Florida Senate - 2016 COMMITTEE AMENDMENT
Bill No. PCS (821992) for SB 12
Ì654058:Î654058
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
02/18/2016 .
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The Committee on Appropriations (Garcia) recommended the
following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Paragraph (e) is added to subsection (10) of
6 section 29.004, Florida Statutes, to read:
7 29.004 State courts system.—For purposes of implementing s.
8 14, Art. V of the State Constitution, the elements of the state
9 courts system to be provided from state revenues appropriated by
10 general law are as follows:
11 (10) Case management. Case management includes:
12 (e) Service referral, coordination, monitoring, and
13 tracking for mental health programs under chapter 394.
14
15 Case management may not include costs associated with the
16 application of therapeutic jurisprudence principles by the
17 courts. Case management also may not include case intake and
18 records management conducted by the clerk of court.
19 Section 2. Subsection (6) of section 39.001, Florida
20 Statutes, is amended to read:
21 39.001 Purposes and intent; personnel standards and
22 screening.—
23 (6) MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES.—
24 (a) The Legislature recognizes that early referral and
25 comprehensive treatment can help combat mental illness and
26 substance abuse disorders in families and that treatment is
27 cost-effective.
28 (b) The Legislature establishes the following goals for the
29 state related to mental illness and substance abuse treatment
30 services in the dependency process:
31 1. To ensure the safety of children.
32 2. To prevent and remediate the consequences of mental
33 illness and substance abuse disorders on families involved in
34 protective supervision or foster care and reduce the occurrences
35 of mental illness and substance abuse disorders, including
36 alcohol abuse or other related disorders, for families who are
37 at risk of being involved in protective supervision or foster
38 care.
39 3. To expedite permanency for children and reunify healthy,
40 intact families, when appropriate.
41 4. To support families in recovery.
42 (c) The Legislature finds that children in the care of the
43 state’s dependency system need appropriate health care services,
44 that the impact of mental illnesses and substance abuse on
45 health indicates the need for health care services to include
46 treatment for mental health and substance abuse disorders for
47 services to children and parents where appropriate, and that it
48 is in the state’s best interest that such children be provided
49 the services they need to enable them to become and remain
50 independent of state care. In order to provide these services,
51 the state’s dependency system must have the ability to identify
52 and provide appropriate intervention and treatment for children
53 with personal or family-related mental illness and substance
54 abuse problems.
55 (d) It is the intent of the Legislature to encourage the
56 use of the mental health programs established under chapter 394
57 and the drug court program model established under by s. 397.334
58 and authorize courts to assess children and persons who have
59 custody or are requesting custody of children where good cause
60 is shown to identify and address mental illnesses and substance
61 abuse disorders problems as the court deems appropriate at every
62 stage of the dependency process. Participation in treatment,
63 including a treatment-based mental health court program or a
64 treatment-based drug court program, may be required by the court
65 following adjudication. Participation in assessment and
66 treatment before prior to adjudication is shall be voluntary,
67 except as provided in s. 39.407(16).
68 (e) It is therefore the purpose of the Legislature to
69 provide authority for the state to contract with mental health
70 service providers and community substance abuse treatment
71 providers for the development and operation of specialized
72 support and overlay services for the dependency system, which
73 will be fully implemented and used as resources permit.
74 (f) Participation in a treatment-based mental health court
75 program or a the treatment-based drug court program does not
76 divest any public or private agency of its responsibility for a
77 child or adult, but is intended to enable these agencies to
78 better meet their needs through shared responsibility and
79 resources.
80 Section 3. Paragraph (c) of subsection (6) of section
81 39.407, Florida Statutes, is amended to read:
82 39.407 Medical, psychiatric, and psychological examination
83 and treatment of child; physical, mental, or substance abuse
84 examination of person with or requesting child custody.—
85 (6) Children who are in the legal custody of the department
86 may be placed by the department, without prior approval of the
87 court, in a residential treatment center licensed under s.
88 394.875 or a hospital licensed under chapter 395 for residential
89 mental health treatment only pursuant to this section or may be
90 placed by the court in accordance with an order of involuntary
91 examination or involuntary placement entered pursuant to s.
92 394.463 or s. 394.467. All children placed in a residential
93 treatment program under this subsection must have a guardian ad
94 litem appointed.
95 (c) Before a child is admitted under this subsection, the
96 child shall be assessed for suitability for residential
97 treatment by a qualified evaluator who has conducted a personal
98 examination and assessment of the child and has made written
99 findings that:
100 1. The child appears to have an emotional disturbance
101 serious enough to require residential treatment and is
102 reasonably likely to benefit from the treatment.
103 2. The child has been provided with a clinically
104 appropriate explanation of the nature and purpose of the
105 treatment.
106 3. All available modalities of treatment less restrictive
107 than residential treatment have been considered, and a less
108 restrictive alternative that would offer comparable benefits to
109 the child is unavailable.
110
111 A copy of the written findings of the evaluation and suitability
112 assessment must be provided to the department, and to the
113 guardian ad litem, and, if the child is a member of a Medicaid
114 Managed Health Care Plan, to the plan that is financially
115 responsible for the child’s care in residential treatment, any
116 of whom must be provided who shall have the opportunity to
117 discuss the findings with the evaluator.
118 Section 4. Subsection (10) of section 39.507, Florida
119 Statutes, is amended to read:
120 39.507 Adjudicatory hearings; orders of adjudication.—
121 (10) After an adjudication of dependency, or a finding of
122 dependency in which where adjudication is withheld, the court
123 may order a person who has, custody or is requesting, custody of
124 the child to submit to a mental health or substance abuse
125 disorder assessment or evaluation. The order may be made only
126 upon good cause shown and pursuant to notice and procedural
127 requirements provided under the Florida Rules of Juvenile
128 Procedure. The assessment or evaluation must be administered by
129 an appropriate a qualified professional, as defined in s.
130 394.455 or s. 397.311. The court may also require such person to
131 participate in and comply with treatment and services identified
132 as necessary, including, when appropriate and available,
133 participation in and compliance with a mental health program
134 established under chapter 394 or a treatment-based drug court
135 program established under s. 397.334. In addition to supervision
136 by the department, the court, including a treatment-based mental
137 health court program or a the treatment-based drug court
138 program, may oversee the progress and compliance with treatment
139 by a person who has custody or is requesting custody of the
140 child. The court may impose appropriate available sanctions for
141 noncompliance upon a person who has custody or is requesting
142 custody of the child or make a finding of noncompliance for
143 consideration in determining whether an alternative placement of
144 the child is in the child’s best interests. Any order entered
145 under this subsection may be made only upon good cause shown.
146 This subsection does not authorize placement of a child with a
147 person seeking custody, other than the parent or legal
148 custodian, who requires mental health or substance abuse
149 disorder treatment.
150 Section 5. Paragraph (b) of subsection (1) of section
151 39.521, Florida Statutes, is amended to read:
152 39.521 Disposition hearings; powers of disposition.—
153 (1) A disposition hearing shall be conducted by the court,
154 if the court finds that the facts alleged in the petition for
155 dependency were proven in the adjudicatory hearing, or if the
156 parents or legal custodians have consented to the finding of
157 dependency or admitted the allegations in the petition, have
158 failed to appear for the arraignment hearing after proper
159 notice, or have not been located despite a diligent search
160 having been conducted.
161 (b) When any child is adjudicated by a court to be
162 dependent, the court having jurisdiction of the child has the
163 power by order to:
164 1. Require the parent and, when appropriate, the legal
165 custodian and the child to participate in treatment and services
166 identified as necessary. The court may require the person who
167 has custody or who is requesting custody of the child to submit
168 to a mental illness or substance abuse disorder assessment or
169 evaluation. The order may be made only upon good cause shown and
170 pursuant to notice and procedural requirements provided under
171 the Florida Rules of Juvenile Procedure. The assessment or
172 evaluation must be administered by an appropriate a qualified
173 professional, as defined in s, 394.455 or s. 397.311. The court
174 may also require such person to participate in and comply with
175 treatment and services identified as necessary, including, when
176 appropriate and available, participation in and compliance with
177 a mental health program established under chapter 394 or a
178 treatment-based drug court program established under s. 397.334.
179 In addition to supervision by the department, the court,
180 including a treatment-based mental health court program or a the
181 treatment-based drug court program, may oversee the progress and
182 compliance with treatment by a person who has custody or is
183 requesting custody of the child. The court may impose
184 appropriate available sanctions for noncompliance upon a person
185 who has custody or is requesting custody of the child or make a
186 finding of noncompliance for consideration in determining
187 whether an alternative placement of the child is in the child’s
188 best interests. Any order entered under this subparagraph may be
189 made only upon good cause shown. This subparagraph does not
190 authorize placement of a child with a person seeking custody of
191 the child, other than the child’s parent or legal custodian, who
192 requires mental health or substance abuse treatment.
193 2. Require, if the court deems necessary, the parties to
194 participate in dependency mediation.
195 3. Require placement of the child either under the
196 protective supervision of an authorized agent of the department
197 in the home of one or both of the child’s parents or in the home
198 of a relative of the child or another adult approved by the
199 court, or in the custody of the department. Protective
200 supervision continues until the court terminates it or until the
201 child reaches the age of 18, whichever date is first. Protective
202 supervision shall be terminated by the court whenever the court
203 determines that permanency has been achieved for the child,
204 whether with a parent, another relative, or a legal custodian,
205 and that protective supervision is no longer needed. The
206 termination of supervision may be with or without retaining
207 jurisdiction, at the court’s discretion, and shall in either
208 case be considered a permanency option for the child. The order
209 terminating supervision by the department must shall set forth
210 the powers of the custodian of the child and shall include the
211 powers ordinarily granted to a guardian of the person of a minor
212 unless otherwise specified. Upon the court’s termination of
213 supervision by the department, no further judicial reviews are
214 not required if, so long as permanency has been established for
215 the child.
216 Section 6. Section 394.455, Florida Statutes, is amended to
217 read:
218 394.455 Definitions.—As used in this part, unless the
219 context clearly requires otherwise, the term:
220 (1) “Access center” means a facility staffed by medical,
221 behavioral, and substance abuse professionals which provides
222 emergency screening and evaluation for mental health or
223 substance abuse disorders and may provide transportation to an
224 appropriate facility if an individual is in need of more
225 intensive services.
226 (2) “Addictions receiving facility” is a secure, acute care
227 facility that, at a minimum, provides emergency screening,
228 evaluation, detoxification and stabilization services; is
229 operated 24 hours per day, 7 days per week; and is designated by
230 the department to serve individuals found to have substance
231 abuse impairment who qualify for services under this part.
232 (3)(1) “Administrator” means the chief administrative
233 officer of a receiving or treatment facility or his or her
234 designee.
235 (4) “Adult” means an individual who is 18 years of age or
236 older or who has had the disability of nonage removed under
237 chapter 743.
238 (5) “Advanced registered nurse practitioner” means any
239 person licensed in this state to practice professional nursing
240 who is certified in advanced or specialized nursing practice
241 under s. 464.012.
242 (6)(2) “Clinical psychologist” means a psychologist as
243 defined in s. 490.003(7) with 3 years of postdoctoral experience
244 in the practice of clinical psychology, inclusive of the
245 experience required for licensure, or a psychologist employed by
246 a facility operated by the United States Department of Veterans
247 Affairs that qualifies as a receiving or treatment facility
248 under this part.
249 (7)(3) “Clinical record” means all parts of the record
250 required to be maintained and includes all medical records,
251 progress notes, charts, and admission and discharge data, and
252 all other information recorded by a facility staff which
253 pertains to the patient’s hospitalization or treatment.
254 (8)(4) “Clinical social worker” means a person licensed as
255 a clinical social worker under s. 491.005 or s. 491.006 chapter
256 491.
257 (9)(5) “Community facility” means a any community service
258 provider that contracts contracting with the department to
259 furnish substance abuse or mental health services under part IV
260 of this chapter.
261 (10)(6) “Community mental health center or clinic” means a
262 publicly funded, not-for-profit center that which contracts with
263 the department for the provision of inpatient, outpatient, day
264 treatment, or emergency services.
265 (11)(7) “Court,” unless otherwise specified, means the
266 circuit court.
267 (12)(8) “Department” means the Department of Children and
268 Families.
269 (13) “Designated receiving facility” means a facility
270 approved by the department which may be a public or private
271 hospital, crisis stabilization unit, addictions receiving
272 facility and provides, at a minimum, emergency screening,
273 evaluation, and short-term stabilization for mental health or
274 substance abuse disorders, and which may have an agreement with
275 a corresponding facility for transportation and services.
276 (14) “Detoxification facility” means a facility licensed to
277 provide detoxification services under chapter 397.
278 (15) “Electronic means” is a form of telecommunication
279 which requires all parties to maintain visual as well as audio
280 communication when being used to conduct an examination by a
281 qualified professional.
282 (16)(9) “Express and informed consent” means consent
283 voluntarily given in writing, by a competent person, after
284 sufficient explanation and disclosure of the subject matter
285 involved to enable the person to make a knowing and willful
286 decision without any element of force, fraud, deceit, duress, or
287 other form of constraint or coercion.
288 (17)(10) “Facility” means any hospital, community facility,
289 public or private facility, or receiving or treatment facility
290 providing for the evaluation, diagnosis, care, treatment,
291 training, or hospitalization of persons who appear to have a
292 mental illness or who have been diagnosed as having a mental
293 illness or substance abuse impairment. The term “Facility” does
294 not include a any program or an entity licensed under pursuant
295 to chapter 400 or chapter 429.
296 (18) “Governmental facility” means a facility owned,
297 operated, or administered by the Department of Corrections or
298 the United States Department of Veterans Affairs.
299 (19)(11) “Guardian” means the natural guardian of a minor,
300 or a person appointed by a court to act on behalf of a ward’s
301 person if the ward is a minor or has been adjudicated
302 incapacitated.
303 (20)(12) “Guardian advocate” means a person appointed by a
304 court to make decisions regarding mental health or substance
305 abuse treatment on behalf of a patient who has been found
306 incompetent to consent to treatment pursuant to this part. The
307 guardian advocate may be granted specific additional powers by
308 written order of the court, as provided in this part.
309 (21)(13) “Hospital” means a hospital facility as defined in
310 s. 395.002 and licensed under chapter 395 and part II of chapter
311 408.
312 (22)(14) “Incapacitated” means that a person has been
313 adjudicated incapacitated pursuant to part V of chapter 744 and
314 a guardian of the person has been appointed.
315 (23)(15) “Incompetent to consent to treatment” means a
316 state in which that a person’s judgment is so affected by a his
317 or her mental illness or a substance abuse impairment, that he
318 or she the person lacks the capacity to make a well-reasoned,
319 willful, and knowing decision concerning his or her medical, or
320 mental health, or substance abuse treatment.
321 (24) “Involuntary examination” means an examination
322 performed under s. 394.463 or s. 397.675 to determine whether a
323 person qualifies for involuntary services.
324 (25) “Involuntary services” in this part means court
325 ordered outpatient services or inpatient placement for mental
326 health treatment pursuant to s. 394.4655 or s. 394.467.
327 (26)(16) “Law enforcement officer” has the same meaning as
328 provided means a law enforcement officer as defined in s.
329 943.10.
330 (27) “Marriage and family therapist” means a person
331 licensed to practice marriage and family therapy under s.
332 491.005 or s. 491.006.
333 (28) “Mental health counselor” means a person licensed to
334 practice mental health counseling under s. 491.005 or s.
335 491.006.
336 (29)(17) “Mental health overlay program” means a mobile
337 service that which provides an independent examination for
338 voluntary admission admissions and a range of supplemental
339 onsite services to persons with a mental illness in a
340 residential setting such as a nursing home, an assisted living
341 facility, or an adult family-care home, or a nonresidential
342 setting such as an adult day care center. Independent
343 examinations provided pursuant to this part through a mental
344 health overlay program must only be provided under contract with
345 the department for this service or be attached to a public
346 receiving facility that is also a community mental health
347 center.
348 (30)(18) “Mental illness” means an impairment of the mental
349 or emotional processes that exercise conscious control of one’s
350 actions or of the ability to perceive or understand reality,
351 which impairment substantially interferes with the person’s
352 ability to meet the ordinary demands of living. For the purposes
353 of this part, the term does not include a developmental
354 disability as defined in chapter 393, intoxication, or
355 conditions manifested only by antisocial behavior or substance
356 abuse impairment.
357 (31) “Minor” means an individual who is 17 years of age or
358 younger and who has not had the disability of nonage removed
359 pursuant to s. 743.01 or s. 743.015.
360 (32)(19) “Mobile crisis response service” means a
361 nonresidential crisis service attached to a public receiving
362 facility and available 24 hours a day, 7 days a week, through
363 which provides immediate intensive assessments and
364 interventions, including screening for admission into a mental
365 health receiving facility, an addictions receiving facility, or
366 a detoxification facility, take place for the purpose of
367 identifying appropriate treatment services.
368 (33)(20) “Patient” means any person, with or without a co
369 occurring substance abuse disorder who is held or accepted for
370 mental health treatment.
371 (34)(21) “Physician” means a medical practitioner licensed
372 under chapter 458 or chapter 459 who has experience in the
373 diagnosis and treatment of mental and nervous disorders or a
374 physician employed by a facility operated by the United States
375 Department of Veterans Affairs or the United States Department
376 of Defense which qualifies as a receiving or treatment facility
377 under this part.
378 (35) “Physician assistant” means a person licensed under
379 chapter 458 or chapter 459 who has experience in the diagnosis
380 and treatment of mental disorders.
381 (36)(22) “Private facility” means any hospital or facility
382 operated by a for-profit or not-for-profit corporation or
383 association which that provides mental health or substance abuse
384 services and is not a public facility.
385 (37)(23) “Psychiatric nurse” means an advanced registered
386 nurse practitioner certified under s. 464.012 who has a master’s
387 or doctoral degree in psychiatric nursing, holds a national
388 advanced practice certification as a psychiatric mental health
389 advanced practice nurse, and has 2 years of post-master’s
390 clinical experience under the supervision of a physician.
391 (38)(24) “Psychiatrist” means a medical practitioner
392 licensed under chapter 458 or chapter 459 who has primarily
393 diagnosed and treated mental and nervous disorders for at least
394 a period of not less than 3 years, inclusive of psychiatric
395 residency.
396 (39)(25) “Public facility” means a any facility that has
397 contracted with the department to provide mental health services
398 to all persons, regardless of their ability to pay, and is
399 receiving state funds for such purpose.
400 (40) “Qualified professional” means a physician or a
401 physician assistant licensed under chapter 458 or chapter 459; a
402 professional licensed under chapter 490.003(7) or chapter 491; a
403 psychiatrist licensed under chapter 458 or chapter 459; or a
404 psychiatric nurse as defined in subsection (37).
405 (41)(26) “Receiving facility” means any public or private
406 facility or hospital designated by the department to receive and
407 hold or refer, as appropriate, involuntary patients under
408 emergency conditions or for mental health or substance abuse
409 psychiatric evaluation and to provide short-term treatment or
410 transportation to the appropriate service provider. The term
411 does not include a county jail.
412 (42)(27) “Representative” means a person selected to
413 receive notice of proceedings during the time a patient is held
414 in or admitted to a receiving or treatment facility.
415 (43)(28)(a) “Restraint” means: a physical device, method,
416 or drug used to control behavior.
417 (a) A physical restraint, including is any manual method or
418 physical or mechanical device, material, or equipment attached
419 or adjacent to an the individual’s body so that he or she cannot
420 easily remove the restraint and which restricts freedom of
421 movement or normal access to one’s body. Physical restraint
422 includes the physical holding of a person during a procedure to
423 forcibly administer psychotropic medication. Physical restraint
424 does not include physical devices such as orthopedically
425 prescribed appliances, surgical dressings and bandages,
426 supportive body bands, or other physical holding when necessary
427 for routine physical examinations and tests or for purposes of
428 orthopedic, surgical, or other similar medical treatment, when
429 used to provide support for the achievement of functional body
430 position or proper balance, or when used to protect a person
431 from falling out of bed.
432 (b) A drug or used as a restraint is a medication used to
433 control a the person’s behavior or to restrict his or her
434 freedom of movement which and is not part of the standard
435 treatment regimen of a person with a diagnosed mental illness
436 who is a client of the department. Physically holding a person
437 during a procedure to forcibly administer psychotropic
438 medication is a physical restraint.
439 (c) Restraint does not include physical devices, such as
440 orthopedically prescribed appliances, surgical dressings and
441 bandages, supportive body bands, or other physical holding when
442 necessary for routine physical examinations and tests; or for
443 purposes of orthopedic, surgical, or other similar medical
444 treatment; when used to provide support for the achievement of
445 functional body position or proper balance; or when used to
446 protect a person from falling out of bed.
447 (44) “School psychologist” has the same meaning as in s.
448 490.003.
449 (45)(29) “Seclusion” means the physical segregation of a
450 person in any fashion or involuntary isolation of a person in a
451 room or area from which the person is prevented from leaving.
452 The prevention may be by physical barrier or by a staff member
453 who is acting in a manner, or who is physically situated, so as
454 to prevent the person from leaving the room or area. For
455 purposes of this part chapter, the term does not mean isolation
456 due to a person’s medical condition or symptoms.
457 (46)(30) “Secretary” means the Secretary of Children and
458 Families.
459 (47) “Service provider” means a receiving facility, any
460 facility licensed under chapter 397, a treatment facility, an
461 entity under contract with the department to provide mental
462 health or substance abuse services, a community mental health
463 center or clinic, a psychologist, a clinical social worker, a
464 marriage and family therapist, a mental health counselor, a
465 physician, a psychiatrist, an advanced registered nurse
466 practitioner, a psychiatric nurse, or a qualified professional
467 as defined in this section.
468 (48) “Substance abuse impairment” means a condition
469 involving the use of alcoholic beverages or any psychoactive or
470 mood-altering substance in such a manner that a person has lost
471 the power of self-control and has inflicted or is likely to
472 inflict physical harm on himself or herself or others.
473 (49)(31) “Transfer evaluation” means the process by which,
474 as approved by the appropriate district office of the
475 department, whereby a person who is being considered for
476 placement in a state treatment facility is first evaluated for
477 appropriateness of admission to a state treatment the facility
478 by a community-based public receiving facility or by a community
479 mental health center or clinic if the public receiving facility
480 is not a community mental health center or clinic.
481 (50)(32) “Treatment facility” means a any state-owned,
482 state-operated, or state-supported hospital, center, or clinic
483 designated by the department for extended treatment and
484 hospitalization, beyond that provided for by a receiving
485 facility, of persons who have a mental illness, including
486 facilities of the United States Government, and any private
487 facility designated by the department when rendering such
488 services to a person pursuant to the provisions of this part.
489 Patients treated in facilities of the United States Government
490 shall be solely those whose care is the responsibility of the
491 United States Department of Veterans Affairs.
492 (51) “Triage center” means a facility that is designated by
493 the department and has medical, behavioral, and substance abuse
494 professionals present or on call to provide emergency screening
495 and evaluation of individuals transported to the center by a law
496 enforcement officer.
497 (33) “Service provider” means any public or private
498 receiving facility, an entity under contract with the Department
499 of Children and Families to provide mental health services, a
500 clinical psychologist, a clinical social worker, a marriage and
501 family therapist, a mental health counselor, a physician, a
502 psychiatric nurse as defined in subsection (23), or a community
503 mental health center or clinic as defined in this part.
