Florida Senate - 2024 SENATOR AMENDMENT
Bill No. CS/CS/HB 7021, 1st Eng.
Ì6513949Î651394
LEGISLATIVE ACTION
Senate . House
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Floor: 1/RE/2R .
03/07/2024 06:16 PM .
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Senator Grall moved the following:
1 Senate Amendment (with title amendment)
2
3 Delete lines 804 - 2517
4 and insert:
5 and provide copies of such reports to the department, the
6 President of the Senate, the Speaker of the House of
7 Representatives, and the minority leaders of the Senate and the
8 House of Representatives by November 30 of each year.
9 (f) A patient must shall be examined by a physician or a
10 clinical psychologist, or by a psychiatric nurse performing
11 within the framework of an established protocol with a
12 psychiatrist at a facility without unnecessary delay to
13 determine if the criteria for involuntary services are met. Such
14 examination shall include, but not be limited to, consideration
15 of the patient’s treatment history at the facility and any
16 information regarding the patient’s condition and behavior
17 provided by knowledgeable individuals. Evidence that criteria
18 under subparagraph (1)(b)1. are met may include, but need not be
19 limited to, repeated admittance for involuntary examination
20 despite implementation of appropriate discharge plans. For
21 purposes of this paragraph, the term “repeated admittance” means
22 three or more admissions into the facility within the
23 immediately preceding 12 months. An individual’s basic needs
24 being served while admitted to the facility may not be
25 considered evidence that criteria under subparagraph (1)(b)1.
26 are met. Emergency treatment may be provided upon the order of a
27 physician or a psychiatric nurse practicing within the framework
28 of an established protocol with a psychiatrist if the physician
29 or psychiatric nurse determines that such treatment is necessary
30 for the safety of the patient or others. The patient may not be
31 released by the receiving facility or its contractor without the
32 documented approval of a psychiatrist or a clinical psychologist
33 or, if the receiving facility is owned or operated by a
34 hospital, health system, or nationally accredited community
35 mental health center, the release may also be approved by a
36 psychiatric nurse performing within the framework of an
37 established protocol with a psychiatrist, or an attending
38 emergency department physician with experience in the diagnosis
39 and treatment of mental illness after completion of an
40 involuntary examination pursuant to this subsection. A
41 psychiatric nurse may not approve the release of a patient if
42 the involuntary examination was initiated by a psychiatrist
43 unless the release is approved by the initiating psychiatrist.
44 The release may be approved through telehealth.
45 (g) The examination period must be for up to 72 hours and
46 begins when a patient arrives at the receiving facility. For a
47 minor, the examination shall be initiated within 12 hours after
48 the patient’s arrival at the facility. Within the examination
49 period, one of the following actions must be taken, based on the
50 individual needs of the patient:
51 1. The patient shall be released, unless he or she is
52 charged with a crime, in which case the patient shall be
53 returned to the custody of a law enforcement officer;
54 2. The patient shall be released, subject to subparagraph
55 1., for voluntary outpatient treatment;
56 3. The patient, unless he or she is charged with a crime,
57 shall be asked to give express and informed consent to placement
58 as a voluntary patient and, if such consent is given, the
59 patient shall be admitted as a voluntary patient; or
60 4. A petition for involuntary services shall be filed in
61 the circuit court if inpatient treatment is deemed necessary or
62 with the criminal county court, as defined in s. 394.4655(1), as
63 applicable. When inpatient treatment is deemed necessary, the
64 least restrictive treatment consistent with the optimum
65 improvement of the patient’s condition shall be made available.
66 The When a petition is to be filed for involuntary outpatient
67 placement, it shall be filed by one of the petitioners specified
68 in s. 394.467, and the court shall dismiss an untimely filed
69 petition s. 394.4655(4)(a). A petition for involuntary inpatient
70 placement shall be filed by the facility administrator. If a
71 patient’s 72-hour examination period ends on a weekend or
72 holiday, including the hours before the ordinary business hours
73 on the morning of the next working day, and the receiving
74 facility:
75 a. Intends to file a petition for involuntary services,
76 such patient may be held at the a receiving facility through the
77 next working day thereafter and the such petition for
78 involuntary services must be filed no later than such date. If
79 the receiving facility fails to file the a petition by for
80 involuntary services at the ordinary close of business on the
81 next working day, the patient shall be released from the
82 receiving facility following approval pursuant to paragraph (f).
83 b. Does not intend to file a petition for involuntary
84 services, the a receiving facility may postpone release of a
85 patient until the next working day thereafter only if a
86 qualified professional documents that adequate discharge
87 planning and procedures in accordance with s. 394.468, and
88 approval pursuant to paragraph (f), are not possible until the
89 next working day.
90 (h) A person for whom an involuntary examination has been
91 initiated who is being evaluated or treated at a hospital for an
92 emergency medical condition specified in s. 395.002 must be
93 examined by a facility within the examination period specified
94 in paragraph (g). The examination period begins when the patient
95 arrives at the hospital and ceases when the attending physician
96 documents that the patient has an emergency medical condition.
97 If the patient is examined at a hospital providing emergency
98 medical services by a professional qualified to perform an
99 involuntary examination and is found as a result of that
100 examination not to meet the criteria for involuntary outpatient
101 services pursuant to s. 394.467 s. 394.4655(2) or involuntary
102 inpatient placement pursuant to s. 394.467(1), the patient may
103 be offered voluntary outpatient or inpatient services or
104 placement, if appropriate, or released directly from the
105 hospital providing emergency medical services. The finding by
106 the professional that the patient has been examined and does not
107 meet the criteria for involuntary inpatient services or
108 involuntary outpatient placement must be entered into the
109 patient’s clinical record. This paragraph is not intended to
110 prevent a hospital providing emergency medical services from
111 appropriately transferring a patient to another hospital before
112 stabilization if the requirements of s. 395.1041(3)(c) have been
113 met.
