289 | of a physician. |
| 290 | (33)(24) "Psychiatrist" means a medical practitioner |
| 291 | licensed under chapter 458 or chapter 459 who has primarily |
| 292 | diagnosed and treated mental and nervous disorders for at least |
| 293 | a period of not less than 3 years, inclusive of psychiatric |
| 294 | residency. |
| 295 | (34)(25) "Public facility" means any facility that has |
| 296 | contracted with the department to provide mental health services |
| 297 | to all individuals persons, regardless of their ability to pay, |
| 298 | and is receiving state funds for such purpose. |
| 299 | (35)(26) "Receiving facility" means any public or private |
| 300 | facility expressly designated by the department to receive and |
| 301 | hold individuals involuntarily involuntary patients under |
| 302 | emergency conditions or for psychiatric evaluation and to |
| 303 | provide short-term treatment. The term does not include a county |
| 304 | jail. |
| 305 | (36)(27) "Representative" means a person selected pursuant |
| 306 | to s. 394.4597(2) to receive notice of proceedings during the |
| 307 | time a patient is held in or admitted to a receiving or |
| 308 | treatment facility. |
| 309 | (37)(28)(a) "Restraint" means a physical device, method, |
| 310 | or drug used to control behavior. |
| 311 | (a) A physical restraint is any manual method or physical |
| 312 | or mechanical device, material, or equipment attached or |
| 313 | adjacent to an the individual's body so that he or she cannot |
| 314 | easily remove the restraint and which restricts freedom of |
| 315 | movement or normal access to one's body. |
| 316 | (b) A drug used as a restraint is a medication used to |
| 317 | control an individual's the person's behavior or to restrict his |
| 318 | or her freedom of movement and is not part of the standard |
| 319 | treatment regimen for an individual having of a person with a |
| 320 | diagnosed mental illness who is a client of the department. |
| 321 | Physically holding an individual a person during a procedure to |
| 322 | forcibly administer psychotropic medication is a physical |
| 323 | restraint. |
| 324 | (c) Restraint does not include physical devices, such as |
| 325 | orthopedically prescribed appliances, surgical dressings and |
| 326 | bandages, supportive body bands, or other physical holding when |
| 327 | necessary for routine physical examinations and tests; or for |
| 328 | purposes of orthopedic, surgical, or other similar medical |
| 329 | treatment; when used to provide support for the achievement of |
| 330 | functional body position or proper balance; or when used to |
| 331 | protect an individual a person from falling out of bed. |
| 332 | (38)(29) "Seclusion" means the physical segregation of a |
| 333 | person in any fashion or involuntary isolation of an individual |
| 334 | a person in a room or area from which the individual person is |
| 335 | prevented from leaving. The prevention may be by physical |
| 336 | barrier or by a staff member who is acting in a manner, or who |
| 337 | is physically situated, so as to prevent the individual person |
| 338 | from leaving the room or area. For purposes of this chapter, the |
| 339 | term does not mean isolation due to an individual's a person's |
| 340 | medical condition or symptoms. |
| 341 | (39)(30) "Secretary" means the Secretary of Children and |
| 342 | Family Services. |
| 343 | (40) "Service provider" means a public or private |
| 344 | receiving facility, an entity under contract with the department |
| 345 | to provide mental health services, a community mental health |
| 346 | center or clinic, a clinical psychologist, a clinical social |
| 347 | worker, a marriage and family therapist, a mental health |
| 348 | counselor, a physician, or a psychiatric nurse. |
| 349 | (41)(31) "Transfer evaluation" means the process, as |
| 350 | approved by the appropriate district office of the department, |
| 351 | during which an individual whereby a person who is being |
| 352 | considered for placement in a state treatment facility is first |
| 353 | evaluated for appropriateness of admission to a state treatment |
| 354 | the facility by a community-based public receiving facility or |
| 355 | by a community mental health center or clinic if the public |
| 356 | receiving facility is not a community mental health center or |
| 357 | clinic. |
| 358 | (42)(32) "Treatment facility" means a any state-owned, |
| 359 | state-operated, or state-supported hospital, or a community |
| 360 | mental health center, or clinic, designated by the department |
| 361 | for extended treatment and hospitalization of individuals who |
| 362 | have a mental illness, beyond that provided for by a receiving |
| 363 | facility or a, of persons who have a mental illness, including |
| 364 | facilities of the United States Government, and any private |
| 365 | facility designated by the department when rendering such |
| 366 | services to a person pursuant to the provisions of this part. |
| 367 | Patients treated in facilities of the United States Government |
| 368 | shall be solely those whose care is the responsibility of the |
| 369 | United States Department of Veterans Affairs. |
| 370 | (33) "Service provider" means any public or private |
| 371 | receiving facility, an entity under contract with the department |
| 372 | of Children and Family Services to provide mental health |
| 373 | services, a clinical psychologist, a clinical social worker, a |
| 374 | marriage and family therapist, a mental health counselor, a |
| 375 | physician, a psychiatric nurse as defined in subsection (23), or |
| 376 | a community mental health center or clinic as defined in this |
| 377 | part. |
| 378 | (34) "Involuntary examination" means an examination |
| 379 | performed under s. 394.463 to determine if an individual |
| 380 | qualifies for involuntary inpatient treatment under s. |
| 381 | 394.467(1) or involuntary outpatient treatment under s. |
| 382 | 394.4655(1). |
| 383 | (35) "Involuntary placement" means either involuntary |
| 384 | outpatient treatment pursuant to s. 394.4655 or involuntary |
| 385 | inpatient treatment pursuant to s. 394.467. |
| 386 | (36) "Marriage and family therapist" means a person |
| 387 | licensed as a marriage and family therapist under chapter 491. |
| 388 | (37) "Mental health counselor" means a person licensed as |
| 389 | a mental health counselor under chapter 491. |
| 390 | (38) "Electronic means" means a form of telecommunication |
| 391 | that requires all parties to maintain visual as well as audio |
| 392 | communication. |
| 393 | Section 3. Section 394.457, Florida Statutes, is amended |
| 394 | to read: |
| 395 | 394.457 Operation and administration.- |
| 396 | (1) ADMINISTRATION.-The Department of Children and Family |
| 397 | Services is designated the "Mental Health Authority" of Florida. |
| 398 | The department and the Agency for Health Care Administration |
| 399 | shall exercise executive and administrative supervision over all |
| 400 | mental health facilities, programs, and services. |
| 401 | (2) RESPONSIBILITIES OF THE DEPARTMENT.-The department is |
| 402 | responsible for: |
| 403 | (a) The planning, evaluation, and implementation of a |
| 404 | complete and comprehensive statewide program of mental health, |
| 405 | including community services, receiving and treatment |
| 406 | facilities, child services, research, and training as authorized |
| 407 | and approved by the Legislature, based on the annual program |
| 408 | budget of the department. The department is also responsible for |
| 409 | the coordination of efforts with other departments and divisions |
| 410 | of the state government, county and municipal governments, and |
| 411 | private agencies concerned with and providing mental health |
| 412 | services. It is responsible for establishing standards, |
| 413 | providing technical assistance, and supervising exercising |
| 414 | supervision of mental health programs of, and the treatment of |
| 415 | individuals patients at, community facilities, other facilities |
| 416 | serving individuals for persons who have a mental illness, and |
| 417 | any agency or facility providing services under to patients |
| 418 | pursuant to this part. |
| 419 | (b) The publication and distribution of an information |
| 420 | handbook to facilitate the understanding of this part, the |
| 421 | policies and procedures involved in the implementation of this |
| 422 | part, and the responsibilities of the various service providers |
| 423 | of services under this part. The department It shall stimulate |
| 424 | research by public and private agencies, institutions of higher |
| 425 | learning, and hospitals in the interest of the elimination and |
| 426 | amelioration of mental illness. |
| 427 | (3) POWER TO CONTRACT.-The department may contract to |
| 428 | provide, and be provided with, services and facilities in order |
| 429 | to carry out its responsibilities under this part with respect |
| 430 | to the following agencies: public and private hospitals; |
| 431 | receiving and treatment facilities; clinics; laboratories; |
| 432 | departments, divisions, and other units of state government; the |
| 433 | state colleges and universities; the community colleges; private |
| 434 | colleges and universities; counties, municipalities, and any |
| 435 | other political subdivisions governmental unit, including |
| 436 | facilities of the United States Government; and any other public |
| 437 | or private entity that which provides or needs facilities or |
| 438 | services. Baker Act funds for community inpatient, crisis |
| 439 | stabilization, short-term residential treatment, and screening |
| 440 | services under this part must be allocated to each county |
| 441 | pursuant to the department's funding allocation methodology. |
| 442 | Notwithstanding the provisions of s. 287.057(5)(f), contracts |
| 443 | for community-based Baker Act services for inpatient, crisis |
| 444 | stabilization, short-term residential treatment, and screening |
| 445 | provided under this part, other than those with other units of |
| 446 | government, to be provided for the department must be awarded |
| 447 | using competitive solicitation if sealed bids when the county |
| 448 | commission of the county receiving the services makes a request |
| 449 | to the department's circuit district office by January 15 of the |
| 450 | contracting year. The office may district shall not enter into a |
| 451 | competitively bid contract under this provision if such action |
| 452 | will result in increases of state or local expenditures for |
| 453 | Baker Act services within the circuit district. Contracts for |
| 454 | these Baker Act services using competitive solicitation are |
| 455 | sealed bids will be effective for 3 years. The department shall |
| 456 | adopt rules establishing minimum standards for such contracted |
| 457 | services and facilities and shall make periodic audits and |
| 458 | inspections to assure that the contracted services are provided |
| 459 | and meet the standards of the department. |
| 460 | (4) APPLICATION FOR AND ACCEPTANCE OF GIFTS AND GRANTS.- |
| 461 | The department may apply for and accept any funds, grants, |
| 462 | gifts, or services made available to it by any agency or |
| 463 | department of the Federal Government or any other public or |
| 464 | private agency or person individual in aid of mental health |
| 465 | programs. All such moneys must shall be deposited in the State |
| 466 | Treasury and shall be disbursed as provided by law. |
| 467 | (5) RULES.-The department shall adopt rules: |
| 468 | (a) The department shall adopt rules Establishing forms |
| 469 | and procedures relating to the rights and privileges of |
| 470 | individuals receiving patients seeking mental health examination |
| 471 | or treatment from facilities under this part. |
| 472 | (b) The department shall adopt rules Necessary for the |
| 473 | implementation and administration of the provisions of this |
| 474 | part., and A program subject to the provisions of this part may |
| 475 | shall not be permitted to operate unless rules designed to |
| 476 | ensure the protection of the health, safety, and welfare of the |
| 477 | individuals examined and patients treated under through such |
| 478 | program have been adopted. Such rules adopted under this |
| 479 | subsection must include provisions governing the use of |
| 480 | restraint and seclusion which are consistent with recognized |
| 481 | best practices and professional judgment; prohibit inherently |
| 482 | dangerous restraint or seclusion procedures; establish |
| 483 | limitations on the use and duration of restraint and seclusion; |
| 484 | establish measures to ensure the safety of program participants |
| 485 | and staff during an incident of restraint or seclusion; |
| 486 | establish procedures for staff to follow before, during, and |
| 487 | after incidents of restraint or seclusion; establish |
| 488 | professional qualifications of and training for staff who may |
| 489 | order or be engaged in the use of restraint or seclusion; and |
| 490 | establish mandatory reporting, data collection, and data |
| 491 | dissemination procedures and requirements. Such rules adopted |
| 492 | under this subsection must require that each instance of the use |
| 493 | of restraint or seclusion be documented in the clinical record |
| 494 | of the individual who has been restrained or secluded patient. |
| 495 | (c) The department shall adopt rules Establishing minimum |
| 496 | standards for services provided by a mental health overlay |
| 497 | program or a mobile crisis response service. |
| 498 | (6) PERSONNEL.- |
| 499 | (a) The department shall, by rule, establish minimum |
| 500 | standards of education and experience for professional and |
| 501 | technical personnel employed in mental health programs, |
| 502 | including members of a mobile crisis response service. |
| 503 | (b) The department shall design and distribute appropriate |
| 504 | materials for the orientation and training of persons actively |
| 505 | engaged in implementing the provisions of this part relating to |
| 506 | the involuntary examination and placement of individuals persons |
| 507 | who are believed to have a mental illness. |
| 508 | (7) PAYMENT FOR CARE OF PATIENTS.-Fees and fee collections |
| 509 | for individuals receiving treatment or services patients in |
| 510 | state-owned, state-operated, or state-supported treatment |
| 511 | facilities must shall be in accordance with according to s. |
| 512 | 402.33. |
| 513 | Section 4. Section 394.4572, Florida Statutes, is amended |
| 514 | to read: |
| 515 | 394.4572 Screening of mental health personnel.- |
| 516 | (1)(a) The department and the Agency for Health Care |
| 517 | Administration shall require employment screening for mental |
| 518 | health personnel using the standards for level 2 screening |
| 519 | standards provided in s. 435.04 set forth in chapter 435. |
| 520 | "Mental health personnel" includes all program directors, |
| 521 | professional clinicians, staff members, and volunteers working |
| 522 | in public or private mental health programs and facilities who |
| 523 | have direct contact with individuals held for examination or |
| 524 | admitted for mental health treatment unmarried patients under |
| 525 | the age of 18 years. For purposes of this chapter, employment |
| 526 | screening of mental health personnel shall also include, but is |
| 527 | not limited to, employment screening as provided under chapter |
| 528 | 435. |
| 529 | (a)(b) Students in the health care professions who are |
| 530 | interning in a mental health facility licensed under chapter |
| 531 | 395, where the primary purpose of the facility is not the |
| 532 | treatment of minors, are exempt from the fingerprinting and |
| 533 | screening requirements if, provided they are under direct |
| 534 | supervision in the actual physical presence of a licensed health |
| 535 | care professional. |
| 536 | (c) Mental health personnel working in a facility licensed |
| 537 | under chapter 395 who have less than 15 hours per week of direct |
| 538 | contact with patients or who are health care professionals |
| 539 | licensed by the Agency for Health Care Administration or a board |
| 540 | thereunder are exempt from the fingerprinting and screening |
| 541 | requirements, except for persons working in mental health |
| 542 | facilities where the primary purpose of the facility is the |
| 543 | treatment of minors. |
| 544 | (b)(d) A volunteer who assists on an intermittent basis |
| 545 | for less than 40 hours per month is exempt from the |
| 546 | fingerprinting and screening requirements if, provided the |
| 547 | volunteer is under direct and constant supervision by persons |
| 548 | who meet the screening requirements of this section paragraph |
| 549 | (a). |
| 550 | (2) The department or the Agency for Health Care |
| 551 | Administration may grant exemptions from disqualification as |
| 552 | provided in s. 435.07 435.06. |
| 553 | (3) Prospective mental health personnel who have |
| 554 | previously been fingerprinted or screened pursuant to this |
| 555 | chapter, chapter 393, chapter 397, chapter 402, or chapter 409, |
| 556 | or teachers who have been fingerprinted pursuant to chapter |
| 557 | 1012, who have not been unemployed for more than 90 days |
| 558 | thereafter, and who under the penalty of perjury attest to the |
| 559 | completion of such fingerprinting or screening and to compliance |
| 560 | with the provisions of this section and the standards for level |
| 561 | 1 screening under contained in chapter 435, are shall not be |
| 562 | required to be refingerprinted or rescreened in order to comply |
| 563 | with the any screening requirements of this part. |
| 564 | Section 5. Section 394.4573, Florida Statutes, is amended |
| 565 | to read: |
| 566 | 394.4573 Continuity of care management system; measures of |
| 567 | performance; reports.- |
| 568 | (1) For the purposes of this section: |
| 569 | (a) "Case management" means those activities aimed at |
| 570 | assessing the client needs, planning services, linking the |
| 571 | service system to a client, coordinating the various system |
| 572 | components, monitoring service delivery, and evaluating the |
| 573 | effect of service delivery for individuals eligible for publicly |
| 574 | funded mental health services. |
| 575 | (b) "Case manager" means a person an individual who works |
| 576 | with individuals who are eligible for publicly funded mental |
| 577 | health services clients, and their families and significant |
| 578 | others, to provide case management. |
| 579 | (c) "Client manager" means an employee of the department |
| 580 | who is assigned to specific provider agencies and geographic |
| 581 | areas to ensure that the full range of needed services is |
| 582 | available to individuals who are eligible for publicly funded |
| 583 | mental health services clients. |
| 584 | (d) "Continuity of care management system" means a system |
| 585 | that assures, within available resources, that individuals who |
| 586 | are eligible for publicly funded mental health services clients |
| 587 | have access to the full array of services within the mental |
| 588 | health services delivery system. |
| 589 | (2) The department shall is directed to implement a |
| 590 | continuity of care management system for the provision of mental |
| 591 | health care, through the provision of client and case |
| 592 | management, including individuals clients referred from state |
| 593 | treatment facilities to community mental health facilities. Such |
| 594 | system must shall include a statewide network of client managers |
| 595 | and case managers throughout the state designed to: |
| 596 | (a) Reduce the possibility of an individual's a client's |
| 597 | admission or readmission to a state treatment facility. |
| 598 | (b) Provide for the creation or designation of an agency |
| 599 | in each county to provide single intake services for each |
| 600 | individual person seeking mental health services. Such agency |
| 601 | shall provide information and referral services necessary to |
| 602 | ensure that such individuals clients receive the most |
| 603 | appropriate and least restrictive form of care, based on the |
| 604 | individual's individual needs of the person seeking treatment. |
| 605 | Such agency shall have a single telephone number, operating 24 |
| 606 | hours per day, 7 days per week, if where practicable, at a |
| 607 | central location, where each individual receiving mental health |
| 608 | services has client will have a client central record. |
| 609 | (c) Advocate on behalf of the individual receiving mental |
| 610 | health services client to ensure that all appropriate services |
| 611 | are provided afforded to the client in a timely and dignified |
| 612 | manner. |
| 613 | (d) Require a that any public receiving facility |
| 614 | initiating an individual's a patient transfer to a licensed |
| 615 | hospital for acute care mental health services not accessible |
| 616 | through the public receiving facility to shall notify the |
| 617 | hospital of the such transfer and send all records relating to |
| 618 | the emergency psychiatric or medical condition. |
| 619 | (3) The department shall is directed to develop and |
| 620 | include performance measures in contracts with service providers |
| 621 | relating to measures of performance with regard to goals and |
| 622 | objectives as specified in the state plan. Such measures shall |
| 623 | use, To the extent practical, such measures must use existing |
| 624 | data collection methods and reports and may shall not require, |
| 625 | as a result of this subsection, additional reports on the part |
| 626 | of service providers. The department shall plan monitoring |
| 627 | visits of community mental health facilities with other state, |
| 628 | federal, and local governmental and private agencies charged |
| 629 | with monitoring such facilities. |
| 630 | (4) The department is directed to submit a report to the |
| 631 | Legislature, prior to April 1 of each year, outlining |
| 632 | departmental progress towards the implementation of the minimum |
| 633 | staffing patterns' standards in state mental health treatment |
| 634 | facilities. The report shall contain, by treatment facility, |
| 635 | information regarding goals and objectives and departmental |
| 636 | performance toward meeting each such goal and objective. |
| 637 | Section 6. Paragraph (a) of subsection (2) and subsection |
| 638 | (3) of section 394.4574, Florida Statutes, are amended to read: |
| 639 | 394.4574 Department responsibilities for a mental health |
| 640 | resident who resides in an assisted living facility that holds a |
| 641 | limited mental health license.- |
| 642 | (2) The department must ensure that: |
| 643 | (a) A mental health resident has been assessed by a |
| 644 | psychiatrist, clinical psychologist, clinical social worker, or |
| 645 | psychiatric nurse, or an individual who is supervised by one of |
| 646 | these professionals, and determined to be appropriate to reside |
| 647 | in an assisted living facility. The documentation must be |
| 648 | provided to the administrator of the facility within 30 days |
| 649 | after the mental health resident has been admitted to the |
| 650 | facility. An evaluation completed upon discharge from a state |
| 651 | mental health treatment facility hospital meets the requirements |
| 652 | of this subsection related to appropriateness for placement as a |
| 653 | mental health resident if it was completed within 90 days before |
| 654 | prior to admission to the facility. |
| 655 | (3) The secretary of Children and Family Services, in |
| 656 | consultation with the Agency for Health Care Administration, |
| 657 | shall annually require each circuit district administrator to |
| 658 | develop, with community input, detailed plans that demonstrate |
| 659 | how the circuit district will ensure the provision of state- |
| 660 | funded mental health and substance abuse treatment services to |
| 661 | residents of assisted living facilities that hold a limited |
| 662 | mental health license. These plans must be consistent with the |
| 663 | substance abuse and mental health circuit district plan |
| 664 | developed pursuant to s. 394.75 and must address case management |
| 665 | services; access to consumer-operated drop-in centers; access to |
| 666 | services during evenings, weekends, and holidays; supervision of |
| 667 | the clinical needs of the residents; and access to emergency |
| 668 | psychiatric care. |
| 669 | Section 7. Subsection (1) of section 394.458, Florida |
| 670 | Statutes, is amended to read: |
| 671 | 394.458 Introduction or removal of certain articles |
| 672 | unlawful; penalty.- |
| 673 | (1)(a) Except as authorized by law or as specifically |
| 674 | authorized by the person in charge of a receiving or treatment |
| 675 | facility each hospital providing mental health services under |
| 676 | this part, it is unlawful to: |
| 677 | (a) Introduce into or upon the grounds of such facility |
| 678 | hospital, or to take or attempt to take or send from the |
| 679 | facility therefrom, any of the following articles, which are |