504 (34) “Involuntary examination” means an examination
505 performed under s. 394.463 to determine if an individual
506 qualifies for involuntary inpatient treatment under s.
507 394.467(1) or involuntary outpatient treatment under s.
508 394.4655(1).
509 (35) “Involuntary placement” means either involuntary
510 outpatient treatment pursuant to s. 394.4655 or involuntary
511 inpatient treatment pursuant to s. 394.467.
512 (36) “Marriage and family therapist” means a person
513 licensed as a marriage and family therapist under chapter 491.
514 (37) “Mental health counselor” means a person licensed as a
515 mental health counselor under chapter 491.
516 (38) “Electronic means” means a form of telecommunication
517 that requires all parties to maintain visual as well as audio
518 communication.
519 Section 7. Section 394.4573, Florida Statutes, is amended
520 to read:
521 394.4573 Coordinated system of care; annual assessment;
522 essential elements Continuity of care management system;
523 measures of performance; system improvement grants; reports.—On
524 or before October 1 of each year, the department shall submit to
525 the Governor, the President of the Senate, and the Speaker of
526 the House of Representatives an assessment of the behavioral
527 health services in this state in the context of the No-Wrong
528 Door model and standards set forth in this section. The
529 department’s assessment shall be based on both quantitative and
530 qualitative data and must identify any significant regional
531 variations. The assessment must include information gathered
532 from managing entities; service providers; facilities performing
533 acute behavioral health care triage functions for the community;
534 crisis stabilization units; detoxification units; addictions
535 receiving facilities and hospitals, both public and private; law
536 enforcement; judicial officials; local governments; behavioral
537 health consumers and their family members; and the public.
538 (1) As used in For the purposes of this section:
539 (a) “Case management” means those direct services provided
540 to a client in order to assess his or her activities aimed at
541 assessing client needs, plan or arrange planning services,
542 coordinate service providers, link linking the service system to
543 a client, monitor coordinating the various system components,
544 monitoring service delivery, and evaluate patient outcomes
545 evaluating the effect of service delivery.
546 (b) “Case manager” means an individual who works with
547 clients, and their families and significant others, to provide
548 case management.
549 (c) “Client manager” means an employee of the managing
550 entity or entity under contract with the managing entity
551 department who is assigned to specific provider agencies and
552 geographic areas to ensure that the full range of needed
553 services is available to clients.
554 (d) “Coordinated system Continuity of care management
555 system” means a system that assures, within available resources,
556 that clients have access to the full array of behavioral and
557 related services in a region or community offered by all service
558 providers, whether participating under contract with the
559 managing entity or another method of community partnership or
560 mutual agreement within the mental health services delivery
561 system.
562 (e) “No-Wrong-Door model” means a model for the delivery of
563 acute care services to persons who have mental health or
564 substance abuse disorders, or both, which optimizes access to
565 care, regardless of the entry point to the behavioral health
566 care system.
567 (2) The essential elements of a coordinated system of care
568 include:
569 (a) Community interventions, such as prevention, primary
570 care for behavioral health needs, therapeutic and supportive
571 services, crisis response services, and diversion programs.
572 (b) A designated receiving system shall consist of one or
573 more facilities serving a defined geographic area and
574 responsible for assessment and evaluation, both voluntary and
575 involuntary, and treatment or triage for patients who present
576 with mental illness, substance abuse disorder, or co-occurring
577 disorders. A county or several counties shall plan the
578 designated receiving system through an inclusive process,
579 approved by the managing entity, and documented through written
580 memoranda of agreement or other binding arrangements. The
581 designated receiving system may be organized in any of the
582 following ways so long as it functions as a No-Wrong-Door model
583 that responds to individual needs and integrates services among
584 various providers:
585 1. A central receiving system, which consists of a
586 designated central receiving facility that serves as a single
587 entry point for persons with mental health or substance abuse
588 disorders, or both. The central receiving facility must be
589 capable of assessment, evaluation, and triage or treatment for
590 various conditions and circumstances.
591 2. A coordinated receiving system, which consists of
592 multiple entry points that are linked by shared data systems,
593 formal referral agreements, and cooperative arrangements for
594 care coordination and case management. Each entry point must be
595 a designated receiving facility and must provide or arrange for
596 necessary services following an initial assessment and
597 evaluation.
598 3. A tiered receiving system, which consists of multiple
599 entry points, some of which offer only specialized or limited
600 services. Each service provider must be classified according to
601 its capabilities as either a designated receiving facility, or
602 another type of service provider such as a residential
603 detoxification center, triage center, or an access center. All
604 participating service providers must be linked by methods to
605 share data that are compliant with both state and federal
606 patient privacy and confidentiality laws, formal referral
607 agreements, and cooperative arrangements for care coordination
608 and case management. An accurate inventory of the participating
609 service providers which specifies the capabilities and
610 limitations of each provider must be maintained and made
611 available at all times to all first responders in the service
612 area.
613 (c) Transportation in accordance with a plan developed
614 under s. 394.462.
615 (d) Crisis services, including mobile response teams,
616 crisis stabilization units, addiction receiving facilities, and
617 detoxification facilities.
618 (e) Case management, including intensive case management
619 for individuals determined to be high-need or high-utilization
620 individuals under s. 394.9082(2(e).
621 (f) Outpatient services.
622 (g) Residential services.
623 (h) Hospital inpatient care.
624 (i) Aftercare and other post-discharge services.
625 (j) Medication Assisted Treatment and medication
626 management.
627 (k) Recovery support, including housing assistance and
628 support for competitive employment, educational attainment,
629 independent living skills development, family support and
630 education, and wellness management and self-care.
631 (3) The department’s annual assessment must compare the
632 status and performance of the extant behavioral health system
633 with the following standards and any other standards or measures
634 that the department determines to be applicable.
635 (a) The capacity of the contracted service providers to
636 meet estimated need when such estimates are based on credible
637 evidence and sound methodologies.
638 (b) The extent to which the behavioral health system uses
639 evidence-informed practices and broadly disseminates the results
640 of quality improvement activities to all service providers.
641 (c) The degree to which services are offered in the least
642 restrictive and most appropriate therapeutic environment.
643 (d) The scope of system-wide accountability activities used
644 to monitor patient outcomes and measure continuous improvement
645 in the behavioral health system.
646 (4) Subject to a specific appropriation by the Legislature,
647 the department may award system improvement grants to managing
648 entities based on the submission of a detailed plan to enhance
649 services, coordination, or performance measurement in accordance
650 with the model and standards specified in this section. Such a
651 grant must be awarded through a performance-based contract that
652 links payments to the documented and measurable achievement of
653 system improvements The department is directed to implement a
654 continuity of care management system for the provision of mental
655 health care, through the provision of client and case
656 management, including clients referred from state treatment
657 facilities to community mental health facilities. Such system
658 shall include a network of client managers and case managers
659 throughout the state designed to:
660 (a) Reduce the possibility of a client’s admission or
661 readmission to a state treatment facility.
662 (b) Provide for the creation or designation of an agency in
663 each county to provide single intake services for each person
664 seeking mental health services. Such agency shall provide
665 information and referral services necessary to ensure that
666 clients receive the most appropriate and least restrictive form
667 of care, based on the individual needs of the person seeking
668 treatment. Such agency shall have a single telephone number,
669 operating 24 hours per day, 7 days per week, where practicable,
670 at a central location, where each client will have a central
671 record.
672 (c) Advocate on behalf of the client to ensure that all
673 appropriate services are afforded to the client in a timely and
674 dignified manner.
675 (d) Require that any public receiving facility initiating a
676 patient transfer to a licensed hospital for acute care mental
677 health services not accessible through the public receiving
678 facility shall notify the hospital of such transfer and send all
679 records relating to the emergency psychiatric or medical
680 condition.
681 (3) The department is directed to develop and include in
682 contracts with service providers measures of performance with
683 regard to goals and objectives as specified in the state plan.
684 Such measures shall use, to the extent practical, existing data
685 collection methods and reports and shall not require, as a
686 result of this subsection, additional reports on the part of
687 service providers. The department shall plan monitoring visits
688 of community mental health facilities with other state, federal,
689 and local governmental and private agencies charged with
690 monitoring such facilities.
691 Section 8. Paragraphs (d) and (e) of subsection (2) of
692 section 394.4597, Florida Statutes, are amended to read:
693 394.4597 Persons to be notified; patient’s representative.—
694 (2) INVOLUNTARY PATIENTS.—
695 (d) When the receiving or treatment facility selects a
696 representative, first preference shall be given to a health care
697 surrogate, if one has been previously selected by the patient.
698 If the patient has not previously selected a health care
699 surrogate, the selection, except for good cause documented in
700 the patient’s clinical record, shall be made from the following
701 list in the order of listing:
702 1. The patient’s spouse.
703 2. An adult child of the patient.
704 3. A parent of the patient.
705 4. The adult next of kin of the patient.
706 5. An adult friend of the patient.
707 6. The appropriate Florida local advocacy council as
708 provided in s. 402.166.
709 (e) The following persons are prohibited from selection as
710 a patient’s representative:
711 1. A professional providing clinical services to the
712 patient under this part.
713 2. The licensed professional who initiated the involuntary
714 examination of the patient, if the examination was initiated by
715 professional certificate.
716 3. An employee, an administrator, or a board member of the
717 facility providing the examination of the patient.
718 4. An employee, an administrator, or a board member of a
719 treatment facility providing treatment for the patient.
720 5. A person providing any substantial professional services
721 to the patient, including clinical services.
722 6. A creditor of the patient.
723 7. A person subject to an injunction for protection against
724 domestic violence under s. 741.30, whether the order of
725 injunction is temporary or final, and for which the patient was
726 the petitioner.
727 8. A person subject to an injunction for protection against
728 repeat violence, stalking, sexual violence, or dating violence
729 under s. 784.046, whether the order of injunction is temporary
730 or final, and for which the patient was the petitioner A
731 licensed professional providing services to the patient under
732 this part, an employee of a facility providing direct services
733 to the patient under this part, a department employee, a person
734 providing other substantial services to the patient in a
735 professional or business capacity, or a creditor of the patient
736 shall not be appointed as the patient’s representative.
737 Section 9. Present subsections (2) through (7) of section
738 394.4598, Florida Statutes, are redesignated as subsections (3)
739 through (8), respectively, a new subsection (2) is added to that
740 section, and present subsections (3) and (4) of that section are
741 amended, to read:
742 394.4598 Guardian advocate.—
743 (2) The following persons are prohibited from appointment
744 as a patient’s guardian advocate:
745 (a) A professional providing clinical services to the
746 patient under this part.
747 (b) The licensed professional who initiated the involuntary
748 examination of the patient, if the examination was initiated by
749 professional certificate.
750 (c) An employee, an administrator, or a board member of the
751 facility providing the examination of the patient.
752 (d) An employee, an administrator, or a board member of a
753 treatment facility providing treatment of the patient.
754 (e) A person providing any substantial professional
755 services, excluding public and professional guardians, to the
756 patient, including clinical services.
757 (f) A creditor of the patient.
758 (g) A person subject to an injunction for protection
759 against domestic violence under s. 741.30, whether the order of
760 injunction is temporary or final, and for which the patient was
761 the petitioner.
762 (h) A person subject to an injunction for protection
763 against repeat violence, stalking, sexual violence, or dating
764 violence under s. 784.046, whether the order of injunction is
765 temporary or final, and for which the patient was the
766 petitioner.
767 (4)(3) In lieu of the training required of guardians
768 appointed pursuant to chapter 744, Prior to a guardian advocate
769 must, at a minimum, participate in a 4-hour training course
770 approved by the court before exercising his or her authority,
771 the guardian advocate shall attend a training course approved by
772 the court. At a minimum, this training course, of not less than
773 4 hours, must include, at minimum, information about the patient
774 rights, psychotropic medications, the diagnosis of mental
775 illness, the ethics of medical decisionmaking, and duties of
776 guardian advocates. This training course shall take the place of
777 the training required for guardians appointed pursuant to
778 chapter 744.
779 (5)(4) The required training course and the information to
780 be supplied to prospective guardian advocates before prior to
781 their appointment and the training course for guardian advocates
782 must be developed and completed through a course developed by
783 the department, and approved by the chief judge of the circuit
784 court, and taught by a court-approved organization, which.
785 Court-approved organizations may include, but is are not limited
786 to, a community college community or junior colleges, a
787 guardianship organization guardianship organizations, a and the
788 local bar association, or The Florida Bar. The training course
789 may be web-based, provided in video format, or other electronic
790 means but must be capable of ensuring the identity and
791 participation of the prospective guardian advocate. The court
792 may, in its discretion, waive some or all of the training
793 requirements for guardian advocates or impose additional
794 requirements. The court shall make its decision on a case-by
795 case basis and, in making its decision, shall consider the
796 experience and education of the guardian advocate, the duties
797 assigned to the guardian advocate, and the needs of the patient.
798 Section 10. Section 394.462, Florida Statutes, is amended
799 to read:
800 394.462 Transportation.—A transportation plan must be
801 developed and implemented by each county in accordance with this
802 section. A county may enter into a memorandum of understanding
803 with the governing boards of nearby counties to establish a
804 shared transportation plan. When multiple counties enter into a
805 memorandum of understanding for this purpose, the managing
806 entity must be notified and provided a copy of the agreement.
807 The transportation plan must describe methods of transport to a
808 facility within the designated receiving system and may identify
809 responsibility for other transportation to a participating
810 facility when necessary and agreed to by the facility. The plan
811 must describe how individuals who meet the criteria for
812 involuntary assessment and evaluation pursuant to ss. 394.463
813 and 397.675 will be transported. The plan may rely on emergency
814 medical transport services or private transport companies as
815 appropriate.
816 (1) TRANSPORTATION TO A RECEIVING FACILITY.—
817 (a) Each county shall designate a single law enforcement
818 agency within the county, or portions thereof, to take a person
819 into custody upon the entry of an ex parte order or the
820 execution of a certificate for involuntary examination by an
821 authorized professional and to transport that person to an
822 appropriate facility within the designated receiving system the
823 nearest receiving facility for examination.
824 (b)1. The designated law enforcement agency may decline to
825 transport the person to a receiving facility only if:
826 a.1. The jurisdiction designated by the county has
827 contracted on an annual basis with an emergency medical
828 transport service or private transport company for
829 transportation of persons to receiving facilities pursuant to
830 this section at the sole cost of the county; and
831 b.2. The law enforcement agency and the emergency medical
832 transport service or private transport company agree that the
833 continued presence of law enforcement personnel is not necessary
834 for the safety of the person or others.
835 2.3. The entity providing transportation jurisdiction
836 designated by the county may seek reimbursement for
837 transportation expenses. The party responsible for payment for
838 such transportation is the person receiving the transportation.
839 The county shall seek reimbursement from the following sources
840 in the following order:
841 a. From a private or public third-party payor an insurance
842 company, health care corporation, or other source, if the person
843 receiving the transportation has applicable coverage is covered
844 by an insurance policy or subscribes to a health care
845 corporation or other source for payment of such expenses.
846 b. From the person receiving the transportation.
847 c. From a financial settlement for medical care, treatment,
848 hospitalization, or transportation payable or accruing to the
849 injured party.
850 (c)(b) A Any company that transports a patient pursuant to
851 this subsection is considered an independent contractor and is
852 solely liable for the safe and dignified transport
853 transportation of the patient. Such company must be insured and
854 provide no less than $100,000 in liability insurance with
855 respect to the transport transportation of patients.
856 (d)(c) Any company that contracts with a governing board of
857 a county to transport patients shall comply with the applicable
858 rules of the department to ensure the safety and dignity of the
859 patients.
860 (e)(d) When a law enforcement officer takes custody of a
861 person pursuant to this part, the officer may request assistance
862 from emergency medical personnel if such assistance is needed
863 for the safety of the officer or the person in custody.
864 (f)(e) When a member of a mental health overlay program or
865 a mobile crisis response service is a professional authorized to
866 initiate an involuntary examination pursuant to s. 394.463 or s.
867 397.675 and that professional evaluates a person and determines
868 that transportation to a receiving facility is needed, the
869 service, at its discretion, may transport the person to the
870 facility or may call on the law enforcement agency or other
871 transportation arrangement best suited to the needs of the
872 patient.
873 (g)(f) When any law enforcement officer has custody of a
874 person based on either noncriminal or minor criminal behavior
875 that meets the statutory guidelines for involuntary examination
876 under this part, the law enforcement officer shall transport the
877 person to an appropriate the nearest receiving facility within
878 the designated receiving system for examination.
879 (h)(g) When any law enforcement officer has arrested a
880 person for a felony and it appears that the person meets the
881 statutory guidelines for involuntary examination or placement
882 under this part, such person must shall first be processed in
883 the same manner as any other criminal suspect. The law
884 enforcement agency shall thereafter immediately notify the
885 appropriate nearest public receiving facility within the
886 designated receiving system, which shall be responsible for
887 promptly arranging for the examination and treatment of the
888 person. A receiving facility is not required to admit a person
889 charged with a crime for whom the facility determines and
890 documents that it is unable to provide adequate security, but
891 shall provide mental health examination and treatment to the
892 person where he or she is held.
893 (i)(h) If the appropriate law enforcement officer believes
894 that a person has an emergency medical condition as defined in
895 s. 395.002, the person may be first transported to a hospital
896 for emergency medical treatment, regardless of whether the
897 hospital is a designated receiving facility.
898 (j)(i) The costs of transportation, evaluation,
899 hospitalization, and treatment incurred under this subsection by
900 persons who have been arrested for violations of any state law
901 or county or municipal ordinance may be recovered as provided in
902 s. 901.35.
903 (k)(j) The nearest receiving facility within the designated
904 receiving system must accept, pursuant to this part, persons
905 brought by law enforcement officers, an emergency medical
906 transport service, or a private transport company for
907 involuntary examination.
908 (l)(k) Each law enforcement agency designated pursuant to
909 paragraph (a) shall establish a policy that develop a memorandum
910 of understanding with each receiving facility within the law
911 enforcement agency’s jurisdiction which reflects a single set of
912 protocols approved by the managing entity for the safe and
913 secure transportation of the person and transfer of custody of
914 the person. These protocols must also address crisis
915 intervention measures.
916 (m)(l) When a jurisdiction has entered into a contract with
917 an emergency medical transport service or a private transport
918 company for transportation of persons to receiving facilities
919 within the designated receiving system, such service or company
920 shall be given preference for transportation of persons from
921 nursing homes, assisted living facilities, adult day care
922 centers, or adult family-care homes, unless the behavior of the
923 person being transported is such that transportation by a law
924 enforcement officer is necessary.
925 (n)(m) Nothing in This section may not shall be construed
926 to limit emergency examination and treatment of incapacitated
927 persons provided in accordance with the provisions of s.
928 401.445.
929 (2) TRANSPORTATION TO A TREATMENT FACILITY.—
930 (a) If neither the patient nor any person legally obligated
931 or responsible for the patient is able to pay for the expense of
932 transporting a voluntary or involuntary patient to a treatment
933 facility, the transportation plan established by the governing
934 board of the county or counties must specify how in which the
935 hospitalized patient will be transported to, from, and between
936 facilities in a is hospitalized shall arrange for such required
937 transportation and shall ensure the safe and dignified manner
938 transportation of the patient. The governing board of each
939 county is authorized to contract with private transport
940 companies for the transportation of such patients to and from a
941 treatment facility.
942 (b) A Any company that transports a patient pursuant to
943 this subsection is considered an independent contractor and is
944 solely liable for the safe and dignified transportation of the
945 patient. Such company must be insured and provide no less than
946 $100,000 in liability insurance with respect to the transport
947 transportation of patients.
948 (c) A Any company that contracts with one or more counties
949 the governing board of a county to transport patients in
950 accordance with this section shall comply with the applicable
951 rules of the department to ensure the safety and dignity of the
952 patients.
953 (d) County or municipal law enforcement and correctional
954 personnel and equipment may shall not be used to transport
955 patients adjudicated incapacitated or found by the court to meet
956 the criteria for involuntary placement pursuant to s. 394.467,
957 except in small rural counties where there are no cost-efficient
958 alternatives.
959 (3) TRANSFER OF CUSTODY.—Custody of a person who is
960 transported pursuant to this part, along with related
961 documentation, shall be relinquished to a responsible individual
962 at the appropriate receiving or treatment facility.
963 (4) EXCEPTIONS.—An exception to the requirements of this
964 section may be granted by the secretary of the department for
965 the purposes of improving service coordination or better meeting
966 the special needs of individuals. A proposal for an exception
967 must be submitted by the district administrator after being
968 approved by the governing boards of any affected counties, prior
969 to submission to the secretary.
970 (a) A proposal for an exception must identify the specific
971 provision from which an exception is requested; describe how the
972 proposal will be implemented by participating law enforcement
973 agencies and transportation authorities; and provide a plan for
974 the coordination of services such as case management.
975 (b) The exception may be granted only for:
976 1. An arrangement centralizing and improving the provision
977 of services within a district, which may include an exception to
978 the requirement for transportation to the nearest receiving
979 facility;
980 2. An arrangement by which a facility may provide, in
981 addition to required psychiatric services, an environment and
982 services which are uniquely tailored to the needs of an
983 identified group of persons with special needs, such as persons
984 with hearing impairments or visual impairments, or elderly
985 persons with physical frailties; or
986 3. A specialized transportation system that provides an
987 efficient and humane method of transporting patients to
988 receiving facilities, among receiving facilities, and to
989 treatment facilities.
990 (c) Any exception approved pursuant to this subsection
991 shall be reviewed and approved every 5 years by the secretary.
992 Section 11. Subsection (2) of section 394.463, Florida
993 Statutes, is amended to read:
994 394.463 Involuntary examination.—
995 (2) INVOLUNTARY EXAMINATION.—
996 (a) An involuntary examination may be initiated by any one
997 of the following means:
998 1. A circuit or county court may enter an ex parte order
999 stating that a person appears to meet the criteria for
1000 involuntary examination and specifying, giving the findings on
1001 which that conclusion is based. The ex parte order for
1002 involuntary examination must be based on written or oral sworn
1003 testimony that includes specific facts that support the
1004 findings, written or oral. If other, less restrictive, means are
1005 not available, such as voluntary appearance for outpatient
1006 evaluation, a law enforcement officer, or other designated agent
1007 of the court, shall take the person into custody and deliver him
1008 or her to an appropriate the nearest receiving facility within
1009 the designated receiving system for involuntary examination. The
1010 order of the court shall be made a part of the patient’s
1011 clinical record. A No fee may not shall be charged for the
1012 filing of an order under this subsection. Any receiving facility
1013 accepting the patient based on this order must send a copy of
1014 the order to the managing entity in the region Agency for Health
1015 Care Administration on the next working day. The order may be
1016 submitted electronically through existing data systems, if
1017 available. The order shall be valid only until the person is
1018 delivered to the appropriate facility executed or, if not
1019 executed, for the period specified in the order itself,
1020 whichever comes first. If no time limit is specified in the
1021 order, the order shall be valid for 7 days after the date that
1022 the order was signed.
