Florida Senate - 2023                             CS for SB 1412
       
       
        
       By the Committee on Children, Families, and Elder Affairs; and
       Senator Bradley
       
       
       
       
       586-02750-23                                          20231412c1
    1                        A bill to be entitled                      
    2         An act relating to mental health; amending s. 394.461,
    3         F.S.; authorizing the Department of Children and
    4         Families to issue a conditional designation for up to
    5         a certain number of days to allow the implementation
    6         of certain corrective measures by receiving
    7         facilities, treatment facilities, and receiving
    8         systems; amending s. 916.107, F.S.; requiring the
    9         sheriff to administer or to permit the department to
   10         administer the appropriate psychotropic medication to
   11         forensic clients before admission to a state mental
   12         health treatment facility; amending s. 916.12, F.S.;
   13         revising what an expert is required to specifically
   14         report on for recommended treatment for a defendant to
   15         attain competence to proceed, if the expert finds that
   16         a defendant is incompetent to proceed; providing
   17         report requirements; amending s. 916.13, F.S.;
   18         revising the circumstances under which every defendant
   19         who is charged with a felony and who is adjudicated
   20         incompetent to proceed may be involuntarily committed
   21         for treatment upon specified findings by the court;
   22         requiring a court to review the examining expert’s
   23         report before issuing a commitment order; decreasing
   24         the timeframe in which an administrator or his or her
   25         designee is required to file a certain report with the
   26         court; requiring that a defendant be transported to
   27         the committing court’s jurisdiction within a certain
   28         number of days after certain occurrences; requiring
   29         that the referring mental health facility transfer the
   30         defendant with medication and assist in discharge
   31         planning with medical teams at the receiving county
   32         jail to ensure continuity of care; reenacting ss.
   33         394.658(1)(a), 916.106(9), and 916.17(1) and (2),
   34         F.S., relating to the Criminal Justice, Mental Health,
   35         and Substance Abuse Reinvestment Grant Program
   36         requirements; the definition of the term “forensic
   37         client” or “client”; and conditional release;
   38         respectively, to incorporate the amendment made to s.
   39         916.13, F.S., in references thereto; providing an
   40         effective date.
   41          
   42  Be It Enacted by the Legislature of the State of Florida:
   43  
   44         Section 1. Section 394.461, Florida Statutes, is amended to
   45  read:
   46         394.461 Designation of receiving and treatment facilities
   47  and receiving systems.—The department is authorized to designate
   48  and monitor receiving facilities, treatment facilities, and
   49  receiving systems and may suspend or withdraw such designation
   50  for failure to comply with this part and rules adopted under
   51  this part. The department may issue a conditional designation
   52  for up to 60 days to allow the implementation of corrective
   53  measures. Unless designated by the department, facilities are
   54  not permitted to hold or treat involuntary patients under this
   55  part.
   56         (1) RECEIVING FACILITY.—The department may designate any
   57  community facility as a receiving facility. Any other facility
   58  within the state, including a private facility or a federal
   59  facility, may be so designated by the department, provided that
   60  such designation is agreed to by the governing body or authority
   61  of the facility.
   62         (2) TREATMENT FACILITY.—The department may designate any
   63  state-owned, state-operated, or state-supported facility as a
   64  state treatment facility. A civil patient may shall not be
   65  admitted to a state treatment facility without previously
   66  undergoing a transfer evaluation. Before a court hearing for
   67  involuntary placement in a state treatment facility, the court
   68  shall receive and consider the information documented in the
   69  transfer evaluation. Any other facility, including a private
   70  facility or a federal facility, may be designated as a treatment
   71  facility by the department, provided that such designation is
   72  agreed to by the appropriate governing body or authority of the
   73  facility.
   74         (3) PRIVATE FACILITIES.—Private facilities designated as
   75  receiving and treatment facilities by the department may provide
   76  examination and treatment of involuntary patients, as well as
   77  voluntary patients, and are subject to all the provisions of
   78  this part.
   79         (4) REPORTING REQUIREMENTS.—
   80         (a) A facility designated as a public receiving or
   81  treatment facility under this section shall report to the
   82  department on an annual basis the following data, unless these
   83  data are currently being submitted to the Agency for Health Care
   84  Administration:
   85         1. Number of licensed beds.
   86         2. Number of contract days.
   87         3. Number of admissions by payor class and diagnoses.
   88         4. Number of bed days by payor class.
   89         5. Average length of stay by payor class.
   90         6. Total revenues by payor class.
   91         (b) For the purposes of this subsection, “payor class”
   92  means Medicare, Medicare HMO, Medicaid, Medicaid HMO, private
   93  pay health insurance, private-pay health maintenance
   94  organization, private preferred provider organization, the
   95  Department of Children and Families, other government programs,
   96  self-pay patients, and charity care.