| 680 | hereby declared to be contraband for the purposes of this |
| 681 | section: |
| 682 | 1. An Any intoxicating beverage or beverage that which |
| 683 | causes or may cause an intoxicating effect; |
| 684 | 2. A Any controlled substance as defined in chapter 893; |
| 685 | or |
| 686 | 3. A firearm Any firearms or deadly weapon. |
| 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 individual receiving mental health services |
| 690 | from a receiving or treatment facility patient of any hospital |
| 691 | providing mental health services under this part any article or |
| 692 | thing declared by this section to be contraband, at any place |
| 693 | which is outside of the grounds of such facility hospital, |
| 694 | except as authorized by law or as specifically authorized by the |
| 695 | person in charge of such hospital. |
| 696 | Section 8. Section 394.459, Florida Statutes, is amended |
| 697 | to read: |
| 698 | 394.459 Rights of individuals receiving treatment and |
| 699 | services patients.- |
| 700 | (1) RIGHT TO INDIVIDUAL DIGNITY.-It is the policy of this |
| 701 | state that the individual dignity of all individuals held for |
| 702 | examination or admitted for mental health treatment the patient |
| 703 | shall be respected at all times and upon all occasions, |
| 704 | including any occasion when the individual patient is taken into |
| 705 | custody, held, or transported. Procedures, facilities, vehicles, |
| 706 | and restraining devices used utilized for criminals or those |
| 707 | accused of a crime may shall not be used in connection with |
| 708 | individuals persons who have a mental illness, except for the |
| 709 | protection of that individual the patient or others. Individuals |
| 710 | Persons who have a mental illness but who are not charged with a |
| 711 | criminal offense may shall not be detained or incarcerated in |
| 712 | the jails of this state. An individual A person who is receiving |
| 713 | treatment for mental illness may shall not be deprived of any |
| 714 | constitutional rights. However, if such individual a person is |
| 715 | adjudicated incapacitated, his or her rights may be limited to |
| 716 | the same extent that the rights of any incapacitated person are |
| 717 | limited by law. |
| 718 | (2) RIGHT TO TREATMENT.-Each individual held for |
| 719 | examination or admitted for mental health treatment: |
| 720 | (a) May A person shall not be denied treatment for mental |
| 721 | illness, and services may shall not be delayed at a receiving or |
| 722 | treatment facility because of inability to pay. However, every |
| 723 | reasonable effort to collect appropriate reimbursement for the |
| 724 | cost of providing mental health services from individuals to |
| 725 | persons able to pay for services, including insurance or third- |
| 726 | party payers payments, shall be made by facilities providing |
| 727 | services under pursuant to this part. |
| 728 | (b) Shall be provided It is further the policy of the |
| 729 | state that the least restrictive appropriate available |
| 730 | treatment, be utilized based on the individual's individual |
| 731 | needs and best interests, of the patient and consistent with the |
| 732 | optimum improvement of the individual's patient's condition. |
| 733 | (c) Each person who remains at a receiving or treatment |
| 734 | facility for more than 12 hours Shall be given a physical |
| 735 | examination and psychiatric evaluation by a health practitioners |
| 736 | practitioner authorized by law to give such examinations, within |
| 737 | 24 hours after arrival at such facility if they have not been |
| 738 | released or discharged pursuant to s. 394.463(2)(h) or s. |
| 739 | 394.469. The physical examination and psychiatric evaluation |
| 740 | must be documented in the clinical record. |
| 741 | (d) Every patient in a facility Shall be afforded the |
| 742 | opportunity to participate in activities designed to enhance |
| 743 | self-image and the beneficial effects of other treatments, as |
| 744 | determined by the facility. |
| 745 | (e) Not more than 5 days after admission to a facility, |
| 746 | each patient Shall have and receive an individualized treatment |
| 747 | plan in writing, which the individual patient has had an |
| 748 | opportunity to assist in preparing and to review prior to its |
| 749 | implementation, within 5 days after admission to a facility. The |
| 750 | plan must shall include a space for the individual's patient's |
| 751 | comments and signature. |
| 752 | (3) RIGHT TO EXPRESS AND INFORMED PATIENT CONSENT.- |
| 753 | (a)1. Each individual patient entering treatment shall be |
| 754 | asked to give express and informed consent for admission or |
| 755 | treatment. |
| 756 | 1. If the individual patient has been adjudicated |
| 757 | incapacitated or found to be incompetent to consent to |
| 758 | treatment, express and informed consent must to treatment shall |
| 759 | be sought instead from his or her the patient's guardian or |
| 760 | guardian advocate. If the individual patient is a minor, express |
| 761 | and informed consent for admission or treatment must be obtained |
| 762 | shall also be requested from the patient's guardian. Express and |
| 763 | informed consent for admission or treatment of a patient under |
| 764 | 18 years of age shall be required from the minor's patient's |
| 765 | guardian, unless the minor is seeking outpatient crisis |
| 766 | intervention services under s. 394.4784. Express and informed |
| 767 | consent for admission or treatment given by a patient who is |
| 768 | under 18 years of age shall not be a condition of admission when |
| 769 | the patient's guardian gives express and informed consent for |
| 770 | the patient's admission pursuant to s. 394.463 or s. 394.467. |
| 771 | 2. Before giving express and informed consent, the |
| 772 | following information shall be provided and explained in plain |
| 773 | language to the individual patient, or to his or her the |
| 774 | patient's guardian if the individual patient is an adult 18 |
| 775 | years of age or older and has been adjudicated incapacitated, or |
| 776 | to his or her the patient's guardian advocate if the individual |
| 777 | patient has been found to be incompetent to consent to |
| 778 | treatment, or to both the individual patient and the guardian if |
| 779 | the individual patient is a minor: the reason for admission or |
| 780 | treatment; the proposed treatment; the purpose of the treatment |
| 781 | to be provided; the common risks, benefits, and side effects |
| 782 | thereof; the specific dosage range for the medication, when |
| 783 | applicable; alternative treatment modalities; the approximate |
| 784 | length of care; the potential effects of stopping treatment; how |
| 785 | treatment will be monitored; and that any consent given for |
| 786 | treatment may be revoked orally or in writing before or during |
| 787 | the treatment period by the individual receiving the treatment |
| 788 | patient or by a person who is legally authorized to make health |
| 789 | care decisions on the individual's behalf of the patient. |
| 790 | (b) Before performing a medical procedure In the case of |
| 791 | medical procedures requiring the use of a general anesthetic or |
| 792 | electroconvulsive treatment, and prior to performing the |
| 793 | procedure, express and informed consent must shall be obtained |
| 794 | from the individual subject to the procedure patient if the |
| 795 | individual patient is legally competent, from the guardian of a |
| 796 | minor patient, from the guardian of an individual a patient who |
| 797 | has been adjudicated incapacitated, or from the individual's |
| 798 | guardian advocate of the patient if the guardian advocate has |
| 799 | been given express court authority to consent to medical |
| 800 | procedures or electroconvulsive treatment as provided under s. |
| 801 | 394.4598. |
| 802 | (c) If When the department is the legal guardian of a |
| 803 | patient, or is the custodian of an individual a patient whose |
| 804 | physician is unwilling to perform a medical procedure, including |
| 805 | an electroconvulsive treatment, based solely on the individual's |
| 806 | patient's consent and whose guardian or guardian advocate is |
| 807 | unknown or unlocatable, the court shall hold a hearing to |
| 808 | determine the medical necessity of the medical procedure. The |
| 809 | individual subject to the procedure must patient shall be |
| 810 | physically present, unless his or her the patient's medical |
| 811 | condition precludes such presence, represented by counsel, and |
| 812 | provided the right and opportunity to be confronted with, and to |
| 813 | cross-examine, all witnesses alleging the medical necessity of |
| 814 | such procedure. In such proceedings, the burden of proof by |
| 815 | clear and convincing evidence is shall be on the party alleging |
| 816 | the medical necessity of the procedure. |
| 817 | (d) The administrator of a receiving or treatment facility |
| 818 | may, upon the recommendation of an individual's the patient's |
| 819 | attending physician, authorize emergency medical treatment, |
| 820 | including a surgical procedure, if such treatment is deemed |
| 821 | lifesaving, or if the situation threatens serious bodily harm to |
| 822 | the individual patient, and the permission of the individual |
| 823 | patient or his or her the patient's guardian or guardian |
| 824 | advocate cannot be obtained. |
| 825 | (4) QUALITY OF TREATMENT.- |
| 826 | (a) Each individual held for examination or admitted for |
| 827 | mental health treatment, or receiving involuntary outpatient |
| 828 | treatment patient shall receive services, including, for a |
| 829 | patient placed under s. 394.4655, shall receive those services |
| 830 | that are included in the court order which are suited to his or |
| 831 | her needs, and which shall be administered skillfully, safely, |
| 832 | and humanely with full respect for the individual's patient's |
| 833 | dignity and personal integrity. Each individual must patient |
| 834 | shall receive such medical, vocational, social, educational, and |
| 835 | rehabilitative services as his or her condition requires in |
| 836 | order to live successfully in the community. In order to achieve |
| 837 | this goal, the department shall is directed to coordinate its |
| 838 | mental health programs with all other programs of the department |
| 839 | and other state agencies. |
| 840 | (b) Facilities shall develop and maintain, in a form |
| 841 | accessible to and readily understandable by individuals held for |
| 842 | examination or admitted for mental health treatment, patients |
| 843 | and consistent with rules adopted by the department, the |
| 844 | following: |
| 845 | 1. Criteria, procedures, and required staff training for |
| 846 | the any use of close or elevated levels of supervision;, of |
| 847 | restraint, seclusion, or isolation;, or of emergency treatment |
| 848 | orders;, and for the use of bodily control and physical |
| 849 | management techniques. |
| 850 | 2. Procedures for documenting, monitoring, and requiring |
| 851 | clinical review of all uses of the procedures described in |
| 852 | subparagraph 1. and for documenting and requiring review of any |
| 853 | incidents resulting in injury to individuals receiving services |
| 854 | patients. |
| 855 | 3. A system for investigating, tracking, managing, and |
| 856 | responding to complaints by individuals persons receiving |
| 857 | services or persons individuals acting on their behalf. |
| 858 | 4. Procedures for reporting events that place individuals |
| 859 | receiving services at risk of harm. Such events must be reported |
| 860 | to the department in accordance with department operating |
| 861 | procedures after discovery and include, but are not limited to: |
| 862 | a. An individual whose life terminates due to a natural, |
| 863 | unnatural, expected, or unexpected cause while in the facility |
| 864 | or within 72 hours after release. |
| 865 | b. An injury sustained, or allegedly sustained, due to an |
| 866 | accident, act of abuse, neglect, or suicide attempt requiring |
| 867 | medical treatment by a licensed health care practitioner in an |
| 868 | acute care medical facility. |
| 869 | c. The unauthorized departure or absence of an individual |
| 870 | from a facility in which he or she has been held for involuntary |
| 871 | examination or involuntary placement. |
| 872 | d. An unusual occurrence or circumstance precipitated by |
| 873 | something uncommon, abnormal, or out of the ordinary, such as a |
| 874 | tornado, kidnapping, riot, or hostage situation that jeopardizes |
| 875 | the health, safety, or welfare of the individual. |
| 876 | e. An allegation of sexual battery upon the individual. |
| 877 | (c) A facility may not use seclusion or restraint for |
| 878 | punishment, to compensate for inadequate staffing, or for the |
| 879 | convenience of staff. Facilities shall ensure that all staff are |
| 880 | made aware of these restrictions on the use of seclusion and |
| 881 | restraint and shall make and maintain records that which |
| 882 | demonstrate that this information has been conveyed to each |
| 883 | individual staff member members. |
| 884 | (5) COMMUNICATION, ABUSE REPORTING, AND VISITS.- |
| 885 | (a) Each individual held for examination or admitted for |
| 886 | mental health treatment person receiving services in a facility |
| 887 | providing mental health services under this part has the right |
| 888 | to communicate freely and privately with persons outside the |
| 889 | facility unless it is determined that such communication is |
| 890 | likely to be harmful to the individual person or others. Each |
| 891 | facility shall make available as soon as reasonably possible to |
| 892 | persons receiving services a telephone that allows for free |
| 893 | local calls and access to a long-distance service available to |
| 894 | the individual as soon as reasonably possible. A facility is not |
| 895 | required to pay the costs of the individual's a patient's long- |
| 896 | distance calls. The telephone must shall be readily accessible |
| 897 | to the patient and shall be placed so that the individual |
| 898 | patient may use it to communicate privately and confidentially. |
| 899 | The facility may establish reasonable rules for the use of this |
| 900 | telephone which, provided that the rules do not interfere with |
| 901 | an individual's a patient's access to a telephone to report |
| 902 | abuse pursuant to paragraph (e). |
| 903 | (b) Each individual patient admitted to a facility under |
| 904 | the provisions of this part shall be allowed to receive, send, |
| 905 | and mail sealed, unopened correspondence; and the individual's |
| 906 | no patient's incoming or outgoing correspondence may not shall |
| 907 | be opened, delayed, held, or censored by the facility unless |
| 908 | there is reason to believe that it contains items or substances |
| 909 | that which may be harmful to the individual patient or others, |
| 910 | in which case the administrator may direct reasonable |
| 911 | examination of such mail and may regulate the disposition of |
| 912 | such items or substances. |
| 913 | (c) Each facility shall allow must permit immediate access |
| 914 | to an individual held for examination or admitted for mental |
| 915 | health treatment any patient, subject to the patient's right to |
| 916 | deny or withdraw consent at any time, by the individual, or by |
| 917 | the individual's patient's family members, guardian, guardian |
| 918 | advocate, representative, Florida statewide or local advocacy |
| 919 | council, or attorney, unless such access would be detrimental to |
| 920 | the individual patient. If the a patient's right to communicate |
| 921 | or to receive visitors is restricted by the facility, written |
| 922 | notice of such restriction and the reasons for the restriction |
| 923 | shall be served on the individual and patient, the individual's |
| 924 | patient's attorney, and the patient's guardian, guardian |
| 925 | advocate, or representative,; and such restriction, and the |
| 926 | reasons for the restriction, must shall be recorded in on the |
| 927 | patient's clinical record with the reasons therefor. The |
| 928 | restriction must of a patient's right to communicate or to |
| 929 | receive visitors shall be reviewed at least every 7 days. The |
| 930 | right to communicate or receive visitors may shall not be |
| 931 | restricted as a means of punishment. Nothing in This paragraph |
| 932 | does not shall be construed to limit the provisions of paragraph |
| 933 | (d). |
| 934 | (d) Each facility shall establish reasonable rules |
| 935 | governing visitors, visiting hours, and the use of telephones by |
| 936 | individuals held for examination or admitted for mental health |
| 937 | treatment patients in the least restrictive possible manner. An |
| 938 | individual has Patients shall have the right to contact and to |
| 939 | receive communication from his or her attorney their attorneys |
| 940 | at any reasonable time. |
| 941 | (e) Each individual held for examination or admitted for |
| 942 | patient receiving mental health treatment in any facility shall |
| 943 | have ready access to a telephone in order to report an alleged |
| 944 | abuse. The facility staff shall orally and in writing inform |
| 945 | each individual patient of the procedure for reporting abuse and |
| 946 | shall make every reasonable effort to present the information in |
| 947 | a language the individual patient understands. A written copy of |
| 948 | that procedure, including the telephone number of the central |
| 949 | abuse hotline and reporting forms, must shall be posted in plain |
| 950 | view. |
| 951 | (f) The department shall adopt rules providing a procedure |
| 952 | for reporting abuse. Facility staff shall be required, as a |
| 953 | condition of employment, must to become familiar with the |
| 954 | requirements and procedures for the reporting of abuse. |
| 955 | (6) CARE AND CUSTODY OF PERSONAL EFFECTS OF PATIENTS.-The |
| 956 | rights of an individual held for examination or admitted for |
| 957 | mental health treatment A patient's right to the possession of |
| 958 | his or her clothing and personal effects shall be respected. The |
| 959 | facility may take temporary custody of such effects if when |
| 960 | required for medical and safety reasons. The A patient's |
| 961 | clothing and personal effects shall be inventoried upon their |
| 962 | removal into temporary custody. Copies of this inventory shall |
| 963 | be given to the individual patient and to his or her the |
| 964 | patient's guardian, guardian advocate, or representative and |
| 965 | shall be recorded in the patient's clinical record. This |
| 966 | inventory may be amended upon the request of the individual |
| 967 | patient or his or her the patient's guardian, guardian advocate, |
| 968 | or representative. The inventory and any amendments to it must |
| 969 | be witnessed by two members of the facility staff and by the |
| 970 | individual patient, if he or she is able. All of the a patient's |
| 971 | clothing and personal effects held by the facility must shall be |
| 972 | returned to the individual patient immediately upon his or her |
| 973 | the discharge or transfer of the patient from the facility, |
| 974 | unless such return would be detrimental to the individual |
| 975 | patient. If personal effects are not returned to the patient, |
| 976 | the reason must be documented in the clinical record along with |
| 977 | the disposition of the clothing and personal effects, which may |
| 978 | be given instead to the individual's patient's guardian, |
| 979 | guardian advocate, or representative. As soon as practicable |
| 980 | after an emergency transfer of a patient, the individual's |
| 981 | patient's clothing and personal effects shall be transferred to |
| 982 | the individual's patient's new location, together with a copy of |
| 983 | the inventory and any amendments, unless an alternate plan is |
| 984 | approved by the individual patient, if he or she is able, and by |
| 985 | his or her the patient's guardian, guardian advocate, or |
| 986 | representative. |
| 987 | (7) VOTING IN PUBLIC ELECTIONS.-An individual held for |
| 988 | examination or admitted for mental health treatment A patient |
| 989 | who is eligible to vote according to the laws of the state has |
| 990 | the right to vote in the primary and general elections. The |
| 991 | department shall establish rules to enable such individuals |
| 992 | patients to obtain voter registration forms, applications for |
| 993 | absentee ballots, and absentee ballots. |
| 994 | (8) HABEAS CORPUS.- |
| 995 | (a) At any time, and without notice, an individual a |
| 996 | person held for examination in a receiving or treatment |
| 997 | facility, or a relative, friend, guardian, guardian advocate, |
| 998 | representative, or attorney, or the department, on behalf of |
| 999 | such individual person, may petition for a writ of habeas corpus |
| 1000 | to question the cause and legality of such detention and request |
| 1001 | that the court order a return to the writ in accordance with |
| 1002 | chapter 79. Each individual patient held in a facility shall |
| 1003 | receive a written notice of the right to petition for a writ of |
| 1004 | habeas corpus. |
| 1005 | (b) At any time, and without notice, an individual |
| 1006 | admitted for mental health treatment a person who is a patient |
| 1007 | in a receiving or treatment facility, or a relative, friend, |
| 1008 | guardian, guardian advocate, representative, or attorney, or the |
| 1009 | department, on behalf of such individual person, may file a |
| 1010 | petition in the circuit court in the county where the individual |
| 1011 | patient is being held alleging that he or she the patient is |
| 1012 | being unjustly denied a right or privilege granted under this |
| 1013 | section herein or that a procedure authorized under this section |
| 1014 | herein is being abused. Upon the filing of such a petition, the |
| 1015 | court may shall have the authority to conduct a judicial inquiry |
| 1016 | and to issue an any order needed to correct an abuse of the |
| 1017 | provisions of this part. |
| 1018 | (c) The administrator of any receiving or treatment |
| 1019 | facility receiving a petition under this subsection shall file |
| 1020 | the petition with the clerk of the court on the next court |
| 1021 | working day. |
| 1022 | (d) A No fee may not shall be charged for the filing of a |
| 1023 | petition under this subsection. |
| 1024 | (9) VIOLATIONS.-The department shall report to the Agency |
| 1025 | for Health Care Administration any violation of the rights or |
| 1026 | privileges of individuals patients, or of any procedures |
| 1027 | provided under this part, by any facility or professional |
| 1028 | licensed or regulated by the agency. The agency may is |
| 1029 | authorized to impose any sanction authorized for violation of |
| 1030 | this part, based solely on the investigation and findings of the |
| 1031 | department. |
| 1032 | (10) LIABILITY FOR VIOLATIONS.-Any person who violates or |
| 1033 | abuses the any rights or privileges of individuals held for |
| 1034 | examination or admitted for mental health treatment patients |
| 1035 | provided under by this part is liable for damages as determined |
| 1036 | by law. Any person who acts reasonably, in good faith, and |
| 1037 | without negligence in compliance with the provisions of this |
| 1038 | part is immune from civil or criminal liability for his or her |
| 1039 | actions in connection with the preparation or execution of |
| 1040 | petitions, applications, certificates, reports, or other |
| 1041 | documents initiating admission to a facility or the |
| 1042 | apprehension, detention, transportation, examination, admission, |
| 1043 | diagnosis, treatment, or discharge of an individual a patient to |
| 1044 | or from a facility. However, this section does not relieve any |
| 1045 | person from liability if such person commits negligence. |
| 1046 | (11) RIGHT TO PARTICIPATE IN TREATMENT AND DISCHARGE |
| 1047 | PLANNING.-An individual held for examination or admitted for |
| 1048 | mental health treatment The patient shall have the opportunity |
| 1049 | to participate in treatment and discharge planning and shall be |
| 1050 | notified in writing of his or her right, upon discharge from the |
| 1051 | facility, to seek treatment from the professional or agency of |
| 1052 | the individual's patient's choice. |
| 1053 | (12) ADVANCE DIRECTIVES.-All receiving and treatment |
| 1054 | facilities and other service providers shall provide information |
| 1055 | concerning advance directives and assist individuals who are |
| 1056 | competent and willing to complete an advance directive. The |
| 1057 | directive may include instructions regarding mental health care. |
| 1058 | Receiving and treatment facilities and service providers must |
| 1059 | honor the advance directive of an individual admitted to or |
| 1060 | served by the facility or provider. |
| 1061 | (13)(12) POSTING OF NOTICE OF RIGHTS OF PATIENTS.-Each |
| 1062 | facility shall post a notice, which lists and describes in |