1023 2. A law enforcement officer shall take a person who
1024 appears to meet the criteria for involuntary examination into
1025 custody and deliver the person or have him or her delivered to
1026 the appropriate nearest receiving facility within the designated
1027 receiving system for examination. The officer shall execute a
1028 written report detailing the circumstances under which the
1029 person was taken into custody, which must and the report shall
1030 be made a part of the patient’s clinical record. Any receiving
1031 facility accepting the patient based on this report must send a
1032 copy of the report to the department and the managing entity
1033 Agency for Health Care Administration on the next working day.
1034 3. A physician, clinical psychologist, psychiatric nurse,
1035 mental health counselor, marriage and family therapist, or
1036 clinical social worker may execute a certificate stating that he
1037 or she has examined a person within the preceding 48 hours and
1038 finds that the person appears to meet the criteria for
1039 involuntary examination and stating the observations upon which
1040 that conclusion is based. If other, less restrictive means, such
1041 as voluntary appearance for outpatient evaluation, are not
1042 available, such as voluntary appearance for outpatient
1043 evaluation, a law enforcement officer shall take into custody
1044 the person named in the certificate into custody and deliver him
1045 or her to the appropriate nearest receiving facility within the
1046 designated receiving system for involuntary examination. The law
1047 enforcement officer shall execute a written report detailing the
1048 circumstances under which the person was taken into custody. The
1049 report and certificate shall be made a part of the patient’s
1050 clinical record. Any receiving facility accepting the patient
1051 based on this certificate must send a copy of the certificate to
1052 the managing entity Agency for Health Care Administration on the
1053 next working day. The document may be submitted electronically
1054 through existing data systems, if applicable.
1055 (b) A person may shall not be removed from any program or
1056 residential placement licensed under chapter 400 or chapter 429
1057 and transported to a receiving facility for involuntary
1058 examination unless an ex parte order, a professional
1059 certificate, or a law enforcement officer’s report is first
1060 prepared. If the condition of the person is such that
1061 preparation of a law enforcement officer’s report is not
1062 practicable before removal, the report shall be completed as
1063 soon as possible after removal, but in any case before the
1064 person is transported to a receiving facility. A receiving
1065 facility admitting a person for involuntary examination who is
1066 not accompanied by the required ex parte order, professional
1067 certificate, or law enforcement officer’s report shall notify
1068 the managing entity Agency for Health Care Administration of
1069 such admission by certified mail or by e-mail, if available, by
1070 no later than the next working day. The provisions of this
1071 paragraph do not apply when transportation is provided by the
1072 patient’s family or guardian.
1073 (c) A law enforcement officer acting in accordance with an
1074 ex parte order issued pursuant to this subsection may serve and
1075 execute such order on any day of the week, at any time of the
1076 day or night.
1077 (d) A law enforcement officer acting in accordance with an
1078 ex parte order issued pursuant to this subsection may use such
1079 reasonable physical force as is necessary to gain entry to the
1080 premises, and any dwellings, buildings, or other structures
1081 located on the premises, and to take custody of the person who
1082 is the subject of the ex parte order.
1083 (e) The managing entity and the department Agency for
1084 Health Care Administration shall receive and maintain the copies
1085 of ex parte petitions and orders, involuntary outpatient
1086 services placement orders issued pursuant to s. 394.4655,
1087 involuntary inpatient placement orders issued pursuant to s.
1088 394.467, professional certificates, and law enforcement
1089 officers’ reports. These documents shall be considered part of
1090 the clinical record, governed by the provisions of s. 394.4615.
1091 These documents shall be used to The agency shall prepare annual
1092 reports analyzing the data obtained from these documents,
1093 without information identifying patients, and shall provide
1094 copies of reports to the department, the President of the
1095 Senate, the Speaker of the House of Representatives, and the
1096 minority leaders of the Senate and the House of Representatives.
1097 (f) A patient shall be examined by a physician or, a
1098 clinical psychologist, or by a psychiatric nurse performing
1099 within the framework of an established protocol with a
1100 psychiatrist at a receiving facility without unnecessary delay
1101 to determine if the criteria for involuntary services are met.
1102 Emergency treatment may be provided and may, upon the order of a
1103 physician, if the physician determines be given emergency
1104 treatment if it is determined that such treatment is necessary
1105 for the safety of the patient or others. The patient may not be
1106 released by the receiving facility or its contractor without the
1107 documented approval of a psychiatrist or a clinical psychologist
1108 or, if the receiving facility is owned or operated by a hospital
1109 or health system, the release may also be approved by a
1110 psychiatric nurse performing within the framework of an
1111 established protocol with a psychiatrist, or an attending
1112 emergency department physician with experience in the diagnosis
1113 and treatment of mental illness and nervous disorders and after
1114 completion of an involuntary examination pursuant to this
1115 subsection. A psychiatric nurse may not approve the release of a
1116 patient if the involuntary examination was initiated by a
1117 psychiatrist unless the release is approved by the initiating
1118 psychiatrist. However, a patient may not be held in a receiving
1119 facility for involuntary examination longer than 72 hours.
1120 (g) A person may not be held for involuntary examination
1121 for more than 72 hours from the time of his or her arrival at
1122 the facility unless one of the following actions is taken at the
1123 end of the 72-hour examination period or the next business day,
1124 if the examination period ends on a weekend or holiday:
1125 1. The person must be released with the approval of a
1126 physician, psychiatrist, psychiatric nurse, or clinical
1127 psychologist. However, if the examination is conducted in a
1128 hospital, an attending emergency department physician with
1129 experience in the diagnosis and treatment of mental illness may
1130 approve the release.
1131 2. The person must be asked to give express and informed
1132 consent for voluntary admission if a physician, psychiatrist,
1133 psychiatric nurse, or clinical psychologist has determined that
1134 the individual is competent to consent to treatment.
1135 3. A petition for involuntary services must be completed
1136 and filed in the circuit court by the facility administrator. If
1137 electronic filing of the petition is not available in the county
1138 and the 72-hour period ends on a weekend or legal holiday, the
1139 petition must be filed by the next working day. If involuntary
1140 services are deemed necessary, the least restrictive treatment
1141 consistent with the optimum improvement of the person’s
1142 condition must be made available.
1143 (h) An individual discharged from a facility who is
1144 currently charged with a crime shall be released to the custody
1145 of a law enforcement officer, unless the individual has been
1146 released from law enforcement custody by posting of a bond, by a
1147 pretrial conditional release, or by other judicial release.
1148 (i)(g) A person for whom an involuntary examination has
1149 been initiated who is being evaluated or treated at a hospital
1150 for an emergency medical condition specified in s. 395.002 must
1151 be examined by an appropriate a receiving facility within 72
1152 hours. The 72-hour period begins when the patient arrives at the
1153 hospital and ceases when the attending physician documents that
1154 the patient has an emergency medical condition. If the patient
1155 is examined at a hospital providing emergency medical services
1156 by a professional qualified to perform an involuntary
1157 examination and is found as a result of that examination not to
1158 meet the criteria for involuntary outpatient services placement
1159 pursuant to s. 394.4655(1) or involuntary inpatient placement
1160 pursuant to s. 394.467(1), the patient may be offered voluntary
1161 services or placement, if appropriate, or released directly from
1162 the hospital providing emergency medical services. The finding
1163 by the professional that the patient has been examined and does
1164 not meet the criteria for involuntary inpatient placement or
1165 involuntary outpatient services placement must be entered into
1166 the patient’s clinical record. Nothing in This paragraph is not
1167 intended to prevent a hospital providing emergency medical
1168 services from appropriately transferring a patient to another
1169 hospital before prior to stabilization if, provided the
1170 requirements of s. 395.1041(3)(c) have been met.
1171 (j)(h) One of the following must occur within 12 hours
1172 after the patient’s attending physician documents that the
1173 patient’s medical condition has stabilized or that an emergency
1174 medical condition does not exist:
1175 1. The patient must be examined by an appropriate a
1176 designated receiving facility and released; or
1177 2. The patient must be transferred to a designated
1178 receiving facility in which appropriate medical treatment is
1179 available. However, the receiving facility must be notified of
1180 the transfer within 2 hours after the patient’s condition has
1181 been stabilized or after determination that an emergency medical
1182 condition does not exist.
1183 (i) Within the 72-hour examination period or, if the 72
1184 hours ends on a weekend or holiday, no later than the next
1185 working day thereafter, one of the following actions must be
1186 taken, based on the individual needs of the patient:
1187 1. The patient shall be released, unless he or she is
1188 charged with a crime, in which case the patient shall be
1189 returned to the custody of a law enforcement officer;
1190 2. The patient shall be released, subject to the provisions
1191 of subparagraph 1., for voluntary outpatient treatment;
1192 3. The patient, unless he or she is charged with a crime,
1193 shall be asked to give express and informed consent to placement
1194 as a voluntary patient, and, if such consent is given, the
1195 patient shall be admitted as a voluntary patient; or
1196 4. A petition for involuntary placement shall be filed in
1197 the circuit court when outpatient or inpatient treatment is
1198 deemed necessary. When inpatient treatment is deemed necessary,
1199 the least restrictive treatment consistent with the optimum
1200 improvement of the patient’s condition shall be made available.
1201 When a petition is to be filed for involuntary outpatient
1202 placement, it shall be filed by one of the petitioners specified
1203 in s. 394.4655(3)(a). A petition for involuntary inpatient
1204 placement shall be filed by the facility administrator.
1205 Section 12. Section 394.4655, Florida Statutes, is amended
1206 to read:
1207 394.4655 Involuntary outpatient services placement.—
1208 (1) CRITERIA FOR INVOLUNTARY OUTPATIENT SERVICES
1209 PLACEMENT.—A person may be ordered to involuntary outpatient
1210 services placement upon a finding of the court, by clear and
1211 convincing evidence, that the person meets all of the following
1212 criteria by clear and convincing evidence:
1213 (a) The person is 18 years of age or older.;
1214 (b) The person has a mental illness.;
1215 (c) The person is unlikely to survive safely in the
1216 community without supervision, based on a clinical
1217 determination.;
1218 (d) The person has a history of lack of compliance with
1219 treatment for mental illness.;
1220 (e) The person has:
1221 1. At least twice within the immediately preceding 36
1222 months been involuntarily admitted to a receiving or treatment
1223 facility as defined in s. 394.455, or has received mental health
1224 services in a forensic or correctional facility. The 36-month
1225 period does not include any period during which the person was
1226 admitted or incarcerated; or
1227 2. Engaged in one or more acts of serious violent behavior
1228 toward self or others, or attempts at serious bodily harm to
1229 himself or herself or others, within the preceding 36 months.;
1230 (f) The person is, as a result of his or her mental
1231 illness, unlikely to voluntarily participate in the recommended
1232 treatment plan and either he or she has refused voluntary
1233 services placement for treatment after sufficient and
1234 conscientious explanation and disclosure of why the services are
1235 necessary purpose of placement for treatment or he or she is
1236 unable to determine for himself or herself whether services are
1237 placement is necessary.;
1238 (g) In view of the person’s treatment history and current
1239 behavior, the person is in need of involuntary outpatient
1240 services placement in order to prevent a relapse or
1241 deterioration that would be likely to result in serious bodily
1242 harm to himself or herself or others, or a substantial harm to
1243 his or her well-being as set forth in s. 394.463(1).;
1244 (h) It is likely that the person will benefit from
1245 involuntary outpatient services. placement; and
1246 (i) All available, less restrictive alternatives that would
1247 offer an opportunity for improvement of his or her condition
1248 have been judged to be inappropriate or unavailable.
1249 (2) INVOLUNTARY OUTPATIENT SERVICES PLACEMENT.—
1250 (a)1. A patient who is being recommended for involuntary
1251 outpatient services placement by the administrator of the
1252 receiving facility where the patient has been examined may be
1253 retained by the facility after adherence to the notice
1254 procedures provided in s. 394.4599. The recommendation must be
1255 supported by the opinion of two qualified professionals a
1256 psychiatrist and the second opinion of a clinical psychologist
1257 or another psychiatrist, both of whom have personally examined
1258 the patient within the preceding 72 hours, that the criteria for
1259 involuntary outpatient services placement are met. However, in a
1260 county having a population of fewer than 50,000, if the
1261 administrator certifies that a psychiatrist or clinical
1262 psychologist is not available to provide the second opinion, the
1263 second opinion may be provided by a licensed physician who has
1264 postgraduate training and experience in diagnosis and treatment
1265 of mental and nervous disorders or by a psychiatric nurse. Any
1266 second opinion authorized in this subparagraph may be conducted
1267 through a face-to-face examination, in person or by electronic
1268 means. Such recommendation must be entered on an involuntary
1269 outpatient services placement certificate that authorizes the
1270 receiving facility to retain the patient pending completion of a
1271 hearing. The certificate must shall be made a part of the
1272 patient’s clinical record.
1273 2. If the patient has been stabilized and no longer meets
1274 the criteria for involuntary examination pursuant to s.
1275 394.463(1), the patient must be released from the receiving
1276 facility while awaiting the hearing for involuntary outpatient
1277 services placement. Before filing a petition for involuntary
1278 outpatient services treatment, the administrator of the a
1279 receiving facility or a designated department representative
1280 must identify the service provider that will have primary
1281 responsibility for service provision under an order for
1282 involuntary outpatient services placement, unless the person is
1283 otherwise participating in outpatient psychiatric treatment and
1284 is not in need of public financing for that treatment, in which
1285 case the individual, if eligible, may be ordered to involuntary
1286 treatment pursuant to the existing psychiatric treatment
1287 relationship.
1288 3. The service provider shall prepare a written proposed
1289 treatment plan in consultation with the patient or the patient’s
1290 guardian advocate, if appointed, for the court’s consideration
1291 for inclusion in the involuntary outpatient services placement
1292 order. The service provider shall also provide a copy of the
1293 treatment plan that addresses the nature and extent of the
1294 mental illness and any co-occurring substance abuse disorders
1295 that necessitate involuntary outpatient services. The treatment
1296 plan must specify the likely level of care, including the use of
1297 medication, and anticipated discharge criteria for terminating
1298 involuntary outpatient services. The service provider shall also
1299 provide a copy of the proposed treatment plan to the patient and
1300 the administrator of the receiving facility. The treatment plan
1301 must specify the nature and extent of the patient’s mental
1302 illness, address the reduction of symptoms that necessitate
1303 involuntary outpatient placement, and include measurable goals
1304 and objectives for the services and treatment that are provided
1305 to treat the person’s mental illness and assist the person in
1306 living and functioning in the community or to prevent a relapse
1307 or deterioration. Service providers may select and supervise
1308 other individuals to implement specific aspects of the treatment
1309 plan. The services in the treatment plan must be deemed
1310 clinically appropriate by a physician, clinical psychologist,
1311 psychiatric nurse, mental health counselor, marriage and family
1312 therapist, or clinical social worker who consults with, or is
1313 employed or contracted by, the service provider. The service
1314 provider must certify to the court in the proposed treatment
1315 plan whether sufficient services for improvement and
1316 stabilization are currently available and whether the service
1317 provider agrees to provide those services. If the service
1318 provider certifies that the services in the proposed treatment
1319 plan are not available, the petitioner may not file the
1320 petition. The service provider must notify the managing entity
1321 as to the availability of the requested services. The managing
1322 entity must document such efforts to obtain the requested
1323 services.
1324 (b) If a patient in involuntary inpatient placement meets
1325 the criteria for involuntary outpatient services placement, the
1326 administrator of the treatment facility may, before the
1327 expiration of the period during which the treatment facility is
1328 authorized to retain the patient, recommend involuntary
1329 outpatient services placement. The recommendation must be
1330 supported by the opinion of two qualified professionals a
1331 psychiatrist and the second opinion of a clinical psychologist
1332 or another psychiatrist, both of whom have personally examined
1333 the patient within the preceding 72 hours, that the criteria for
1334 involuntary outpatient services placement are met. However, in a
1335 county having a population of fewer than 50,000, if the
1336 administrator certifies that a psychiatrist or clinical
1337 psychologist is not available to provide the second opinion, the
1338 second opinion may be provided by a licensed physician who has
1339 postgraduate training and experience in diagnosis and treatment
1340 of mental and nervous disorders or by a psychiatric nurse. Any
1341 second opinion authorized in this subparagraph may be conducted
1342 through a face-to-face examination, in person or by electronic
1343 means. Such recommendation must be entered on an involuntary
1344 outpatient services placement certificate, and the certificate
1345 must be made a part of the patient’s clinical record.
1346 (c)1. The administrator of the treatment facility shall
1347 provide a copy of the involuntary outpatient services placement
1348 certificate and a copy of the state mental health discharge form
1349 to the managing entity a department representative in the county
1350 where the patient will be residing. For persons who are leaving
1351 a state mental health treatment facility, the petition for
1352 involuntary outpatient services placement must be filed in the
1353 county where the patient will be residing.
1354 2. The service provider that will have primary
1355 responsibility for service provision shall be identified by the
1356 designated department representative before prior to the order
1357 for involuntary outpatient services placement and must, before
1358 prior to filing a petition for involuntary outpatient services
1359 placement, certify to the court whether the services recommended
1360 in the patient’s discharge plan are available in the local
1361 community and whether the service provider agrees to provide
1362 those services. The service provider must develop with the
1363 patient, or the patient’s guardian advocate, if appointed, a
1364 treatment or service plan that addresses the needs identified in
1365 the discharge plan. The plan must be deemed to be clinically
1366 appropriate by a physician, clinical psychologist, psychiatric
1367 nurse, mental health counselor, marriage and family therapist,
1368 or clinical social worker, as defined in this chapter, who
1369 consults with, or is employed or contracted by, the service
1370 provider.
1371 3. If the service provider certifies that the services in
1372 the proposed treatment or service plan are not available, the
1373 petitioner may not file the petition. The service provider must
1374 notify the managing entity as to the availability of the
1375 requested services. The managing entity must document such
1376 efforts to obtain the requested services.
1377 (3) PETITION FOR INVOLUNTARY OUTPATIENT SERVICES
1378 PLACEMENT.—
1379 (a) A petition for involuntary outpatient services
1380 placement may be filed by:
1381 1. The administrator of a receiving facility; or
1382 2. The administrator of a treatment facility.
1383 (b) Each required criterion for involuntary outpatient
1384 services placement must be alleged and substantiated in the
1385 petition for involuntary outpatient services placement. A copy
1386 of the certificate recommending involuntary outpatient services
1387 placement completed by two a qualified professionals
1388 professional specified in subsection (2) must be attached to the
1389 petition. A copy of the proposed treatment plan must be attached
1390 to the petition. Before the petition is filed, the service
1391 provider shall certify that the services in the proposed
1392 treatment plan are available. If the necessary services are not
1393 available in the patient’s local community to respond to the
1394 person’s individual needs, the petition may not be filed. The
1395 service provider must notify the managing entity as to the
1396 availability of the requested services. The managing entity must
1397 document such efforts to obtain the requested services.
1398 (c) The petition for involuntary outpatient services
1399 placement must be filed in the county where the patient is
1400 located, unless the patient is being placed from a state
1401 treatment facility, in which case the petition must be filed in
1402 the county where the patient will reside. When the petition has
1403 been filed, the clerk of the court shall provide copies of the
1404 petition and the proposed treatment plan to the department, the
1405 managing entity, the patient, the patient’s guardian or
1406 representative, the state attorney, and the public defender or
1407 the patient’s private counsel. A fee may not be charged for
1408 filing a petition under this subsection.
1409 (4) APPOINTMENT OF COUNSEL.—
1410 (a) Within 1 court working day after the filing of a
1411 petition for involuntary outpatient services placement, the
1412 court shall appoint the public defender to represent the person
1413 who is the subject of the petition, unless the person is
1414 otherwise represented by counsel. The clerk of the court shall
1415 immediately notify the public defender of the appointment. The
1416 public defender shall represent the person until the petition is
1417 dismissed, the court order expires, or the patient is discharged
1418 from involuntary outpatient services placement. An attorney who
1419 represents the patient must be provided shall have access to the
1420 patient, witnesses, and records relevant to the presentation of
1421 the patient’s case and shall represent the interests of the
1422 patient, regardless of the source of payment to the attorney.
1423 (b) The state attorney for the circuit in which the patient
1424 is located shall represent the state as the real party in
1425 interest in the proceeding and must be provided access to the
1426 patient’s clinical records and witnesses. The state attorney is
1427 authorized to independently evaluate the sufficiency and
1428 appropriateness of the petition for involuntary outpatient
1429 services.
1430 (5) CONTINUANCE OF HEARING.—The patient is entitled, with
1431 the concurrence of the patient’s counsel, to at least one
1432 continuance of the hearing. The continuance shall be for a
1433 period of up to 4 weeks.
1434 (6) HEARING ON INVOLUNTARY OUTPATIENT SERVICES PLACEMENT.—
1435 (a)1. The court shall hold the hearing on involuntary
1436 outpatient services placement within 5 working days after the
1437 filing of the petition, unless a continuance is granted. The
1438 hearing must shall be held in the county where the petition is
1439 filed, must shall be as convenient to the patient as is
1440 consistent with orderly procedure, and must shall be conducted
1441 in physical settings not likely to be injurious to the patient’s
1442 condition. If the court finds that the patient’s attendance at
1443 the hearing is not consistent with the best interests of the
1444 patient and if the patient’s counsel does not object, the court
1445 may waive the presence of the patient from all or any portion of
1446 the hearing. The state attorney for the circuit in which the
1447 patient is located shall represent the state, rather than the
1448 petitioner, as the real party in interest in the proceeding.
1449 2. The court may appoint a magistrate master to preside at
1450 the hearing. One of the professionals who executed the
1451 involuntary outpatient services placement certificate shall be a
1452 witness. The patient and the patient’s guardian or
1453 representative shall be informed by the court of the right to an
1454 independent expert examination. If the patient cannot afford
1455 such an examination, the court shall ensure that one is
1456 provided, as otherwise provided by law provide for one. The
1457 independent expert’s report is shall be confidential and not
1458 discoverable, unless the expert is to be called as a witness for
1459 the patient at the hearing. The court shall allow testimony from
1460 individuals, including family members, deemed by the court to be
1461 relevant under state law, regarding the person’s prior history
1462 and how that prior history relates to the person’s current
1463 condition. The testimony in the hearing must be given under
1464 oath, and the proceedings must be recorded. The patient may
1465 refuse to testify at the hearing.
1466 (b)1. If the court concludes that the patient meets the
1467 criteria for involuntary outpatient services placement pursuant
1468 to subsection (1), the court shall issue an order for
1469 involuntary outpatient services placement. The court order shall
1470 be for a period of up to 90 days 6 months. The order must
1471 specify the nature and extent of the patient’s mental illness.
1472 The order of the court and the treatment plan must shall be made
1473 part of the patient’s clinical record. The service provider
1474 shall discharge a patient from involuntary outpatient services
1475 placement when the order expires or any time the patient no
1476 longer meets the criteria for involuntary services placement.
1477 Upon discharge, the service provider shall send a certificate of
1478 discharge to the court.
1479 2. The court may not order the department or the service
1480 provider to provide services if the program or service is not
1481 available in the patient’s local community, if there is no space
1482 available in the program or service for the patient, or if
1483 funding is not available for the program or service. The service
1484 provider must notify the managing entity as to the availability
1485 of the requested services. The managing entity must document
1486 such efforts to obtain the requested services. A copy of the
1487 order must be sent to the managing entity Agency for Health Care
1488 Administration by the service provider within 1 working day
1489 after it is received from the court. The order may be submitted
1490 electronically through existing data systems. After the
1491 placement order for involuntary services is issued, the service
1492 provider and the patient may modify provisions of the treatment
1493 plan. For any material modification of the treatment plan to
1494 which the patient or, if one is appointed, the patient’s
1495 guardian advocate agrees, if appointed, does agree, the service
1496 provider shall send notice of the modification to the court. Any
1497 material modifications of the treatment plan which are contested
1498 by the patient or the patient’s guardian advocate, if applicable
1499 appointed, must be approved or disapproved by the court
1500 consistent with subsection (2).