   97         (c) The data required under this subsection shall be
   98  submitted to the department no later than 90 days following the
   99  end of the facility’s fiscal year.
  100         (d) The department shall issue an annual report based on
  101  the data required pursuant to this subsection. The report shall
  102  include individual facilities’ data, as well as statewide
  103  totals. The report shall be submitted to the Governor, the
  104  President of the Senate, and the Speaker of the House of
  105  Representatives.
  106         (5) RECEIVING SYSTEM.—The department shall designate as a
  107  receiving system one or more facilities serving a defined
  108  geographic area developed pursuant to s. 394.4573 which is
  109  responsible for assessment and evaluation, both voluntary and
  110  involuntary, and treatment, stabilization, or triage for
  111  patients who have a mental illness, a substance use disorder, or
  112  co-occurring disorders. Any transportation plans developed
  113  pursuant to s. 394.462 must support the operation of the
  114  receiving system.
  115         (6) RULES.—The department may adopt rules relating to:
  116         (a) Procedures and criteria for receiving and evaluating
  117  facility applications for designation, which may include onsite
  118  facility inspection and evaluation of an applicant’s licensing
  119  status and performance history, as well as consideration of
  120  local service needs.
  121         (b) Minimum standards consistent with this part that a
  122  facility must meet and maintain in order to be designated as a
  123  receiving or treatment facility and procedures for monitoring
  124  continued adherence to such standards.
  125         (c) Procedures and criteria for designating receiving
  126  systems which may include consideration of the adequacy of
  127  services provided by facilities within the receiving system to
  128  meet the needs of the geographic area using available resources.
  129         (d) Procedures for receiving complaints against a
  130  designated facility or designated receiving system and for
  131  initiating inspections and investigations of facilities or
  132  receiving systems alleged to have violated the provisions of
  133  this part or rules adopted under this part.
  134         (e) Procedures and criteria for the suspension or
  135  withdrawal of designation as a receiving facility or receiving
  136  system.
  137         Section 2. Subsection (1) of section 916.107, Florida
  138  Statutes, is amended to read:
  139         916.107 Rights of forensic clients.—
  140         (1) RIGHT TO INDIVIDUAL DIGNITY.—
  141         (a) The policy of the state is that the individual dignity
  142  of the client shall be respected at all times and upon all
  143  occasions, including any occasion when the forensic client is
  144  detained, transported, or treated. Clients with mental illness,
  145  intellectual disability, or autism and who are charged with
  146  committing felonies shall receive appropriate treatment or
  147  training. In a criminal case involving a client who has been
  148  adjudicated incompetent to proceed or not guilty by reason of
  149  insanity, a jail may be used as an emergency facility for up to
  150  15 days following the date the department or agency receives a
  151  completed copy of the court commitment order containing all
  152  documentation required by the applicable Florida Rules of
  153  Criminal Procedure. For a forensic client who is held in a jail
  154  awaiting admission to a facility of the department or agency,
  155  evaluation and treatment or training may be provided in the jail
  156  by the local community mental health provider for mental health
  157  services, by the developmental disabilities program for persons
  158  with intellectual disability or autism, the client’s physician
  159  or psychologist, or any other appropriate program until the
  160  client is transferred to a civil or forensic facility. The
  161  sheriff shall administer or permit the department to administer
  162  the appropriate psychotropic medication to a forensic client
  163  before his or her admission to a state mental health treatment
  164  facility.
  165         (b) Forensic clients who are initially placed in, or
  166  subsequently transferred to, a civil facility as described in
  167  part I of chapter 394 or to a residential facility as described
  168  in chapter 393 shall have the same rights as other persons
  169  committed to these facilities for as long as they remain there.
  170         Section 3. Subsection (4) of section 916.12, Florida
  171  Statutes, is amended to read:
  172         916.12 Mental competence to proceed.—
  173         (4) If an expert finds that the defendant is incompetent to
  174  proceed, the expert shall report on any recommended treatment
  175  for the defendant to attain competence to proceed. In
  176  considering the issues relating to treatment, the examining
  177  expert shall specifically report on all of the following:
  178         (a) The mental illness causing the incompetence.;
  179         (b) The completion of a clinical assessment by approved
  180  mental health experts trained by the department to ensure the
  181  safety of the defendant and the community.