| 1063 | listing and describing, in the language and terminology that the |
| 1064 | individual persons to whom the notice is addressed can |
| 1065 | understand, of the rights provided under in this section. This |
| 1066 | notice must shall include a statement that provisions of the |
| 1067 | federal Americans with Disabilities Act apply and the name and |
| 1068 | telephone number of a person to contact for further information. |
| 1069 | The This notice must shall be posted in a place readily |
| 1070 | accessible to patients and in a format easily seen by the |
| 1071 | individuals served patients. The This notice must shall include |
| 1072 | the telephone numbers of the Florida local advocacy council and |
| 1073 | Advocacy Center for Persons with Disabilities, Inc. |
| 1074 | Section 9. Subsections (1), (2), (3), and (4) of section |
| 1075 | 394.4593, Florida Statutes, are amended to read: |
| 1076 | 394.4593 Sexual misconduct prohibited; reporting required; |
| 1077 | penalties.- |
| 1078 | (1) As used in this section, the term: |
| 1079 | (a) "Employee" includes any paid staff member, volunteer, |
| 1080 | or intern of the department; any person under contract with the |
| 1081 | department; and any person providing care or support to an |
| 1082 | individual a client on behalf of the department or its service |
| 1083 | providers. |
| 1084 | (b) "Sexual activity" means: |
| 1085 | 1. Fondling the genital area, groin, inner thighs, |
| 1086 | buttocks, or breasts of an individual a person. |
| 1087 | 2. The oral, anal, or vaginal penetration by or union with |
| 1088 | the sexual organ of another or the anal or vaginal penetration |
| 1089 | of another by any other object. |
| 1090 | 3. Intentionally touching in a lewd or lascivious manner |
| 1091 | the breasts, genitals, the genital area, or buttocks, or the |
| 1092 | clothing covering them, of an individual a person, or forcing or |
| 1093 | enticing an individual a person to touch the perpetrator. |
| 1094 | 4. Intentionally masturbating in the presence of another |
| 1095 | person. |
| 1096 | 5. Intentionally exposing the genitals in a lewd or |
| 1097 | lascivious manner in the presence of another individual person. |
| 1098 | 6. Intentionally committing any other sexual act that does |
| 1099 | not involve actual physical or sexual contact with another |
| 1100 | individual the victim, including, but not limited to, |
| 1101 | sadomasochistic abuse, sexual bestiality, or the simulation of |
| 1102 | any act involving sexual activity in the presence of the |
| 1103 | individual a victim. |
| 1104 | (c) "Sexual misconduct" means any sexual activity between |
| 1105 | an employee and an individual held for examination or admitted |
| 1106 | for mental health treatment a patient, regardless of the consent |
| 1107 | of that individual the patient. The term does not include an act |
| 1108 | done for a bona fide medical purpose or an internal search |
| 1109 | conducted in the lawful performance of duty by an employee. |
| 1110 | (2) An employee who engages in sexual misconduct with an |
| 1111 | individual a patient who: |
| 1112 | (a) Is in the custody of the department; or |
| 1113 | (b) Resides in a receiving facility or a treatment |
| 1114 | facility, as those terms are defined in s. 394.455, |
| 1115 |
|
| 1116 | commits a felony of the second degree, punishable as provided in |
| 1117 | s. 775.082, s. 775.083, or s. 775.084. An employee may be found |
| 1118 | guilty of violating this subsection without having committed the |
| 1119 | crime of sexual battery. |
| 1120 | (3) The consent of an individual held for examination or |
| 1121 | admitted for treatment the patient to the sexual activity is not |
| 1122 | a defense to prosecution under this section. |
| 1123 | (4) This section does not apply to an employee who: |
| 1124 | (a) Is legally married to the individual patient; or |
| 1125 | (b) Has no reason to believe that the person with whom the |
| 1126 | employee engaged in sexual misconduct is an individual a patient |
| 1127 | receiving services as described in subsection (2). |
| 1128 | Section 10. Section 394.4595, Florida Statutes, is amended |
| 1129 | to read: |
| 1130 | 394.4595 Florida statewide and local advocacy councils; |
| 1131 | access to patients and records.-Any facility designated by the |
| 1132 | department as a receiving or treatment facility must allow |
| 1133 | access to any individual held for examination or admitted for |
| 1134 | mental health treatment patient and his or her the clinical and |
| 1135 | legal records of any patient admitted pursuant to the provisions |
| 1136 | of this act by members of the Florida statewide and local |
| 1137 | advocacy councils. |
| 1138 | Section 11. Section 394.4597, Florida Statutes, is amended |
| 1139 | to read: |
| 1140 | 394.4597 Persons to be notified; appointment of a |
| 1141 | patient's representative.- |
| 1142 | (1) VOLUNTARY ADMISSION PATIENTS.-At the time an |
| 1143 | individual a patient is voluntarily admitted to a receiving or |
| 1144 | treatment facility, the identity and contact information of the |
| 1145 | a person to be notified in case of an emergency shall be entered |
| 1146 | in the patient's clinical record. |
| 1147 | (2) INVOLUNTARY ADMISSION PATIENTS.- |
| 1148 | (a) At the time an individual a patient is admitted to a |
| 1149 | facility for involuntary examination or placement, or when a |
| 1150 | petition for involuntary placement is filed, the names, |
| 1151 | addresses, and telephone numbers of the individual's patient's |
| 1152 | guardian or guardian advocate, or representative if he or she |
| 1153 | the patient has no guardian or guardian advocate, health care |
| 1154 | surrogate, and the patient's attorney shall be entered in the |
| 1155 | patient's clinical record. |
| 1156 | (a)(b) If the individual patient has no guardian or |
| 1157 | guardian advocate, he or she the patient shall be asked to |
| 1158 | designate a representative. If the individual patient is unable |
| 1159 | or unwilling to designate a representative, the facility shall |
| 1160 | select a representative. |
| 1161 | (b)(c) The individual patient shall be consulted with |
| 1162 | regard to the selection of a representative by the receiving or |
| 1163 | treatment facility and may shall have authority to request that |
| 1164 | the any such representative be replaced. |
| 1165 | (c)(d) If When the receiving or treatment facility selects |
| 1166 | a representative, first preference shall be given to a health |
| 1167 | care surrogate, if one has been previously selected by the |
| 1168 | patient. If the individual patient has not previously selected a |
| 1169 | health care surrogate, the selection, except for good cause |
| 1170 | documented in the patient's clinical record, shall be made from |
| 1171 | the following list in the order of listing: |
| 1172 | 1. The individual's patient's spouse. |
| 1173 | 2. An adult child of the individual patient. |
| 1174 | 3. A parent of the individual patient. |
| 1175 | 4. The adult next of kin of the individual patient. |
| 1176 | 5. An adult friend of the individual patient. |
| 1177 | 6. The appropriate Florida local advocacy council as |
| 1178 | provided in s. 402.166. |
| 1179 | (d)(e) A licensed professional providing services to the |
| 1180 | individual patient under this part, an employee of a facility |
| 1181 | providing direct services to the individual patient under this |
| 1182 | part, a department employee, a person providing other |
| 1183 | substantial services to the individual patient in a professional |
| 1184 | or business capacity, or a creditor of the individual may |
| 1185 | patient shall not be appointed as the patient's representative. |
| 1186 | (e) The representative selected by the individual or |
| 1187 | designated by the facility has the right, authority, and |
| 1188 | responsibility to: |
| 1189 | 1. Receive notice of the individual's admission; |
| 1190 | 2. Receive notice of proceedings affecting the individual; |
| 1191 | 3. Have immediate access to the individual unless such |
| 1192 | access is documented to be detrimental to the individual; |
| 1193 | 4. Receive notice of any restriction of the individual's |
| 1194 | right to communicate or receive visitors; |
| 1195 | 5. Receive a copy of the inventory of personal effects |
| 1196 | upon the individual's admission and to request an amendment to |
| 1197 | the inventory at any time; |
| 1198 | 6. Receive disposition of the individual's clothing and |
| 1199 | personal effects if not returned to the individual, or to |
| 1200 | approve an alternate plan; |
| 1201 | 7. Petition on behalf of the individual for a writ of |
| 1202 | habeas corpus to question the cause and legality of the |
| 1203 | individual's detention or to allege that the individual is being |
| 1204 | unjustly denied a right or privilege granted under this section, |
| 1205 | or that a procedure authorized under this section is being |
| 1206 | abused; |
| 1207 | 8. Apply for a change of venue for the individual's |
| 1208 | involuntary placement hearing for the convenience of the parties |
| 1209 | or witnesses or because of the individual's condition; |
| 1210 | 9. Receive written notice of any restriction of the |
| 1211 | individual's right to inspect his or her clinical record; |
| 1212 | 10. Receive notice of the release of the individual from a |
| 1213 | receiving facility where an involuntary examination was |
| 1214 | performed; |
| 1215 | 11. Receive a copy of any petition for the individual's |
| 1216 | involuntary placement filed with the court; and |
| 1217 | 12. Be informed by the court of the individual's right to |
| 1218 | an independent expert evaluation pursuant to involuntary |
| 1219 | placement procedures. |
| 1220 | Section 12. Section 394.4598, Florida Statutes, is amended |
| 1221 | to read: |
| 1222 | 394.4598 Guardian advocate.- |
| 1223 | (1) The administrator may petition the court for the |
| 1224 | appointment of a guardian advocate based upon the opinion of a |
| 1225 | psychiatrist that an individual held for examination or admitted |
| 1226 | for mental health treatment the patient is incompetent to |
| 1227 | consent to treatment. If the court finds that the individual a |
| 1228 | patient is incompetent to consent to treatment and has not been |
| 1229 | adjudicated incapacitated and a guardian having with the |
| 1230 | authority to consent to mental health treatment has not been |
| 1231 | appointed, it shall appoint a guardian advocate. The individual |
| 1232 | patient has the right to have an attorney represent him or her |
| 1233 | at the hearing. If the individual person is indigent, the court |
| 1234 | shall appoint the office of the public defender to represent him |
| 1235 | or her at the hearing. The individual patient has the right to |
| 1236 | testify, cross-examine witnesses, and present witnesses. The |
| 1237 | proceeding must shall be recorded either electronically or |
| 1238 | stenographically, and testimony shall be provided under oath. |
| 1239 | One of the professionals authorized to give an opinion in |
| 1240 | support of a petition for involuntary placement, as described in |
| 1241 | s. 394.4655 or s. 394.467, must testify. The A guardian advocate |
| 1242 | must meet the qualifications of a guardian pursuant to contained |
| 1243 | in part IV of chapter 744., except that A professional providing |
| 1244 | services to the individual under referred to in this part, an |
| 1245 | employee of the facility providing direct services to the |
| 1246 | individual patient under this part, a departmental employee, a |
| 1247 | facility administrator, or a member of the Florida local |
| 1248 | advocacy council may shall not be appointed. A person who is |
| 1249 | appointed as a guardian advocate must agree to the appointment. |
| 1250 | (2) A facility requesting appointment of a guardian |
| 1251 | advocate must, prior to the appointment, provide the prospective |
| 1252 | guardian advocate with information concerning about the duties |
| 1253 | and responsibilities of guardian advocates, including the |
| 1254 | information about the ethics of medical decisionmaking. Before |
| 1255 | asking a guardian advocate to give consent to treatment for an |
| 1256 | individual held for examination or admitted for mental health |
| 1257 | treatment a patient, the facility must shall provide to the |
| 1258 | guardian advocate sufficient information so that the guardian |
| 1259 | advocate can decide whether to give express and informed consent |
| 1260 | to the treatment, including information that the treatment is |
| 1261 | essential to the care of the individual patient, and that the |
| 1262 | treatment does not present an unreasonable risk of serious, |
| 1263 | hazardous, or irreversible side effects. Before giving consent |
| 1264 | to treatment, the guardian advocate must meet and talk with the |
| 1265 | individual patient and the individual's patient's physician |
| 1266 | face-to-face in person, if at all possible, and by telephone, if |
| 1267 | not. The guardian advocate shall make every effort to make the |
| 1268 | mental health care decision that he or she believes the |
| 1269 | individual would have made under the circumstances if the |
| 1270 | individual were capable of making such decision. The decision of |
| 1271 | the guardian advocate may be reviewed by the court, upon |
| 1272 | petition of the individual's patient's attorney or, the |
| 1273 | patient's family, or the facility administrator. |
| 1274 | (3) Before Prior to a guardian advocate may exercise |
| 1275 | exercising his or her authority, the guardian advocate must |
| 1276 | complete shall attend a training course approved by the court. |
| 1277 | The This training course, of not less than 4 hours, must |
| 1278 | include, at minimum, information concerning individual about the |
| 1279 | patient rights, psychotropic medications, diagnosis of mental |
| 1280 | illness, the ethics of medical decisionmaking, and duties of |
| 1281 | guardian advocates. This training course shall take the place of |
| 1282 | the training required for guardians appointed under pursuant to |
| 1283 | chapter 744. |
| 1284 | (4) The information provided to be supplied to prospective |
| 1285 | guardian advocates before prior to their appointment and the |
| 1286 | training course for guardian advocates must be developed and |
| 1287 | completed through a course developed by the department and |
| 1288 | approved by the chief judge of the circuit court and taught by a |
| 1289 | court-approved organization. Court-approved organizations may |
| 1290 | include, but are not limited to, community or junior colleges, |
| 1291 | guardianship organizations, and the local bar association or The |
| 1292 | Florida Bar. The court may, in its discretion, waive some or all |
| 1293 | of the training requirements for guardian advocates or impose |
| 1294 | additional requirements. The court shall make its decision on a |
| 1295 | case-by-case basis and, in making its decision, shall consider |
| 1296 | the experience and education of the guardian advocate, the |
| 1297 | duties assigned to the guardian advocate, and the needs of the |
| 1298 | individual whom the guardian advocate represents patient. |
| 1299 | (5) In selecting a guardian advocate, the court shall give |
| 1300 | preference to a health care surrogate, if one has already been |
| 1301 | designated by the individual held for examination or admitted |
| 1302 | for mental health treatment patient. If the individual patient |
| 1303 | has not previously selected a health care surrogate, except for |
| 1304 | good cause documented in the court record, the selection shall |
| 1305 | be made from the following list in the order of listing: |
| 1306 | (a) The individual's patient's spouse. |
| 1307 | (b) An adult child of the individual patient. |
| 1308 | (c) A parent of the individual patient. |
| 1309 | (d) The adult next of kin of the individual patient. |
| 1310 | (e) An adult friend of the individual patient. |
| 1311 | (f) An adult trained and willing to serve as guardian |
| 1312 | advocate for the individual patient. |
| 1313 | (6) If a guardian having with the authority to consent to |
| 1314 | medical treatment has not already been appointed, or if the |
| 1315 | individual held for examination or admitted for mental health |
| 1316 | treatment patient has not already designated a health care |
| 1317 | surrogate, the court may authorize the guardian advocate to |
| 1318 | consent to medical treatment, as well as mental health |
| 1319 | treatment. Unless otherwise limited by the court, a guardian |
| 1320 | advocate that has with authority to consent to medical treatment |
| 1321 | shall have the same authority to make health care decisions and |
| 1322 | be subject to the same restrictions as a proxy appointed under |
| 1323 | part IV of chapter 765. Unless the guardian advocate has sought |
| 1324 | and received express court approval in proceeding separate from |
| 1325 | the proceeding to determine the competence of the patient to |
| 1326 | consent to medical treatment, the guardian advocate may not |
| 1327 | consent to: |
| 1328 | (a) Abortion. |
| 1329 | (b) Sterilization. |
| 1330 | (c) Electroconvulsive treatment. |
| 1331 | (d) Psychosurgery. |
| 1332 | (e) Experimental treatments that have not been approved by |
| 1333 | a federally approved institutional review board in accordance |
| 1334 | with 45 C.F.R. part 46 or 21 C.F.R. part 56. |
| 1335 |
|
| 1336 | The court shall must base its decision on evidence that the |
| 1337 | treatment or procedure is essential to the care of the |
| 1338 | individual patient and that the treatment does not present an |
| 1339 | unreasonable risk of serious, hazardous, or irreversible side |
| 1340 | effects. The court shall follow the procedures set forth in |
| 1341 | subsection (1) of this section. |
| 1342 | (7) The guardian advocate shall be discharged when the |
| 1343 | individual whom he or she represents patient is discharged from |
| 1344 | an order for involuntary outpatient placement or involuntary |
| 1345 | inpatient placement or when the individual patient |
| 1346 | transferred from involuntary to voluntary status. The court or a |
| 1347 | hearing officer shall consider the competence of the individual |
| 1348 | patient pursuant to subsection (1) and may consider an |
| 1349 | involuntarily placed individual's patient's competence to |
| 1350 | consent to treatment at any hearing. Upon sufficient evidence, |
| 1351 | the court may restore, or the magistrate hearing officer may |
| 1352 | recommend that the court restore, the individual's patient's |
| 1353 | competence. A copy of the order restoring competence or the |
| 1354 | certificate of discharge containing the restoration of |
| 1355 | competence shall be provided to the individual patient and the |
| 1356 | guardian advocate. |
| 1357 | Section 13. Section 394.4599, Florida Statutes, is amended |
| 1358 | to read: |
| 1359 | 394.4599 Notice.- |
| 1360 | (1) VOLUNTARY ADMISSION PATIENTS.-Notice of an |
| 1361 | individual's a voluntary patient's admission shall only be given |
| 1362 | only at the individual's request of the patient, except that in |
| 1363 | an emergency, notice shall be given as determined by the |
| 1364 | facility. |
| 1365 | (2) INVOLUNTARY ADMISSION PATIENTS.- |
| 1366 | (a) If notice of involuntary admission Whenever notice is |
| 1367 | required to be given under this part, such notice shall be given |
| 1368 | to the individual admitted patient and his or her the patient's |
| 1369 | guardian, guardian advocate, attorney, and representative. |
| 1370 | 1. If When notice is required to be given to an individual |
| 1371 | a patient, it shall be given both orally and in writing, in the |
| 1372 | language and terminology that the individual patient can |
| 1373 | understand, and, if needed, the facility shall provide an |
| 1374 | interpreter for the individual patient. |
| 1375 | 2. Notice to an individual's a patient's guardian, |
| 1376 | guardian advocate, health care surrogate or proxy, attorney, and |
| 1377 | representative shall be given by United States mail and by |
| 1378 | registered or certified mail with the receipts attached to the |
| 1379 | patient's clinical record. Hand delivery by a facility employee |
| 1380 | may be used as an alternative, with delivery documented in the |
| 1381 | clinical record. If notice is given by a state attorney or an |
| 1382 | attorney for the department, a certificate of service is shall |
| 1383 | be sufficient to document service. |
| 1384 | (b) A receiving facility shall give prompt notice of the |
| 1385 | whereabouts of an individual a patient who is being |
| 1386 | involuntarily held for examination to the individual's guardian |
| 1387 | or representative, by telephone or in person within 24 hours |
| 1388 | after the individual's patient's arrival at the facility, unless |
| 1389 | the patient requests that no notification be made. Contact |
| 1390 | attempts must shall be documented in the individual's patient's |
| 1391 | clinical record and shall begin as soon as reasonably possible |
| 1392 | after the individual's patient's arrival. Notice that an |
| 1393 | individual is being involuntarily held must a patient is being |
| 1394 | admitted as an involuntary patient shall be given to the Florida |
| 1395 | local advocacy council by no later than the next working day |
| 1396 | after the individual patient is admitted. |
| 1397 | (c) The written notice of the filing of the petition for |
| 1398 | the involuntary placement of an individual being held must |
| 1399 | include contain the following: |
| 1400 | 1. Notice that the petition has been filed with the |
| 1401 | circuit court in the county in which the individual patient is |
| 1402 | hospitalized and the court's address of such court. |
| 1403 | 2. Notice that the office of the public defender has been |
| 1404 | appointed to represent the individual patient in the proceeding, |
| 1405 | if the individual patient is not otherwise represented by |
| 1406 | counsel. |
| 1407 | 3. The date, time, and place of the hearing and the name |
| 1408 | of each examining expert and every other person expected to |
| 1409 | testify in support of continued detention. |
| 1410 | 4. Notice that the individual patient, the individual's |
| 1411 | patient's guardian or representative, or the administrator may |
| 1412 | apply for a change of venue for the convenience of the parties |
| 1413 | or witnesses or because of the individual's condition of the |
| 1414 | patient. |
| 1415 | 5. Notice that the individual patient is entitled to an |
| 1416 | independent expert examination and, if the individual patient |
| 1417 | cannot afford such an examination, that the court will provide |
| 1418 | for one. |
| 1419 | (d) A treatment facility shall provide notice of an |
| 1420 | individual's a patient's involuntary admission on the next |
| 1421 | regular working day after the individual's patient's arrival at |
| 1422 | the facility. |
| 1423 | (e) If an individual When a patient is to be transferred |
| 1424 | from one facility to another, notice shall be given by the |
| 1425 | facility where the individual patient is located before prior to |
| 1426 | the transfer. |
| 1427 | Section 14. Section 394.460, Florida Statutes, is |
| 1428 | repealed. |
| 1429 | Section 15. Section 394.461, Florida Statutes, is amended |
| 1430 | to read: |
| 1431 | 394.461 Designation of receiving and treatment |
| 1432 | facilities.-The department may is authorized to designate and |
| 1433 | monitor receiving facilities and treatment facilities and may |
| 1434 | suspend or withdraw such designation for failure to comply with |
| 1435 | this part and rules adopted under this part. Only governmental |
| 1436 | facilities, and other facilities Unless designated by the |
| 1437 | department, may facilities are not permitted to hold or treat |
| 1438 | individuals on an involuntary basis patients under this part. |
| 1439 | (1) RECEIVING FACILITY.-The department may designate any |
| 1440 | community facility as a receiving facility. Any other facility |
| 1441 | within the state, including a private facility, as a receiving |
| 1442 | facility if or a federal facility, may be so designated by the |
| 1443 | department, provided that such designation is agreed to by the |
| 1444 | governing body or authority of the facility. |
| 1445 | (2) TREATMENT FACILITY.-The department may designate any |
| 1446 | state-owned, state-operated, or state-supported facility as a |
| 1447 | state treatment facility. An individual may A civil patient |
| 1448 | shall not be admitted to a civil state treatment facility |
| 1449 | without previously undergoing a transfer evaluation. Before a |
| 1450 | court hearing for involuntary placement in a state treatment |
| 1451 | facility, the court shall receive and consider the information |
| 1452 | documented in the transfer evaluation. Any other facility, |
| 1453 | including a private facility or a federal facility, may be |
| 1454 | designated as a treatment facility by the department if, |
| 1455 | provided that such designation is agreed to by the appropriate |
| 1456 | governing body or authority of the facility. |