1501 3. If, in the clinical judgment of a physician, the patient
1502 has failed or has refused to comply with the treatment ordered
1503 by the court, and, in the clinical judgment of the physician,
1504 efforts were made to solicit compliance and the patient may meet
1505 the criteria for involuntary examination, a person may be
1506 brought to a receiving facility pursuant to s. 394.463. If,
1507 after examination, the patient does not meet the criteria for
1508 involuntary inpatient placement pursuant to s. 394.467, the
1509 patient must be discharged from the receiving facility. The
1510 involuntary outpatient services placement order shall remain in
1511 effect unless the service provider determines that the patient
1512 no longer meets the criteria for involuntary outpatient services
1513 placement or until the order expires. The service provider must
1514 determine whether modifications should be made to the existing
1515 treatment plan and must attempt to continue to engage the
1516 patient in treatment. For any material modification of the
1517 treatment plan to which the patient or the patient’s guardian
1518 advocate, if applicable appointed, agrees does agree, the
1519 service provider shall send notice of the modification to the
1520 court. Any material modifications of the treatment plan which
1521 are contested by the patient or the patient’s guardian advocate,
1522 if applicable appointed, must be approved or disapproved by the
1523 court consistent with subsection (2).
1524 (c) If, at any time before the conclusion of the initial
1525 hearing on involuntary outpatient services placement, it appears
1526 to the court that the person does not meet the criteria for
1527 involuntary outpatient services placement under this section
1528 but, instead, meets the criteria for involuntary inpatient
1529 placement, the court may order the person admitted for
1530 involuntary inpatient examination under s. 394.463. If the
1531 person instead meets the criteria for involuntary assessment,
1532 protective custody, or involuntary admission pursuant to s.
1533 397.675, the court may order the person to be admitted for
1534 involuntary assessment for a period of 5 days pursuant to s.
1535 397.6811. Thereafter, all proceedings are shall be governed by
1536 chapter 397.
1537 (d) At the hearing on involuntary outpatient services
1538 placement, the court shall consider testimony and evidence
1539 regarding the patient’s competence to consent to treatment. If
1540 the court finds that the patient is incompetent to consent to
1541 treatment, it shall appoint a guardian advocate as provided in
1542 s. 394.4598. The guardian advocate shall be appointed or
1543 discharged in accordance with s. 394.4598.
1544 (e) The administrator of the receiving facility or the
1545 designated department representative shall provide a copy of the
1546 court order and adequate documentation of a patient’s mental
1547 illness to the service provider for involuntary outpatient
1548 services placement. Such documentation must include any advance
1549 directives made by the patient, a psychiatric evaluation of the
1550 patient, and any evaluations of the patient performed by a
1551 clinical psychologist or a clinical social worker.
1552 (7) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT SERVICES
1553 PLACEMENT.—
1554 (a)1. If the person continues to meet the criteria for
1555 involuntary outpatient services placement, the service provider
1556 shall, at least 10 days before the expiration of the period
1557 during which the treatment is ordered for the person, file in
1558 the circuit court a petition for continued involuntary
1559 outpatient services placement. The court shall immediately
1560 schedule a hearing on the petition to be held within 15 days
1561 after the petition is filed.
1562 2. The existing involuntary outpatient services placement
1563 order remains in effect until disposition on the petition for
1564 continued involuntary outpatient services placement.
1565 3. A certificate shall be attached to the petition which
1566 includes a statement from the person’s physician or clinical
1567 psychologist justifying the request, a brief description of the
1568 patient’s treatment during the time he or she was receiving
1569 involuntarily services placed, and an individualized plan of
1570 continued treatment.
1571 4. The service provider shall develop the individualized
1572 plan of continued treatment in consultation with the patient or
1573 the patient’s guardian advocate, if applicable appointed. When
1574 the petition has been filed, the clerk of the court shall
1575 provide copies of the certificate and the individualized plan of
1576 continued treatment to the department, the patient, the
1577 patient’s guardian advocate, the state attorney, and the
1578 patient’s private counsel or the public defender.
1579 (b) Within 1 court working day after the filing of a
1580 petition for continued involuntary outpatient services
1581 placement, the court shall appoint the public defender to
1582 represent the person who is the subject of the petition, unless
1583 the person is otherwise represented by counsel. The clerk of the
1584 court shall immediately notify the public defender of such
1585 appointment. The public defender shall represent the person
1586 until the petition is dismissed or the court order expires or
1587 the patient is discharged from involuntary outpatient services
1588 placement. Any attorney representing the patient shall have
1589 access to the patient, witnesses, and records relevant to the
1590 presentation of the patient’s case and shall represent the
1591 interests of the patient, regardless of the source of payment to
1592 the attorney.
1593 (c) Hearings on petitions for continued involuntary
1594 outpatient services must placement shall be before the circuit
1595 court. The court may appoint a magistrate master to preside at
1596 the hearing. The procedures for obtaining an order pursuant to
1597 this paragraph must meet the requirements of shall be in
1598 accordance with subsection (6), except that the time period
1599 included in paragraph (1)(e) does not apply when is not
1600 applicable in determining the appropriateness of additional
1601 periods of involuntary outpatient services placement.
1602 (d) Notice of the hearing must shall be provided as set
1603 forth in s. 394.4599. The patient and the patient’s attorney may
1604 agree to a period of continued outpatient services placement
1605 without a court hearing.
1606 (e) The same procedure must shall be repeated before the
1607 expiration of each additional period the patient is placed in
1608 treatment.
1609 (f) If the patient has previously been found incompetent to
1610 consent to treatment, the court shall consider testimony and
1611 evidence regarding the patient’s competence. Section 394.4598
1612 governs the discharge of the guardian advocate if the patient’s
1613 competency to consent to treatment has been restored.
1614 Section 13. Section 394.467, Florida Statutes, is amended
1615 to read:
1616 394.467 Involuntary inpatient placement.—
1617 (1) CRITERIA.—A person may be ordered for placed in
1618 involuntary inpatient placement for treatment upon a finding of
1619 the court by clear and convincing evidence that:
1620 (a) He or she has a mental illness is mentally ill and
1621 because of his or her mental illness:
1622 1.a. He or she has refused voluntary inpatient placement
1623 for treatment after sufficient and conscientious explanation and
1624 disclosure of the purpose of inpatient placement for treatment;
1625 or
1626 b. He or she is unable to determine for himself or herself
1627 whether inpatient placement is necessary; and
1628 2.a. He or she is manifestly incapable of surviving alone
1629 or with the help of willing and responsible family or friends,
1630 including available alternative services, and, without
1631 treatment, is likely to suffer from neglect or refuse to care
1632 for himself or herself, and such neglect or refusal poses a real
1633 and present threat of substantial harm to his or her well-being;
1634 or
1635 b. There is substantial likelihood that in the near future
1636 he or she will inflict serious bodily harm on self or others
1637 himself or herself or another person, as evidenced by recent
1638 behavior causing, attempting, or threatening such harm; and
1639 (b) All available less restrictive treatment alternatives
1640 that which would offer an opportunity for improvement of his or
1641 her condition have been judged to be inappropriate.
1642 (2) ADMISSION TO A TREATMENT FACILITY.—A patient may be
1643 retained by a receiving facility or involuntarily placed in a
1644 treatment facility upon the recommendation of the administrator
1645 of the receiving facility where the patient has been examined
1646 and after adherence to the notice and hearing procedures
1647 provided in s. 394.4599. The recommendation must be supported by
1648 the opinion two qualified professionals of a psychiatrist and
1649 the second opinion of a clinical psychologist or another
1650 psychiatrist, both of whom have personally examined the patient
1651 within the preceding 72 hours, that the criteria for involuntary
1652 inpatient placement are met. However, in a county that has a
1653 population of fewer than 50,000, if the administrator certifies
1654 that a psychiatrist or clinical psychologist is not available to
1655 provide the second opinion, the second opinion may be provided
1656 by a licensed physician who has postgraduate training and
1657 experience in diagnosis and treatment of mental and nervous
1658 disorders or by a psychiatric nurse. Any second opinion
1659 authorized in this subsection may be conducted through a face
1660 to-face examination, in person or by electronic means. Such
1661 recommendation shall be entered on a petition for an involuntary
1662 inpatient placement certificate that authorizes the receiving
1663 facility to retain the patient pending transfer to a treatment
1664 facility or completion of a hearing.
1665 (3) PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.—
1666 (a) The administrator of the facility shall file a petition
1667 for involuntary inpatient placement in the court in the county
1668 where the patient is located. Upon filing, the clerk of the
1669 court shall provide copies to the department, the patient, the
1670 patient’s guardian or representative, and the state attorney and
1671 public defender of the judicial circuit in which the patient is
1672 located. A No fee may not shall be charged for the filing of a
1673 petition under this subsection.
1674 (b) A facility filing a petition under this subsection for
1675 involuntary inpatient placement shall send a copy of the
1676 petition to the managing entity in its area.
1677 (4) APPOINTMENT OF COUNSEL.—
1678 (a) Within 1 court working day after the filing of a
1679 petition for involuntary inpatient placement, the court shall
1680 appoint the public defender to represent the person who is the
1681 subject of the petition, unless the person is otherwise
1682 represented by counsel. The clerk of the court shall immediately
1683 notify the public defender of such appointment. Any attorney
1684 representing the patient shall have access to the patient,
1685 witnesses, and records relevant to the presentation of the
1686 patient’s case and shall represent the interests of the patient,
1687 regardless of the source of payment to the attorney.
1688 (b) The state attorney for the circuit in which the patient
1689 is located shall represent the state as the real party in
1690 interest in the proceeding and must be provided access to the
1691 patient’s clinical records and witnesses. The state attorney is
1692 authorized to independently evaluate the sufficiency and
1693 appropriateness of the petition for involuntary inpatient
1694 placement.
1695 (5) CONTINUANCE OF HEARING.—The patient is entitled, with
1696 the concurrence of the patient’s counsel, to at least one
1697 continuance of the hearing. The continuance shall be for a
1698 period of up to 4 weeks.
1699 (6) HEARING ON INVOLUNTARY INPATIENT PLACEMENT.—
1700 (a)1. The court shall hold the hearing on involuntary
1701 inpatient placement within 5 court working days, unless a
1702 continuance is granted.
1703 2. Except for good cause documented in the court file, the
1704 hearing must shall be held in the county or the facility, as
1705 appropriate, where the patient is located, must and shall be as
1706 convenient to the patient as is may be consistent with orderly
1707 procedure, and shall be conducted in physical settings not
1708 likely to be injurious to the patient’s condition. If the court
1709 finds that the patient’s attendance at the hearing is not
1710 consistent with the best interests of the patient, and the
1711 patient’s counsel does not object, the court may waive the
1712 presence of the patient from all or any portion of the hearing.
1713 The state attorney for the circuit in which the patient is
1714 located shall represent the state, rather than the petitioning
1715 facility administrator, as the real party in interest in the
1716 proceeding.
1717 3.2. The court may appoint a general or special magistrate
1718 to preside at the hearing. One of the two professionals who
1719 executed the petition for involuntary inpatient placement
1720 certificate shall be a witness. The patient and the patient’s
1721 guardian or representative shall be informed by the court of the
1722 right to an independent expert examination. If the patient
1723 cannot afford such an examination, the court shall ensure that
1724 one is provided, as otherwise provided for by law provide for
1725 one. The independent expert’s report is shall be confidential
1726 and not discoverable, unless the expert is to be called as a
1727 witness for the patient at the hearing. The testimony in the
1728 hearing must be given under oath, and the proceedings must be
1729 recorded. The patient may refuse to testify at the hearing.
1730 (b) If the court concludes that the patient meets the
1731 criteria for involuntary inpatient placement, it may shall order
1732 that the patient be transferred to a treatment facility or, if
1733 the patient is at a treatment facility, that the patient be
1734 retained there or be treated at any other appropriate receiving
1735 or treatment facility, or that the patient receive services from
1736 such a receiving or treatment facility or service provider, on
1737 an involuntary basis, for a period of up to 90 days 6 months.
1738 However, any order for involuntary mental health services in a
1739 treatment facility may be for up to 6 months. The order shall
1740 specify the nature and extent of the patient’s mental illness.
1741 The facility shall discharge a patient any time the patient no
1742 longer meets the criteria for involuntary inpatient placement,
1743 unless the patient has transferred to voluntary status.
1744 (c) If at any time before prior to the conclusion of the
1745 hearing on involuntary inpatient placement it appears to the
1746 court that the person does not meet the criteria for involuntary
1747 inpatient placement under this section, but instead meets the
1748 criteria for involuntary outpatient services placement, the
1749 court may order the person evaluated for involuntary outpatient
1750 services placement pursuant to s. 394.4655. The petition and
1751 hearing procedures set forth in s. 394.4655 shall apply. If the
1752 person instead meets the criteria for involuntary assessment,
1753 protective custody, or involuntary admission pursuant to s.
1754 397.675, then the court may order the person to be admitted for
1755 involuntary assessment for a period of 5 days pursuant to s.
1756 397.6811. Thereafter, all proceedings are shall be governed by
1757 chapter 397.
1758 (d) At the hearing on involuntary inpatient placement, the
1759 court shall consider testimony and evidence regarding the
1760 patient’s competence to consent to treatment. If the court finds
1761 that the patient is incompetent to consent to treatment, it
1762 shall appoint a guardian advocate as provided in s. 394.4598.
1763 (e) The administrator of the petitioning receiving facility
1764 shall provide a copy of the court order and adequate
1765 documentation of a patient’s mental illness to the administrator
1766 of a treatment facility if the whenever a patient is ordered for
1767 involuntary inpatient placement, whether by civil or criminal
1768 court. The documentation must shall include any advance
1769 directives made by the patient, a psychiatric evaluation of the
1770 patient, and any evaluations of the patient performed by a
1771 psychiatric nurse, clinical psychologist, a marriage and family
1772 therapist, a mental health counselor, or a clinical social
1773 worker. The administrator of a treatment facility may refuse
1774 admission to any patient directed to its facilities on an
1775 involuntary basis, whether by civil or criminal court order, who
1776 is not accompanied at the same time by adequate orders and
1777 documentation.
1778 (7) PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT
1779 PLACEMENT.—
1780 (a) Hearings on petitions for continued involuntary
1781 inpatient placement of an individual placed at any treatment
1782 facility are shall be administrative hearings and must shall be
1783 conducted in accordance with the provisions of s. 120.57(1),
1784 except that any order entered by the administrative law judge is
1785 shall be final and subject to judicial review in accordance with
1786 s. 120.68. Orders concerning patients committed after
1787 successfully pleading not guilty by reason of insanity are shall
1788 be governed by the provisions of s. 916.15.
1789 (b) If the patient continues to meet the criteria for
1790 involuntary inpatient placement and is being treated at a
1791 treatment facility, the administrator shall, before prior to the
1792 expiration of the period during which the treatment facility is
1793 authorized to retain the patient, file a petition requesting
1794 authorization for continued involuntary inpatient placement. The
1795 request must shall be accompanied by a statement from the
1796 patient’s physician, psychiatrist, psychiatric nurse, or
1797 clinical psychologist justifying the request, a brief
1798 description of the patient’s treatment during the time he or she
1799 was involuntarily placed, and an individualized plan of
1800 continued treatment. Notice of the hearing must shall be
1801 provided as provided set forth in s. 394.4599. If a patient’s
1802 attendance at the hearing is voluntarily waived, the
1803 administrative law judge must determine that the waiver is
1804 knowing and voluntary before waiving the presence of the patient
1805 from all or a portion of the hearing. Alternatively, if at the
1806 hearing the administrative law judge finds that attendance at
1807 the hearing is not consistent with the best interests of the
1808 patient, the administrative law judge may waive the presence of
1809 the patient from all or any portion of the hearing, unless the
1810 patient, through counsel, objects to the waiver of presence. The
1811 testimony in the hearing must be under oath, and the proceedings
1812 must be recorded.
1813 (c) Unless the patient is otherwise represented or is
1814 ineligible, he or she shall be represented at the hearing on the
1815 petition for continued involuntary inpatient placement by the
1816 public defender of the circuit in which the facility is located.
1817 (d) If at a hearing it is shown that the patient continues
1818 to meet the criteria for involuntary inpatient placement, the
1819 administrative law judge shall sign the order for continued
1820 involuntary inpatient placement for a period of up to 90 days
1821 not to exceed 6 months. However, any order for involuntary
1822 mental health services in a treatment facility may be for up to
1823 6 months. The same procedure shall be repeated prior to the
1824 expiration of each additional period the patient is retained.
1825 (e) If continued involuntary inpatient placement is
1826 necessary for a patient admitted while serving a criminal
1827 sentence, but his or her whose sentence is about to expire, or
1828 for a minor patient involuntarily placed, while a minor but who
1829 is about to reach the age of 18, the administrator shall
1830 petition the administrative law judge for an order authorizing
1831 continued involuntary inpatient placement.
1832 (f) If the patient has been previously found incompetent to
1833 consent to treatment, the administrative law judge shall
1834 consider testimony and evidence regarding the patient’s
1835 competence. If the administrative law judge finds evidence that
1836 the patient is now competent to consent to treatment, the
1837 administrative law judge may issue a recommended order to the
1838 court that found the patient incompetent to consent to treatment
1839 that the patient’s competence be restored and that any guardian
1840 advocate previously appointed be discharged.
1841 (g) If the patient has been ordered to undergo involuntary
1842 inpatient placement and has previously been found incompetent to
1843 consent to treatment, the court shall consider testimony and
1844 evidence regarding the patient’s incompetence. If the patient’s
1845 competency to consent to treatment is restored, the discharge of
1846 the guardian advocate shall be governed by the provisions of s.
1847 394.4598.
1848
1849 The procedure required in this subsection must be followed
1850 before the expiration of each additional period the patient is
1851 involuntarily receiving services.
1852 (8) RETURN TO FACILITY OF PATIENTS.—If a patient
1853 involuntarily held When a patient at a treatment facility under
1854 this part leaves the facility without the administrator’s
1855 authorization, the administrator may authorize a search for the
1856 patient and his or her the return of the patient to the
1857 facility. The administrator may request the assistance of a law
1858 enforcement agency in this regard the search for and return of
1859 the patient.
1860 Section 14. Section 394.46715, Florida Statutes, is amended
1861 to read:
1862 394.46715 Rulemaking authority.—The department may adopt
1863 rules to administer this part Department of Children and
1864 Families shall have rulemaking authority to implement the
1865 provisions of ss. 394.455, 394.4598, 394.4615, 394.463,
1866 394.4655, and 394.467 as amended or created by this act. These
1867 rules shall be for the purpose of protecting the health, safety,
1868 and well-being of persons examined, treated, or placed under
1869 this act.
1870 Section 15. Section 394.656, Florida Statutes, is amended
1871 to read:
1872 394.656 Criminal Justice, Mental Health, and Substance
1873 Abuse Reinvestment Grant Program.—
1874 (1) There is created within the Department of Children and
1875 Families the Criminal Justice, Mental Health, and Substance
1876 Abuse Reinvestment Grant Program. The purpose of the program is
1877 to provide funding to counties with which they may use to can
1878 plan, implement, or expand initiatives that increase public
1879 safety, avert increased spending on criminal justice, and
1880 improve the accessibility and effectiveness of treatment
1881 services for adults and juveniles who have a mental illness,
1882 substance abuse disorder, or co-occurring mental health and
1883 substance abuse disorders and who are in, or at risk of
1884 entering, the criminal or juvenile justice systems.
1885 (2) The department shall establish a Criminal Justice,
1886 Mental Health, and Substance Abuse Statewide Grant Review
1887 Committee. The committee shall include:
1888 (a) One representative of the Department of Children and
1889 Families;
1890 (b) One representative of the Department of Corrections;
1891 (c) One representative of the Department of Juvenile
1892 Justice;
1893 (d) One representative of the Department of Elderly
1894 Affairs; and
1895 (e) One representative of the Office of the State Courts
1896 Administrator;.
1897 (f) One representative of the Department of Veterans’
1898 Affairs;
1899 (g) One representative of the Florida Sheriffs Association;
1900 (h) One representative of the Florida Police Chiefs
1901 Association;
1902 (i) One representative of the Florida Association of
1903 Counties;
1904 (j) One representative of the Florida Alcohol and Drug
1905 Abuse Association;
1906 (k) One representative of the Florida Association of
1907 Managing Entities;
1908 (l) One representative of the Florida Council for Community
1909 Mental Health;
1910 (m) One representative of the Florida Prosecuting Attorneys
1911 Association;
1912 (n) One representative of the Florida Public Defender
1913 Association; and
1914 (o) One administrator of an assisted living facility that
1915 holds a limited mental health license.
1916 (3) The committee shall serve as the advisory body to
1917 review policy and funding issues that help reduce the impact of
1918 persons with mental illness and substance abuse disorders on
1919 communities, criminal justice agencies, and the court system.
1920 The committee shall advise the department in selecting
1921 priorities for grants and investing awarded grant moneys.
1922 (4) The committee must have experience in substance use and
1923 mental health disorders, community corrections, and law
1924 enforcement. To the extent possible, the members of the
1925 committee shall have expertise in grant review writing, grant
1926 reviewing, and grant application scoring.
1927 (5)(a)(3)(a) A county, or a not-for-profit community
1928 provider or managing entity designated by the county planning
1929 council or committee, as described in s. 394.657, may apply for
1930 a 1-year planning grant or a 3-year implementation or expansion
1931 grant. The purpose of the grants is to demonstrate that
1932 investment in treatment efforts related to mental illness,
1933 substance abuse disorders, or co-occurring mental health and
1934 substance abuse disorders results in a reduced demand on the
1935 resources of the judicial, corrections, juvenile detention, and
1936 health and social services systems.
1937 (b) To be eligible to receive a 1-year planning grant or a
1938 3-year implementation or expansion grant:,
1939 1. A county applicant must have a county planning council
1940 or committee that is in compliance with the membership
1941 requirements set forth in this section.
1942 2. A not-for-profit community provider or managing entity
1943 must be designated by the county planning council or committee
1944 and have written authorization to submit an application. A not
1945 for-profit community provider or managing entity must have
1946 written authorization for each submitted application.
1947 (c) The department may award a 3-year implementation or
1948 expansion grant to an applicant who has not received a 1-year
1949 planning grant.
1950 (d) The department may require an applicant to conduct
1951 sequential intercept mapping for a project. For purposes of this
1952 paragraph, the term “sequential intercept mapping” means a
1953 process for reviewing a local community’s mental health,
1954 substance abuse, criminal justice, and related systems and
1955 identifying points of interceptions where interventions may be
1956 made to prevent an individual with a substance abuse disorder or
1957 mental illness from deeper involvement in the criminal justice
1958 system.
1959 (6)(4) The grant review and selection committee shall
1960 select the grant recipients and notify the department of
1961 Children and Families in writing of the recipients’ names of the
1962 applicants who have been selected by the committee to receive a
1963 grant. Contingent upon the availability of funds and upon
1964 notification by the grant review and selection committee of
1965 those applicants approved to receive planning, implementation,
1966 or expansion grants, the department of Children and Families may
1967 transfer funds appropriated for the grant program to a selected
1968 grant recipient to any county awarded a grant.