  182         (c) The treatment or treatments appropriate for the mental
  183  illness of the defendant and an explanation of each of the
  184  possible treatment alternatives, including, at a minimum, mental
  185  health services, treatment services, rehabilitative services,
  186  support services, and case management services as those terms
  187  are defined in s. 394.67(16), which may be provided by or within
  188  multidisciplinary community treatment teams, such as Florida
  189  Assertive Community Treatment, conditional release programs,
  190  outpatient services or intensive outpatient treatment programs,
  191  and supportive employment and supportive housing opportunities
  192  in treating and supporting the recovery of the defendant. in
  193  order of choices;
  194         (d)(c) The availability of acceptable treatment, and, if
  195  treatment is available in the community, the expert shall so
  196  state in the report.; and
  197         (e)(d) The likelihood of the defendant’s attaining
  198  competence under the treatment recommended, an assessment of the
  199  probable duration of the treatment required to restore
  200  competence, and the probability that the defendant will attain
  201  competence to proceed in the foreseeable future.
  202  
  203  The examining expert’s report to the court must include a full
  204  and detailed explanation regarding why the alternative treatment
  205  options referenced in the evaluation are insufficient to meet
  206  the needs of the defendant.
  207         Section 4. Section 916.13, Florida Statutes, is amended to
  208  read:
  209         916.13 Involuntary commitment of defendant adjudicated
  210  incompetent.—
  211         (1) Every defendant who is charged with a felony and who is
  212  adjudicated incompetent to proceed may be involuntarily
  213  committed for treatment upon a finding by the court of clear and
  214  convincing evidence that:
  215         (a) The defendant has a mental illness and because of the
  216  mental illness:
  217         1. The defendant is manifestly incapable of surviving alone
  218  or with the help of willing and responsible family or friends,
  219  including available alternative services, and, without
  220  treatment, the defendant is likely to suffer from neglect or
  221  refuse to care for herself or himself and such neglect or
  222  refusal poses a real and present threat of substantial harm to
  223  the defendant’s well-being; or
  224         2. There is a substantial likelihood that in the near
  225  future the defendant will inflict serious bodily harm on herself
  226  or himself or another person, as evidenced by recent behavior
  227  causing, attempting, or threatening such harm;
  228         (b) All available, less restrictive treatment alternatives,
  229  including treatment in community residential facilities, or
  230  community inpatient or outpatient settings, or any other mental
  231  health services, treatment services, rehabilitative services,
  232  support services, or case management services as those terms are
  233  defined or described in s. 394.67(16) which would offer an
  234  opportunity for improvement of the defendant’s condition have
  235  been judged to be inappropriate; and
  236         (c) There is a substantial probability that the mental
  237  illness causing the defendant’s incompetence will respond to
  238  treatment and the defendant will regain competency to proceed in
  239  the reasonably foreseeable future.
  240  
  241  Before issuing a commitment order, the court must review the
  242  examining expert’s report to ensure alternative treatment
  243  options have been fully considered and found insufficient to
  244  meet the needs of the defendant.
  245         (2) A defendant who has been charged with a felony and who
  246  has been adjudicated incompetent to proceed due to mental
  247  illness, and who meets the criteria for involuntary commitment
  248  under this chapter, may be committed to the department, and the
  249  department shall retain and treat the defendant.
  250         (a) Immediately after receipt of a completed copy of the
  251  court commitment order containing all documentation required by
  252  the applicable Florida Rules of Criminal Procedure, the
  253  department shall request all medical information relating to the
  254  defendant from the jail. The jail shall provide the department
  255  with all medical information relating to the defendant within 3
  256  business days after receipt of the department’s request or at
  257  the time the defendant enters the physical custody of the
  258  department, whichever is earlier.
  259         (b) Within 60 days 6 months after the date of admission and
  260  at the end of any period of extended commitment, or at any time
  261  the administrator or his or her designee determines that the
  262  defendant has regained competency to proceed or no longer meets
  263  the criteria for continued commitment, the administrator or
  264  designee shall file a report with the court pursuant to the
  265  applicable Florida Rules of Criminal Procedure.
  266         (c) A competency hearing must be held within 30 days after
  267  the court receives notification that the defendant is competent
  268  to proceed or no longer meets the criteria for continued
  269  commitment. The defendant must be transported in accordance with
  270  s. 916.107 to the committing court’s jurisdiction within 7 days
  271  after notification that the defendant is competent to proceed or
  272  no longer meets the criteria for continued commitment. A
  273  determination on the issue of competency must be made at a
  274  hearing within 30 days after the notification for the hearing.
  275  If the defendant is receiving psychotropic medication at a
  276  mental health facility at the time he or she is discharged and
  277  transferred to the jail, the administering of such medication
  278  must continue unless the jail physician documents the need to
  279  change or discontinue it. To ensure continuity of care, the
  280  referring mental health facility shall transfer the defendant
  281  with up to 30 days of medications and assist in discharge
  282  planning with medical teams at the receiving county jail. The
  283  jail and department physicians shall collaborate to ensure that
  284  medication changes do not adversely affect the defendant’s
  285  mental health status or his or her ability to continue with
  286  court proceedings; however, the final authority regarding the
  287  administering of medication to an inmate in jail rests with the
  288  jail physician.