| 1457 | (3) GOVERNMENTAL FACILITIES.-Governmental facilities may |
| 1458 | provide voluntary and involuntary mental health examination and |
| 1459 | treatment for individuals in their care and custody and must |
| 1460 | protect the rights of these individuals, pursuant to this part. |
| 1461 | (4)(3) PRIVATE FACILITIES.-Private facilities designated |
| 1462 | as receiving and treatment facilities by the department may |
| 1463 | provide examination and treatment of individuals on an of |
| 1464 | involuntary or patients, as well as voluntary basis patients, |
| 1465 | and are subject to all the provisions of this part. |
| 1466 | (5)(4) REPORT.- |
| 1467 | (a) A facility designated as a public receiving or |
| 1468 | treatment facility under this section shall annually report to |
| 1469 | the department on an annual basis the following data to the |
| 1470 | department, unless such these data are currently being submitted |
| 1471 | to the Agency for Health Care Administration: |
| 1472 | 1. Number of licensed beds by payor class. |
| 1473 | 2. Number of contract days by payor class. |
| 1474 | 3. Number of persons served admissions by payor class and |
| 1475 | diagnoses. |
| 1476 | 4. Number of bed days by payor class. |
| 1477 | 5. Average length of stay by payor class. |
| 1478 | 6. Total revenues by payor class. |
| 1479 | (b) For the purposes of this subsection, "payor class" |
| 1480 | means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private- |
| 1481 | pay health insurance, private-pay health maintenance |
| 1482 | organization, private preferred provider organization, the |
| 1483 | Department of Children and Family Services, other government |
| 1484 | programs, self-pay individuals patients, and charity care. |
| 1485 | (c) The data required under this subsection shall be |
| 1486 | submitted to the department within no later than 90 days after |
| 1487 | following the end of the facility's fiscal year. A facility |
| 1488 | designated as a public receiving or treatment facility shall |
| 1489 | submit its initial report for the 6-month period ending June 30, |
| 1490 | 2008. |
| 1491 | (d) The department shall issue an annual report based on |
| 1492 | the data collected required pursuant to this subsection, which |
| 1493 | must. The report shall include individual facilities' data by |
| 1494 | facility, as well as statewide totals. The report shall be |
| 1495 | submitted to the Governor, the President of the Senate, and the |
| 1496 | Speaker of the House of Representatives. |
| 1497 | (6)(5) RULES.-The department shall adopt rules relating |
| 1498 | to: |
| 1499 | (a) Procedures and criteria for receiving and evaluating |
| 1500 | facility applications for designation as a receiving or |
| 1501 | treatment facility, which may include an onsite facility |
| 1502 | inspection and evaluation of an applicant's licensing status and |
| 1503 | performance history, as well as consideration of local service |
| 1504 | needs. |
| 1505 | (b) Minimum standards consistent with this part which that |
| 1506 | a facility must meet and maintain in order to be designated as a |
| 1507 | receiving or treatment facility, and procedures for monitoring |
| 1508 | continued adherence to such standards. |
| 1509 | (c) Procedures for receiving complaints against a |
| 1510 | designated facility and for initiating inspections and |
| 1511 | investigations of facilities alleged to have violated the |
| 1512 | provisions of this part or rules adopted under this part. |
| 1513 | (d) Procedures and criteria for the suspension or |
| 1514 | withdrawal of designation as a receiving or treatment facility. |
| 1515 | Section 16. Section 394.4615, Florida Statutes, is amended |
| 1516 | to read: |
| 1517 | 394.4615 Clinical records; confidentiality.- |
| 1518 | (1) A clinical record shall be maintained for each |
| 1519 | individual held for examination or admitted for mental health |
| 1520 | treatment patient. The record must shall include data pertaining |
| 1521 | to admission and such other information as may be required under |
| 1522 | rules of the department. A clinical record is confidential and |
| 1523 | exempt from the provisions of s. 119.07(1). Unless waived by the |
| 1524 | express and informed consent of the individual, by the patient |
| 1525 | or by his or her the patient's guardian, or guardian advocate, |
| 1526 | health care surrogate or proxy, or, if the patient is deceased, |
| 1527 | by his or her the patient's personal representative or the |
| 1528 | family member who stands next in line of intestate succession, |
| 1529 | the confidential status of the clinical record is shall not be |
| 1530 | lost by either authorized or unauthorized disclosure to any |
| 1531 | person, organization, or agency. |
| 1532 | (2) The clinical record of an individual held for |
| 1533 | examination or admitted for mental health treatment shall be |
| 1534 | released if when: |
| 1535 | (a) The individual patient or the individual's patient's |
| 1536 | guardian, guardian advocate, or health care surrogate or proxy |
| 1537 | authorizes the release. The guardian, or guardian advocate, or |
| 1538 | surrogate shall be provided access to the appropriate clinical |
| 1539 | records of the patient. The individual patient or the |
| 1540 | individual's patient's guardian, or guardian advocate, or |
| 1541 | surrogate or proxy may authorize the release of information and |
| 1542 | clinical records to appropriate persons to ensure the continuity |
| 1543 | of the individual's patient's health care or mental health care. |
| 1544 | (b) The individual patient is represented by counsel and |
| 1545 | the records are needed by such the patient's counsel for |
| 1546 | adequate representation. |
| 1547 | (c) A petition for involuntary placement is filed and the |
| 1548 | records are needed by the state attorney to evaluate and confirm |
| 1549 | the allegations set forth in the petition or to prosecute the |
| 1550 | petition. |
| 1551 | (d)(c) The court orders such release. In determining |
| 1552 | whether there is good cause for disclosure, the court shall |
| 1553 | weigh the need for the information to be disclosed against the |
| 1554 | possible harm of disclosure to the individual person to whom |
| 1555 | such information pertains. |
| 1556 | (e)(d) The individual patient is committed to, or is to be |
| 1557 | returned to, the Department of Corrections from the Department |
| 1558 | of Children and Family Services, and the Department of |
| 1559 | Corrections requests such records. The These records shall be |
| 1560 | furnished without charge to the Department of Corrections. |
| 1561 | (3) Information from the clinical record may be released |
| 1562 | if in the following circumstances: |
| 1563 | (a) The individual When a patient has declared an |
| 1564 | intention to harm other persons. If When such declaration has |
| 1565 | been made, the administrator may authorize the release of |
| 1566 | sufficient information to provide adequate warning to the person |
| 1567 | threatened with harm by the patient. |
| 1568 | (b) When The administrator of the facility or secretary of |
| 1569 | the department deems that release to a qualified researcher as |
| 1570 | defined in administrative rule, an aftercare treatment provider, |
| 1571 | or an employee or agent of the department is necessary for |
| 1572 | treatment of the individual patient, maintenance of adequate |
| 1573 | records, compilation of treatment data, aftercare planning, or |
| 1574 | evaluation of programs. |
| 1575 | (c) The information is necessary for the purpose of |
| 1576 | determining whether an individual a person meets the criteria |
| 1577 | for involuntary outpatient placement or for preparing the |
| 1578 | proposed treatment plan pursuant to s. 394.4655, the clinical |
| 1579 | record may be released to the state attorney, the public |
| 1580 | defender or the individual's patient's private legal counsel, |
| 1581 | the court, and to the appropriate mental health professionals, |
| 1582 | including the service provider identified in s. 394.4655(6)(b) |
| 1583 | 394.4655(6)(b)2., in accordance with state and federal law. |
| 1584 | (4) Information from clinical records may be used for |
| 1585 | statistical and research purposes if the information is |
| 1586 | abstracted in such a way as to protect the identity of |
| 1587 | individuals served and meets department policy. |
| 1588 | (5) Information from clinical records may be used by the |
| 1589 | Agency for Health Care Administration, the department, and the |
| 1590 | Florida advocacy councils for the purpose of monitoring facility |
| 1591 | activity and complaints concerning facilities. |
| 1592 | (6) Clinical records relating to a Medicaid recipient |
| 1593 | shall be furnished to the Medicaid Fraud Control Unit in the |
| 1594 | Department of Legal Affairs, upon request. |
| 1595 | (7) Any person, agency, or entity receiving information |
| 1596 | pursuant to this section shall maintain such information as |
| 1597 | confidential and exempt from the provisions of s. 119.07(1). |
| 1598 | (8) Any facility or private mental health practitioner who |
| 1599 | acts in good faith in releasing information pursuant to this |
| 1600 | section is not subject to civil or criminal liability for such |
| 1601 | release. |
| 1602 | (9) Nothing in This section does not is intended to |
| 1603 | prohibit the parent or next of kin of an individual a person who |
| 1604 | is held for examination in or admitted for treated under a |
| 1605 | mental health treatment facility or program from requesting and |
| 1606 | receiving information limited to a summary of that individual's |
| 1607 | person's treatment plan and current physical and mental |
| 1608 | condition. Release of such information must shall be in |
| 1609 | accordance with the code of ethics of the profession involved. |
| 1610 | (10) An adult individual Patients shall have reasonable |
| 1611 | access to his or her their clinical records, unless such access |
| 1612 | is determined by the individual's patient's physician to be |
| 1613 | harmful to the individual patient. If the individual's patient's |
| 1614 | right to inspect his or her clinical record is restricted by the |
| 1615 | facility, written notice of the such restriction must shall be |
| 1616 | given to the individual patient and to his or her the patient's |
| 1617 | guardian, guardian advocate, attorney, and representative. In |
| 1618 | addition, the restriction must shall be recorded in the clinical |
| 1619 | record, together with the reasons for it. The restriction |
| 1620 | expires of a patient's right to inspect his or her clinical |
| 1621 | record shall expire after 7 days but may be renewed, after |
| 1622 | review, for subsequent 7-day periods. |
| 1623 | (11) Any person who fraudulently alters, defaces, or |
| 1624 | falsifies the clinical record of an individual any person |
| 1625 | receiving mental health services in a facility subject to |
| 1626 | part, or causes or procures any of these offenses to be |
| 1627 | committed, commits a misdemeanor of the second degree, |
| 1628 | punishable as provided in s. 775.082 or s. 775.083. |
| 1629 | Section 17. Section 394.462, Florida Statutes, is amended |
| 1630 | to read: |
| 1631 | 394.462 Transportation.- |
| 1632 | (1) TRANSPORTATION TO A RECEIVING FACILITY.- |
| 1633 | (a) Each county shall designate a single law enforcement |
| 1634 | agency within the county, or portions thereof, to take an |
| 1635 | individual a person into custody upon the entry of an ex parte |
| 1636 | order or the execution of a certificate for involuntary |
| 1637 | examination by an authorized professional and to transport that |
| 1638 | individual person to the nearest receiving facility, excluding a |
| 1639 | governmental facility, for examination. A law enforcement |
| 1640 | officer acting in good faith pursuant to this part may not be |
| 1641 | held criminally or civilly liable for false imprisonment. The |
| 1642 | designated law enforcement agency may decline to transport the |
| 1643 | individual person to a receiving facility only if: |
| 1644 | 1. The county or jurisdiction designated by the county has |
| 1645 | contracted on an annual basis with an emergency medical |
| 1646 | transport service or private transport company for |
| 1647 | transportation of individuals persons to receiving facilities |
| 1648 | pursuant to this section at the sole cost of the county; and |
| 1649 | 2. The law enforcement agency and the emergency medical |
| 1650 | transport service or private transport company agree that the |
| 1651 | continued presence of law enforcement personnel is not necessary |
| 1652 | for the safety of the individual being transported person or |
| 1653 | others. |
| 1654 | (b)3. If transportation for involuntary examination is |
| 1655 | provided by an emergency medical transport service or private |
| 1656 | transport company, the county or law enforcement agency The |
| 1657 | jurisdiction designated by the county may seek reimbursement for |
| 1658 | transportation expenses. The individual being transported is |
| 1659 | party responsible for payment for such transportation is the |
| 1660 | person receiving the transportation. The county shall seek |
| 1661 | reimbursement from the following sources in the following order: |
| 1662 | 1.a. From an insurance company, health care corporation, |
| 1663 | or other source, if the individual being transported person |
| 1664 | receiving the transportation is covered by an insurance policy |
| 1665 | or subscribes to a health care corporation or other source for |
| 1666 | payment of such expenses. |
| 1667 | 2.b. From the individual being transported person |
| 1668 | receiving the transportation. |
| 1669 | 3.c. From a financial settlement for medical care, |
| 1670 | treatment, hospitalization, or transportation payable or |
| 1671 | accruing to the injured party. |
| 1672 | (c)(b) Any company that transports an individual a patient |
| 1673 | pursuant to this subsection is considered an independent |
| 1674 | contractor and is solely liable for the safe and dignified |
| 1675 | transportation of the individual patient. Such company must be |
| 1676 | insured and maintain at least provide no less than $100,000 in |
| 1677 | liability insurance with respect to such the transportation of |
| 1678 | patients. |
| 1679 | (d)(c) Any company that contracts with a governing board |
| 1680 | of a county to transport individuals for examination or |
| 1681 | treatment must patients shall comply with the applicable rules |
| 1682 | of the department to ensure their the safety and dignity of the |
| 1683 | patients. |
| 1684 | (e)(d) If When a law enforcement officer takes custody of |
| 1685 | an individual a person pursuant to this part, the officer may |
| 1686 | request assistance from emergency medical personnel if such |
| 1687 | assistance is needed for the safety of the officer or the |
| 1688 | individual person in custody. |
| 1689 | (f)(e) If When a member of a mental health overlay program |
| 1690 | or a mobile crisis response service who is a professional |
| 1691 | authorized to initiate an involuntary examination pursuant to s. |
| 1692 | 394.463 and that professional evaluates an individual a person |
| 1693 | and determines that transportation to a receiving facility is |
| 1694 | needed, the service, at its discretion, may transport the |
| 1695 | individual person to the facility or may call on the law |
| 1696 | enforcement agency or other transportation arrangement best |
| 1697 | suited to the needs of the individual being transported patient. |
| 1698 | (g)(f) If a When any law enforcement officer has custody |
| 1699 | of an individual a person based on either noncriminal or minor |
| 1700 | criminal behavior that meets the statutory guidelines for |
| 1701 | involuntary examination under this part, the law enforcement |
| 1702 | officer shall transport the individual person to the nearest |
| 1703 | receiving facility for examination. |
| 1704 | (h)(g) If a When any law enforcement officer has arrested |
| 1705 | an adult individual a person for a felony and it appears that |
| 1706 | the individual person meets the statutory guidelines for |
| 1707 | involuntary examination or placement under this part, the |
| 1708 | individual such person shall first be processed in the same |
| 1709 | manner as any other criminal suspect. The law enforcement agency |
| 1710 | shall thereafter immediately notify the nearest public receiving |
| 1711 | facility, which shall be responsible for promptly arranging for |
| 1712 | the examination and treatment of the individual person. A |
| 1713 | receiving facility is not required to admit an individual a |
| 1714 | person charged with a crime for whom the facility determines and |
| 1715 | documents that it is unable to provide adequate security, but |
| 1716 | shall provide mental health examination and treatment to the |
| 1717 | individual person where he or she is held. |
| 1718 | (i)(h) If the appropriate law enforcement officer believes |
| 1719 | that an individual a person has an emergency medical condition |
| 1720 | as defined in s. 395.002, the individual person may be first |
| 1721 | transported to a hospital for emergency medical treatment, |
| 1722 | regardless of whether the hospital is a designated receiving |
| 1723 | facility. |
| 1724 | (j)(i) The costs of transportation, evaluation, |
| 1725 | hospitalization, and treatment incurred under this subsection by |
| 1726 | individuals persons who have been arrested for violations of any |
| 1727 | state law or county or municipal ordinance may be recovered as |
| 1728 | provided in s. 901.35. |
| 1729 | (k)(j) The nearest receiving facility must accept |
| 1730 | individuals persons brought by law enforcement officers for |
| 1731 | involuntary examination. |
| 1732 | (l)(k) Each law enforcement agency shall develop a |
| 1733 | memorandum of understanding with each receiving facility within |
| 1734 | the law enforcement agency's jurisdiction which reflects a |
| 1735 | single set of protocols for the safe and secure transportation |
| 1736 | of the person and transfer of custody of the person. These |
| 1737 | protocols must also address crisis intervention measures. |
| 1738 | (m)(l) If When a jurisdiction has entered into a contract |
| 1739 | with an emergency medical transport service or a private |
| 1740 | transport company for transportation of individuals persons to |
| 1741 | receiving facilities, such service or company shall be given |
| 1742 | preference for transportation of individuals persons from |
| 1743 | nursing homes, assisted living facilities, adult day care |
| 1744 | centers, or adult family-care homes, unless the behavior of the |
| 1745 | individual person being transported is such that transportation |
| 1746 | by a law enforcement officer is necessary. |
| 1747 | (n)(m) Nothing in This section does not shall be construed |
| 1748 | to limit emergency examination and treatment of incapacitated |
| 1749 | individuals persons provided in accordance with the provisions |
| 1750 | of s. 401.445. |
| 1751 | (2) TRANSPORTATION TO A TREATMENT FACILITY.- |
| 1752 | (a) If neither the individual held for examination or |
| 1753 | admitted for mental health treatment or patient nor any person |
| 1754 | legally obligated or responsible for the individual patient is |
| 1755 | not able to pay for the expense of transporting an individual a |
| 1756 | voluntary or involuntary patient to a treatment facility, the |
| 1757 | governing board of the county in which the individual patient is |
| 1758 | hospitalized shall arrange for the such required transportation |
| 1759 | and shall ensure the safe and dignified transportation of the |
| 1760 | individual patient. The governing board of each county may is |
| 1761 | authorized to contract with private transport companies for such |
| 1762 | the transportation of such patients to and from a treatment |
| 1763 | facility. |
| 1764 | (b) Any company that transports an individual a patient |
| 1765 | pursuant to this subsection is considered an |
| 1766 | contractor and is solely liable for the safe and |
| 1767 | transportation of the individual patient. Such company |
| 1768 | insured and provide at least no less than $100,000 in liability |
| 1769 | insurance for such with respect to the transportation of |
| 1770 | patients. |
| 1771 | (c) Any company that contracts with the governing board of |
| 1772 | a county to transport individuals must patients shall comply |
| 1773 | with the applicable rules of the department to ensure the safety |
| 1774 | and dignity of the individuals transported patients. |
| 1775 | (d) County or municipal law enforcement and correctional |
| 1776 | personnel and equipment may shall not be used to transport |
| 1777 | individuals patients adjudicated incapacitated or found by the |
| 1778 | court to meet the criteria for involuntary placement under |
| 1779 | pursuant to s. 394.467, except in small rural counties where |
| 1780 | there are no cost-efficient alternatives. |
| 1781 | (3) TRANSFER OF CUSTODY.-Custody of a person who is |
| 1782 | transported pursuant to this part, along with related |
| 1783 | documentation, shall be relinquished to a responsible individual |
| 1784 | at the appropriate receiving or treatment facility. |
| 1785 | (4) EXCEPTIONS.- |
| 1786 | (a) An exception to the requirements of this section may |
| 1787 | be granted by the secretary of the department for the purposes |
| 1788 | of improving service coordination or better meeting the special |
| 1789 | needs of individuals. A proposal for an exception shall must be |
| 1790 | submitted to the secretary by the circuit district administrator |
| 1791 | after being approved by the governing board of each affected |
| 1792 | county boards of any affected counties, prior to submission to |
| 1793 | the secretary. |
| 1794 | 1.(a) A proposal for an exception must identify the |
| 1795 | specific provision from which an exception is requested,; |
| 1796 | describe how the proposal will be implemented by participating |
| 1797 | law enforcement agencies and transportation authorities,; and |
| 1798 | provide a plan for the coordination of services such as case |
| 1799 | management. |
| 1800 | 2.(b) An The exception may be granted only for: |
| 1801 | a.1. An arrangement centralizing and improving the |
| 1802 | provision of services within a circuit district, which may |
| 1803 | include an exception to the requirement for transportation to |
| 1804 | the nearest receiving facility; |
| 1805 | b.2. An arrangement whereby by which a facility may |
| 1806 | provide, in addition to required psychiatric services, an |
| 1807 | environment and services that which are uniquely tailored to the |
| 1808 | needs of an identified group of individuals who have persons |
| 1809 | with special needs, such as persons who have with hearing |
| 1810 | impairments or visual impairments, or elderly persons who have |
| 1811 | with physical frailties; or |
| 1812 | c.3. A specialized transportation system that provides an |
| 1813 | efficient and humane method of transporting individuals patients |
| 1814 | to receiving facilities, among receiving facilities, and to |
| 1815 | treatment facilities. |
| 1816 | 2.(c) Any exception approved pursuant to this subsection |
| 1817 | must shall be reviewed and approved every 5 years by the |
| 1818 | secretary. |
| 1819 | (b) The Department of Corrections may transport an |
| 1820 | individual who is being released from its custody to a receiving |
| 1821 | or treatment facility for involuntary examination or placement. |
| 1822 | Such transport shall be to a facility, specified by the |
| 1823 | department, which is able to meet the specific needs of the |
| 1824 | individual, or, if such specification cannot be made due to |
| 1825 | exigent circumstances, transport may be to the nearest receiving |
| 1826 | facility. |
| 1827 | Section 18. Section 394.4625, Florida Statutes, is amended |
| 1828 | to read: |
| 1829 | 394.4625 Voluntary admissions.- |
| 1830 | (1) EXAMINATION AND TREATMENT AUTHORITY TO RECEIVE |
| 1831 | PATIENTS.- |
| 1832 | (a) A facility may receive for observation, diagnosis, or |
| 1833 | treatment an adult who makes any person 18 years of age or older |
| 1834 | making application by express and informed consent for admission |
| 1835 | or any minor person age 17 or under for whom such application is |
| 1836 | made by his or her guardian. |
| 1837 | 1. If found to show evidence of mental illness, to be |
| 1838 | competent to provide express and informed consent, and to be |
| 1839 | suitable for treatment, an adult such person 18 years of age or |
| 1840 | older may be admitted to the facility. |
| 1841 | 2. A minor person age 17 or under may be admitted only |
| 1842 | with the minor's assent, which must be obtained in conjunction |
| 1843 | with consent from the minor's guardian. The minor's assent means |
| 1844 | that the minor has affirmatively agreed to stay at the facility |
| 1845 | for examination or mental health treatment. Mere failure to |
| 1846 | object, absent affirmative agreement, is not assent. The minor's |
| 1847 | assent must be verified through a clinical assessment that is |
| 1848 | documented in the clinical record and conducted within 12 hours |