1969 Section 16. Section 394.761, Florida Statutes, is created
1970 to read:
1971 394.761 Revenue maximization.—The department, in
1972 coordination with the Agency for Health Care and the managing
1973 entities, shall compile detailed documentation of the cost and
1974 reimbursements for Medicaid covered services provided to
1975 Medicaid eligible individuals by providers of behavioral health
1976 services that are also funded for programs authorized by this
1977 chapter and chapter 397. The department’s documentation, along
1978 with a report of general revenue funds supporting behavioral
1979 health services that are not counted as maintenance of effort or
1980 match for any other federal program, will be submitted to the
1981 Agency for Health Care Administration by December 31, 2016.
1982 Copies of the report must also be provided to the Governor, the
1983 President of the Senate, and the Speaker of the House of
1984 Representatives. If this report presents clear evidence that
1985 Medicaid reimbursements are less than the costs of providing the
1986 services, the Agency for Health Care Administration and the
1987 Department of Children and Families will prepare and submit any
1988 budget amendments necessary to use unmatched general revenue
1989 funds in the 2016-2017 fiscal year to draw additional federal
1990 funding to increase Medicaid funding to behavioral health
1991 service providers receiving the unmatched general revenue.
1992 Payments shall be made to providers in such manner as is allowed
1993 by federal law and regulations.
1994 Section 17. Subsection (11) is added to section 394.875,
1995 Florida Statutes, to read:
1996 394.875 Crisis stabilization units, residential treatment
1997 facilities, and residential treatment centers for children and
1998 adolescents; authorized services; license required.—
1999 (11) By January 1, 2017, the department and the agency
2000 shall modify licensure rules and procedures to create an option
2001 for a single, consolidated license for a provider who offers
2002 multiple types of mental health and substance abuse services
2003 regulated under this chapter and chapter 397. Providers eligible
2004 for a consolidated license shall operate these services through
2005 a single corporate entity and a unified management structure.
2006 Any provider serving adults and children must meet department
2007 standards for separate facilities and other requirements
2008 necessary to ensure children’s safety and promote therapeutic
2009 efficacy.
2010 Section 18. Section 394.9082, Florida Statutes, is amended
2011 to read:
2012 (Substantial rewording of section. See
2013 s. 394.9082, F.S., for present text.)
2014 394.9082 Behavioral health managing entities’ purpose;
2015 definitions; duties; contracting; accountability.—
2016 (1) PURPOSE.—The purpose of the behavioral health managing
2017 entities is to plan, coordinate and contract for the delivery of
2018 community mental health and substance abuse services, to improve
2019 access to care, to promote service continuity, to purchase
2020 services, and to support efficient and effective delivery of
2021 services.
2022 (2) DEFINITIONS.—As used in this section, the term:
2023 (a) “Behavioral health services” means mental health
2024 services and substance abuse prevention and treatment services
2025 as described in this chapter and chapter 397.
2026 (b) “Case management” means those direct services provided
2027 to a client in order to assess needs, plan or arrange services,
2028 coordinate service providers, monitor service delivery, and
2029 evaluate outcomes.
2030 (c) “Coordinated system of care” means the full array of
2031 behavioral health and related services in a region or a
2032 community offered by all service providers, whether
2033 participating under contract with the managing entity or through
2034 another method of community partnership or mutual agreement.
2035 (d) “Geographic area” means one or more contiguous
2036 counties, circuits, or regions as described in s. 409.966.
2037 (e) “High-need or high-utilization individual” means a
2038 recipient who meets one or more of the following criteria and
2039 may be eligible for intensive case management services:
2040 1. Has resided in a state mental health facility for at
2041 least 6 months in the last 36 months;
2042 2. Has had two or more admissions to a state mental health
2043 facility in the last 36 months; or
2044 3. Has had three or more admissions to a crisis
2045 stabilization unit, an addictions receiving facility, a short
2046 term residential detoxification facility, or an inpatient
2047 psychiatric unit within the last 12 months.
2048 (f) “Managed behavioral health organization” means a
2049 Medicaid managed care organization currently under contract with
2050 the statewide Medicaid managed medical assistance program in
2051 this state pursuant to part IV of chapter 409, including a
2052 managed care organization operating as a behavioral health
2053 specialty plan.
2054 (g) “Managing entity” means a corporation designated or
2055 filed as a nonprofit organization under s. 501(c)(3) of the
2056 Internal Revenue Code which is selected by, and is under
2057 contract with, the department to manage the daily operational
2058 delivery of behavioral health services through a coordinated
2059 system of care.
2060 (h) “Provider network” means the group of direct service
2061 providers, facilities, and organizations under contract with a
2062 managing entity to provide a comprehensive array of emergency,
2063 acute care, residential, outpatient, recovery support, and
2064 consumer support services, including prevention services.
2065 (i) “Receiving facility” means any public or private
2066 facility designated by the department to receive and hold or to
2067 refer, as appropriate, involuntary patients under emergency
2068 conditions for mental health or substance abuse evaluation and
2069 to provide treatment or transportation to the appropriate
2070 service provider. County jails may not be used or designated as
2071 a receiving facility, a triage center, or an access center.
2072 (3) DEPARTMENT DUTIES.—The department shall:
2073 (a) Designate, with input from the managing entity,
2074 facilities that meet the definitions in s. 394.455(1), (2),
2075 (13), and (41) and the receiving system developed by one or more
2076 counties pursuant to s. 394.4573(2)(b).
2077 (b) Contract with organizations to serve as the managing
2078 entity in accordance with the requirements of this section.
2079 (c) Specify the geographic area served.
2080 (d) Specify data reporting and use of shared data systems.
2081 (e) Develop strategies to divert persons with mental
2082 illness or substance abuse disorders from the criminal and
2083 juvenile justice systems.
2084 (f) Support the development and implementation of a
2085 coordinated system of care by requiring each provider that
2086 receives state funds for behavioral health services through a
2087 direct contract with the department to work with the managing
2088 entity in the provider’s service area to coordinate the
2089 provision of behavioral health services, as part of the contract
2090 with the department.
2091 (g) Require that any public receiving facility initiating a
2092 patient transfer to a licensed hospital for acute care mental
2093 health services not accessible through the public receiving
2094 facility notify the hospital of such transfer and provide all
2095 records relating to the emergency psychiatric or medical
2096 condition.
2097 (h) Set performance measures and performance standards for
2098 managing entities based on nationally recognized standards, such
2099 as those developed by the National Quality Forum, the National
2100 Committee for Quality Assurance, or similar credible sources.
2101 Performance standards must include all of the following:
2102 1. Annual improvement in the extent to which the need for
2103 behavioral health services is met by the coordinated system of
2104 care in the geographic area served.
2105 2. Annual improvement in the percentage of patients who
2106 receive services through the coordinated system of care and who
2107 achieve improved functional status as indicated by health
2108 condition, employment status, and housing stability.
2109 3. Annual reduction in the rates of readmissions to acute
2110 care facilities, jails, prisons, and forensic facilities for
2111 persons receiving care coordination.
2112 4. Annual improvement in consumer and family satisfaction.
2113 (i) Provide technical assistance to the managing entities.
2114 (j) Promote the integration of behavioral health care and
2115 primary care.
2116 (k) Facilitate the coordination between the managing entity
2117 and other payors of behavioral health care.
2118 (l) Develop and provide a unique identifier for clients
2119 receiving services under the managing entity to coordinate care.
2120 (m) Coordinate procedures for the referral and admission of
2121 patients to, and the discharge of patients from, state treatment
2122 facilities and their return to the community.
2123 (n) Ensure that managing entities comply with state and
2124 federal laws, rules, and regulations.
2125 (o) Develop rules for the operations of, and the
2126 requirements that must be met by, the managing entity, if
2127 necessary.
2128 (4) CONTRACT FOR SERVICES.—
2129 (a) In contracting for services with managing entities
2130 under this section, the department must first attempt to
2131 contract with not-for-profit, community-based organizations that
2132 have competence in managing networks of providers serving
2133 persons with mental health and substance abuse disorders.
2134 (b) The department shall issue an invitation to negotiate
2135 under s. 287.057 to select an organization to serve as a
2136 managing entity. If the department receives fewer than two
2137 responsive bids to the solicitation, the department shall
2138 reissue the invitation to negotiate, in which case managed
2139 behavioral health organizations shall be eligible to bid and be
2140 awarded a contract.
2141 (c) If the managing entity is a not-for-profit, community
2142 based organization, it must have a governing board that is
2143 representative. At a minimum, the governing board must include
2144 consumers and their family members; representatives of local
2145 government, area law enforcement agencies, health care
2146 facilities, and community-based care lead agencies; business
2147 leaders; and providers of substance abuse and mental health
2148 services as defined in this chapter and chapter 397.
2149 (d) If the managing entity is a managed behavioral health
2150 organization, it must establish an advisory board that meets the
2151 same requirements specified in paragraph (c) for a governing
2152 board.
2153 (e) If the department issues an invitation to negotiate
2154 pursuant to paragraph (b), the department shall consider the
2155 advice and recommendations of the provider network and community
2156 stakeholders in determining the criteria and relative weight of
2157 the criteria that will be used in the solicitation of the new
2158 contractor. The department shall consider all of the following
2159 factors:
2160 1. Experience serving persons with mental health and
2161 substance abuse disorders.
2162 2. Establishment of community partnerships with behavioral
2163 health providers.
2164 3. Demonstrated organizational capabilities for network
2165 management functions.
2166 4. Capability to coordinate behavioral health with primary
2167 care services.
2168 (f) The department’s contracts with managing entities must
2169 support efficient and effective administration of the behavioral
2170 health system and ensure accountability for performance.
2171 (g) A contractor serving as a managing entity shall operate
2172 under the same data reporting, administrative, and
2173 administrative rate requirements, regardless of whether it is a
2174 for-profit or a not-for-profit entity.
2175 (h) The contract must designate the geographic area that
2176 will be served by the managing entity, which area must be of
2177 sufficient size in population, funding, and services to allow
2178 for flexibility and efficiency.
2179 (i) The contract must require that, when there is a change
2180 in the managing entity in a geographic area, a transition plan
2181 be developed and implemented by the department which ensures
2182 continuity of care for patients receiving behavioral health
2183 services.
2184 (j) As of October 31, 2019, if all other contract
2185 requirements and performance standards are met and the
2186 department determines that the managing entity has made progress
2187 toward the implementation of a coordinated system of care in its
2188 geographic region, the department may continue its contract with
2189 the managing entity for up to, but not exceeding, 5 years,
2190 including any and all renewals and extensions. Thereafter, the
2191 department must issue a competitive solicitation pursuant to
2192 paragraph (b).
2193 (5) MANAGING ENTITIES DUTIES.—A managing entity shall:
2194 (a) Maintain a board of directors that is representative of
2195 the community and that, at a minimum, includes consumers and
2196 family members, community stakeholders and organizations, and
2197 providers of mental health and substance abuse services,
2198 including public and private receiving facilities.
2199 (b) Conduct a community behavioral health care needs
2200 assessment in the geographic area served by the managing entity.
2201 The needs assessment must be updated annually and provided to
2202 the department. The assessment must include, at a minimum, the
2203 information the department needs for its annual report to the
2204 Governor and Legislature pursuant to s. 394.4573.
2205 (c) Develop local resources by pursuing third-party
2206 payments for services, applying for grants, assisting providers
2207 in securing local matching funds and in-kind services, and any
2208 other methods needed to ensure services are available and
2209 accessible.
2210 (d) Provide assistance to counties to develop a designated
2211 receiving system pursuant to s. 394.4573(2)(b) and a
2212 transportation plan pursuant to s. 394.462.
2213 (e) Promote the development and effective implementation of
2214 a coordinated system of care pursuant to s. 394.4573.
2215 (f) Develop a comprehensive network of qualified providers
2216 to deliver behavioral health services. The managing entity is
2217 not required to competitively procure network providers, but
2218 must have a process in place to publicize opportunities to join
2219 the network and to evaluate providers in the network to
2220 determine if they can remain in the network. These processes
2221 must be published on the website of the managing entity. The
2222 managing entity must ensure continuity of care for clients if a
2223 provider ceases to provide a service or leaves the network.
2224 (g) Enter into cooperative agreements with local homeless
2225 councils and organizations to allow the sharing of available
2226 resource information, shared client information, client referral
2227 services, and any other data or information that may be useful
2228 in addressing the homelessness of persons suffering from a
2229 behavioral health crisis. All information sharing must comply
2230 with federal and state privacy and confidentiality laws,
2231 statutes and regulations.
2232 (h) Monitor network providers’ performance and their
2233 compliance with contract requirements and federal and state
2234 laws, rules, and regulations.
2235 (i) Provide or contract for case management services.
2236 (j) Manage and allocate funds for services to meet the
2237 requirements of law or rule.
2238 (k) Promote integration of behavioral health with primary
2239 care.
2240 (l) Implement shared data systems necessary for the
2241 delivery of coordinated care and integrated services, the
2242 assessment of managing entity performance and provider
2243 performance, and the reporting of outcomes and costs of
2244 services.
2245 (m) Operate in a transparent manner, providing public
2246 access to information, notice of meetings, and opportunities for
2247 public participation in managing entity decision-making.
2248 (n) Establish and maintain effective relationships with
2249 community stakeholders, including local governments and other
2250 organizations that serve individuals with behavioral health
2251 needs.
2252 (o) Collaborate with local criminal and juvenile justice
2253 systems to divert persons with mental illness or substance abuse
2254 disorders, or both, from the criminal and juvenile justice
2255 systems.
2256 (p) Collaborate with the local court system to develop
2257 procedures to maximize the use of involuntary outpatient
2258 services; reduce involuntary inpatient treatment; and increase
2259 diversion from the criminal and juvenile justice systems.
2260 (6) FUNDING FOR MANAGING ENTITIES.—
2261 (a) A contract established between the department and a
2262 managing entity under this section must be funded by general
2263 revenue, other applicable state funds, or applicable federal
2264 funding sources. A managing entity may carry forward documented
2265 unexpended state funds from one fiscal year to the next, but the
2266 cumulative amount carried forward may not exceed 8 percent of
2267 the total value of the contract. Any unexpended state funds in
2268 excess of that percentage must be returned to the department.
2269 The funds carried forward may not be used in a way that would
2270 increase future recurring obligations or for any program or
2271 service that was not authorized as of July 1, 2016, under the
2272 existing contract with the department. Expenditures of funds
2273 carried forward must be separately reported to the department.
2274 Any unexpended funds that remain at the end of the contract
2275 period must be returned to the department. Funds carried forward
2276 may be retained through contract renewals and new contract
2277 procurements as long as the same managing entity is retained by
2278 the department.
2279 (b) The method of payment for a fixed-price contract with a
2280 managing entity must provide for a 2-month advance payment at
2281 the beginning of each fiscal year and equal monthly payments
2282 thereafter.
2283 (7) CRISIS STABILIZATION SERVICES UTILIZATION DATABASE.—The
2284 department shall develop, implement, and maintain standards
2285 under which a managing entity shall collect utilization data
2286 from all public receiving facilities situated within its
2287 geographic service area. As used in this subsection, the term
2288 “public receiving facility” means an entity that meets the
2289 licensure requirements of, and is designated by, the department
2290 to operate as a public receiving facility under s. 394.875 and
2291 that is operating as a licensed crisis stabilization unit.
2292 (a) The department shall develop standards and protocols
2293 for managing entities and public receiving facilities to be used
2294 for data collection, storage, transmittal, and analysis. The
2295 standards and protocols must allow for compatibility of data and
2296 data transmittal between public receiving facilities, managing
2297 entities, and the department for the implementation and
2298 requirements of this subsection.
2299 (b) A managing entity shall require a public receiving
2300 facility within its provider network to submit data, in real
2301 time or at least daily, to the managing entity for:
2302 1. All admissions and discharges of clients receiving
2303 public receiving facility services who qualify as indigent, as
2304 defined in s. 394.4787; and
2305 2. The current active census of total licensed beds, the
2306 number of beds purchased by the department, the number of
2307 clients qualifying as indigent who occupy those beds, and the
2308 total number of unoccupied licensed beds regardless of funding.
2309 (c) A managing entity shall require a public receiving
2310 facility within its provider network to submit data, on a
2311 monthly basis, to the managing entity which aggregates the daily
2312 data submitted under paragraph (b). The managing entity shall
2313 reconcile the data in the monthly submission to the data
2314 received by the managing entity under paragraph (b) to check for
2315 consistency. If the monthly aggregate data submitted by a public
2316 receiving facility under this paragraph are inconsistent with
2317 the daily data submitted under paragraph (b), the managing
2318 entity shall consult with the public receiving facility to make
2319 corrections necessary to ensure accurate data.
2320 (d) A managing entity shall require a public receiving
2321 facility within its provider network to submit data, on an
2322 annual basis, to the managing entity which aggregates the data
2323 submitted and reconciled under paragraph (c). The managing
2324 entity shall reconcile the data in the annual submission to the
2325 data received and reconciled by the managing entity under
2326 paragraph (c) to check for consistency. If the annual aggregate
2327 data submitted by a public receiving facility under this
2328 paragraph are inconsistent with the data received and reconciled
2329 under paragraph (c), the managing entity shall consult with the
2330 public receiving facility to make corrections necessary to
2331 ensure accurate data.
2332 (e) After ensuring the accuracy of data pursuant to
2333 paragraphs (c) and (d), the managing entity shall submit the
2334 data to the department on a monthly and an annual basis. The
2335 department shall create a statewide database for the data
2336 described under paragraph (b) and submitted under this paragraph
2337 for the purpose of analyzing the payments for and the use of
2338 crisis stabilization services funded by the Baker Act on a
2339 statewide basis and on an individual public receiving facility
2340 basis.
2341 Section 19. Present subsections (20) through (45) of
2342 section 397.311, Florida Statutes, are redesignated as
2343 subsections (22) through (47), respectively, new subsections
2344 (20) and (21) are added to that section, and present subsections
2345 (30) and (38) of that section are amended, to read:
2346 397.311 Definitions.—As used in this chapter, except part
2347 VIII, the term:
2348 (20) “Informed consent” means consent voluntarily given in
2349 writing by a competent person after sufficient explanation and
2350 disclosure of the subject matter involved to enable the person
2351 to make a knowing and willful decision without any element of
2352 force, fraud, deceit, duress, or other form of constraint or
2353 coercion.
2354 (21) “Involuntary services” means an array of behavioral
2355 health services that may be ordered by the court for persons
2356 with substance abuse or co-occurring mental health disorders.
2357 (31)(30) “Qualified professional” means a physician or a
2358 physician assistant licensed under chapter 458 or chapter 459; a
2359 professional licensed under chapter 490 or chapter 491; an
2360 advanced registered nurse practitioner having a specialty in
2361 psychiatry licensed under part I of chapter 464; or a person who
2362 is certified through a department-recognized certification
2363 process for substance abuse treatment services and who holds, at
2364 a minimum, a bachelor’s degree. A person who is certified in
2365 substance abuse treatment services by a state-recognized
2366 certification process in another state at the time of employment
2367 with a licensed substance abuse provider in this state may
2368 perform the functions of a qualified professional as defined in
2369 this chapter but must meet certification requirements contained
2370 in this subsection no later than 1 year after his or her date of
2371 employment.
2372 (39)(38) “Service component” or “component” means a
2373 discrete operational entity within a service provider which is
2374 subject to licensing as defined by rule. Service components
2375 include prevention, intervention, and clinical treatment
2376 described in subsection (24) (22).
2377 Section 20. Section 397.675, Florida Statutes, is amended
2378 to read:
2379 397.675 Criteria for involuntary admissions, including
2380 protective custody, emergency admission, and other involuntary
2381 assessment, involuntary treatment, and alternative involuntary
2382 assessment for minors, for purposes of assessment and
2383 stabilization, and for involuntary treatment.—A person meets the
2384 criteria for involuntary admission if there is good faith reason
2385 to believe that the person has a substance abuse or co-occurring
2386 mental health disorder is substance abuse impaired and, because
2387 of such disorder impairment:
2388 (1) Has lost the power of self-control with respect to
2389 substance abuse use; and either
2390 (2)(a) Has inflicted, or threatened or attempted to
2391 inflict, or unless admitted is likely to inflict, physical harm
2392 on himself or herself or another; or
2393 (b) Is in need of substance abuse services and, by reason
2394 of substance abuse impairment, his or her judgment has been so
2395 impaired that he or she the person is incapable of appreciating
2396 his or her need for such services and of making a rational
2397 decision in that regard, although thereto; however, mere refusal
2398 to receive such services does not constitute evidence of lack of
2399 judgment with respect to his or her need for such services.
2400 (b) Without care or treatment, is likely to suffer from
2401 neglect or to refuse to care for himself or herself, that such
2402 neglect or refusal poses a real and present threat of
2403 substantial harm to his or her well-being and that it is not
2404 apparent that such harm may be avoided through the help of
2405 willing family members or friends or the provision of other
2406 services, or there is substantial likelihood that the person has
2407 inflicted, or threatened to or attempted to inflict, or, unless
2408 admitted, is likely to inflict, physical harm on himself,
2409 herself, or another.
2410 Section 21. Section 397.679, Florida Statutes, is amended
2411 to read:
2412 397.679 Emergency admission; circumstances justifying.—A
2413 person who meets the criteria for involuntary admission in s.
2414 397.675 may be admitted to a hospital or to a licensed
2415 detoxification facility or addictions receiving facility for
2416 emergency assessment and stabilization, or to a less intensive
2417 component of a licensed service provider for assessment only,
2418 upon receipt by the facility of a the physician’s certificate by
2419 a physician, an advanced registered nurse practitioner, a
2420 clinical psychologist, a licensed clinical social worker, a
2421 licensed marriage and family therapist, a licensed mental health
2422 counselor, a physician assistant working under the scope of
2423 practice of the supervising physician, or a master’s-level
2424 certified addictions professional, if the certificate is
2425 specific to substance abuse disorders, and the completion of an
2426 application for emergency admission.
2427 Section 22. Section 397.6791, Florida Statutes, is amended
2428 to read:
2429 397.6791 Emergency admission; persons who may initiate.—The
2430 following professionals persons may request a certificate for an
2431 emergency assessment or admission:
2432 (1) In the case of an adult, physicians, advanced
2433 registered nurse practitioners, clinical psychologists, licensed
2434 clinical social workers, licensed marriage and family
2435 therapists, licensed mental health counselors, physician
2436 assistants working under the scope of practice of the
2437 supervising physician, and a master’s-level-certified addictions
2438 professional, if the certificate is specific to substance abuse
2439 disorders the certifying physician, the person’s spouse or legal
2440 guardian, any relative of the person, or any other responsible
2441 adult who has personal knowledge of the person’s substance abuse
2442 impairment.
2443 (2) In the case of a minor, the minor’s parent, legal
2444 guardian, or legal custodian.