  289         Section 5. For the purpose of incorporating the amendment
  290  made by this act to section 916.13, Florida Statutes, in a
  291  reference thereto, paragraph (a) of subsection (1) of section
  292  394.658, Florida Statutes, is reenacted to read:
  293         394.658 Criminal Justice, Mental Health, and Substance
  294  Abuse Reinvestment Grant Program requirements.—
  295         (1) The Criminal Justice, Mental Health, and Substance
  296  Abuse Statewide Grant Review Committee, in collaboration with
  297  the Department of Children and Families, the Department of
  298  Corrections, the Department of Juvenile Justice, the Department
  299  of Elderly Affairs, and the Office of the State Courts
  300  Administrator, shall establish criteria to be used to review
  301  submitted applications and to select the county that will be
  302  awarded a 1-year planning grant or a 3-year implementation or
  303  expansion grant. A planning, implementation, or expansion grant
  304  may not be awarded unless the application of the county meets
  305  the established criteria.
  306         (a) The application criteria for a 1-year planning grant
  307  must include a requirement that the applicant county or counties
  308  have a strategic plan to initiate systemic change to identify
  309  and treat individuals who have a mental illness, substance abuse
  310  disorder, or co-occurring mental health and substance abuse
  311  disorders who are in, or at risk of entering, the criminal or
  312  juvenile justice systems. The 1-year planning grant must be used
  313  to develop effective collaboration efforts among participants in
  314  affected governmental agencies, including the criminal,
  315  juvenile, and civil justice systems, mental health and substance
  316  abuse treatment service providers, transportation programs, and
  317  housing assistance programs. The collaboration efforts shall be
  318  the basis for developing a problem-solving model and strategic
  319  plan for treating adults and juveniles who are in, or at risk of
  320  entering, the criminal or juvenile justice system and doing so
  321  at the earliest point of contact, taking into consideration
  322  public safety. The planning grant shall include strategies to
  323  divert individuals from judicial commitment to community-based
  324  service programs offered by the Department of Children and
  325  Families in accordance with ss. 916.13 and 916.17.
  326         Section 6. For the purpose of incorporating the amendment
  327  made by this act to section 916.13, Florida Statutes, in a
  328  reference thereto, subsection (9) of section 916.106, Florida
  329  Statutes, is reenacted to read:
  330         916.106 Definitions.—For the purposes of this chapter, the
  331  term:
  332         (9) “Forensic client” or “client” means any defendant who
  333  has been committed to the department or agency pursuant to s.
  334  916.13, s. 916.15, or s. 916.302.
  335         Section 7. For the purpose of incorporating the amendment
  336  made by this act to section 916.13, Florida Statutes, in
  337  references thereto, subsections (1) and (2) of section 916.17,
  338  Florida Statutes, are reenacted to read:
  339         916.17 Conditional release.—
  340         (1) Except for an inmate currently serving a prison
  341  sentence, the committing court may order a conditional release
  342  of any defendant in lieu of an involuntary commitment to a
  343  facility pursuant to s. 916.13 or s. 916.15 based upon an
  344  approved plan for providing appropriate outpatient care and
  345  treatment. Upon a recommendation that outpatient treatment of
  346  the defendant is appropriate, a written plan for outpatient
  347  treatment, including recommendations from qualified
  348  professionals, must be filed with the court, with copies to all
  349  parties. Such a plan may also be submitted by the defendant and
  350  filed with the court with copies to all parties. The plan shall
  351  include:
  352         (a) Special provisions for residential care or adequate
  353  supervision of the defendant.
  354         (b) Provisions for outpatient mental health services.
  355         (c) If appropriate, recommendations for auxiliary services
  356  such as vocational training, educational services, or special
  357  medical care.
  358  
  359  In its order of conditional release, the court shall specify the
  360  conditions of release based upon the release plan and shall
  361  direct the appropriate agencies or persons to submit periodic
  362  reports to the court regarding the defendant’s compliance with
  363  the conditions of the release and progress in treatment, with
  364  copies to all parties.
  365         (2) Upon the filing of an affidavit or statement under oath
  366  by any person that the defendant has failed to comply with the
  367  conditions of release, that the defendant’s condition has
  368  deteriorated to the point that inpatient care is required, or
  369  that the release conditions should be modified, the court shall
  370  hold a hearing within 7 days after receipt of the affidavit or
  371  statement under oath. After the hearing, the court may modify
  372  the release conditions. The court may also order that the
  373  defendant be returned to the department if it is found, after
  374  the appointment and report of experts, that the person meets the
  375  criteria for involuntary commitment under s. 916.13 or s.
  376  916.15.
  377         Section 8. This act shall take effect July 1, 2023.