| 1849 | after admission by a licensed professional authorized to |
| 1850 | initiate an involuntary examination pursuant to s. 394.463. In |
| 1851 | verifying the minor's assent, the examining professional must |
| 1852 | first provide the minor with an explanation of why the minor |
| 1853 | will be examined and treated, what the minor can expect while in |
| 1854 | the facility, and when the minor may expect to be released, |
| 1855 | using language that is appropriate to the minor's age, |
| 1856 | experience, maturity, and condition. Unless the minor's assent |
| 1857 | is verified pursuant to this section, a petition for involuntary |
| 1858 | inpatient placement must be filed with the court within 1 |
| 1859 | working day after admission or the minor must be released to his |
| 1860 | or her guardian within 24 hours after admission only after a |
| 1861 | hearing to verify the voluntariness of the consent. |
| 1862 | (b) A mental health overlay program, or a mobile crisis |
| 1863 | response service, or a licensed professional who is authorized |
| 1864 | to initiate an involuntary examination pursuant to s. 394.463 |
| 1865 | and is employed by a community mental health center or clinic |
| 1866 | must, pursuant to circuit district procedure approved by the |
| 1867 | respective circuit district administrator, conduct an initial |
| 1868 | assessment of the ability of the following individuals persons |
| 1869 | to give express and informed consent to treatment before such |
| 1870 | individuals persons may be admitted voluntarily: |
| 1871 | 1. An individual A person 60 years of age or older for |
| 1872 | whom transfer is being sought from a nursing home, assisted |
| 1873 | living facility, adult day care center, or adult family-care |
| 1874 | home, if when such person has been diagnosed as suffering from |
| 1875 | dementia. |
| 1876 | 2. An individual A person 60 years of age or older for |
| 1877 | whom transfer is being sought from a nursing home pursuant to s. |
| 1878 | 400.0255(11) 400.0255(12). |
| 1879 | 3. An individual A person for whom all decisions |
| 1880 | concerning medical treatment are currently being lawfully made |
| 1881 | by a the health care surrogate or proxy designated under chapter |
| 1882 | 765. |
| 1883 | (c) If When an initial assessment of the ability of an |
| 1884 | individual a person to give express and informed consent to |
| 1885 | treatment is required under this section, and a mobile crisis |
| 1886 | response service does not respond to a the request for an |
| 1887 | assessment within 2 hours after the request is made or informs |
| 1888 | the requesting facility that it will not be able to respond |
| 1889 | within 2 hours after the request is made, the requesting |
| 1890 | facility may arrange for assessment by a any licensed |
| 1891 | professional authorized to initiate an involuntary examination |
| 1892 | under pursuant to s. 394.463. The professional may not be who is |
| 1893 | not employed by or under contract with, or and does not have a |
| 1894 | financial interest in, either the facility initiating the |
| 1895 | transfer or the receiving facility to which the transfer may be |
| 1896 | made, and may not have a financial interest in the outcome of |
| 1897 | the assessment. |
| 1898 | (d) A facility may not admit an individual on as a |
| 1899 | voluntary status patient a person who has been adjudicated |
| 1900 | incapacitated, unless the condition of incapacity has been |
| 1901 | judicially removed. If a facility admits an individual on |
| 1902 | voluntary status as a voluntary patient a person who is later |
| 1903 | determined to have been adjudicated incapacitated, and the |
| 1904 | condition of incapacity had not been removed by the time of the |
| 1905 | admission, the facility must either discharge the patient or |
| 1906 | transfer the individual patient to involuntary status. |
| 1907 | (e) The health care surrogate or proxy of an individual on |
| 1908 | a voluntary status patient may not consent to the provision of |
| 1909 | mental health treatment for that individual the patient. An |
| 1910 | individual on voluntary status A voluntary patient who is |
| 1911 | unwilling or unable to provide express and informed consent to |
| 1912 | mental health treatment must either be discharged or transferred |
| 1913 | to involuntary status. |
| 1914 | (f) Within 24 hours after an individual's voluntary |
| 1915 | admission of a voluntary patient, the admitting physician shall |
| 1916 | document in the patient's clinical record that the individual |
| 1917 | patient is able to give express and informed consent for |
| 1918 | admission. If the individual patient is not able to give express |
| 1919 | and informed consent for admission, the facility must shall |
| 1920 | either discharge the patient or transfer the individual patient |
| 1921 | to involuntary status pursuant to subsection (5). |
| 1922 | (2) RELEASE OR DISCHARGE OF VOLUNTARY PATIENTS.- |
| 1923 | (a) A facility shall discharge an individual admitted on a |
| 1924 | voluntary status who patient: |
| 1925 | 1. Who Has sufficiently improved so that retention in the |
| 1926 | facility is no longer desirable. The individual A patient may |
| 1927 | also be discharged to the care of a community facility. |
| 1928 | 2. Who Has revoked revokes consent to admission or |
| 1929 | requests discharge. The individual A voluntary patient or his or |
| 1930 | her a relative, friend, or attorney of the patient may request |
| 1931 | discharge either orally or in writing at any time following |
| 1932 | admission to the facility. The individual patient must be |
| 1933 | discharged within 24 hours after of the request, unless the |
| 1934 | request is rescinded or the individual patient is transferred to |
| 1935 | involuntary status pursuant to this section. The 24-hour time |
| 1936 | period may be extended by a treatment facility if when necessary |
| 1937 | for adequate discharge planning, but may shall not exceed 3 days |
| 1938 | exclusive of weekends and holidays. If the individual patient, |
| 1939 | or another on his or her the patient's behalf, makes an oral |
| 1940 | request for discharge to a staff member, such request must shall |
| 1941 | be immediately entered in the patient's clinical record. If the |
| 1942 | request for discharge is made by a person other than the |
| 1943 | individual patient, the discharge may be conditioned upon the |
| 1944 | individual's express and informed consent of the patient. |
| 1945 | (b) An individual on A voluntary status patient who has |
| 1946 | been admitted to a facility and who refuses to consent to or |
| 1947 | revokes consent to treatment must shall be discharged within 24 |
| 1948 | hours after such refusal or revocation, unless transferred to |
| 1949 | involuntary status pursuant to this section or unless the |
| 1950 | refusal or revocation is freely and voluntarily rescinded by the |
| 1951 | individual patient. |
| 1952 | (c) An individual on voluntary status who has been charged |
| 1953 | with a crime shall be returned to the custody of a law |
| 1954 | enforcement officer upon release or discharge from a facility. |
| 1955 | (3) NOTICE OF RIGHT TO DISCHARGE.-At the time of admission |
| 1956 | and at least every 6 months thereafter, an individual on a |
| 1957 | voluntary status patient shall be notified in writing of his or |
| 1958 | her right to apply for a discharge. |
| 1959 | (4) TRANSFER TO VOLUNTARY STATUS.-An individual on |
| 1960 | involuntary status patient who has been certified by a physician |
| 1961 | or psychologist as competent to provide express and informed |
| 1962 | consent and who applies to be transferred to voluntary status |
| 1963 | shall be transferred to voluntary status immediately, unless the |
| 1964 | individual patient has been charged with a crime, or has been |
| 1965 | involuntarily placed for treatment by a court pursuant to s. |
| 1966 | 394.467 and continues to meet the criteria for involuntary |
| 1967 | placement. When transfer to voluntary status occurs, notice |
| 1968 | shall be given as provided in s. 394.4599. |
| 1969 | (5) TRANSFER TO INVOLUNTARY STATUS.-If an individual on |
| 1970 | When a voluntary status patient, or an authorized person on the |
| 1971 | individual's the patient's behalf, makes a request for |
| 1972 | discharge, the request for discharge, unless freely and |
| 1973 | voluntarily rescinded, must be communicated to a physician, |
| 1974 | clinical psychologist, or psychiatrist as quickly as possible, |
| 1975 | but within not later than 12 hours after the request is made. If |
| 1976 | the individual patient meets the criteria for involuntary |
| 1977 | placement, the administrator of the facility must file with the |
| 1978 | court a petition for involuntary placement, within 2 court |
| 1979 | working days after the request for discharge is made. If the |
| 1980 | petition is not filed within 2 court working days, the |
| 1981 | individual must patient shall be discharged. Pending the filing |
| 1982 | of the petition, the individual patient may be held and |
| 1983 | emergency treatment rendered in the least restrictive manner, |
| 1984 | upon the written order of a physician, if it is determined that |
| 1985 | such treatment is necessary for the safety of the individual |
| 1986 | patient or others. |
| 1987 | Section 19. Section 394.463, Florida Statutes, is amended |
| 1988 | to read: |
| 1989 | 394.463 Involuntary examination.- |
| 1990 | (1) CRITERIA.-An individual A person may be taken to a |
| 1991 | receiving facility for involuntary examination if there is |
| 1992 | reason to believe that he or she the person has a mental illness |
| 1993 | and because of this his or her mental illness: |
| 1994 | (a)1. The individual person has refused voluntary |
| 1995 | examination after conscientious explanation and disclosure of |
| 1996 | the purpose of the examination; or |
| 1997 | 2. The individual person is unable to determine for |
| 1998 | himself or herself whether examination is necessary; and |
| 1999 | (b)1. Without care or treatment:, the person |
| 2000 | 1. The individual is likely to suffer from neglect or |
| 2001 | refuse to care for himself or herself; such neglect or refusal |
| 2002 | poses a real and present threat of substantial harm to his or |
| 2003 | her well-being; and it is not apparent that such harm may be |
| 2004 | avoided through the help of willing family members or friends or |
| 2005 | the provision of other services; or |
| 2006 | 2. There is a substantial likelihood that without care or |
| 2007 | treatment the individual person will cause serious bodily harm |
| 2008 | to self himself or herself or others in the near future, as |
| 2009 | evidenced by recent behavior. |
| 2010 | (2) INVOLUNTARY EXAMINATION.- |
| 2011 | (a) An involuntary examination may be initiated by any one |
| 2012 | of the following means: |
| 2013 | 1. A court may enter an ex parte order stating that an |
| 2014 | individual a person appears to meet the criteria for involuntary |
| 2015 | examination, giving the findings on which that conclusion is |
| 2016 | based. The ex parte order for involuntary examination must be |
| 2017 | based on sworn testimony, written or oral, which includes |
| 2018 | specific facts that support the finding that the criteria have |
| 2019 | been met. Any behavior relied on for the issuance of the ex |
| 2020 | parte order must have occurred within the preceding 14 days. If |
| 2021 | other less restrictive means are not available, such as |
| 2022 | voluntary appearance for outpatient evaluation, A law |
| 2023 | enforcement officer, or other designated agent of the court, |
| 2024 | shall take the individual person into custody and deliver him or |
| 2025 | her to the nearest receiving facility for involuntary |
| 2026 | examination. The order of the court order must shall be made a |
| 2027 | part of the patient's clinical record. A No fee may not shall be |
| 2028 | charged for the filing of an order under this subsection. Any |
| 2029 | receiving facility accepting the individual patient based on the |
| 2030 | this order must send a copy of the order to the Agency for |
| 2031 | Health Care Administration on the next working day. The order is |
| 2032 | shall be valid only until the individual is delivered to the |
| 2033 | receiving facility until executed or, if not executed, for the |
| 2034 | period specified in the order itself, whichever occurs first. If |
| 2035 | a no time limit is not specified in the order, the order is |
| 2036 | shall be valid for 7 days after the date it that the order was |
| 2037 | signed. |
| 2038 | 2. A law enforcement officer shall take an individual a |
| 2039 | person who appears to meet the criteria for involuntary |
| 2040 | examination into custody and deliver or arrange for the delivery |
| 2041 | of the individual the person or have him or her delivered to the |
| 2042 | nearest receiving facility for examination. The officer shall |
| 2043 | complete execute a written report detailing the circumstances |
| 2044 | under which the individual person was taken into custody., and |
| 2045 | The report must shall be made a part of the patient's clinical |
| 2046 | record. Any receiving facility accepting the individual patient |
| 2047 | based on the this report must send a copy of the report to the |
| 2048 | Agency for Health Care Administration on the next working day. |
| 2049 | 3. A physician, clinical psychologist, psychiatric nurse, |
| 2050 | mental health counselor, marriage and family therapist, or |
| 2051 | clinical social worker, or physician assistant may execute a |
| 2052 | certificate stating that he or she has examined the individual a |
| 2053 | person within the preceding 48 hours and finds that the |
| 2054 | individual person appears to meet the criteria for involuntary |
| 2055 | examination and stating the observations upon which that |
| 2056 | conclusion is based. If other less restrictive means are not |
| 2057 | available, such as voluntary appearance for outpatient |
| 2058 | evaluation, A law enforcement officer shall take the individual |
| 2059 | person named in the certificate into custody and deliver him or |
| 2060 | her to the nearest receiving facility for involuntary |
| 2061 | examination. The law enforcement officer shall complete execute |
| 2062 | a written report detailing the circumstances under which the |
| 2063 | individual person was taken into custody. The report and |
| 2064 | certificate shall be made a part of the patient's clinical |
| 2065 | record. Any receiving facility accepting the individual patient |
| 2066 | based on the this certificate must send a copy of the |
| 2067 | certificate to the Agency for Health Care Administration on the |
| 2068 | next working day. The certificate is valid only until the |
| 2069 | individual is delivered to the receiving facility or until 7 |
| 2070 | calendar days after the certificate was executed, whichever |
| 2071 | occurs first. |
| 2072 | (b) A person who initiates an involuntary examination of a |
| 2073 | minor shall make and document immediate attempts to notify the |
| 2074 | minor's guardian of such examination. A receiving facility |
| 2075 | accepting a minor for involuntary examination must immediately |
| 2076 | notify the minor's guardian upon the minor's arrival. |
| 2077 | (c)(b) An individual may A person shall not be removed |
| 2078 | from a any program or residential placement licensed under |
| 2079 | chapter 400 or chapter 429 and transported to a receiving |
| 2080 | facility for involuntary examination unless an ex parte order, a |
| 2081 | professional certificate, or a law enforcement officer's report |
| 2082 | is first prepared. If the condition of the individual person is |
| 2083 | such that preparation of a law enforcement officer's report is |
| 2084 | not practicable before removal, the report must shall be |
| 2085 | completed as soon as possible after removal, but in any case |
| 2086 | before the individual person is transported to a receiving |
| 2087 | facility. A receiving facility admitting an individual a person |
| 2088 | for involuntary examination who is not accompanied by the |
| 2089 | required ex parte order, professional certificate, or law |
| 2090 | enforcement officer's report must shall notify the Agency for |
| 2091 | Health Care Administration of such admission by certified mail |
| 2092 | by no later than the next working day. The provisions of this |
| 2093 | paragraph do not apply when transportation is provided by the |
| 2094 | patient's family or guardian. |
| 2095 | (d)(c) A law enforcement officer acting in accordance with |
| 2096 | an ex parte order issued pursuant to this subsection may serve |
| 2097 | and execute such order on any day of the week, at any time of |
| 2098 | the day or night. |
| 2099 | (e)(d) A law enforcement officer acting in accordance with |
| 2100 | an ex parte order issued pursuant to this subsection may use |
| 2101 | such reasonable physical force if as is necessary to gain entry |
| 2102 | to the premises, and any dwellings, buildings, or other |
| 2103 | structures located on the premises, and to take custody of the |
| 2104 | individual person who is the subject of the ex parte order. |
| 2105 | (f)(e) The Agency for Health Care Administration shall |
| 2106 | receive and maintain the copies of ex parte orders, involuntary |
| 2107 | outpatient placement orders issued pursuant to s. 394.4655, |
| 2108 | involuntary inpatient placement orders issued pursuant to s. |
| 2109 | 394.467, professional certificates, and law enforcement |
| 2110 | officers' reports. These documents shall be considered part of |
| 2111 | the clinical record, governed by the provisions of s. 394.4615. |
| 2112 | The agency shall prepare annual reports analyzing the data |
| 2113 | obtained from these documents, without information identifying |
| 2114 | individuals held for examination or admitted for mental health |
| 2115 | treatment patients, and shall provide copies of reports to the |
| 2116 | department, the President of the Senate, the Speaker of the |
| 2117 | House of Representatives, and the minority leaders of the Senate |
| 2118 | and the House of Representatives. |
| 2119 | (g)(f) An individual A patient shall be examined by a |
| 2120 | physician or clinical psychologist at a receiving facility |
| 2121 | without unnecessary delay to determine if the criteria for |
| 2122 | involuntary inpatient placement is met. Emergency treatment may |
| 2123 | be provided and may, upon the order of a physician, be given |
| 2124 | emergency treatment if it is determined that such treatment is |
| 2125 | necessary for the safety of the patient or others. The patient |
| 2126 | may not be released by the receiving facility or its contractor |
| 2127 | without the documented approval of a psychiatrist, a clinical |
| 2128 | psychologist, or, if the receiving facility is a hospital, the |
| 2129 | release may also be approved by an attending emergency |
| 2130 | department physician with experience in the diagnosis and |
| 2131 | treatment of mental and nervous disorders and after completion |
| 2132 | of an involuntary examination pursuant to this subsection. |
| 2133 | However, a patient may not be held in a receiving facility for |
| 2134 | involuntary examination longer than 72 hours. |
| 2135 | (h) An individual may not be held for involuntary |
| 2136 | examination for more than 72 hours. Based on the individual's |
| 2137 | needs, one of the following actions must be taken within the 72- |
| 2138 | hour period: |
| 2139 | 1. The individual shall be released after the completion |
| 2140 | of the involuntary examination and with the documented approval |
| 2141 | of a psychiatrist or a clinical psychologist or, if the facility |
| 2142 | is a hospital, the release may be approved by an attending |
| 2143 | emergency department physician; |
| 2144 | 2. The individual shall be asked to give express and |
| 2145 | informed consent for voluntary admission if a physician or |
| 2146 | clinical psychologist has determined that the individual is |
| 2147 | competent to consent to treatment; or |
| 2148 | 3. A petition for involuntary placement shall be completed |
| 2149 | and filed in the circuit court if involuntary outpatient or |
| 2150 | inpatient treatment is deemed necessary. If the 72-hour period |
| 2151 | ends on a weekend or holiday, the petition must be filed by the |
| 2152 | next working day. If inpatient treatment is deemed necessary, |
| 2153 | the least restrictive treatment consistent with the optimum |
| 2154 | improvement of the individual's condition must be made |
| 2155 | available. |
| 2156 | (i) An individual released from a receiving or treatment |
| 2157 | facility on a voluntary or involuntary basis who is charged with |
| 2158 | a crime shall be returned to the custody of a law enforcement |
| 2159 | officer. |
| 2160 | (j)(g) If an individual A person for whom an involuntary |
| 2161 | examination has been initiated who is also being evaluated or |
| 2162 | treated at a hospital for an emergency medical condition |
| 2163 | specified in s. 395.002, must be examined by a receiving |
| 2164 | facility within 72 hours. the 72-hour period begins when the |
| 2165 | individual patient arrives at the hospital and ceases when the |
| 2166 | attending physician documents that the individual patient has an |
| 2167 | emergency medical condition. The 72-hour period resumes when the |
| 2168 | physician documents that the emergency medical condition has |
| 2169 | stabilized or does not exist. If the patient is examined at a |
| 2170 | hospital providing emergency medical services by a professional |
| 2171 | qualified to perform an involuntary examination and is found as |
| 2172 | a result of that examination not to meet the criteria for |
| 2173 | involuntary outpatient placement pursuant to s. 394.4655(1) or |
| 2174 | involuntary inpatient placement pursuant to s. 394.467(1), the |
| 2175 | patient may be offered voluntary placement, if appropriate, or |
| 2176 | released directly from the hospital providing emergency medical |
| 2177 | services. The finding by the professional that the patient has |
| 2178 | been examined and does not meet the criteria for involuntary |
| 2179 | inpatient placement or involuntary outpatient placement must be |
| 2180 | entered into the patient's clinical record. Nothing in this |
| 2181 | paragraph is intended to prevent A hospital providing emergency |
| 2182 | medical services may transfer an individual from appropriately |
| 2183 | transferring a patient to another hospital before prior to |
| 2184 | stabilization if, provided the requirements of s. 395.1041(3)(c) |
| 2185 | are have been met. |
| 2186 | (h) One of the following must occur within 12 hours after |
| 2187 | the patient's attending physician documents that the |
| 2188 | individual's patient's medical condition has stabilized or that |
| 2189 | an emergency medical condition does not exist: |
| 2190 | 1. The individual shall be examined by a physician or |
| 2191 | clinical psychologist and, if found not to meet the criteria for |
| 2192 | involuntary examination pursuant to s. 394.463, shall be |
| 2193 | released directly from the hospital providing the emergency |
| 2194 | medical services. The results of the examination, including the |
| 2195 | final disposition, shall be entered into the clinical record; or |
| 2196 | 2. The individual shall be transferred to a receiving |
| 2197 | facility for examination if appropriate medical and mental |
| 2198 | health treatment is available. However, the receiving facility |
| 2199 | must be notified of the transfer within 2 hours after the |
| 2200 | individual's condition has been stabilized or after |
| 2201 | determination that an emergency medical condition does not |
| 2202 | exist. |
| 2203 | 1. The patient must be examined by a designated receiving |
| 2204 | facility and released; or |
| 2205 | 2. The patient must be transferred to a designated |
| 2206 | receiving facility in which appropriate medical treatment is |
| 2207 | available. However, the receiving facility must be notified of |
| 2208 | the transfer within 2 hours after the patient's condition has |
| 2209 | been stabilized or after determination that an emergency medical |
| 2210 | condition does not exist. |
| 2211 | (i) Within the 72-hour examination period or, if the 72 |
| 2212 | hours ends on a weekend or holiday, no later than the next |
| 2213 | working day thereafter, one of the following actions must be |
| 2214 | taken, based on the individual needs of the patient: |
| 2215 | 1. The patient shall be released, unless he or she is |
| 2216 | charged with a crime, in which case the patient shall be |
| 2217 | returned to the custody of a law enforcement officer; |
| 2218 | 2. The patient shall be released, subject to the |
| 2219 | provisions of subparagraph 1., for voluntary outpatient |
| 2220 | treatment; |
| 2221 | 3. The patient, unless he or she is charged with a crime, |
| 2222 | shall be asked to give express and informed consent to placement |
| 2223 | as a voluntary patient, and, if such consent is given, the |
| 2224 | patient shall be admitted as a voluntary patient; or |
| 2225 | 4. A petition for involuntary placement shall be filed in |