2445 Section 23. Section 397.6793, Florida Statutes, is amended
2446 to read:
2447 397.6793 Professional’s Physician’s certificate for
2448 emergency admission.—
2449 (1) The professional’s physician’s certificate must include
2450 the name of the person to be admitted, the relationship between
2451 the person and the professional executing the certificate
2452 physician, the relationship between the applicant and the
2453 professional physician, any relationship between the
2454 professional physician and the licensed service provider, and a
2455 statement that the person has been examined and assessed within
2456 the preceding 5 days of the application date, and must include
2457 factual allegations with respect to the need for emergency
2458 admission, including:
2459 (a) The reason for the physician’s belief that the person
2460 is substance abuse impaired; and
2461 (b) The reason for the physician’s belief that because of
2462 such impairment the person has lost the power of self-control
2463 with respect to substance abuse; and either
2464 (c)1. The reason for the belief physician believes that,
2465 without care or treatment, the person is likely to suffer from
2466 neglect or refuse to care for himself or herself; that such
2467 neglect or refusal poses a real and present threat of
2468 substantial harm to his or her well-being; and that it is not
2469 apparent that such harm may be avoided through the help of
2470 willing family members or friends or the provision of other
2471 services or there is substantial likelihood that the person has
2472 inflicted or is likely to inflict physical harm on himself or
2473 herself or others unless admitted; or
2474 2. The reason for the belief physician believes that the
2475 person’s refusal to voluntarily receive care is based on
2476 judgment so impaired by reason of substance abuse that the
2477 person is incapable of appreciating his or her need for care and
2478 of making a rational decision regarding his or her need for
2479 care.
2480 (2) The professional’s physician’s certificate must
2481 recommend the least restrictive type of service that is
2482 appropriate for the person. The certificate must be signed by
2483 the professional physician. If other less restrictive means are
2484 not available, such as voluntary appearance for outpatient
2485 evaluation, a law enforcement officer shall take the person
2486 named in the certificate into custody and deliver him or her to
2487 the appropriate facility for involuntary examination.
2488 (3) A signed copy of the professional’s physician’s
2489 certificate shall accompany the person, and shall be made a part
2490 of the person’s clinical record, together with a signed copy of
2491 the application. The application and the professional’s
2492 physician’s certificate authorize the involuntary admission of
2493 the person pursuant to, and subject to the provisions of, ss.
2494 397.679-397.6797.
2495 (4) The professional’s certificate is valid for 7 days
2496 after issuance.
2497 (5) The professional’s physician’s certificate must
2498 indicate whether the person requires transportation assistance
2499 for delivery for emergency admission and specify, pursuant to s.
2500 397.6795, the type of transportation assistance necessary.
2501 Section 24. Section 397.6795, Florida Statutes, is amended
2502 to read:
2503 397.6795 Transportation-assisted delivery of persons for
2504 emergency assessment.—An applicant for a person’s emergency
2505 admission, or the person’s spouse or guardian, or a law
2506 enforcement officer, or a health officer may deliver a person
2507 named in the professional’s physician’s certificate for
2508 emergency admission to a hospital or a licensed detoxification
2509 facility or addictions receiving facility for emergency
2510 assessment and stabilization.
2511 Section 25. Subsection (1) of section 397.681, Florida
2512 Statutes, is amended to read:
2513 397.681 Involuntary petitions; general provisions; court
2514 jurisdiction and right to counsel.—
2515 (1) JURISDICTION.—The courts have jurisdiction of
2516 involuntary assessment and stabilization petitions and
2517 involuntary treatment petitions for substance abuse impaired
2518 persons, and such petitions must be filed with the clerk of the
2519 court in the county where the person is located. The clerk of
2520 the court may not charge a fee for the filing of a petition
2521 under this section. The chief judge may appoint a general or
2522 special magistrate to preside over all or part of the
2523 proceedings. The alleged impaired person is named as the
2524 respondent.
2525 Section 26. Subsection (1) of section 397.6811, Florida
2526 Statutes, is amended to read:
2527 397.6811 Involuntary assessment and stabilization.—A person
2528 determined by the court to appear to meet the criteria for
2529 involuntary admission under s. 397.675 may be admitted for a
2530 period of 5 days to a hospital or to a licensed detoxification
2531 facility or addictions receiving facility, for involuntary
2532 assessment and stabilization or to a less restrictive component
2533 of a licensed service provider for assessment only upon entry of
2534 a court order or upon receipt by the licensed service provider
2535 of a petition. Involuntary assessment and stabilization may be
2536 initiated by the submission of a petition to the court.
2537 (1) If the person upon whose behalf the petition is being
2538 filed is an adult, a petition for involuntary assessment and
2539 stabilization may be filed by the respondent’s spouse, or legal
2540 guardian, any relative, a private practitioner, the director of
2541 a licensed service provider or the director’s designee, or any
2542 individual three adults who has direct have personal knowledge
2543 of the respondent’s substance abuse impairment.
2544 Section 27. Section 397.6814, Florida Statutes, is amended
2545 to read:
2546 397.6814 Involuntary assessment and stabilization; contents
2547 of petition.—A petition for involuntary assessment and
2548 stabilization must contain the name of the respondent,; the name
2549 of the applicant or applicants,; the relationship between the
2550 respondent and the applicant, and; the name of the respondent’s
2551 attorney, if known, and a statement of the respondent’s ability
2552 to afford an attorney; and must state facts to support the need
2553 for involuntary assessment and stabilization, including:
2554 (1) The reason for the petitioner’s belief that the
2555 respondent is substance abuse impaired; and
2556 (2) The reason for the petitioner’s belief that because of
2557 such impairment the respondent has lost the power of self
2558 control with respect to substance abuse; and either
2559 (3)(a) The reason the petitioner believes that the
2560 respondent has inflicted or is likely to inflict physical harm
2561 on himself or herself or others unless admitted; or
2562 (b) The reason the petitioner believes that the
2563 respondent’s refusal to voluntarily receive care is based on
2564 judgment so impaired by reason of substance abuse that the
2565 respondent is incapable of appreciating his or her need for care
2566 and of making a rational decision regarding that need for care.
2567 If the respondent has refused to submit to an assessment, such
2568 refusal must be alleged in the petition.
2569
2570 A fee may not be charged for the filing of a petition pursuant
2571 to this section.
2572 Section 28. Section 397.6819, Florida Statutes, is amended
2573 to read:
2574 397.6819 Involuntary assessment and stabilization;
2575 responsibility of licensed service provider.—
2576 (1) A licensed service provider may admit an individual for
2577 involuntary assessment and stabilization for a period not to
2578 exceed 5 days unless a petition has been filed pursuant to s.
2579 397.6821 or s. 397.6822. The individual must be assessed within
2580 72 hours without unnecessary delay by a qualified professional.
2581 If an assessment is performed by a qualified professional who is
2582 not a physician, the assessment must be reviewed by a physician
2583 before the end of the assessment period.
2584 (2) The managing entity must be notified of the
2585 recommendation for involuntary services so that it may assist in
2586 locating and providing the requested services, if such services
2587 are available. The managing entity shall document its efforts to
2588 obtain the recommended services.
2589 Section 29. Section 397.695, Florida Statutes, is amended
2590 to read:
2591 397.695 Involuntary services treatment; persons who may
2592 petition.—
2593 (1)(a) If the respondent is an adult, a petition for
2594 involuntary services treatment may be filed by the respondent’s
2595 spouse or legal guardian, any relative, a service provider, or
2596 any individual three adults who has direct have personal
2597 knowledge of the respondent’s substance abuse impairment and his
2598 or her prior course of assessment and treatment.
2599 (2) If the respondent is a minor, a petition for
2600 involuntary treatment may be filed by a parent, legal guardian,
2601 or service provider.
2602 Section 30. Section 397.6951, Florida Statutes, is amended
2603 to read:
2604 397.6951 Contents of petition for involuntary services
2605 treatment.—A petition for involuntary services treatment must
2606 contain the name of the respondent to be admitted; the name of
2607 the petitioner or petitioners; the relationship between the
2608 respondent and the petitioner; the name of the respondent’s
2609 attorney, if known, and a statement of the petitioner’s
2610 knowledge of the respondent’s ability to afford an attorney; the
2611 findings and recommendations of the assessment performed by the
2612 qualified professional; and the factual allegations presented by
2613 the petitioner establishing the need for involuntary outpatient
2614 services. The factual allegations must demonstrate treatment,
2615 including:
2616 (1) The reason for the petitioner’s belief that the
2617 respondent is substance abuse impaired; and
2618 (2) The reason for the petitioner’s belief that because of
2619 such impairment the respondent has lost the power of self
2620 control with respect to substance abuse; and either
2621 (3)(a) The reason the petitioner believes that the
2622 respondent has inflicted or is likely to inflict physical harm
2623 on himself or herself or others unless the court orders the
2624 involuntary services admitted; or
2625 (b) The reason the petitioner believes that the
2626 respondent’s refusal to voluntarily receive care is based on
2627 judgment so impaired by reason of substance abuse that the
2628 respondent is incapable of appreciating his or her need for care
2629 and of making a rational decision regarding that need for care.
2630 Section 31. Section 397.6955, Florida Statutes, is amended
2631 to read:
2632 397.6955 Duties of court upon filing of petition for
2633 involuntary services treatment.—
2634 (1) Upon the filing of a petition for the involuntary
2635 services for treatment of a substance abuse impaired person with
2636 the clerk of the court, the court shall immediately determine
2637 whether the respondent is represented by an attorney or whether
2638 the appointment of counsel for the respondent is appropriate. If
2639 the court appoints counsel for the person, the clerk of the
2640 court shall immediately notify the regional conflict counsel,
2641 created pursuant to s. 27.511, of the appointment. The regional
2642 conflict counsel shall represent the person until the petition
2643 is dismissed, the court order expires, or the person is
2644 discharged from involuntary services. An attorney that
2645 represents the person named in the petition shall have access to
2646 the person, witnesses, and records relevant to the presentation
2647 of the person’s case and shall represent the interests of the
2648 person, regardless of the source of payment to the attorney.
2649 (2) The court shall schedule a hearing to be held on the
2650 petition within 5 10 days unless a continuance is granted. The
2651 court may appoint a magistrate to preside at the hearing.
2652 (3) A copy of the petition and notice of the hearing must
2653 be provided to the respondent; the respondent’s parent,
2654 guardian, or legal custodian, in the case of a minor; the
2655 respondent’s attorney, if known; the petitioner; the
2656 respondent’s spouse or guardian, if applicable; and such other
2657 persons as the court may direct. If the respondent is a minor, a
2658 copy of the petition and notice of the hearing must be and have
2659 such petition and order personally delivered to the respondent
2660 if he or she is a minor. The court shall also issue a summons to
2661 the person whose admission is sought.
2662 Section 32. Section 397.6957, Florida Statutes, is amended
2663 to read:
2664 397.6957 Hearing on petition for involuntary services
2665 treatment.—
2666 (1) At a hearing on a petition for involuntary services
2667 treatment, the court shall hear and review all relevant
2668 evidence, including the review of results of the assessment
2669 completed by the qualified professional in connection with the
2670 respondent’s protective custody, emergency admission,
2671 involuntary assessment, or alternative involuntary admission.
2672 The respondent must be present unless the court finds that his
2673 or her presence is likely to be injurious to himself or herself
2674 or others, in which event the court must appoint a guardian
2675 advocate to act in behalf of the respondent throughout the
2676 proceedings.
2677 (2) The petitioner has the burden of proving by clear and
2678 convincing evidence that:
2679 (a) The respondent is substance abuse impaired and has a
2680 history of lack of compliance with treatment for substance
2681 abuse;, and
2682 (b) Because of such impairment the respondent is unlikely
2683 to voluntarily participate in the recommended services or is
2684 unable to determine for himself or herself whether services are
2685 necessary the respondent has lost the power of self-control with
2686 respect to substance abuse; and either
2687 1. Without services, the respondent is likely to suffer
2688 from neglect or to refuse to care for himself or herself; that
2689 such neglect or refusal poses a real and present threat of
2690 substantial harm to his or her well-being; and that there is a
2691 substantial likelihood that without services the respondent will
2692 cause serious bodily harm to himself or herself or others in the
2693 near future, as evidenced by recent behavior The respondent has
2694 inflicted or is likely to inflict physical harm on himself or
2695 herself or others unless admitted; or
2696 2. The respondent’s refusal to voluntarily receive care is
2697 based on judgment so impaired by reason of substance abuse that
2698 the respondent is incapable of appreciating his or her need for
2699 care and of making a rational decision regarding that need for
2700 care.
2701 (3) One of the qualified professionals who executed the
2702 involuntary services certificate must be a witness. The court
2703 shall allow testimony from individuals, including family
2704 members, deemed by the court to be relevant under state law,
2705 regarding the respondent’s prior history and how that prior
2706 history relates to the person’s current condition. The testimony
2707 in the hearing must be under oath, and the proceedings must be
2708 recorded. The patient may refuse to testify at the hearing.
2709 (4)(3) At the conclusion of the hearing the court shall
2710 either dismiss the petition or order the respondent to receive
2711 undergo involuntary services from his or her substance abuse
2712 treatment, with the respondent’s chosen licensed service
2713 provider if to deliver the involuntary substance abuse treatment
2714 where possible and appropriate.
2715 Section 33. Section 397.697, Florida Statutes, is amended
2716 to read:
2717 397.697 Court determination; effect of court order for
2718 involuntary services substance abuse treatment.—
2719 (1) When the court finds that the conditions for
2720 involuntary services substance abuse treatment have been proved
2721 by clear and convincing evidence, it may order the respondent to
2722 receive undergo involuntary services from treatment by a
2723 licensed service provider for a period not to exceed 90 60 days.
2724 The court may order a respondent to undergo treatment through a
2725 privately funded licensed service provider if the respondent has
2726 the ability to pay for the treatment, or if any person on the
2727 respondent’s behalf voluntarily demonstrates a willingness and
2728 an ability to pay for the treatment. If the court finds it
2729 necessary, it may direct the sheriff to take the respondent into
2730 custody and deliver him or her to the licensed service provider
2731 specified in the court order, or to the nearest appropriate
2732 licensed service provider, for involuntary services treatment.
2733 When the conditions justifying involuntary services treatment no
2734 longer exist, the individual must be released as provided in s.
2735 397.6971. When the conditions justifying involuntary services
2736 treatment are expected to exist after 90 60 days of services
2737 treatment, a renewal of the involuntary services treatment order
2738 may be requested pursuant to s. 397.6975 before prior to the end
2739 of the 90 60-day period.
2740 (2) In all cases resulting in an order for involuntary
2741 services substance abuse treatment, the court shall retain
2742 jurisdiction over the case and the parties for the entry of such
2743 further orders as the circumstances may require. The court’s
2744 requirements for notification of proposed release must be
2745 included in the original treatment order.
2746 (3) An involuntary services treatment order authorizes the
2747 licensed service provider to require the individual to receive
2748 services that undergo such treatment as will benefit him or her,
2749 including services treatment at any licensable service component
2750 of a licensed service provider.
2751 (4) If the court orders involuntary services, a copy of the
2752 order must be sent to the managing entity within 1 working day
2753 after it is received from the court. Documents may be submitted
2754 electronically though existing data systems, if applicable.
2755 Section 34. Section 397.6971, Florida Statutes, is amended
2756 to read:
2757 397.6971 Early release from involuntary services substance
2758 abuse treatment.—
2759 (1) At any time before prior to the end of the 90 60-day
2760 involuntary services treatment period, or prior to the end of
2761 any extension granted pursuant to s. 397.6975, an individual
2762 receiving admitted for involuntary services treatment may be
2763 determined eligible for discharge to the most appropriate
2764 referral or disposition for the individual when any of the
2765 following apply:
2766 (a) The individual no longer meets the criteria for
2767 involuntary admission and has given his or her informed consent
2768 to be transferred to voluntary treatment status.;
2769 (b) If the individual was admitted on the grounds of
2770 likelihood of infliction of physical harm upon himself or
2771 herself or others, such likelihood no longer exists.; or
2772 (c) If the individual was admitted on the grounds of need
2773 for assessment and stabilization or treatment, accompanied by
2774 inability to make a determination respecting such need, either:
2775 1. Such inability no longer exists; or
2776 2. It is evident that further treatment will not bring
2777 about further significant improvements in the individual’s
2778 condition.;
2779 (d) The individual is no longer in need of services.; or
2780 (e) The director of the service provider determines that
2781 the individual is beyond the safe management capabilities of the
2782 provider.
2783 (2) Whenever a qualified professional determines that an
2784 individual admitted for involuntary services qualifies treatment
2785 is ready for early release under for any of the reasons listed
2786 in subsection (1), the service provider shall immediately
2787 discharge the individual, and must notify all persons specified
2788 by the court in the original treatment order.
2789 Section 35. Section 397.6975, Florida Statutes, is amended
2790 to read:
2791 397.6975 Extension of involuntary services substance abuse
2792 treatment period.—
2793 (1) Whenever a service provider believes that an individual
2794 who is nearing the scheduled date of his or her release from
2795 involuntary services treatment continues to meet the criteria
2796 for involuntary services treatment in s. 397.693, a petition for
2797 renewal of the involuntary services treatment order may be filed
2798 with the court at least 10 days before the expiration of the
2799 court-ordered services treatment period. The court shall
2800 immediately schedule a hearing to be held not more than 15 days
2801 after filing of the petition. The court shall provide the copy
2802 of the petition for renewal and the notice of the hearing to all
2803 parties to the proceeding. The hearing is conducted pursuant to
2804 s. 397.6957.
2805 (2) If the court finds that the petition for renewal of the
2806 involuntary services treatment order should be granted, it may
2807 order the respondent to receive undergo involuntary services
2808 treatment for a period not to exceed an additional 90 days. When
2809 the conditions justifying involuntary services treatment no
2810 longer exist, the individual must be released as provided in s.
2811 397.6971. When the conditions justifying involuntary services
2812 treatment continue to exist after an additional 90 days of
2813 service additional treatment, a new petition requesting renewal
2814 of the involuntary services treatment order may be filed
2815 pursuant to this section.
2816 (3) Within 1 court working day after the filing of a
2817 petition for continued involuntary services, the court shall
2818 appoint the regional conflict counsel to represent the
2819 respondent, unless the respondent is otherwise represented by
2820 counsel. The clerk of the court shall immediately notify the
2821 regional conflict counsel of such appointment. The regional
2822 conflict counsel shall represent the respondent until the
2823 petition is dismissed or the court order expires or the
2824 respondent is discharged from involuntary services. Any attorney
2825 representing the respondent shall have access to the respondent,
2826 witnesses, and records relevant to the presentation of the
2827 respondent’s case and shall represent the interests of the
2828 respondent, regardless of the source of payment to the attorney.
2829 (4) Hearings on petitions for continued involuntary
2830 services shall be before the circuit court. The court may
2831 appoint a magistrate to preside at the hearing. The procedures
2832 for obtaining an order pursuant to this section shall be in
2833 accordance with s. 397.697.
2834 (5) Notice of hearing shall be provided to the respondent
2835 or his or her counsel. The respondent and the respondent’s
2836 counsel may agree to a period of continued involuntary services
2837 without a court hearing.
2838 (6) The same procedure shall be repeated before the
2839 expiration of each additional period of involuntary services.
2840 (7) If the respondent has previously been found incompetent
2841 to consent to treatment, the court shall consider testimony and
2842 evidence regarding the respondent’s competence.
2843 Section 36. Section 397.6977, Florida Statutes, is amended
2844 to read:
2845 397.6977 Disposition of individual upon completion of
2846 involuntary services substance abuse treatment.—At the
2847 conclusion of the 90 60-day period of court-ordered involuntary
2848 services treatment, the respondent individual is automatically
2849 discharged unless a motion for renewal of the involuntary
2850 services treatment order has been filed with the court pursuant
2851 to s. 397.6975.
2852 Section 37. Section 397.6978, Florida Statutes, is created
2853 to read:
2854 397.6978 Guardian advocate; patient incompetent to consent;
2855 substance abuse disorder.—
2856 (1) The administrator of a receiving facility or addictions
2857 receiving facility may petition the court for the appointment of
2858 a guardian advocate based upon the opinion of a qualified
2859 professional that the patient is incompetent to consent to
2860 treatment. If the court finds that a patient is incompetent to
2861 consent to treatment and has not been adjudicated incapacitated
2862 and that a guardian with the authority to consent to mental
2863 health treatment has not been appointed, it may appoint a
2864 guardian advocate. The patient has the right to have an attorney
2865 represent him or her at the hearing. If the person is indigent,
2866 the court shall appoint the office of the regional conflict
2867 counsel to represent him or her at the hearing. The patient has
2868 the right to testify, cross-examine witnesses, and present
2869 witnesses. The proceeding shall be recorded electronically or
2870 stenographically, and testimony must be provided under oath. One
2871 of the qualified professionals authorized to give an opinion in
2872 support of a petition for involuntary placement, as described in
2873 s. 397.675 or s. 397.6981, must testify. A guardian advocate
2874 must meet the qualifications of a guardian contained in part IV
2875 of chapter 744. The person who is appointed as a guardian
2876 advocate must agree to the appointment.
2877 (2) The following persons are prohibited from appointment
2878 as a patient’s guardian advocate:
2879 (a) A professional providing clinical services to the
2880 individual under this part.
2881 (b) The qualified professional who initiated the
2882 involuntary examination of the individual, if the examination
2883 was initiated by a qualified professional’s certificate.
2884 (c) An employee, an administrator, or a board member of the
2885 facility providing the examination of the individual.
2886 (d) An employee, an administrator, or a board member of the
2887 treatment facility providing treatment of the individual.
2888 (e) A person providing any substantial professional
2889 services, excluding public guardians or professional guardians,
2890 to the individual, including clinical services.
2891 (f) A creditor of the individual.
2892 (g) A person subject to an injunction for protection
2893 against domestic violence under s. 741.30, whether the order of
2894 injunction is temporary or final, and for which the individual
2895 was the petitioner.
2896 (h) A person subject to an injunction for protection
2897 against repeat violence, stalking, sexual violence, or dating
2898 violence under s. 784.046, whether the order of injunction is
2899 temporary or final, and for which the individual was the
2900 petitioner.
2901 (3) A facility requesting appointment of a guardian
2902 advocate must, before the appointment, provide the prospective
2903 guardian advocate with information about the duties and
2904 responsibilities of guardian advocates, including information
2905 about the ethics of medical decision-making. Before asking a
2906 guardian advocate to give consent to treatment for a patient,
2907 the facility must provide to the guardian advocate sufficient
2908 information so that the guardian advocate can decide whether to
2909 give express and informed consent to the treatment. Such
2910 information must include information that demonstrates that the
2911 treatment is essential to the care of the patient and does not
2912 present an unreasonable risk of serious, hazardous, or
2913 irreversible side effects. If possible, before giving consent to
2914 treatment, the guardian advocate must personally meet and talk
2915 with the patient and the patient’s physician. If that is not
2916 possible, the discussion may be conducted by telephone. The
2917 decision of the guardian advocate may be reviewed by the court,
2918 upon petition of the patient’s attorney, the patient’s family,
2919 or the facility administrator.
2920 (4) In lieu of the training required for guardians
2921 appointed pursuant to chapter 744, a guardian advocate shall
2922 attend at least a 4-hour training course approved by the court
2923 before exercising his or her authority. At a minimum, the
2924 training course must include information about patient rights,
2925 the diagnosis of substance abuse disorders, the ethics of
2926 medical decision-making, and the duties of guardian advocates.
2927 (5) The required training course and the information to be
2928 supplied to prospective guardian advocates before their
2929 appointment must be developed by the department, approved by the
2930 chief judge of the circuit court, and taught by a court-approved
2931 organization, which may include, but need not be limited to, a
2932 community college, a guardianship organization, a local bar
2933 association, or The Florida Bar. The training course may be web
2934 based, provided in video format, or other electronic means but
2935 must be capable of ensuring the identity and participation of
2936 the prospective guardian advocate. The court may waive some or
2937 all of the training requirements for guardian advocates or
2938 impose additional requirements. The court shall make its
2939 decision on a case-by-case basis and, in making its decision,
2940 shall consider the experience and education of the guardian
2941 advocate, the duties assigned to the guardian advocate, and the
2942 needs of the patient.