| 2226 | the circuit court when outpatient or inpatient treatment is |
| 2227 | deemed necessary. When inpatient treatment is deemed necessary, |
| 2228 | the least restrictive treatment consistent with the optimum |
| 2229 | improvement of the patient's condition shall be made available. |
| 2230 | When a petition is to be filed for involuntary outpatient |
| 2231 | placement, it shall be filed by one of the petitioners specified |
| 2232 | in s. 394.4655(3)(a). A petition for involuntary inpatient |
| 2233 | placement shall be filed by the facility administrator. |
| 2234 | (3) NOTICE OF RELEASE.-Notice of the release shall be |
| 2235 | given to the individual's patient's guardian or representative, |
| 2236 | to any person who executed a certificate admitting the |
| 2237 | individual patient to the receiving facility, and to any court |
| 2238 | that which ordered the individual's patient's evaluation. |
| 2239 | Section 20. Section 394.4655, Florida Statutes, is amended |
| 2240 | to read: |
| 2241 | 394.4655 Involuntary outpatient placement.- |
| 2242 | (1) CRITERIA FOR INVOLUNTARY OUTPATIENT PLACEMENT.-An |
| 2243 | individual A person may be ordered to involuntary outpatient |
| 2244 | placement upon a finding of the court that by clear and |
| 2245 | convincing evidence that: |
| 2246 | (a) The individual is an adult person is 18 years of age |
| 2247 | or older; |
| 2248 | (b) The individual person has a mental illness; |
| 2249 | (c) The individual person is unlikely to survive safely in |
| 2250 | the community without supervision, based on a clinical |
| 2251 | determination; |
| 2252 | (d) The individual person has a history of lack of |
| 2253 | compliance with treatment for mental illness; |
| 2254 | (e) The individual person has: |
| 2255 | 1. At least twice within the immediately preceding 36 |
| 2256 | months been involuntarily admitted to a receiving or treatment |
| 2257 | facility as defined in s. 394.455, or has received mental health |
| 2258 | services in a forensic or correctional facility. The 36-month |
| 2259 | period does not include any period during which the individual |
| 2260 | person was admitted or incarcerated; or |
| 2261 | 2. Engaged in one or more acts of serious violent behavior |
| 2262 | toward self or others, or attempts at serious bodily harm to |
| 2263 | self himself or herself or others, within the preceding 36 |
| 2264 | months; |
| 2265 | (f) Due to The person is, as a result of his or her mental |
| 2266 | illness, the individual is unlikely to voluntarily participate |
| 2267 | in the recommended treatment plan and either he or she has |
| 2268 | refused voluntary placement for treatment after sufficient and |
| 2269 | conscientious explanation and disclosure of the purpose of |
| 2270 | placement for treatment or he or she is unable to determine for |
| 2271 | himself or herself whether placement is necessary; |
| 2272 | (g) In view of the individual's person's treatment history |
| 2273 | and current behavior, the individual person is in need of |
| 2274 | involuntary outpatient placement in order to prevent a relapse |
| 2275 | or deterioration that would be likely to result in serious |
| 2276 | bodily harm to self himself or herself or others, or a |
| 2277 | substantial harm to his or her well-being as set forth in s. |
| 2278 | 394.463(1); |
| 2279 | (h) It is likely that the individual person will benefit |
| 2280 | from involuntary outpatient placement; and |
| 2281 | (i) All available, less restrictive alternatives that |
| 2282 | would offer an opportunity for improvement of his or her |
| 2283 | condition have been judged to be inappropriate or unavailable. |
| 2284 | (2) INVOLUNTARY OUTPATIENT PLACEMENT.- |
| 2285 | (a)1. An individual A patient who is being recommended for |
| 2286 | involuntary outpatient placement by the administrator of the |
| 2287 | receiving facility where the patient has been examined may be |
| 2288 | retained by the facility after adherence to the notice |
| 2289 | procedures provided in s. 394.4599. |
| 2290 | 1. The recommendation must be supported by the opinion of |
| 2291 | a psychiatrist and the second opinion of a clinical psychologist |
| 2292 | or another psychiatrist, both of whom have personally examined |
| 2293 | the individual patient within the preceding 72 hours, that the |
| 2294 | criteria for involuntary outpatient placement are met. However, |
| 2295 | in a county having a population of fewer than 50,000, if the |
| 2296 | administrator certifies that a psychiatrist or clinical |
| 2297 | psychologist is not available to provide the second opinion, the |
| 2298 | second opinion may be provided by a licensed physician who has |
| 2299 | postgraduate training and experience in diagnosis and treatment |
| 2300 | of mental and nervous disorders or by a psychiatric nurse. Any |
| 2301 | second opinion authorized in this subparagraph may be conducted |
| 2302 | through a face-to-face examination, in person or by electronic |
| 2303 | means. Such recommendation must be entered on an involuntary |
| 2304 | outpatient placement certificate that authorizes the receiving |
| 2305 | facility to retain the patient pending completion of a hearing. |
| 2306 | The certificate shall be made a part of the patient's clinical |
| 2307 | record. |
| 2308 | 2. If the individual patient has been stabilized and no |
| 2309 | longer meets the criteria for involuntary examination pursuant |
| 2310 | to s. 394.463(1), he or she the patient must be released from |
| 2311 | the receiving facility while awaiting the hearing for |
| 2312 | involuntary outpatient placement. |
| 2313 | 3. Before filing a petition for involuntary outpatient |
| 2314 | treatment, the administrator of the a receiving facility or a |
| 2315 | designated department representative must identify the service |
| 2316 | provider that will have primary responsibility for service |
| 2317 | provision under an order for involuntary outpatient placement, |
| 2318 | unless the individual person is otherwise participating in |
| 2319 | outpatient psychiatric treatment and is not in need of public |
| 2320 | financing for that treatment, in which case the individual, if |
| 2321 | eligible, may be ordered to involuntary treatment pursuant to |
| 2322 | the existing psychiatric treatment relationship. |
| 2323 | 4.3. The service provider shall prepare a written |
| 2324 | proposed treatment plan in consultation with the individual |
| 2325 | being held patient or his or her the patient's guardian |
| 2326 | advocate, if appointed, for the court's consideration for |
| 2327 | inclusion in the involuntary outpatient placement order. The |
| 2328 | service provider shall also provide a copy of the proposed |
| 2329 | treatment plan to the individual patient and the administrator |
| 2330 | of the receiving facility. The treatment plan must specify the |
| 2331 | nature and extent of the individual's patient's mental illness, |
| 2332 | address the reduction of symptoms that necessitate involuntary |
| 2333 | outpatient placement, and include measurable goals and |
| 2334 | objectives for the services and treatment that are provided to |
| 2335 | treat the individual's person's mental illness and assist the |
| 2336 | individual person in living and functioning in the community or |
| 2337 | to prevent a relapse or deterioration. Service providers may |
| 2338 | select and supervise other providers individuals to implement |
| 2339 | specific aspects of the treatment plan. The services in the |
| 2340 | treatment plan must be deemed clinically appropriate by a |
| 2341 | physician, clinical psychologist, psychiatric nurse, mental |
| 2342 | health counselor, marriage and family therapist, or clinical |
| 2343 | social worker who consults with, or is employed or contracted |
| 2344 | by, the service provider. The service provider must certify to |
| 2345 | the court in the proposed treatment plan whether sufficient |
| 2346 | services for improvement and stabilization are currently |
| 2347 | available and whether the service provider agrees to provide |
| 2348 | those services. If the service provider certifies that the |
| 2349 | services in the proposed treatment plan are not available, the |
| 2350 | petitioner may not file the petition. |
| 2351 | (b) If an individual a patient in involuntary inpatient |
| 2352 | placement meets the criteria for involuntary outpatient |
| 2353 | placement, the administrator of the treatment facility may, |
| 2354 | before the expiration of the period during which the treatment |
| 2355 | facility is authorized to retain the individual patient, |
| 2356 | recommend involuntary outpatient placement. |
| 2357 | 1. The recommendation must be supported by the opinion of |
| 2358 | a psychiatrist and the second opinion of a clinical psychologist |
| 2359 | or another psychiatrist, both of whom have personally examined |
| 2360 | the individual patient within the preceding 72 hours, that the |
| 2361 | criteria for involuntary outpatient placement are met. However, |
| 2362 | in a county having a population of fewer than 50,000, if the |
| 2363 | administrator certifies that a psychiatrist or clinical |
| 2364 | psychologist is not available to provide the second opinion, the |
| 2365 | second opinion may be provided by a licensed physician who has |
| 2366 | postgraduate training and experience in diagnosis and treatment |
| 2367 | of mental and nervous disorders or by a psychiatric nurse. Any |
| 2368 | second opinion authorized in this subparagraph may be conducted |
| 2369 | through a face-to-face examination, in person or by electronic |
| 2370 | means. Such recommendation must be entered on an involuntary |
| 2371 | outpatient placement certificate, and the certificate must be |
| 2372 | made a part of the patient's clinical record. |
| 2373 | (c)1. The administrator of the treatment facility shall |
| 2374 | provide a copy of the involuntary outpatient placement |
| 2375 | certificate and a copy of the state mental health discharge form |
| 2376 | to a department representative in the county where the |
| 2377 | individual patient will be residing. For persons who are leaving |
| 2378 | a state mental health treatment facility, the petition for |
| 2379 | involuntary outpatient placement must be filed in the county |
| 2380 | where the patient will be residing. |
| 2381 | 2. The service provider that will have primary |
| 2382 | responsibility for service provision shall be identified by the |
| 2383 | designated department representative prior to the order for |
| 2384 | involuntary outpatient placement and shall must, before prior to |
| 2385 | filing a petition for involuntary outpatient placement, certify |
| 2386 | to the court whether the services recommended in the |
| 2387 | individual's patient's discharge plan are available in the local |
| 2388 | community and whether the service provider agrees to provide |
| 2389 | those services. The service provider shall must develop with the |
| 2390 | individual patient, or the individual's patient's guardian |
| 2391 | advocate, if one is appointed, a treatment or service plan that |
| 2392 | addresses the needs identified in the discharge plan. The plan |
| 2393 | must be deemed to be clinically appropriate by a physician, |
| 2394 | clinical psychologist, psychiatric nurse, mental health |
| 2395 | counselor, marriage and family therapist, or clinical social |
| 2396 | worker, as defined in this chapter, who consults with, or is |
| 2397 | employed or contracted by, the service provider. |
| 2398 | 3. If the service provider certifies that the services in |
| 2399 | the proposed treatment or service plan are not available, the |
| 2400 | petitioner may not file the petition. |
| 2401 | (3) PETITION FOR INVOLUNTARY OUTPATIENT PLACEMENT.- |
| 2402 | (a) A petition for involuntary outpatient placement may be |
| 2403 | filed by: |
| 2404 | 1. The administrator of a receiving facility; or |
| 2405 | 2. The administrator of a treatment facility. |
| 2406 | (b) Each required criterion for involuntary outpatient |
| 2407 | placement must be alleged and substantiated in the petition for |
| 2408 | involuntary outpatient placement. A copy of the certificate |
| 2409 | recommending involuntary outpatient placement completed by a |
| 2410 | qualified professional specified in subsection (2) must be |
| 2411 | attached to the petition. A copy of the proposed treatment plan |
| 2412 | must be attached to the petition. Before the petition is filed, |
| 2413 | the service provider shall certify that the services in the |
| 2414 | proposed treatment plan are available. If the necessary services |
| 2415 | are not available in the patient's local community where the |
| 2416 | individual will reside to respond to the person's individual |
| 2417 | needs, the petition may not be filed. |
| 2418 | (c) A The petition for involuntary outpatient placement |
| 2419 | must be filed in the county where the individual who is the |
| 2420 | subject of the petition patient is located, unless the |
| 2421 | individual the patient is being placed from a state treatment |
| 2422 | facility, in which case the petition must be filed in the county |
| 2423 | where the individual patient will reside. When the petition is |
| 2424 | has been filed, the clerk of the court shall provide copies of |
| 2425 | the petition and the proposed treatment plan to the department, |
| 2426 | the individual patient, the individual's patient's guardian or |
| 2427 | representative, the state attorney, and the public defender or |
| 2428 | the patient's private counsel representing the individual. A fee |
| 2429 | may not be charged for filing a petition under this subsection. |
| 2430 | (4) APPOINTMENT OF COUNSEL.-Within 1 court working day |
| 2431 | after the filing of a petition for involuntary outpatient |
| 2432 | placement, the court shall appoint a the public defender to |
| 2433 | represent the individual person who is the subject of the |
| 2434 | petition, unless the individual person is otherwise represented |
| 2435 | by counsel. The clerk of the court shall immediately notify the |
| 2436 | public defender of the appointment. The public defender shall |
| 2437 | represent the individual person until the petition is dismissed, |
| 2438 | the court order expires, or the individual patient is discharged |
| 2439 | from involuntary outpatient placement. An attorney who |
| 2440 | represents the individual patient shall have access to the |
| 2441 | individual patient, witnesses, and records relevant to the |
| 2442 | presentation of the individual's patient's case and shall |
| 2443 | represent the interests of the individual patient, regardless of |
| 2444 | the source of payment to the attorney. |
| 2445 | (5) CONTINUANCE OF HEARING.-The patient is entitled, with |
| 2446 | the concurrence of the patient's counsel, to at least one |
| 2447 | continuance of the hearing. The continuance shall be for a |
| 2448 | period of up to 4 weeks. |
| 2449 | (5)(6) HEARING ON INVOLUNTARY OUTPATIENT PLACEMENT.- |
| 2450 | (a)1. The court shall hold the hearing on involuntary |
| 2451 | outpatient placement within 5 working days after the filing of |
| 2452 | the petition, unless a continuance is granted. The hearing shall |
| 2453 | be held in the county where the petition is filed, shall be as |
| 2454 | convenient to the individual who is the subject of the petition |
| 2455 | patient as is consistent with orderly procedure, and shall be |
| 2456 | conducted in physical settings not likely to be injurious to the |
| 2457 | individual's patient's condition. If the court finds that the |
| 2458 | individual's patient's attendance at the hearing is not |
| 2459 | consistent with the individual's best interests, of the patient |
| 2460 | and if the individual's patient's counsel does not object, the |
| 2461 | court may waive the presence of the individual patient from all |
| 2462 | or any portion of the hearing. The state attorney for the |
| 2463 | circuit in which the individual patient is located shall |
| 2464 | represent the state, rather than the petitioner, as the real |
| 2465 | party in interest in the proceeding. |
| 2466 | (b)2. The court may appoint a magistrate master to preside |
| 2467 | at the hearing. One of the professionals who executed the |
| 2468 | involuntary outpatient placement certificate shall be a witness. |
| 2469 | The individual who is the subject of the petition patient and |
| 2470 | his or her the patient's guardian or representative shall be |
| 2471 | informed by the court of the right to an independent expert |
| 2472 | examination. If the individual patient cannot afford such an |
| 2473 | examination, the court shall provide for one. The independent |
| 2474 | expert's report is shall be confidential and not discoverable, |
| 2475 | unless the expert is to be called as a witness for the |
| 2476 | individual patient at the hearing. The court shall allow |
| 2477 | testimony from persons individuals, including family members, |
| 2478 | deemed by the court to be relevant under state law, regarding |
| 2479 | the individual's person's prior history and how that prior |
| 2480 | history relates to the individual's person's current condition. |
| 2481 | The testimony in the hearing must be given under oath, and the |
| 2482 | proceedings must be recorded. The individual patient may refuse |
| 2483 | to testify at the hearing. |
| 2484 | (c) At the hearing on involuntary outpatient placement, |
| 2485 | the court shall consider testimony and evidence regarding the |
| 2486 | competence of the individual being held to consent to treatment. |
| 2487 | If the court finds that the individual is incompetent to |
| 2488 | consent, it shall appoint a guardian advocate as provided in s. |
| 2489 | 394.4598. |
| 2490 | (d) The individual who is the subject of the petition is |
| 2491 | entitled to at least one continuance of the hearing for up to 4 |
| 2492 | weeks, with the concurrence of the individual's counsel. |
| 2493 | However, the individual's counsel may not request a continuance |
| 2494 | unless the continuance is the individual's expressed desire. |
| 2495 | (6) COURT ORDER.- |
| 2496 | (a)(b)1. If the court concludes that the individual who is |
| 2497 | the subject of the petition patient meets the criteria for |
| 2498 | involuntary outpatient placement under pursuant to subsection |
| 2499 | (1), the court shall issue an order for involuntary outpatient |
| 2500 | placement. The court order may shall be for a period of up to 6 |
| 2501 | months. The order must specify the nature and extent of the |
| 2502 | individual's patient's mental illness. The court order of the |
| 2503 | court and the treatment plan must shall be made part of the |
| 2504 | patient's clinical record. The service provider shall discharge |
| 2505 | an individual a patient from involuntary outpatient placement |
| 2506 | when the order expires or any time the individual patient no |
| 2507 | longer meets the criteria for involuntary placement. Upon |
| 2508 | discharge, the service provider shall send a certificate of |
| 2509 | discharge to the court. |
| 2510 | (b)2. The court may not order the department or the |
| 2511 | service provider to provide services if the program or service |
| 2512 | is not available in the patient's local community of the |
| 2513 | individual being served, if there is no space available in the |
| 2514 | program or service for the individual patient, or if funding is |
| 2515 | not available for the program or service. A copy of the order |
| 2516 | must be sent to the Agency for Health Care Administration by the |
| 2517 | service provider within 1 working day after it is received from |
| 2518 | the court. After the placement order is issued, the service |
| 2519 | provider and the individual patient may modify provisions of the |
| 2520 | treatment plan. For any material modification of the treatment |
| 2521 | plan to which the individual patient or the individual's |
| 2522 | patient's guardian advocate, if appointed, agrees does agree, |
| 2523 | the service provider shall send notice of the modification to |
| 2524 | the court. Any material modifications of the treatment plan |
| 2525 | which are contested by the individual patient or the |
| 2526 | individual's patient's guardian advocate, if appointed, must be |
| 2527 | approved or disapproved by the court consistent with the |
| 2528 | requirements of subsection (2). |
| 2529 | (c)3. If, in the clinical judgment of a physician, the |
| 2530 | individual being served patient has failed or has refused to |
| 2531 | comply with the treatment ordered by the court, and, in the |
| 2532 | clinical judgment of the physician, efforts were made to solicit |
| 2533 | compliance and the individual patient may meet the criteria for |
| 2534 | involuntary examination, the individual a person may be brought |
| 2535 | to a receiving facility pursuant to s. 394.463 for involuntary |
| 2536 | examination. If, after examination, the individual patient does |
| 2537 | not meet the criteria for involuntary inpatient placement under |
| 2538 | pursuant to s. 394.467, the individual patient must be |
| 2539 | discharged from the receiving facility. The involuntary |
| 2540 | outpatient placement order remains shall remain in effect unless |
| 2541 | the service provider determines that the individual patient no |
| 2542 | longer meets the criteria for involuntary outpatient placement |
| 2543 | or until the order expires. The service provider shall must |
| 2544 | determine whether modifications should be made to the existing |
| 2545 | treatment plan and must continue to attempt to continue to |
| 2546 | engage the individual patient in treatment. For any material |
| 2547 | modification of the treatment plan to which the individual |
| 2548 | patient or the individual's patient's guardian advocate, if |
| 2549 | appointed, agrees does agree, the service provider shall send |
| 2550 | notice of the modification to the court. Any material |
| 2551 | modifications of the treatment plan which are contested by the |
| 2552 | individual patient or the individual's patient's guardian |
| 2553 | advocate, if appointed, must be approved or disapproved by the |
| 2554 | court consistent with the requirements of subsection (2). |
| 2555 | (d)(c) If, at any time before the conclusion of the |
| 2556 | initial hearing on involuntary outpatient placement, it appears |
| 2557 | to the court that the individual person does not meet the |
| 2558 | criteria for involuntary outpatient placement under this section |
| 2559 | but, instead, meets the criteria for involuntary inpatient |
| 2560 | placement, the court may order the individual person admitted |
| 2561 | for involuntary inpatient examination under s. 394.463. If the |
| 2562 | individual person instead meets the criteria for involuntary |
| 2563 | assessment, protective custody, or involuntary admission under |
| 2564 | pursuant to s. 397.675, the court may order the individual |
| 2565 | person to be admitted for involuntary assessment for a period of |
| 2566 | 5 days pursuant to s. 397.6811. Thereafter, all proceedings are |
| 2567 | shall be governed by chapter 397. |
| 2568 | (d) At the hearing on involuntary outpatient placement, |
| 2569 | the court shall consider testimony and evidence regarding the |
| 2570 | patient's competence to consent to treatment. If the court finds |
| 2571 | that the patient is incompetent to consent to treatment, it |
| 2572 | shall appoint a guardian advocate as provided in s. 394.4598. |
| 2573 | The guardian advocate shall be appointed or discharged in |
| 2574 | accordance with s. 394.4598. |
| 2575 | (e) The administrator of the receiving facility or the |
| 2576 | designated department representative shall provide a copy of the |
| 2577 | court order and adequate documentation of an individual's a |
| 2578 | patient's mental illness to the service provider for involuntary |
| 2579 | outpatient placement. Such documentation must include any |
| 2580 | advance directives made by the individual patient, a psychiatric |
| 2581 | evaluation of the individual patient, and any evaluations of the |
| 2582 | individual patient performed by a clinical psychologist or a |
| 2583 | clinical social worker. |
| 2584 | (7) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT |
| 2585 | PLACEMENT.- |
| 2586 | (a)1. If an individual the person continues to meet the |
| 2587 | criteria for involuntary outpatient placement, the service |
| 2588 | provider shall, before the expiration of the period during which |
| 2589 | the placement treatment is ordered for the person, file in the |
| 2590 | circuit court a petition for continued involuntary outpatient |
| 2591 | placement. |
| 2592 | 1.2. The existing involuntary outpatient placement order |
| 2593 | remains in effect until disposition of on the petition for |
| 2594 | continued involuntary outpatient placement. |
| 2595 | 2.3. A certificate must shall be attached to the petition |
| 2596 | which includes a statement from the individual's person's |
| 2597 | physician or clinical psychologist justifying the request, a |
| 2598 | brief description of the individual's patient's treatment during |
| 2599 | the time he or she was involuntarily placed, and a personalized |
| 2600 | an individualized plan of continued treatment. |
| 2601 | 3.4. The service provider shall develop the individualized |
| 2602 | plan of continued treatment in consultation with the individual |
| 2603 | patient or his or her the patient's guardian advocate, if |
| 2604 | appointed. When the petition has been filed, the clerk of the |
| 2605 | court shall provide copies of the certificate and the |
| 2606 | individualized plan of continued treatment to the department, |
| 2607 | the individual patient, the individual's patient's guardian |
| 2608 | advocate, the state attorney, and the individual's patient's |
| 2609 | private counsel or the public defender. |
| 2610 | (b) Within 1 court working day after the filing of a |
| 2611 | petition for continued involuntary outpatient placement, the |
| 2612 | court shall appoint the public defender to represent the |
| 2613 | individual person who is the subject of the petition, unless the |
| 2614 | individual person is otherwise represented by counsel. The clerk |
| 2615 | of the court shall immediately notify the public defender of |
| 2616 | such appointment. The public defender shall represent the |
| 2617 | individual person until the petition is dismissed, or the court |
| 2618 | order expires, or the individual patient is discharged from |
| 2619 | involuntary outpatient placement. An Any attorney representing |
| 2620 | the individual must patient shall have access to the individual |
| 2621 | patient, witnesses, and records relevant to the presentation of |
| 2622 | the individual's patient's case and shall represent the |
| 2623 | interests of the individual patient, regardless of the source of |
| 2624 | payment to the attorney. |
| 2625 | (c) The court shall inform the individual who is the |
| 2626 | subject of the petition and his or her guardian, guardian |
| 2627 | advocate, or representative of the individual's right to an |
| 2628 | independent expert examination. If the individual cannot afford |
| 2629 | such an examination, the court shall provide one. |
| 2630 | (d)(c) Hearings on petitions for continued involuntary |
| 2631 | outpatient placement are shall be before the circuit court. The |
| 2632 | court may appoint a magistrate master to preside at the hearing. |
| 2633 | The procedures for obtaining an order pursuant to this paragraph |
| 2634 | must shall be in accordance with subsection (5) (6), except that |
| 2635 | the time period included in paragraph (1)(e) is not applicable |
| 2636 | for in determining the appropriateness of additional periods of |
| 2637 | involuntary outpatient placement. |
| 2638 | (e)(d) Notice of the hearing shall be provided in |
| 2639 | accordance with as set forth in s. 394.4599. The individual |
| 2640 | being served patient and the individual's patient's attorney may |
| 2641 | agree to a period of continued outpatient placement without a |
| 2642 | court hearing. |
| 2643 | (f)(e) The same procedure must shall be repeated before |
| 2644 | the expiration of each additional period the individual being |
| 2645 | served patient is placed in treatment. |
| 2646 | (g)(f) If the individual in involuntary outpatient |
| 2647 | placement patient has previously been found incompetent to |
| 2648 | consent to treatment, the court shall consider testimony and |
| 2649 | evidence regarding the individual's patient's competence. |
| 2650 | Section 394.4598 governs the discharge of the guardian advocate |
| 2651 | if the individual's patient's competency to consent to treatment |
| 2652 | has been restored. |
| 2653 | Section 21. Section 394.467, Florida Statutes, is amended |
| 2654 | to read: |
| 2655 | 394.467 Involuntary inpatient placement.- |
| 2656 | (1) CRITERIA.-An individual A person may be placed in |
| 2657 | involuntary inpatient placement for treatment upon a finding of |
| 2658 | the court by clear and convincing evidence that: |
| 2659 | (a) He or she has a mental illness is mentally ill and |
| 2660 | because of his or her mental illness: |
| 2661 | 1.a. He or she has refused voluntary placement for |
| 2662 | treatment after sufficient and conscientious explanation and |
| 2663 | disclosure of the purpose of placement for treatment; or |
| 2664 | b. He or she is unable to determine for himself or herself |
| 2665 | whether placement is necessary; and |
| 2666 | 2.a. He or she is manifestly incapable of surviving alone |
| 2667 | or with the help of willing and responsible family or friends, |
| 2668 | including available alternative services, and, without |
| 2669 | treatment, is likely to suffer from neglect or refuse to care |
| 2670 | for himself or herself, and such neglect or refusal poses a real |
| 2671 | and present threat of substantial harm to his or her well-being; |
| 2672 | or |
| 2673 | b. There is substantial likelihood that in the near future |
| 2674 | he or she will inflict serious bodily harm on self or others |
| 2675 | himself or herself or another person, as evidenced by recent |
| 2676 | behavior causing, attempting, or threatening such harm; and |
| 2677 | (b) All available less restrictive treatment alternatives |
| 2678 | that which would offer an opportunity for improvement of his or |
| 2679 | her condition have been judged to be inappropriate. |
| 2680 | (2) ADMISSION TO A TREATMENT FACILITY.-An individual A |
| 2681 | patient may be retained by a receiving facility or involuntarily |
| 2682 | placed in a treatment facility upon the recommendation of the |
| 2683 | administrator of the receiving facility where the individual |
| 2684 | patient has been examined and after adherence to the notice and |
| 2685 | hearing procedures provided in s. 394.4599. The recommendation |
| 2686 | must be supported by the opinion of a psychiatrist and the |
| 2687 | second opinion of a clinical psychologist or another |
| 2688 | psychiatrist, both of whom have personally examined the |
| 2689 | individual patient within the preceding 72 hours, that the |
| 2690 | criteria for involuntary inpatient placement are met. However, |
| 2691 | in a county that has a population of fewer than 50,000, if the |
| 2692 | administrator certifies that a psychiatrist or clinical |
| 2693 | psychologist is not available to provide the second opinion, the |
| 2694 | second opinion may be provided by a licensed physician who has |
| 2695 | postgraduate training and experience in diagnosis and treatment |
| 2696 | of mental and nervous disorders or by a psychiatric nurse. Any |
| 2697 | second opinion authorized in this subsection may be conducted |
| 2698 | through a face-to-face examination, in person or by electronic |
| 2699 | means. Such recommendation must shall be entered on an |
| 2700 | involuntary inpatient placement certificate that authorizes the |
| 2701 | receiving facility to retain the individual being held patient |
| 2702 | pending transfer to a treatment facility or completion of a |
| 2703 | hearing. |
| 2704 | (3) PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.- |
| 2705 | (a) The administrator of the facility shall file a |
| 2706 | petition for involuntary inpatient placement in the court in the |
| 2707 | county where the individual patient is located. Upon filing, the |
| 2708 | clerk of the court shall provide copies to the department, the |
| 2709 | individual patient, the individual's patient's guardian or |
| 2710 | representative, and the state attorney and public defender of |
| 2711 | the judicial circuit in which the individual patient is located. |
| 2712 | A No fee may not shall be charged for the filing of a petition |
| 2713 | under this subsection. |
| 2714 | (b) A receiving or treatment facility filing a petition |
| 2715 | for involuntary inpatient placement shall send a copy of the |
| 2716 | petition to the Agency for Health Care Administration by the |
| 2717 | next working day. |
| 2718 | (4) APPOINTMENT OF COUNSEL.- |
| 2719 | (a) Within 1 court working day after the filing of a |
| 2720 | petition for involuntary inpatient placement, the court shall |
| 2721 | appoint the public defender to represent the individual person |
| 2722 | who is the subject of the petition, unless the individual person |
| 2723 | is otherwise represented by counsel. The clerk of the court |
| 2724 | shall immediately notify the public defender of such |
| 2725 | appointment. Any attorney representing the individual patient |
| 2726 | shall have access to the individual patient, witnesses, and |
| 2727 | records relevant to the presentation of the individual's |
| 2728 | patient's case and shall represent the interests of the |
| 2729 | individual patient, regardless of the source of payment to the |
| 2730 | attorney. An attorney representing an individual in involuntary |
| 2731 | placement proceedings shall represent the individual's expressed |
| 2732 | desires and must be present and actively participate in all |
| 2733 | hearings on involuntary placement. |
| 2734 | (b) The state attorney for the circuit in which the |
| 2735 | individual is located shall represent the state rather than the |
| 2736 | petitioning facility administrator as the real party in interest |
| 2737 | in the proceeding. The state attorney shall have access to the |
| 2738 | individual's clinical record and witnesses and shall |
| 2739 | independently evaluate and confirm the allegations set forth in |
| 2740 | the petition for involuntary placement. If the allegations are |
| 2741 | substantiated, the state attorney shall vigorously prosecute the |
| 2742 | petition. If the allegations are not substantiated, the state |
| 2743 | attorney shall withdraw the petition. The state attorney shall |
| 2744 | be present and actively participate in all hearings on |
| 2745 | involuntary placement. |
| 2746 | (5) CONTINUANCE OF HEARING.-The individual patient is |
| 2747 | entitled, with the concurrence of the individual's patient's |
| 2748 | counsel, to at least one continuance of the hearing. Requests |
| 2749 | for a continuance from parties other than the individual or his |
| 2750 | or her counsel may not be granted. The continuance shall be for |
| 2751 | a period of up to 4 weeks. At the time the court is considering |
| 2752 | a motion for continuance, the court shall also conduct a hearing |
| 2753 | to consider the capacity of the individual to consent to |
| 2754 | treatment if there is a pending petition for adjudication of |
| 2755 | incompetence to consent to treatment. If the court finds that |
| 2756 | the individual is not competent to consent to treatment, a |
| 2757 | guardian advocate shall be appointed at the time the involuntary |
| 2758 | placement hearing is continued to make mental health decisions |
| 2759 | for the individual. |
| 2760 | (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.- |
| 2761 | (a)1. The court shall hold the hearing on involuntary |
| 2762 | inpatient placement within 5 working days after the petition is |
| 2763 | filed, unless a continuance is granted. |
| 2764 | 1. Except for good cause documented in the court file, the |
| 2765 | hearing shall be held in the receiving or treatment facility |
| 2766 | county where the individual patient is located. If the hearing |
| 2767 | cannot be held in the receiving or treatment facility, it must |
| 2768 | held in a location and shall be as convenient to the individual |
| 2769 | patient as is may be consistent with orderly procedure and which |
| 2770 | is shall be conducted in physical settings not likely to be |
| 2771 | injurious to the individual's patient's condition. If the |
| 2772 | individual wishes to waive his or her court finds that the |
| 2773 | patient's attendance at the hearing, the court must |
| 2774 | that the waiver is knowing, intelligent, and voluntary before |
| 2775 | waiving is not consistent with the best interests of the |
| 2776 | patient, and the patient's counsel does not object, the court |
| 2777 | may waive the presence of the individual patient from all or any |
| 2778 | portion of the hearing. The state attorney for the circuit in |
| 2779 | which the patient is located shall represent the state, rather |
| 2780 | than the petitioning facility administrator, as the real party |
| 2781 | in interest in the proceeding. |
| 2782 | 2. The court may appoint a general or special magistrate |
| 2783 | to preside at the hearing. One of the two professionals who |
| 2784 | executed the involuntary inpatient placement certificate shall |
| 2785 | be a witness. The individual patient and the individual's |
| 2786 | patient's guardian or representative shall be informed by the |
| 2787 | court of the right to an independent expert examination. If the |
| 2788 | individual patient cannot afford such an examination, the court |
| 2789 | shall provide for one. The independent expert's report is shall |
| 2790 | be confidential and not discoverable, unless the expert is to be |
| 2791 | called as a witness for the individual patient at the hearing. |
| 2792 | The testimony in the hearing must be given under oath, and the |
| 2793 | proceedings must be recorded. The individual patient may refuse |
| 2794 | to testify at the hearing. |
| 2795 | 3. The court shall allow testimony from persons, including |
| 2796 | family members, deemed by the court to be relevant regarding the |
| 2797 | individual's prior history and how that prior history relates to |
| 2798 | the individual's current condition. |
| 2799 | (b) If the court concludes that the individual patient |
| 2800 | meets the criteria for involuntary inpatient placement, it shall |
| 2801 | order that the individual patient be transferred to a treatment |
| 2802 | facility or, if the individual patient is at a treatment |
| 2803 | facility, that the individual patient be retained there or be |
| 2804 | treated at any other appropriate receiving or treatment |
| 2805 | facility, or that the individual patient receive services from a |
| 2806 | receiving or treatment facility, on an involuntary basis, for a |
| 2807 | period of up to 6 months. The order must shall specify the |
| 2808 | nature and extent of the individual's patient's mental illness. |
| 2809 | The facility shall discharge the individual a patient any time |
| 2810 | the individual patient no longer meets the criteria for |
| 2811 | involuntary inpatient placement, unless the individual patient |
| 2812 | has transferred to voluntary status. |
| 2813 | (c) If at any time before prior to the conclusion of the |
| 2814 | hearing on involuntary inpatient placement it appears to the |
| 2815 | court that the individual person does not meet the criteria for |
| 2816 | involuntary inpatient placement under this section, but instead |
| 2817 | meets the criteria for involuntary outpatient placement, the |
| 2818 | court may order the individual person evaluated for involuntary |
| 2819 | outpatient placement pursuant to s. 394.4655. The petition and |
| 2820 | hearing procedures set forth in s. 394.4655 shall apply. If the |
| 2821 | individual person instead meets the criteria for involuntary |
| 2822 | assessment, protective custody, or involuntary admission |
| 2823 | pursuant to s. 397.675, then the court may order the individual |
| 2824 | person to be admitted for involuntary assessment for up to a |
| 2825 | period of 5 days pursuant to s. 397.6811. Thereafter, all |
| 2826 | proceedings are shall be governed by chapter 397. |
| 2827 | (d) At the hearing on involuntary inpatient placement, the |
| 2828 | court shall consider testimony and evidence regarding the |
| 2829 | individual's patient's competence to consent to treatment. If |
| 2830 | the court finds that the individual patient is incompetent to |
| 2831 | consent to treatment, it shall appoint a guardian advocate as |
| 2832 | provided in s. 394.4598. |
| 2833 | (e) The administrator of the receiving facility shall |
| 2834 | provide a copy of the court order and adequate documentation of |
| 2835 | an individual's a patient's mental illness to the administrator |
| 2836 | of a treatment facility if the individual whenever a patient is |
| 2837 | ordered for involuntary inpatient placement, whether by civil or |
| 2838 | criminal court. The documentation must shall include any advance |
| 2839 | directives made by the individual patient, a psychiatric |
| 2840 | evaluation of the individual patient, and any evaluations of the |
| 2841 | individual patient performed by a clinical psychologist, a |
| 2842 | marriage and family therapist, a mental health counselor, or a |
| 2843 | clinical social worker. The administrator of a treatment |
| 2844 | facility may refuse admission to an individual any patient |
| 2845 | directed to its facilities on an involuntary basis, whether by |
| 2846 | civil or criminal court order, who is not accompanied at the |
| 2847 | same time by adequate orders and documentation. |
| 2848 | (7) PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT |
| 2849 | PLACEMENT.- |
| 2850 | (a) Hearings on petitions for continued involuntary |
| 2851 | inpatient placement shall be administrative hearings and shall |
| 2852 | be conducted in accordance with the provisions of s. 120.57(1), |
| 2853 | except that an any order entered by an the administrative law |
| 2854 | judge is shall be final and subject to judicial review in |
| 2855 | accordance with s. 120.68. Orders concerning an individual |
| 2856 | patients committed after successfully pleading not guilty by |
| 2857 | reason of insanity are shall be governed by the provisions of s. |
| 2858 | 916.15. |
| 2859 | (b) If the individual patient continues to meet the |
| 2860 | criteria for involuntary inpatient placement, the administrator |
| 2861 | shall, before prior to the expiration of the period during which |
| 2862 | the treatment facility is authorized to retain the individual |
| 2863 | patient, file a petition requesting authorization for continued |
| 2864 | involuntary inpatient placement. The request must shall be |
| 2865 | accompanied by a statement from the individual's patient's |
| 2866 | physician or clinical psychologist justifying the request, a |
| 2867 | brief description of the individual's patient's treatment during |
| 2868 | the time he or she was involuntarily placed, and a personalized |
| 2869 | an individualized plan of continued treatment. Notice of the |
| 2870 | hearing must shall be provided in accordance with as set forth |
| 2871 | in s. 394.4599. If at the hearing the administrative law judge |
| 2872 | finds that attendance at the hearing is not consistent with the |
| 2873 | individual's best interests of the patient, the administrative |
| 2874 | law judge may waive the presence of the individual patient from |
| 2875 | all or any portion of the hearing, unless the individual |
| 2876 | patient, through counsel, objects to the waiver of presence. The |
| 2877 | testimony in the hearing must be under oath, and the proceedings |
| 2878 | must be recorded. |
| 2879 | (c) Unless the individual patient is otherwise represented |
| 2880 | or is ineligible, he or she shall be represented at the hearing |
| 2881 | on the petition for continued involuntary inpatient placement by |
| 2882 | the public defender of the circuit in which the facility is |
| 2883 | located. |
| 2884 | (d) The Division of Administrative Hearings shall inform |
| 2885 | the individual and his or her guardian, guardian advocate, or |
| 2886 | representative of the right to an independent expert |
| 2887 | examination. If the individual cannot afford such an |
| 2888 | examination, the administrative law judge shall appoint an |
| 2889 | independent expert and the county of the individual's residence |
| 2890 | shall be billed for the cost of the examination. |
| 2891 | (e)(d) If at a hearing it is shown that the individual |
| 2892 | patient continues to meet the criteria for involuntary inpatient |
| 2893 | placement, the administrative law judge shall sign the order for |
| 2894 | continued involuntary inpatient placement for a period of up to |
| 2895 | not to exceed 6 months. The same procedure must shall be |
| 2896 | repeated before prior to the expiration of each additional |
| 2897 | period the individual patient is retained. |
| 2898 | (f)(e) If continued involuntary inpatient placement is |
| 2899 | necessary for an individual a patient admitted while serving a |
| 2900 | criminal sentence, but whose sentence is about to expire, or for |
| 2901 | a minor patient involuntarily placed while a minor but who is |
| 2902 | about to reach the age of 18, the administrator shall petition |
| 2903 | the administrative law judge for an order authorizing continued |
| 2904 | involuntary inpatient placement. |
| 2905 | (g)(f) If the individual patient has been previously found |
| 2906 | incompetent to consent to treatment, the administrative law |
| 2907 | judge shall consider testimony and evidence regarding the |
| 2908 | individual's patient's competence. If the administrative law |
| 2909 | judge finds evidence that the individual patient is now |
| 2910 | competent to consent to treatment, the administrative law judge |
| 2911 | may issue a recommended order to the court that found the |
| 2912 | individual patient incompetent to consent to treatment that the |
| 2913 | individual's patient's competence be restored and that any |
| 2914 | guardian advocate previously appointed be discharged. |
| 2915 | (8) RETURN TO FACILITY OF PATIENTS.-If an individual held |
| 2916 | When a patient at a treatment facility leaves the facility |
| 2917 | without authorization, the administrator may authorize a search |
| 2918 | for, the patient and the return of, the individual patient to |
| 2919 | the facility. The administrator may request the assistance of a |
| 2920 | law enforcement agency in the search for and return of the |
| 2921 | patient. |
| 2922 | Section 22. Section 394.46715, Florida Statutes, is |
| 2923 | amended to read: |
| 2924 | 394.46715 Rulemaking authority.-The department may adopt |
| 2925 | rules to administer of Children and Family Services shall have |
| 2926 | rulemaking authority to implement the provisions of ss. 394.455, |
| 2927 | 394.4598, 394.4615, 394.463, 394.4655, and 394.467 as amended or |
| 2928 | created by this act. These rules are shall be for the purpose of |
| 2929 | protecting the health, safety, and well-being of individuals |
| 2930 | persons examined, treated, or placed under this part act. |
| 2931 | Section 23. Section 394.4672, Florida Statutes, is amended |
| 2932 | to read: |
| 2933 | 394.4672 Procedure for placement of veteran with federal |
| 2934 | agency.- |
| 2935 | (1) If a Whenever it is determined by the court determines |
| 2936 | that an individual a person meets the criteria for involuntary |
| 2937 | placement and he or she it appears that such person is eligible |
| 2938 | for care or treatment by the United States Department of |
| 2939 | Veterans Affairs or other agency of the United States |
| 2940 | Government, the court, upon receipt of a certificate from the |
| 2941 | United States Department of Veterans Affairs or such other |
| 2942 | agency showing that facilities are available and that the |
| 2943 | individual person is eligible for care or treatment therein, may |
| 2944 | place that individual person with the United States Department |
| 2945 | of Veterans Affairs or other federal agency. The individual |
| 2946 | person whose placement is sought shall be personally served with |
| 2947 | notice of the pending placement proceeding in the manner as |
| 2948 | provided in this part., and nothing in This section does not |
| 2949 | shall affect the individual's his or her right to appear and be |
| 2950 | heard in the proceeding. Upon placement, the individual is |
| 2951 | person shall be subject to the rules and regulations of the |
| 2952 | United States Department of Veterans Affairs or other federal |
| 2953 | agency. |
| 2954 | (2) The judgment or order of placement issued by a court |
| 2955 | of competent jurisdiction of another state or of the District of |
| 2956 | Columbia which places an individual, placing a person with the |
| 2957 | United States Department of Veterans Affairs or other federal |
| 2958 | agency for care or treatment has, shall have the same force and |
| 2959 | effect in this state as in the jurisdiction of the court |
| 2960 | entering the judgment or making the order.; and The courts of |
| 2961 | the placing state or of the District of Columbia shall retain be |
| 2962 | deemed to have retained jurisdiction over of the individual |
| 2963 | person so placed. Consent is hereby given to the application of |
| 2964 | the law of the placing state or district with respect to the |
| 2965 | authority of the chief officer of any facility of the United |
| 2966 | States Department of Veterans Affairs or other federal agency |
| 2967 | operated in this state to retain custody or to transfer, parole, |
| 2968 | or discharge the individual person. |
| 2969 | (3) Upon receipt of a certificate of the United States |
| 2970 | Department of Veterans Affairs or another such other federal |
| 2971 | agency that facilities are available for the care or treatment |
| 2972 | individuals who have mental illness of mentally ill persons and |
| 2973 | that the individual person is eligible for that care or |
| 2974 | treatment, the administrator of the receiving or treatment |
| 2975 | facility may cause the transfer of that individual person to the |
| 2976 | United States Department of Veterans Affairs or other federal |