2943 (6) In selecting a guardian advocate, the court shall give
2944 preference to the patient’s health care surrogate, if one has
2945 already been designated by the patient. If the patient has not
2946 previously designated a health care surrogate, the selection
2947 shall be made, except for good cause documented in the court
2948 record, from among the following persons, listed in order of
2949 priority:
2950 (a) The patient’s spouse.
2951 (b) An adult child of the patient.
2952 (c) A parent of the patient.
2953 (d) The adult next of kin of the patient.
2954 (e) An adult friend of the patient.
2955 (f) An adult trained and willing to serve as the guardian
2956 advocate for the patient.
2957 (7) If a guardian with the authority to consent to medical
2958 treatment has not already been appointed, or if the patient has
2959 not already designated a health care surrogate, the court may
2960 authorize the guardian advocate to consent to medical treatment
2961 as well as substance abuse disorder treatment. Unless otherwise
2962 limited by the court, a guardian advocate with authority to
2963 consent to medical treatment has the same authority to make
2964 health care decisions and is subject to the same restrictions as
2965 a proxy appointed under part IV of chapter 765. Unless the
2966 guardian advocate has sought and received express court approval
2967 in a proceeding separate from the proceeding to determine the
2968 competence of the patient to consent to medical treatment, the
2969 guardian advocate may not consent to:
2970 (a) Abortion.
2971 (b) Sterilization.
2972 (c) Electroshock therapy.
2973 (d) Psychosurgery.
2974 (e) Experimental treatments that have not been approved by
2975 a federally approved institutional review board in accordance
2976 with 45 C.F.R. part 46 or 21 C.F.R. part 56.
2977
2978 The court must base its authorization on evidence that the
2979 treatment or procedure is essential to the care of the patient
2980 and that the treatment does not present an unreasonable risk of
2981 serious, hazardous, or irreversible side effects. In complying
2982 with this subsection, the court shall follow the procedures set
2983 forth in subsection (1).
2984 (8) The guardian advocate shall be discharged when the
2985 patient is discharged from an order for involuntary services or
2986 when the patient is transferred from involuntary to voluntary
2987 status. The court or a hearing officer shall consider the
2988 competence of the patient as provided in subsection (1) and may
2989 consider an involuntarily placed patient’s competence to consent
2990 to services at any hearing. Upon sufficient evidence, the court
2991 may restore, or the magistrate may recommend that the court
2992 restore, the patient’s competence. A copy of the order restoring
2993 competence or the certificate of discharge containing the
2994 restoration of competence shall be provided to the patient and
2995 the guardian advocate.
2996 Section 38. Present paragraphs (d) through (m) of
2997 subsection (2) of section 409.967, are redesignated as
2998 paragraphs (e) through (n), respectively, and a new paragraph
2999 (d) is added to that subsection, to read:
3000 409.967 Managed care plan accountability.—
3001 (2) The agency shall establish such contract requirements
3002 as are necessary for the operation of the statewide managed care
3003 program. In addition to any other provisions the agency may deem
3004 necessary, the contract must require:
3005 (d) Quality care.—Managed care plans shall provide, or
3006 contract for the provision of, care coordination to facilitate
3007 the appropriate delivery of behavioral health care services in
3008 the least restrictive setting with treatment and recovery
3009 capabilities that address the needs of the patient. Services
3010 shall be provided in a manner that integrates behavioral health
3011 services and primary care. Plans shall be required to achieve
3012 specific behavioral health outcome standards, established by the
3013 agency in consultation with the department.
3014 Section 39. Subsection (5) is added to section 409.973,
3015 Florida Statutes, to read:
3016 409.973 Benefits.—
3017 (5) INTEGRATED BEHAVIORAL HEALTH INITIATIVE.—Each plan
3018 operating in the managed medical assistance program shall work
3019 with the managing entity in its service area to establish
3020 specific organizational supports and protocols that enhance the
3021 integration and coordination of primary care and behavioral
3022 health services for Medicaid recipients. Progress in this
3023 initiative shall be measured using the integration framework and
3024 core measures developed by the Agency for Healthcare Research
3025 and Quality.
3026 Section 40. Section 491.0045, Florida Statutes, is amended
3027 to read:
3028 491.0045 Intern registration; requirements.—
3029 (1) Effective January 1, 1998, An individual who has not
3030 satisfied intends to practice in Florida to satisfy the
3031 postgraduate or post-master’s level experience requirements, as
3032 specified in s. 491.005(1)(c), (3)(c), or (4)(c), must register
3033 as an intern in the profession for which he or she is seeking
3034 licensure prior to commencing the post-master’s experience
3035 requirement or an individual who intends to satisfy part of the
3036 required graduate-level practicum, internship, or field
3037 experience, outside the academic arena for any profession, must
3038 register as an intern in the profession for which he or she is
3039 seeking licensure prior to commencing the practicum, internship,
3040 or field experience.
3041 (2) The department shall register as a clinical social
3042 worker intern, marriage and family therapist intern, or mental
3043 health counselor intern each applicant who the board certifies
3044 has:
3045 (a) Completed the application form and remitted a
3046 nonrefundable application fee not to exceed $200, as set by
3047 board rule;
3048 (b)1. Completed the education requirements as specified in
3049 s. 491.005(1)(c), (3)(c), or (4)(c) for the profession for which
3050 he or she is applying for licensure, if needed; and
3051 2. Submitted an acceptable supervision plan, as determined
3052 by the board, for meeting the practicum, internship, or field
3053 work required for licensure that was not satisfied in his or her
3054 graduate program.
3055 (c) Identified a qualified supervisor.
3056 (3) An individual registered under this section must remain
3057 under supervision while practicing under registered intern
3058 status until he or she is in receipt of a license or a letter
3059 from the department stating that he or she is licensed to
3060 practice the profession for which he or she applied.
3061 (4) An individual who has applied for intern registration
3062 on or before December 31, 2001, and has satisfied the education
3063 requirements of s. 491.005 that are in effect through December
3064 31, 2000, will have met the educational requirements for
3065 licensure for the profession for which he or she has applied.
3066 (4)(5) An individual who fails Individuals who have
3067 commenced the experience requirement as specified in s.
3068 491.005(1)(c), (3)(c), or (4)(c) but failed to register as
3069 required by subsection (1) shall register with the department
3070 before January 1, 2000. Individuals who fail to comply with this
3071 section may subsection shall not be granted a license under this
3072 chapter, and any time spent by the individual completing the
3073 experience requirement as specified in s. 491.005(1)(c), (3)(c),
3074 or (4)(c) before prior to registering as an intern does shall
3075 not count toward completion of the such requirement.
3076 (5) An intern registration is valid for 5 years.
3077 (6) A registration issued on or before March 31, 2017,
3078 expires March 31, 2022, and may not be renewed or reissued. Any
3079 registration issued after March 31, 2017, expires 60 months
3080 after the date it is issued. A subsequent intern registration
3081 may not be issued unless the candidate has passed the theory and
3082 practice examination described in s. 491.005(1)(d), (3)(d), and
3083 (4)(d).
3084 (7) An individual who has held a provisional license issued
3085 by the board may not apply for an intern registration in the
3086 same profession.
3087 Section 41. Section 394.4674, Florida Statutes, is
3088 repealed.
3089 Section 42. Section 394.4985, Florida Statutes, is
3090 repealed.
3091 Section 43. Section 394.745, Florida Statutes, is repealed.
3092 Section 44. Section 397.331, Florida Statutes, is repealed.
3093 Section 45. Section 397.801, Florida Statutes, is repealed.
3094 Section 46. Section 397.811, Florida Statutes, is repealed.
3095 Section 47. Section 397.821, Florida Statutes, is repealed.
3096 Section 48. Section 397.901, Florida Statutes, is repealed.
3097 Section 49. Section 397.93, Florida Statutes, is repealed.
3098 Section 50. Section 397.94, Florida Statutes, is repealed.
3099 Section 51. Section 397.951, Florida Statutes, is repealed.
3100 Section 52. Section 397.97, Florida Statutes, is repealed.
3101 Section 53. Section 397.98, Florida Statutes, is repealed.
3102 Section 54. Paragraph (a) of subsection (3) of section
3103 39.407, Florida Statutes, is amended to read:
3104 39.407 Medical, psychiatric, and psychological examination
3105 and treatment of child; physical, mental, or substance abuse
3106 examination of person with or requesting child custody.—
3107 (3)(a)1. Except as otherwise provided in subparagraph (b)1.
3108 or paragraph (e), before the department provides psychotropic
3109 medications to a child in its custody, the prescribing physician
3110 shall attempt to obtain express and informed consent, as defined
3111 in s. 394.455(16) s. 394.455(9) and as described in s.
3112 394.459(3)(a), from the child’s parent or legal guardian. The
3113 department must take steps necessary to facilitate the inclusion
3114 of the parent in the child’s consultation with the physician.
3115 However, if the parental rights of the parent have been
3116 terminated, the parent’s location or identity is unknown or
3117 cannot reasonably be ascertained, or the parent declines to give
3118 express and informed consent, the department may, after
3119 consultation with the prescribing physician, seek court
3120 authorization to provide the psychotropic medications to the
3121 child. Unless parental rights have been terminated and if it is
3122 possible to do so, the department shall continue to involve the
3123 parent in the decisionmaking process regarding the provision of
3124 psychotropic medications. If, at any time, a parent whose
3125 parental rights have not been terminated provides express and
3126 informed consent to the provision of a psychotropic medication,
3127 the requirements of this section that the department seek court
3128 authorization do not apply to that medication until such time as
3129 the parent no longer consents.
3130 2. Any time the department seeks a medical evaluation to
3131 determine the need to initiate or continue a psychotropic
3132 medication for a child, the department must provide to the
3133 evaluating physician all pertinent medical information known to
3134 the department concerning that child.
3135 Section 55. Paragraph (e) of subsection (5) of section
3136 212.055, Florida Statutes, is amended to read:
3137 212.055 Discretionary sales surtaxes; legislative intent;
3138 authorization and use of proceeds.—It is the legislative intent
3139 that any authorization for imposition of a discretionary sales
3140 surtax shall be published in the Florida Statutes as a
3141 subsection of this section, irrespective of the duration of the
3142 levy. Each enactment shall specify the types of counties
3143 authorized to levy; the rate or rates which may be imposed; the
3144 maximum length of time the surtax may be imposed, if any; the
3145 procedure which must be followed to secure voter approval, if
3146 required; the purpose for which the proceeds may be expended;
3147 and such other requirements as the Legislature may provide.
3148 Taxable transactions and administrative procedures shall be as
3149 provided in s. 212.054.
3150 (5) COUNTY PUBLIC HOSPITAL SURTAX.—Any county as defined in
3151 s. 125.011(1) may levy the surtax authorized in this subsection
3152 pursuant to an ordinance either approved by extraordinary vote
3153 of the county commission or conditioned to take effect only upon
3154 approval by a majority vote of the electors of the county voting
3155 in a referendum. In a county as defined in s. 125.011(1), for
3156 the purposes of this subsection, “county public general
3157 hospital” means a general hospital as defined in s. 395.002
3158 which is owned, operated, maintained, or governed by the county
3159 or its agency, authority, or public health trust.
3160 (e) A governing board, agency, or authority shall be
3161 chartered by the county commission upon this act becoming law.
3162 The governing board, agency, or authority shall adopt and
3163 implement a health care plan for indigent health care services.
3164 The governing board, agency, or authority shall consist of no
3165 more than seven and no fewer than five members appointed by the
3166 county commission. The members of the governing board, agency,
3167 or authority shall be at least 18 years of age and residents of
3168 the county. No member may be employed by or affiliated with a
3169 health care provider or the public health trust, agency, or
3170 authority responsible for the county public general hospital.
3171 The following community organizations shall each appoint a
3172 representative to a nominating committee: the South Florida
3173 Hospital and Healthcare Association, the Miami-Dade County
3174 Public Health Trust, the Dade County Medical Association, the
3175 Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade
3176 County. This committee shall nominate between 10 and 14 county
3177 citizens for the governing board, agency, or authority. The
3178 slate shall be presented to the county commission and the county
3179 commission shall confirm the top five to seven nominees,
3180 depending on the size of the governing board. Until such time as
3181 the governing board, agency, or authority is created, the funds
3182 provided for in subparagraph (d)2. shall be placed in a
3183 restricted account set aside from other county funds and not
3184 disbursed by the county for any other purpose.
3185 1. The plan shall divide the county into a minimum of four
3186 and maximum of six service areas, with no more than one
3187 participant hospital per service area. The county public general
3188 hospital shall be designated as the provider for one of the
3189 service areas. Services shall be provided through participants’
3190 primary acute care facilities.
3191 2. The plan and subsequent amendments to it shall fund a
3192 defined range of health care services for both indigent persons
3193 and the medically poor, including primary care, preventive care,
3194 hospital emergency room care, and hospital care necessary to
3195 stabilize the patient. For the purposes of this section,
3196 “stabilization” means stabilization as defined in s. 397.311(43)
3197 s. 397.311(41). Where consistent with these objectives, the plan
3198 may include services rendered by physicians, clinics, community
3199 hospitals, and alternative delivery sites, as well as at least
3200 one regional referral hospital per service area. The plan shall
3201 provide that agreements negotiated between the governing board,
3202 agency, or authority and providers shall recognize hospitals
3203 that render a disproportionate share of indigent care, provide
3204 other incentives to promote the delivery of charity care to draw
3205 down federal funds where appropriate, and require cost
3206 containment, including, but not limited to, case management.
3207 From the funds specified in subparagraphs (d)1. and 2. for
3208 indigent health care services, service providers shall receive
3209 reimbursement at a Medicaid rate to be determined by the
3210 governing board, agency, or authority created pursuant to this
3211 paragraph for the initial emergency room visit, and a per-member
3212 per-month fee or capitation for those members enrolled in their
3213 service area, as compensation for the services rendered
3214 following the initial emergency visit. Except for provisions of
3215 emergency services, upon determination of eligibility,
3216 enrollment shall be deemed to have occurred at the time services
3217 were rendered. The provisions for specific reimbursement of
3218 emergency services shall be repealed on July 1, 2001, unless
3219 otherwise reenacted by the Legislature. The capitation amount or
3220 rate shall be determined before prior to program implementation
3221 by an independent actuarial consultant. In no event shall such
3222 reimbursement rates exceed the Medicaid rate. The plan must also
3223 provide that any hospitals owned and operated by government
3224 entities on or after the effective date of this act must, as a
3225 condition of receiving funds under this subsection, afford
3226 public access equal to that provided under s. 286.011 as to any
3227 meeting of the governing board, agency, or authority the subject
3228 of which is budgeting resources for the retention of charity
3229 care, as that term is defined in the rules of the Agency for
3230 Health Care Administration. The plan shall also include
3231 innovative health care programs that provide cost-effective
3232 alternatives to traditional methods of service and delivery
3233 funding.
3234 3. The plan’s benefits shall be made available to all
3235 county residents currently eligible to receive health care
3236 services as indigents or medically poor as defined in paragraph
3237 (4)(d).
3238 4. Eligible residents who participate in the health care
3239 plan shall receive coverage for a period of 12 months or the
3240 period extending from the time of enrollment to the end of the
3241 current fiscal year, per enrollment period, whichever is less.
3242 5. At the end of each fiscal year, the governing board,
3243 agency, or authority shall prepare an audit that reviews the
3244 budget of the plan, delivery of services, and quality of
3245 services, and makes recommendations to increase the plan’s
3246 efficiency. The audit shall take into account participant
3247 hospital satisfaction with the plan and assess the amount of
3248 poststabilization patient transfers requested, and accepted or
3249 denied, by the county public general hospital.
3250 Section 56. Paragraph (c) of subsection (2) of section
3251 394.4599, Florida Statutes, is amended to read:
3252 394.4599 Notice.—
3253 (2) INVOLUNTARY ADMISSION.—
3254 (c)1. A receiving facility shall give notice of the
3255 whereabouts of a minor who is being involuntarily held for
3256 examination pursuant to s. 394.463 to the minor’s parent,
3257 guardian, caregiver, or guardian advocate, in person or by
3258 telephone or other form of electronic communication, immediately
3259 after the minor’s arrival at the facility. The facility may
3260 delay notification for no more than 24 hours after the minor’s
3261 arrival if the facility has submitted a report to the central
3262 abuse hotline, pursuant to s. 39.201, based upon knowledge or
3263 suspicion of abuse, abandonment, or neglect and if the facility
3264 deems a delay in notification to be in the minor’s best
3265 interest.
3266 2. The receiving facility shall attempt to notify the
3267 minor’s parent, guardian, caregiver, or guardian advocate until
3268 the receiving facility receives confirmation from the parent,
3269 guardian, caregiver, or guardian advocate, verbally, by
3270 telephone or other form of electronic communication, or by
3271 recorded message, that notification has been received. Attempts
3272 to notify the parent, guardian, caregiver, or guardian advocate
3273 must be repeated at least once every hour during the first 12
3274 hours after the minor’s arrival and once every 24 hours
3275 thereafter and must continue until such confirmation is
3276 received, unless the minor is released at the end of the 72-hour
3277 examination period, or until a petition for involuntary services
3278 placement is filed with the court pursuant to s. 394.463(2)(g)
3279 s. 394.463(2)(i). The receiving facility may seek assistance
3280 from a law enforcement agency to notify the minor’s parent,
3281 guardian, caregiver, or guardian advocate if the facility has
3282 not received within the first 24 hours after the minor’s arrival
3283 a confirmation by the parent, guardian, caregiver, or guardian
3284 advocate that notification has been received. The receiving
3285 facility must document notification attempts in the minor’s
3286 clinical record.
3287 Section 57. Subsection (3) of section 394.495, Florida
3288 Statutes, is amended to read:
3289 394.495 Child and adolescent mental health system of care;
3290 programs and services.—
3291 (3) Assessments must be performed by:
3292 (a) A professional as defined in s. 394.455(6), (8), (34),
3293 (37), or (38) s. 394.455(2), (4), (21), (23), or (24);
3294 (b) A professional licensed under chapter 491; or
3295 (c) A person who is under the direct supervision of a
3296 professional as defined in s. 394.455(6), (8), (34), (37), or
3297 (38) s. 394.455(2), (4), (21), (23), or (24) or a professional
3298 licensed under chapter 491.
3299 Section 58. Subsection (5) of section 394.496, Florida
3300 Statutes, is amended to read:
3301 394.496 Service planning.—
3302 (5) A professional as defined in s. 394.455(6), (8), (34),
3303 (37), or (38) s. 394.455(2), (4), (21), (23), or (24) or a
3304 professional licensed under chapter 491 must be included among
3305 those persons developing the services plan.
3306 Section 59. Subsection (6) of section 394.9085, Florida
3307 Statutes, is amended to read:
3308 394.9085 Behavioral provider liability.—
3309 (6) For purposes of this section, the terms “detoxification
3310 services,” “addictions receiving facility,” and “receiving
3311 facility” have the same meanings as those provided in ss.
3312 397.311(24)(a)4., 397.311(24)(a)1., and 394.455(41) ss.
3313 397.311(22)(a)4., 397.311(22)(a)1., and 394.455(26),
3314 respectively.
3315 Section 60. Subsection (15) of section 397.321, Florida
3316 Statutes, is amended to read:
3317 397.321 Duties of the department.—The department shall:
3318 (15) Appoint a substance abuse impairment coordinator to
3319 represent the department in efforts initiated by the statewide
3320 substance abuse impairment prevention and treatment coordinator
3321 established in s. 397.801 and to assist the statewide
3322 coordinator in fulfilling the responsibilities of that position.
3323 Section 61. Subsection (8) of section 397.405, Florida
3324 Statutes, is amended to read:
3325 397.405 Exemptions from licensure.—The following are exempt
3326 from the licensing provisions of this chapter:
3327 (8) A legally cognizable church or nonprofit religious
3328 organization or denomination providing substance abuse services,
3329 including prevention services, which are solely religious,
3330 spiritual, or ecclesiastical in nature. A church or nonprofit
3331 religious organization or denomination providing any of the
3332 licensed service components itemized under s. 397.311(24) s.
3333 397.311(22) is not exempt from substance abuse licensure but
3334 retains its exemption with respect to all services which are
3335 solely religious, spiritual, or ecclesiastical in nature.
3336
3337 The exemptions from licensure in this section do not apply to
3338 any service provider that receives an appropriation, grant, or
3339 contract from the state to operate as a service provider as
3340 defined in this chapter or to any substance abuse program
3341 regulated pursuant to s. 397.406. Furthermore, this chapter may
3342 not be construed to limit the practice of a physician or
3343 physician assistant licensed under chapter 458 or chapter 459, a
3344 psychologist licensed under chapter 490, a psychotherapist
3345 licensed under chapter 491, or an advanced registered nurse
3346 practitioner licensed under part I of chapter 464, who provides
3347 substance abuse treatment, so long as the physician, physician
3348 assistant, psychologist, psychotherapist, or advanced registered
3349 nurse practitioner does not represent to the public that he or
3350 she is a licensed service provider and does not provide services
3351 to individuals pursuant to part V of this chapter. Failure to
3352 comply with any requirement necessary to maintain an exempt
3353 status under this section is a misdemeanor of the first degree,
3354 punishable as provided in s. 775.082 or s. 775.083.
3355 Section 62. Subsections (1) and (5) of section 397.407,
3356 Florida Statutes, are amended to read:
3357 397.407 Licensure process; fees.—
3358 (1) The department shall establish the licensure process to
3359 include fees and categories of licenses and must prescribe a fee
3360 range that is based, at least in part, on the number and
3361 complexity of programs listed in s. 397.311(24) s. 397.311(22)
3362 which are operated by a licensee. The fees from the licensure of
3363 service components are sufficient to cover at least 50 percent
3364 of the costs of regulating the service components. The
3365 department shall specify a fee range for public and privately
3366 funded licensed service providers. Fees for privately funded
3367 licensed service providers must exceed the fees for publicly
3368 funded licensed service providers.
3369 (5) The department may issue probationary, regular, and
3370 interim licenses. The department shall issue one license for
3371 each service component that is operated by a service provider
3372 and defined pursuant to s. 397.311(24) s. 397.311(22). The
3373 license is valid only for the specific service components listed
3374 for each specific location identified on the license. The
3375 licensed service provider shall apply for a new license at least
3376 60 days before the addition of any service components or 30 days
3377 before the relocation of any of its service sites. Provision of
3378 service components or delivery of services at a location not
3379 identified on the license may be considered an unlicensed
3380 operation that authorizes the department to seek an injunction
3381 against operation as provided in s. 397.401, in addition to
3382 other sanctions authorized by s. 397.415. Probationary and
3383 regular licenses may be issued only after all required
3384 information has been submitted. A license may not be
3385 transferred. As used in this subsection, the term “transfer”
3386 includes, but is not limited to, the transfer of a majority of
3387 the ownership interest in the licensed entity or transfer of
3388 responsibilities under the license to another entity by
3389 contractual arrangement.
3390 Section 63. Section 397.416, Florida Statutes, is amended
3391 to read:
3392 397.416 Substance abuse treatment services; qualified
3393 professional.—Notwithstanding any other provision of law, a
3394 person who was certified through a certification process
3395 recognized by the former Department of Health and Rehabilitative
3396 Services before January 1, 1995, may perform the duties of a
3397 qualified professional with respect to substance abuse treatment
3398 services as defined in this chapter, and need not meet the
3399 certification requirements contained in s. 397.311(32) s.