| 2977 | agency. Upon effecting such transfer, the committing court shall |
| 2978 | be notified by the transferring agency. An individual may not No |
| 2979 | person shall be transferred to the United States Department of |
| 2980 | Veterans Affairs or other federal agency if he or she is |
| 2981 | confined pursuant to the conviction of any felony or misdemeanor |
| 2982 | or if he or she has been acquitted of the charge solely on the |
| 2983 | ground of insanity, unless prior to transfer the court placing |
| 2984 | the individual such person enters an order for the transfer |
| 2985 | after appropriate motion and hearing and without objection by |
| 2986 | the United States Department of Veterans Affairs. |
| 2987 | (4) An individual Any person transferred as provided in |
| 2988 | this section shall be deemed to be placed with the United States |
| 2989 | Department of Veterans Affairs or other federal agency pursuant |
| 2990 | to the original placement. |
| 2991 | Section 24. Section 394.4674, Florida Statutes, is |
| 2992 | repealed. |
| 2993 | Section 25. Section 394.4685, Florida Statutes, is amended |
| 2994 | to read: |
| 2995 | 394.4685 Transfer between of patients among facilities.- |
| 2996 | (1) TRANSFER BETWEEN PUBLIC FACILITIES.- |
| 2997 | (a) An individual A patient who has been admitted to a |
| 2998 | public receiving facility, or his or her the family member, |
| 2999 | guardian, or guardian advocate of such patient, may request the |
| 3000 | transfer of the individual patient to another public receiving |
| 3001 | facility. An individual A patient who has been admitted to a |
| 3002 | public treatment facility, or his or her the family member, |
| 3003 | guardian, or guardian advocate of such patient, may request the |
| 3004 | transfer of the individual patient to another public treatment |
| 3005 | facility. Depending on the medical treatment or mental health |
| 3006 | treatment needs of the individual patient and the availability |
| 3007 | of appropriate facility resources, the individual patient may be |
| 3008 | transferred at the discretion of the department. If the |
| 3009 | department approves the transfer of an individual on involuntary |
| 3010 | status patient, notice in accordance with according to the |
| 3011 | provisions of s. 394.4599 must shall be given before prior to |
| 3012 | the transfer by the transferring facility. The department shall |
| 3013 | respond to the request for transfer within 2 working days after |
| 3014 | receipt of the request by the facility administrator. |
| 3015 | (b) If When required by the medical treatment or mental |
| 3016 | health treatment needs of the individual patient or the |
| 3017 | efficient use utilization of a public receiving or public |
| 3018 | treatment facility, an individual a patient may be transferred |
| 3019 | from one receiving facility to another, or one treatment |
| 3020 | facility to another, at the department's discretion, or, with |
| 3021 | the express and informed consent of the individual patient or |
| 3022 | the individual's patient's guardian or guardian advocate, to a |
| 3023 | facility in another state. Notice in accordance with according |
| 3024 | to the provisions of s. 394.4599 must shall be given before |
| 3025 | prior to the transfer by the transferring facility. If prior |
| 3026 | notice is not possible, notice of the transfer must shall be |
| 3027 | provided as soon as practicable after the transfer. |
| 3028 | (2) TRANSFER FROM PUBLIC TO PRIVATE FACILITIES.- |
| 3029 | (a) An individual A patient who has been admitted to a |
| 3030 | public receiving or public treatment facility and has requested, |
| 3031 | either personally or through his or her guardian or guardian |
| 3032 | advocate, and is able to pay for treatment in a private facility |
| 3033 | shall be transferred at the individual's patient's expense to a |
| 3034 | private facility upon acceptance of the individual patient by |
| 3035 | the private facility. |
| 3036 | (b) A public facility may request the transfer of an |
| 3037 | individual from the facility to a private facility, and the |
| 3038 | individual may be transferred upon acceptance of the individual |
| 3039 | by the private facility. |
| 3040 | (3) TRANSFER FROM PRIVATE TO PUBLIC FACILITIES.- |
| 3041 | (a) An individual A patient or his or her the patient's |
| 3042 | guardian or guardian advocate may request the transfer of the |
| 3043 | individual patient from a private to a public facility, and the |
| 3044 | individual patient may be so transferred upon acceptance of the |
| 3045 | individual patient by the public facility. |
| 3046 | (b) A private facility may request the transfer of an |
| 3047 | individual a patient from the facility to a public facility, and |
| 3048 | the individual patient may be so transferred upon acceptance of |
| 3049 | the individual patient by the public facility. The cost of such |
| 3050 | transfer is shall be the responsibility of the transferring |
| 3051 | facility. |
| 3052 | (c) A public facility must respond to a request for the |
| 3053 | transfer of an individual a patient within 2 working days after |
| 3054 | receipt of the request. |
| 3055 | (4) TRANSFER BETWEEN PRIVATE FACILITIES.-An individual |
| 3056 | being held A patient in a private facility or his or her the |
| 3057 | patient's guardian or guardian advocate may request the transfer |
| 3058 | of the individual patient to another private facility at any |
| 3059 | time, and the individual patient shall be transferred upon |
| 3060 | acceptance of the individual patient by the facility to which |
| 3061 | transfer is sought. |
| 3062 | Section 26. Section 394.469, Florida Statutes, is amended |
| 3063 | to read: |
| 3064 | 394.469 Discharge of involuntary placements patients.- |
| 3065 | (1) POWER TO DISCHARGE.-At any time an individual a |
| 3066 | patient is found to no longer meet the criteria for involuntary |
| 3067 | placement, the administrator shall: |
| 3068 | (a) Discharge the individual patient, unless the patient |
| 3069 | is under a criminal charge, in which case the patient shall be |
| 3070 | transferred to the custody of the appropriate law enforcement |
| 3071 | officer; |
| 3072 | (b) Transfer the individual patient to voluntary status on |
| 3073 | his or her own authority or at the individual's patient's |
| 3074 | request, unless the individual patient is under criminal charge |
| 3075 | or adjudicated incapacitated; or |
| 3076 | (c) Return an individual released from a receiving or |
| 3077 | treatment facility on voluntary or involuntary status who is |
| 3078 | charged with a crime to the custody of a law enforcement officer |
| 3079 | Place an improved patient, except a patient under a criminal |
| 3080 | charge, on convalescent status in the care of a community |
| 3081 | facility. |
| 3082 | (2) NOTICE.-Notice of discharge or transfer of an |
| 3083 | individual must be provided in accordance with a patient shall |
| 3084 | be given as provided in s. 394.4599. |
| 3085 | Section 27. Section 394.473, Florida Statutes, is amended |
| 3086 | to read: |
| 3087 | 394.473 Attorney's fee; expert witness fee.- |
| 3088 | (1) In the case of an indigent person for whom An attorney |
| 3089 | is appointed to represent an indigent individual pursuant to the |
| 3090 | provisions of this part, the attorney shall be compensated by |
| 3091 | the state pursuant to s. 27.5304. In the case of an indigent |
| 3092 | person, the court may appoint a public defender. A The public |
| 3093 | defender appointed to represent an indigent person may shall |
| 3094 | receive no additional compensation other than that usually paid |
| 3095 | his or her office. |
| 3096 | (2) An In the case of an indigent person for whom expert |
| 3097 | whose testimony is required for an indigent individual in a |
| 3098 | court hearing pursuant to the provisions of this part act, the |
| 3099 | expert, except one who is classified as a full-time employee of |
| 3100 | the state or who is receiving remuneration from the state for |
| 3101 | his or her time in attendance at the hearing, shall be |
| 3102 | compensated by the state pursuant to s. 27.5304. |
| 3103 | Section 28. Section 394.475, Florida Statutes, is amended |
| 3104 | to read: |
| 3105 | 394.475 Acceptance, examination, and involuntary placement |
| 3106 | of Florida residents from out-of-state mental health |
| 3107 | authorities.- |
| 3108 | (1) Upon the request of the state mental health authority |
| 3109 | of another state, the department may is authorized to accept an |
| 3110 | individual as a patient, for up to a period of not more than 15 |
| 3111 | days, a person who is and has been a bona fide resident of this |
| 3112 | state for at least a period of not less than 1 year. |
| 3113 | (2) An individual Any person received pursuant to |
| 3114 | subsection (1) shall be examined by the staff of the state |
| 3115 | facility where the individual such patient has been admitted |
| 3116 | accepted, which examination shall be completed during the 15-day |
| 3117 | period. |
| 3118 | (3) If, upon examination, the individual such a person |
| 3119 | requires continued involuntary placement, a petition for a |
| 3120 | hearing regarding involuntary placement shall be filed with the |
| 3121 | court of the county where wherein the treatment facility |
| 3122 | receiving the individual patient is located or the county where |
| 3123 | the individual patient is a resident. |
| 3124 | (4) During the pendency of the examination period and the |
| 3125 | pendency of the involuntary placement proceedings, an individual |
| 3126 | such person may continue to be held in the treatment facility |
| 3127 | unless the court having jurisdiction enters an order to the |
| 3128 | contrary. |
| 3129 | Section 29. Section 394.4785, Florida Statutes, is amended |
| 3130 | to read: |
| 3131 | 394.4785 Children and adolescents; admission and placement |
| 3132 | in mental health facilities.- |
| 3133 | (1) A child or adolescent as defined in s. 394.492 may not |
| 3134 | be admitted to a state-owned or state-operated mental health |
| 3135 | treatment facility. A child may be admitted pursuant to s. |
| 3136 | 394.4625 or s. 394.467 to a crisis stabilization unit or a |
| 3137 | residential treatment center licensed under this chapter or a |
| 3138 | hospital licensed under chapter 395. The treatment center, unit, |
| 3139 | or hospital must provide the least restrictive available |
| 3140 | treatment that is appropriate to the individual needs of the |
| 3141 | child or adolescent and must adhere to the guiding principles, |
| 3142 | system of care, and service planning provisions of contained in |
| 3143 | part III of this chapter. |
| 3144 | (2) A child or adolescent, as defined in s. 394.492, who |
| 3145 | is younger than person under the age of 14 years of age and who |
| 3146 | is admitted to a any hospital licensed pursuant to chapter 395 |
| 3147 | may not be admitted to a bed in a room or ward with an adult |
| 3148 | patient in a mental health unit or share common areas with an |
| 3149 | adult patient in a mental health unit. However, an adolescent a |
| 3150 | person 14 years of age or older may be admitted to a bed in a |
| 3151 | room or ward in the mental health unit with an adult if the |
| 3152 | admitting physician documents in the case record that such |
| 3153 | placement is medically indicated or for reasons of safety. Such |
| 3154 | placement shall be reviewed by the attending physician or a |
| 3155 | designee or on-call physician each day and documented in the |
| 3156 | clinical case record. |
| 3157 | Section 30. Subsection (2) of section 394.4786, Florida |
| 3158 | Statutes, is amended to read: |
| 3159 | 394.4786 Intent.- |
| 3160 | (2) Further, the Legislature intends that a specialty |
| 3161 | psychiatric hospital that provides health care to specified |
| 3162 | indigent individuals patients be eligible for reimbursement up |
| 3163 | to the amount that hospital contributed to the Public Medical |
| 3164 | Assistance Trust Fund in the previous fiscal year. |
| 3165 | Section 31. Subsection (2) of section 394.47865, Florida |
| 3166 | Statutes, is amended to read: |
| 3167 | 394.47865 South Florida State Hospital; privatization.- |
| 3168 | (2) The contractor shall operate South Florida State |
| 3169 | Hospital as a mental health treatment facility that serves |
| 3170 | voluntarily and involuntarily committed indigent adult |
| 3171 | individuals adults who meet the criteria of this part I of this |
| 3172 | chapter and who reside in the South Florida State Hospital |
| 3173 | service area. |
| 3174 | (a) South Florida State Hospital shall remain a |
| 3175 | participant in the mental health disproportionate share program |
| 3176 | so long as such individuals the residents receive eligible |
| 3177 | services. |
| 3178 | (b) The department and the contractor shall ensure that |
| 3179 | the treatment facility is operated as a part of a total |
| 3180 | continuum of care for individuals persons who are mentally ill. |
| 3181 | The contractor shall have as its primary goal for the treatment |
| 3182 | facility to effectively treat and assist individuals held at the |
| 3183 | facility residents to return to the community as quickly as |
| 3184 | possible. |
| 3185 | Section 32. Section 394.4787, Florida Statutes, is amended |
| 3186 | to read: |
| 3187 | 394.4787 Definitions; ss. 394.4786, 394.4787, 394.4788, |
| 3188 | and 394.4789.-As used in ss. 394.4786-394.4789, the term this |
| 3189 | section and ss. 394.4786, 394.4788, and 394.4789: |
| 3190 | (1) "Acute mental health services" means mental health |
| 3191 | services provided through inpatient hospitalization. |
| 3192 | (2) "Agency" means the Agency for Health Care |
| 3193 | Administration. |
| 3194 | (3) "Charity care" means that portion of hospital charges |
| 3195 | for care provided to an individual a patient whose family income |
| 3196 | for the 12 months preceding the determination is equal to or |
| 3197 | below 150 percent of the current federal nonfarm poverty |
| 3198 | guideline or the amount of hospital charges due from the |
| 3199 | individual patient which exceeds 25 percent of the annual family |
| 3200 | income and for which there is no compensation. Charity care does |
| 3201 | shall not include administrative or courtesy discounts, |
| 3202 | contractual allowances to third party payors, or failure of a |
| 3203 | hospital to collect full charges due to partial payment by |
| 3204 | governmental programs. |
| 3205 | (4) "Indigent" means an individual whose financial status |
| 3206 | would qualify him or her for charity care. |
| 3207 | (5) "Operating expense" means all common and accepted |
| 3208 | costs appropriate in developing and maintaining the operating of |
| 3209 | the patient care facility and its activities. |
| 3210 | (6) "PMATF" means the Public Medical Assistance Trust |
| 3211 | Fund. |
| 3212 | (7) "Specialty psychiatric hospital" has the same meaning |
| 3213 | as in means a hospital licensed by the agency pursuant to s. |
| 3214 | 395.002(28), and includes facilities licensed under and part II |
| 3215 | of chapter 408 as a specialty psychiatric hospital. |
| 3216 | Section 33. Subsections (1), (2), and (6) of section |
| 3217 | 394.4788, Florida Statutes, are amended to read: |
| 3218 | 394.4788 Use of certain PMATF funds for the purchase of |
| 3219 | acute care mental health services.- |
| 3220 | (1) A hospital may be eligible to be reimbursed an amount |
| 3221 | no greater than the hospital's previous year contribution to the |
| 3222 | PMATF for acute mental health services provided to indigent |
| 3223 | individuals who are mentally ill persons who have been |
| 3224 | determined by the agency or its agent to require such treatment |
| 3225 | and who: |
| 3226 | (a) Do not meet Medicaid eligibility criteria, unless the |
| 3227 | agency makes a referral for a Medicaid eligible individual |
| 3228 | patient pursuant to s. 394.4789; |
| 3229 | (b) Meet the criteria for mental illness under this part; |
| 3230 | and |
| 3231 | (c) Meet the definition of charity care. |
| 3232 | (2) The agency shall annually calculate a per diem |
| 3233 | reimbursement rate for each specialty psychiatric hospital to be |
| 3234 | paid to the specialty psychiatric hospitals for the provision of |
| 3235 | acute mental health services provided to indigent individuals |
| 3236 | who are mentally ill individuals patients who meet the criteria |
| 3237 | in subsection (1). After the first rate period, providers shall |
| 3238 | be notified of new reimbursement rates for each new state fiscal |
| 3239 | year by June 1. The new reimbursement rates shall commence on |
| 3240 | July 1. |
| 3241 | (6) Hospitals that agree to participate in the program set |
| 3242 | forth in this section and ss. 394.4786, 394.4787, and 394.4789 |
| 3243 | shall agree that payment from the PMATF is payment in full for |
| 3244 | all individuals patients for which reimbursement is received |
| 3245 | under this section and ss. 394.4786, 394.4787, and 394.4789, |
| 3246 | until the funds for this program are no longer available. |
| 3247 | Section 34. Section 394.4789, Florida Statutes, is amended |
| 3248 | to read: |
| 3249 | 394.4789 Establishment of referral process and eligibility |
| 3250 | determination.- |
| 3251 | (1) The department shall adopt by rule a referral process |
| 3252 | that provides which shall provide each participating specialty |
| 3253 | psychiatric hospital with a system for accepting into the |
| 3254 | hospital's care indigent individuals who are mentally ill |
| 3255 | persons referred by the department. It is the intent of the |
| 3256 | Legislature that a hospital that which seeks payment under s. |
| 3257 | 394.4788 shall accept referrals from the department. However, a |
| 3258 | hospital may shall have the right to refuse the admission of an |
| 3259 | individual a patient due to lack of functional bed space or lack |
| 3260 | of services appropriate to a patient's specific treatment and is |
| 3261 | not no hospital shall be required to accept referrals if the |
| 3262 | costs for treating the referred patient are no longer |
| 3263 | reimbursable because the hospital has reached the level of |
| 3264 | contribution made to the PMATF in the previous fiscal year. |
| 3265 | Furthermore, a hospital that does not seek compensation for |
| 3266 | indigent individuals who are mentally ill patients under the |
| 3267 | provisions of this part is act shall not be obliged to accept |
| 3268 | department referrals, notwithstanding any agreements it may have |
| 3269 | entered into with the department. The right of refusal in this |
| 3270 | subsection does shall not affect a hospital's requirement to |
| 3271 | provide emergency care pursuant to s. 395.1041 or other state or |
| 3272 | federal law statutory requirements related to the provision of |
| 3273 | emergency care. |
| 3274 | (2) The department shall adopt by rule a patient |
| 3275 | eligibility form and is shall be responsible for eligibility |
| 3276 | determination. However, the department may contract with |
| 3277 | participating psychiatric hospitals for eligibility |
| 3278 | determination. The eligibility form must shall provide the |
| 3279 | mechanism for determining a patient's eligibility according to |
| 3280 | the requirements of s. 394.4788(1). |
| 3281 | (a) A specialty psychiatric hospital is shall be eligible |
| 3282 | for reimbursement only if when an eligibility form has been |
| 3283 | completed for each indigent individual who is mentally ill |
| 3284 | person for whom reimbursement is sought. |
| 3285 | (b) As part of eligibility determination, every effort |
| 3286 | shall be made by the hospital to determine if any third party |
| 3287 | insurance coverage is available. |
| 3288 | Section 35. Paragraph (a) of subsection (3) of section |
| 3289 | 39.407, Florida Statutes, is amended to read: |
| 3290 | 39.407 Medical, psychiatric, and psychological examination |
| 3291 | and treatment of child; physical, mental, or substance abuse |
| 3292 | examination of person with or requesting child custody.- |
| 3293 | (3)(a)1. Except as otherwise provided in subparagraph |
| 3294 | (b)1. or paragraph (e), before the department provides |
| 3295 | psychotropic medications to a child in its custody, the |
| 3296 | prescribing physician shall attempt to obtain express and |
| 3297 | informed consent, as defined in s. 394.455 394.455(9) and as |
| 3298 | described in s. 394.459(3) 394.459(3)(a), from the child's |
| 3299 | parent or legal guardian. The department shall must take steps |
| 3300 | necessary to facilitate the inclusion of the parent in the |
| 3301 | child's consultation with the physician. However, if the |
| 3302 | parental rights of the parent have been terminated, the parent's |
| 3303 | location or identity is unknown or cannot reasonably be |
| 3304 | ascertained, or the parent declines to give express and informed |
| 3305 | consent, the department may, after consultation with the |
| 3306 | prescribing physician, seek court authorization to provide the |
| 3307 | psychotropic medications to the child. Unless parental rights |
| 3308 | have been terminated and if it is possible to do so, the |
| 3309 | department shall continue to involve the parent in the |
| 3310 | decisionmaking process regarding the provision of psychotropic |
| 3311 | medications. If, at any time, a parent whose parental rights |
| 3312 | have not been terminated provides express and informed consent |
| 3313 | to the provision of a psychotropic medication, the requirements |
| 3314 | of this section that the department seek court authorization do |
| 3315 | not apply to that medication until such time as the parent no |
| 3316 | longer consents. |
| 3317 | 2. If Any time the department seeks a medical evaluation |
| 3318 | to determine the need to initiate or continue a psychotropic |
| 3319 | medication for a child, the department must provide to the |
| 3320 | evaluating physician all pertinent medical information known to |
| 3321 | the department concerning that child. |
| 3322 | Section 36. Subsection (3) of section 394.495, Florida |
| 3323 | Statutes, is amended to read: |
| 3324 | 394.495 Child and adolescent mental health system of care; |
| 3325 | programs and services.- |
| 3326 | (3) Assessments shall must be performed by: |
| 3327 | (a) A clinical psychologist, clinical social worker, |
| 3328 | physician, psychiatric nurse, or psychiatrist professional as |
| 3329 | defined in s. 394.455 394.455(2), (4), (21), (23), or (24); |
| 3330 | (b) A professional licensed under chapter 491; or |
| 3331 | (c) A person who is under the direct supervision of a |
| 3332 | professional listed in paragraph (a) or paragraph (b) as defined |
| 3333 | in s. 394.455(2), (4), (21), (23), or (24) or a |
| 3334 | licensed under chapter 491. |
| 3335 |
|
| 3336 | The department shall adopt by rule statewide standards for |
| 3337 | mental health assessments, which are must be based on current |
| 3338 | relevant professional and accreditation standards. |
| 3339 | Section 37. Subsection (6) of section 394.496, Florida |
| 3340 | Statutes, is amended to read: |
| 3341 | 394.496 Service planning.- |
| 3342 | (6) A clinical psychologist, clinical social worker, |
| 3343 | physician, psychiatric nurse, or psychiatrist professional as |
| 3344 | defined in s. 394.455, 394.455(2), (4), (21), (23), or (24) or a |
| 3345 | professional licensed under chapter 491, must be included among |
| 3346 | those persons developing the services plan. |
| 3347 | Section 38. Subsection (6) of section 394.9085, Florida |
| 3348 | Statutes, is amended to read: |
| 3349 | 394.9085 Behavioral provider liability.- |
| 3350 | (6) For purposes of this section, the terms |
| 3351 | "detoxification services," "addictions receiving facility," and |
| 3352 | "receiving facility" have the same meanings as those provided in |
| 3353 | ss. 397.311(18)(a)4., 397.311(18)(a)1., and 394.455 394.455(26), |
| 3354 | respectively. |
| 3355 | Section 39. Paragraph (d) of subsection (1) of section |
| 3356 | 419.001, Florida Statutes, is amended to read: |
| 3357 | 419.001 Site selection of community residential homes.- |
| 3358 | (1) For the purposes of this section, the following |
| 3359 | definitions shall apply: |
| 3360 | (d) "Resident" means any of the following: a frail elder |
| 3361 | as defined in s. 429.65; a physically disabled or handicapped |
| 3362 | person as defined in s. 760.22(7)(a); a developmentally disabled |
| 3363 | person as defined in s. 393.063; a nondangerous individual who |
| 3364 | has a mental illness as defined in s. 394.455 mentally ill |
| 3365 | person as defined in s. 394.455(18); or a child who is found to |
| 3366 | be dependent as defined in s. 39.01 or s. 984.03, or a child in |
| 3367 | need of services as defined in s. 984.03 or s. 985.03. |
| 3368 | Section 40. Subsection (7) of section 744.704, Florida |
| 3369 | Statutes, is amended to read: |
| 3370 | 744.704 Powers and duties.- |
| 3371 | (7) A public guardian may shall not commit a ward to a |
| 3372 | mental health treatment facility, as defined in s. 394.455 |
| 3373 | 394.455(32), without an involuntary placement proceeding as |
| 3374 | provided by law. |
| 3375 | Section 41. This act shall take effect July 1, 2010. |