3400 397.311(30).
3401 Section 64. Subsection (2) of section 397.4871, Florida
3402 Statutes, is amended to read:
3403 397.4871 Recovery residence administrator certification.—
3404 (2) The department shall approve at least one credentialing
3405 entity by December 1, 2015, for the purpose of developing and
3406 administering a voluntary credentialing program for
3407 administrators. The department shall approve any credentialing
3408 entity that the department endorses pursuant to s. 397.321(15)
3409 s. 397.321(16) if the credentialing entity also meets the
3410 requirements of this section. The approved credentialing entity
3411 shall:
3412 (a) Establish recovery residence administrator core
3413 competencies, certification requirements, testing instruments,
3414 and recertification requirements.
3415 (b) Establish a process to administer the certification
3416 application, award, and maintenance processes.
3417 (c) Develop and administer:
3418 1. A code of ethics and disciplinary process.
3419 2. Biennial continuing education requirements and annual
3420 certification renewal requirements.
3421 3. An education provider program to approve training
3422 entities that are qualified to provide precertification training
3423 to applicants and continuing education opportunities to
3424 certified persons.
3425 Section 65. Paragraph (e) of subsection (3) of section
3426 409.966, Florida Statutes, is amended to read:
3427 409.966 Eligible plans; selection.—
3428 (3) QUALITY SELECTION CRITERIA.—
3429 (e) To ensure managed care plan participation in Regions 1
3430 and 2, the agency shall award an additional contract to each
3431 plan with a contract award in Region 1 or Region 2. Such
3432 contract shall be in any other region in which the plan
3433 submitted a responsive bid and negotiates a rate acceptable to
3434 the agency. If a plan that is awarded an additional contract
3435 pursuant to this paragraph is subject to penalties pursuant to
3436 s. 409.967(2)(i) s. 409.967(2)(h) for activities in Region 1 or
3437 Region 2, the additional contract is automatically terminated
3438 180 days after the imposition of the penalties. The plan must
3439 reimburse the agency for the cost of enrollment changes and
3440 other transition activities.
3441 Section 66. Paragraph (b) of subsection (1) of section
3442 409.972, Florida Statutes, is amended to read:
3443 409.972 Mandatory and voluntary enrollment.—
3444 (1) The following Medicaid-eligible persons are exempt from
3445 mandatory managed care enrollment required by s. 409.965, and
3446 may voluntarily choose to participate in the managed medical
3447 assistance program:
3448 (b) Medicaid recipients residing in residential commitment
3449 facilities operated through the Department of Juvenile Justice
3450 or a mental health treatment facility facilities as defined in
3451 s. 394.455(50) by s. 394.455(32).
3452 Section 67. Paragraphs (d) and (g) of subsection (1) of
3453 section 440.102, Florida Statutes, are amended to read:
3454 440.102 Drug-free workplace program requirements.—The
3455 following provisions apply to a drug-free workplace program
3456 implemented pursuant to law or to rules adopted by the Agency
3457 for Health Care Administration:
3458 (1) DEFINITIONS.—Except where the context otherwise
3459 requires, as used in this act:
3460 (d) “Drug rehabilitation program” means a service provider,
3461 established pursuant to s. 397.311(41) s. 397.311(39), that
3462 provides confidential, timely, and expert identification,
3463 assessment, and resolution of employee drug abuse.
3464 (g) “Employee assistance program” means an established
3465 program capable of providing expert assessment of employee
3466 personal concerns; confidential and timely identification
3467 services with regard to employee drug abuse; referrals of
3468 employees for appropriate diagnosis, treatment, and assistance;
3469 and followup services for employees who participate in the
3470 program or require monitoring after returning to work. If, in
3471 addition to the above activities, an employee assistance program
3472 provides diagnostic and treatment services, these services shall
3473 in all cases be provided by service providers pursuant to s.
3474 397.311(41) s. 397.311(39).
3475 Section 68. Subsection (7) of section 744.704, Florida
3476 Statutes, is amended to read:
3477 744.704 Powers and duties.—
3478 (7) A public guardian may shall not commit a ward to a
3479 mental health treatment facility, as defined in s. 394.455(50)
3480 s. 394.455(32), without an involuntary placement proceeding as
3481 provided by law.
3482 Section 69. Paragraph (a) of subsection (2) of section
3483 790.065, Florida Statutes, is amended to read:
3484 790.065 Sale and delivery of firearms.—
3485 (2) Upon receipt of a request for a criminal history record
3486 check, the Department of Law Enforcement shall, during the
3487 licensee’s call or by return call, forthwith:
3488 (a) Review any records available to determine if the
3489 potential buyer or transferee:
3490 1. Has been convicted of a felony and is prohibited from
3491 receipt or possession of a firearm pursuant to s. 790.23;
3492 2. Has been convicted of a misdemeanor crime of domestic
3493 violence, and therefore is prohibited from purchasing a firearm;
3494 3. Has had adjudication of guilt withheld or imposition of
3495 sentence suspended on any felony or misdemeanor crime of
3496 domestic violence unless 3 years have elapsed since probation or
3497 any other conditions set by the court have been fulfilled or
3498 expunction has occurred; or
3499 4. Has been adjudicated mentally defective or has been
3500 committed to a mental institution by a court or as provided in
3501 sub-sub-subparagraph b.(II), and as a result is prohibited by
3502 state or federal law from purchasing a firearm.
3503 a. As used in this subparagraph, “adjudicated mentally
3504 defective” means a determination by a court that a person, as a
3505 result of marked subnormal intelligence, or mental illness,
3506 incompetency, condition, or disease, is a danger to himself or
3507 herself or to others or lacks the mental capacity to contract or
3508 manage his or her own affairs. The phrase includes a judicial
3509 finding of incapacity under s. 744.331(6)(a), an acquittal by
3510 reason of insanity of a person charged with a criminal offense,
3511 and a judicial finding that a criminal defendant is not
3512 competent to stand trial.
3513 b. As used in this subparagraph, “committed to a mental
3514 institution” means:
3515 (I) Involuntary commitment, commitment for mental
3516 defectiveness or mental illness, and commitment for substance
3517 abuse. The phrase includes involuntary inpatient placement as
3518 defined in s. 394.467, involuntary outpatient services placement
3519 as defined in s. 394.4655, involuntary assessment and
3520 stabilization under s. 397.6818, and involuntary substance abuse
3521 treatment under s. 397.6957, but does not include a person in a
3522 mental institution for observation or discharged from a mental
3523 institution based upon the initial review by the physician or a
3524 voluntary admission to a mental institution; or
3525 (II) Notwithstanding sub-sub-subparagraph (I), voluntary
3526 admission to a mental institution for outpatient or inpatient
3527 treatment of a person who had an involuntary examination under
3528 s. 394.463, where each of the following conditions have been
3529 met:
3530 (A) An examining physician found that the person is an
3531 imminent danger to himself or herself or others.
3532 (B) The examining physician certified that if the person
3533 did not agree to voluntary treatment, a petition for involuntary
3534 outpatient or inpatient services treatment would have been filed
3535 under s. 394.463(2)(g) s. 394.463(2)(i)4., or the examining
3536 physician certified that a petition was filed and the person
3537 subsequently agreed to voluntary treatment before prior to a
3538 court hearing on the petition.
3539 (C) Before agreeing to voluntary treatment, the person
3540 received written notice of that finding and certification, and
3541 written notice that as a result of such finding, he or she may
3542 be prohibited from purchasing a firearm, and may not be eligible
3543 to apply for or retain a concealed weapon or firearms license
3544 under s. 790.06 and the person acknowledged such notice in
3545 writing, in substantially the following form:
3546
3547 “I understand that the doctor who examined me believes
3548 I am a danger to myself or to others. I understand
3549 that if I do not agree to voluntary treatment, a
3550 petition will be filed in court to require me to
3551 receive involuntary treatment. I understand that if
3552 that petition is filed, I have the right to contest
3553 it. In the event a petition has been filed, I
3554 understand that I can subsequently agree to voluntary
3555 treatment prior to a court hearing. I understand that
3556 by agreeing to voluntary treatment in either of these
3557 situations, I may be prohibited from buying firearms
3558 and from applying for or retaining a concealed weapons
3559 or firearms license until I apply for and receive
3560 relief from that restriction under Florida law.”
3561
3562 (D) A judge or a magistrate has, pursuant to sub-sub
3563 subparagraph c.(II), reviewed the record of the finding,
3564 certification, notice, and written acknowledgment classifying
3565 the person as an imminent danger to himself or herself or
3566 others, and ordered that such record be submitted to the
3567 department.
3568 c. In order to check for these conditions, the department
3569 shall compile and maintain an automated database of persons who
3570 are prohibited from purchasing a firearm based on court records
3571 of adjudications of mental defectiveness or commitments to
3572 mental institutions.
3573 (I) Except as provided in sub-sub-subparagraph (II), clerks
3574 of court shall submit these records to the department within 1
3575 month after the rendition of the adjudication or commitment.
3576 Reports shall be submitted in an automated format. The reports
3577 must, at a minimum, include the name, along with any known alias
3578 or former name, the sex, and the date of birth of the subject.
3579 (II) For persons committed to a mental institution pursuant
3580 to sub-sub-subparagraph b.(II), within 24 hours after the
3581 person’s agreement to voluntary admission, a record of the
3582 finding, certification, notice, and written acknowledgment must
3583 be filed by the administrator of the receiving or treatment
3584 facility, as defined in s. 394.455, with the clerk of the court
3585 for the county in which the involuntary examination under s.
3586 394.463 occurred. No fee shall be charged for the filing under
3587 this sub-sub-subparagraph. The clerk must present the records to
3588 a judge or magistrate within 24 hours after receipt of the
3589 records. A judge or magistrate is required and has the lawful
3590 authority to review the records ex parte and, if the judge or
3591 magistrate determines that the record supports the classifying
3592 of the person as an imminent danger to himself or herself or
3593 others, to order that the record be submitted to the department.
3594 If a judge or magistrate orders the submittal of the record to
3595 the department, the record must be submitted to the department
3596 within 24 hours.
3597 d. A person who has been adjudicated mentally defective or
3598 committed to a mental institution, as those terms are defined in
3599 this paragraph, may petition the circuit court that made the
3600 adjudication or commitment, or the court that ordered that the
3601 record be submitted to the department pursuant to sub-sub
3602 subparagraph c.(II), for relief from the firearm disabilities
3603 imposed by such adjudication or commitment. A copy of the
3604 petition shall be served on the state attorney for the county in
3605 which the person was adjudicated or committed. The state
3606 attorney may object to and present evidence relevant to the
3607 relief sought by the petition. The hearing on the petition may
3608 be open or closed as the petitioner may choose. The petitioner
3609 may present evidence and subpoena witnesses to appear at the
3610 hearing on the petition. The petitioner may confront and cross
3611 examine witnesses called by the state attorney. A record of the
3612 hearing shall be made by a certified court reporter or by court
3613 approved electronic means. The court shall make written findings
3614 of fact and conclusions of law on the issues before it and issue
3615 a final order. The court shall grant the relief requested in the
3616 petition if the court finds, based on the evidence presented
3617 with respect to the petitioner’s reputation, the petitioner’s
3618 mental health record and, if applicable, criminal history
3619 record, the circumstances surrounding the firearm disability,
3620 and any other evidence in the record, that the petitioner will
3621 not be likely to act in a manner that is dangerous to public
3622 safety and that granting the relief would not be contrary to the
3623 public interest. If the final order denies relief, the
3624 petitioner may not petition again for relief from firearm
3625 disabilities until 1 year after the date of the final order. The
3626 petitioner may seek judicial review of a final order denying
3627 relief in the district court of appeal having jurisdiction over
3628 the court that issued the order. The review shall be conducted
3629 de novo. Relief from a firearm disability granted under this
3630 sub-subparagraph has no effect on the loss of civil rights,
3631 including firearm rights, for any reason other than the
3632 particular adjudication of mental defectiveness or commitment to
3633 a mental institution from which relief is granted.
3634 e. Upon receipt of proper notice of relief from firearm
3635 disabilities granted under sub-subparagraph d., the department
3636 shall delete any mental health record of the person granted
3637 relief from the automated database of persons who are prohibited
3638 from purchasing a firearm based on court records of
3639 adjudications of mental defectiveness or commitments to mental
3640 institutions.
3641 f. The department is authorized to disclose data collected
3642 pursuant to this subparagraph to agencies of the Federal
3643 Government and other states for use exclusively in determining
3644 the lawfulness of a firearm sale or transfer. The department is
3645 also authorized to disclose this data to the Department of
3646 Agriculture and Consumer Services for purposes of determining
3647 eligibility for issuance of a concealed weapons or concealed
3648 firearms license and for determining whether a basis exists for
3649 revoking or suspending a previously issued license pursuant to
3650 s. 790.06(10). When a potential buyer or transferee appeals a
3651 nonapproval based on these records, the clerks of court and
3652 mental institutions shall, upon request by the department,
3653 provide information to help determine whether the potential
3654 buyer or transferee is the same person as the subject of the
3655 record. Photographs and any other data that could confirm or
3656 negate identity must be made available to the department for
3657 such purposes, notwithstanding any other provision of state law
3658 to the contrary. Any such information that is made confidential
3659 or exempt from disclosure by law shall retain such confidential
3660 or exempt status when transferred to the department.
3661 Section 70. This act shall take effect July 1, 2016.
3662
3663 ================= T I T L E A M E N D M E N T ================
3664 And the title is amended as follows:
3665 Delete everything before the enacting clause
3666 and insert:
3667 A bill to be entitled
3668 An act relating to mental health and substance abuse;
3669 amending s. 29.004, F.S.; including services provided
3670 to treatment-based mental health programs within case
3671 management funded from state revenues as an element of
3672 the state courts system; amending s. 39.001, F.S.;
3673 providing legislative intent regarding mental illness
3674 for purposes of the child welfare system; amending s.
3675 39.407, F.S.; requiring assessment findings to be
3676 provided to the plan that is financially responsible
3677 for a child’s care in residential treatment under
3678 certain circumstances; amending s. 39.507, F.S.;
3679 providing for consideration of mental health issues
3680 and involvement in treatment-based mental health
3681 programs in adjudicatory hearings and orders;
3682 providing requirements for certain court orders;
3683 amending s. 39.521, F.S.; providing for consideration
3684 of mental health issues and involvement in treatment
3685 based mental health programs in disposition hearings;
3686 providing requirements for certain court orders;
3687 amending s. 394.455, F.S.; defining terms; revising
3688 definitions; amending s. 394.4573, F.S.; requiring the
3689 Department of Children and Families to submit a
3690 certain assessment to the Governor and the Legislature
3691 by a specified date; redefining terms; providing
3692 essential elements of a coordinated system of care;
3693 providing requirements for the department’s annual
3694 assessment; authorizing the department to award
3695 certain grants; deleting duties and measures of the
3696 department regarding continuity of care management
3697 systems; amending s. 394.4597, F.S.; revising the
3698 prioritization of health care surrogates to be
3699 selected for involuntary patients; specifying certain
3700 persons who are prohibited from being selected as an
3701 individual’s representative; amending s. 394.4598,
3702 F.S.; specifying certain persons who are prohibited
3703 from being appointed as a person’s guardian advocate;
3704 amending s. 394.462, F.S.; requiring that counties
3705 develop and implement transportation plans; providing
3706 requirements for the plans; revising requirements for
3707 transportation to receiving facilities and treatment
3708 facilities; deleting exceptions to such requirements;
3709 amending s. 394.463, F.S.; authorizing county or
3710 circuit courts to enter ex parte orders for
3711 involuntary examinations; requiring a facility to
3712 provide copies of ex parte orders, reports, and
3713 certifications to managing entities and the
3714 department, rather than the Agency for Health Care
3715 Administration; requiring the managing entity and
3716 department to receive certain orders, certificates,
3717 and reports; requiring the managing entity and the
3718 department to receive and maintain copies of certain
3719 documents; prohibiting a person from being held for
3720 involuntary examination for more than a specified
3721 period of time; providing exceptions; requiring
3722 certain individuals to be released to law enforcement
3723 custody; providing exceptions; amending s. 394.4655,
3724 F.S.; providing for involuntary outpatient services;
3725 requiring a service provider to document certain
3726 inquiries; requiring the managing entity to document
3727 certain efforts; providing requirements for the
3728 appointment of state counsel; making technical
3729 changes; amending s. 394.467, F.S.; revising criteria
3730 for involuntary inpatient placement; requiring a
3731 facility filing a petition for involuntary inpatient
3732 placement to send a copy to the department and
3733 managing entity; providing requirements for the
3734 appointment of state counsel; revising criteria for a
3735 hearing on involuntary inpatient placement; revising
3736 criteria for a procedure for continued involuntary
3737 inpatient services; specifying requirements for a
3738 certain waiver of the patient’s attendance at a
3739 hearing; requiring the court to consider certain
3740 testimony and evidence regarding a patient’s
3741 incompetence; amending s. 394.46715, F.S.; revising
3742 rulemaking authority of the department; amending s.
3743 394.656, F.S.; revising the membership of the Criminal
3744 Justice, Mental Health, and Substance Abuse Statewide
3745 Grant Review Committee; providing duties for the
3746 committee; authorizing a not-for-profit community
3747 provider or managing entity to apply for certain
3748 grants; revising eligibility for such grants; defining
3749 a term; creating s. 394.761, F.S.; authorizing the
3750 agency and the department to develop a plan for
3751 revenue maximization; requiring the plan to be
3752 submitted to the Legislature by a certain date;
3753 amending s. 394.875, F.S.; requiring the department to
3754 modify licensure rules and procedures to create an
3755 option for a single, consolidated license for certain
3756 providers by a specified date; amending s. 394.9082,
3757 F.S.; providing a purpose for behavioral health
3758 managing entities; revising definitions; providing
3759 duties of the department; requiring the department to
3760 revise its contracts with managing entities; providing
3761 duties for managing entities; deleting provisions
3762 relating to legislative findings and intent, service
3763 delivery strategies, essential elements, reporting
3764 requirements, and rulemaking authority; amending s.
3765 397.311, F.S.; defining the terms “informed consent”
3766 and “involuntary services”; revising the definition of
3767 the term “qualified professional”; conforming a cross
3768 reference; amending s. 397.675, F.S.; revising the
3769 criteria for involuntary admissions due to substance
3770 abuse or co-occurring mental health disorders;
3771 amending s. 397.679, F.S.; specifying the licensed
3772 professionals who may complete a certificate for the
3773 involuntary admission of an individual; amending s.
3774 397.6791, F.S.; providing a list of professionals
3775 authorized to initiate a certificate for an emergency
3776 assessment or admission of a person with a substance
3777 abuse disorder; amending s. 397.6793, F.S.; revising
3778 the criteria for initiation of a certificate for an
3779 emergency admission for a person who is substance
3780 abuse impaired; amending s. 397.6795, F.S.; revising
3781 the list of persons who may deliver a person for an
3782 emergency assessment; amending s. 397.681, F.S.;
3783 prohibiting the court from charging a fee for
3784 involuntary petitions; amending s. 397.6811, F.S.;
3785 revising the list of persons who may file a petition
3786 for an involuntary assessment and stabilization;
3787 amending s. 397.6814, F.S.; prohibiting a fee from
3788 being charged for the filing of a petition for
3789 involuntary assessment and stabilization; amending s.
3790 397.6819, F.S.; revising the responsibilities of
3791 service providers who admit an individual for an
3792 involuntary assessment and stabilization; requiring a
3793 managing entity to be notified of certain
3794 recommendations; amending s. 397.695, F.S.;
3795 authorizing certain persons to file a petition for
3796 involuntary outpatient services of an individual;
3797 providing procedures and requirements for such
3798 petitions; amending s. 397.6951, F.S.; requiring that
3799 certain additional information be included in a
3800 petition for involuntary outpatient services; amending
3801 s. 397.6955, F.S.; requiring a court to fulfill
3802 certain additional duties upon the filing of a
3803 petition for involuntary outpatient services; amending
3804 s. 397.6957, F.S.; providing additional requirements
3805 for a hearing on a petition for involuntary outpatient
3806 services; amending s. 397.697, F.S.; authorizing a
3807 court to make a determination of involuntary
3808 outpatient services; authorizing a court to order a
3809 respondent to undergo treatment through a privately
3810 funded licensed service provider under certain
3811 circumstances; prohibiting a court from ordering
3812 involuntary outpatient services under certain
3813 circumstances; requiring the service provider to
3814 document certain inquiries; requiring the managing
3815 entity to document certain efforts; requiring a copy
3816 of the court’s order to be sent to the department and
3817 managing entity; providing procedures for
3818 modifications to such orders; amending s. 397.6971,
3819 F.S.; establishing the requirements for an early
3820 release from involuntary outpatient services; amending
3821 s. 397.6975, F.S.; requiring the court to appoint
3822 certain counsel; providing requirements for hearings
3823 on petitions for continued involuntary outpatient
3824 services; requiring notice of such hearings; amending
3825 s. 397.6977, F.S.; conforming provisions to changes
3826 made by the act; creating s. 397.6978, F.S.; providing
3827 for the appointment of guardian advocates if an
3828 individual is found incompetent to consent to
3829 treatment; providing a list of persons prohibited from
3830 being appointed as an individual’s guardian advocate;
3831 providing requirements for a facility requesting the
3832 appointment of a guardian advocate; requiring a
3833 training course for guardian advocates; providing
3834 requirements for the training course; providing
3835 requirements for the prioritization of individuals to
3836 be selected as guardian advocates; authorizing certain
3837 guardian advocates to consent to medical treatment;
3838 providing exceptions; providing procedures for the
3839 discharge of a guardian advocate; amending s. 409.967,
3840 F.S.; requiring managed care plans to provide for
3841 quality care; amending s. 409.973, F.S.; providing an
3842 integrated behavioral health initiative; amending s.
3843 491.0045, F.S.; revising registration requirements for
3844 interns; repealing s. 394.4674, F.S., relating to the
3845 comprehensive plan and report on the
3846 deinstitutionalization of patients in a treatment
3847 facility; repealing s. 394.4985, F.S., relating to the
3848 implementation of a districtwide information and
3849 referral network; repealing s. 394.745, F.S., relating
3850 to the annual report on the compliance of providers
3851 under contract with the department; repealing s.
3852 397.331, F.S., relating to definitions and legislative
3853 intent; repealing part IX of chapter 397, consisting
3854 of ss. 397.801, 397.811, and 397.821, F.S., relating
3855 to substance abuse impairment services coordination;
3856 repealing s. 397.901, F.S., relating to prototype
3857 juvenile addictions receiving facilities; repealing s.
3858 397.93, F.S., relating to target populations for
3859 children’s substance abuse services; repealing s.
3860 397.94, F.S., relating to the information and referral
3861 network for children’s substance abuse services;
3862 repealing s. 397.951, F.S., relating to substance
3863 abuse treatment and sanctions; repealing s. 397.97,
3864 F.S., relating to demonstration models for children’s
3865 substance abuse services; repealing s. 397.98, F.S.,
3866 relating to utilization management for children’s
3867 substance abuse services; amending ss. 39.407,
3868 212.055, 394.4599, 394.495, 394.496, 394.9085,
3869 397.321, 397.405, 397.407, 397.416, 397.4871, 409.966,
3870 409.972, 440.102, 744.704, and 790.065, F.S.;
3871 conforming cross-references; providing an effective
3872 date.