114 (4) DATA ANALYSIS.—
115 (a) The department shall provide the Using data collected
116 under paragraph (2)(a) and s. 1006.07(10), and child welfare
117 data related to involuntary examinations, to the Louis de la
118 Parte Florida Mental Health Institute established under s.
119 1004.44. The Agency for Health Care Administration shall provide
120 Medicaid data to the institute, requested by the institute,
121 related to involuntary examination of children enrolled in
122 Medicaid for the purpose of administering the program and
123 improving service provision for such children. The department
124 and agency shall enter into any necessary agreements with the
125 institute to provide such data. The institute shall use such
126 data to the department shall, at a minimum, analyze data on both
127 the initiation of involuntary examinations of children and the
128 initiation of involuntary examinations of students who are
129 removed from a school; identify any patterns or trends and cases
130 in which involuntary examinations are repeatedly initiated on
131 the same child or student; study root causes for such patterns,
132 trends, or repeated involuntary examinations; and make
133 recommendations to encourage the use of alternatives to
134 eliminate inappropriate initiations of such examinations.
135 (b) The institute shall analyze service data on individuals
136 who are high utilizers of crisis stabilization services provided
137 in designated receiving facilities, and shall, at a minimum,
138 identify any patterns or trends and make recommendations to
139 decrease avoidable admissions. Recommendations may be addressed
140 in the department’s contracts with the behavioral health
141 managing entities and in the contracts between the Agency for
142 Health Care Administration and the Medicaid managed medical
143 assistance plans.
144 (c) The institute department shall publish submit a report
145 on its findings and recommendations on its website and submit
146 the report to the Governor, the President of the Senate, and the
147 Speaker of the House of Representatives, the department, and the
148 Agency for Health Care Administration by November 1 of each odd
149 numbered year.
150 Section 10. Section 394.4655, Florida Statutes, is amended
151 to read:
152 394.4655 Orders to involuntary outpatient placement
153 services.—
154 (1) DEFINITIONS.—As used in this section, the term
155 “involuntary outpatient placement” means involuntary outpatient
156 services as defined in s. 394.467.:
157 (a) “Court” means a circuit court or a criminal county
158 court.
159 (b) “Criminal County court” means a county court exercising
160 its original jurisdiction in a misdemeanor case under s. 34.01.
161 (2) A court or a county court may order an individual to
162 involuntary outpatient placement under s. 394.467. CRITERIA FOR
163 INVOLUNTARY OUTPATIENT SERVICES.—A person may be ordered to
164 involuntary outpatient services upon a finding of the court, by
165 clear and convincing evidence, that the person meets all of the
166 following criteria:
167 (a) The person is 18 years of age or older.
168 (b) The person has a mental illness.
169 (c) The person is unlikely to survive safely in the
170 community without supervision, based on a clinical
171 determination.
172 (d) The person has a history of lack of compliance with
173 treatment for mental illness.
174 (e) The person has:
175 1. At least twice within the immediately preceding 36
176 months been involuntarily admitted to a receiving or treatment
177 facility as defined in s. 394.455, or has received mental health
178 services in a forensic or correctional facility. The 36-month
179 period does not include any period during which the person was
180 admitted or incarcerated; or
181 2. Engaged in one or more acts of serious violent behavior
182 toward self or others, or attempts at serious bodily harm to
183 himself or herself or others, within the preceding 36 months.
184 (f) The person is, as a result of his or her mental
185 illness, unlikely to voluntarily participate in the recommended
186 treatment plan and has refused voluntary services for treatment
187 after sufficient and conscientious explanation and disclosure of
188 why the services are necessary or is unable to determine for
189 himself or herself whether services are necessary.
190 (g) In view of the person’s treatment history and current
191 behavior, the person is in need of involuntary outpatient
192 services in order to prevent a relapse or deterioration that
193 would be likely to result in serious bodily harm to himself or
194 herself or others, or a substantial harm to his or her well
195 being as set forth in s. 394.463(1).
196 (h) It is likely that the person will benefit from
197 involuntary outpatient services.
198 (i) All available, less restrictive alternatives that would
199 offer an opportunity for improvement of his or her condition
200 have been judged to be inappropriate or unavailable.
201 (3) INVOLUNTARY OUTPATIENT SERVICES.—
202 (a)1. A patient who is being recommended for involuntary
203 outpatient services by the administrator of the facility where
204 the patient has been examined may be retained by the facility
205 after adherence to the notice procedures provided in s.
206 394.4599. The recommendation must be supported by the opinion of
207 a psychiatrist and the second opinion of a clinical psychologist
208 or another psychiatrist, both of whom have personally examined
209 the patient within the preceding 72 hours, that the criteria for
210 involuntary outpatient services are met. However, if the
211 administrator certifies that a psychiatrist or clinical
212 psychologist is not available to provide the second opinion, the
213 second opinion may be provided by a licensed physician who has
214 postgraduate training and experience in diagnosis and treatment
215 of mental illness, a physician assistant who has at least 3
216 years’ experience and is supervised by such licensed physician
217 or a psychiatrist, a clinical social worker, or by a psychiatric
218 nurse. Any second opinion authorized in this subparagraph may be
219 conducted through a face-to-face examination, in person or by
220 electronic means. Such recommendation must be entered on an
221 involuntary outpatient services certificate that authorizes the
222 facility to retain the patient pending completion of a hearing.
223 The certificate must be made a part of the patient’s clinical
224 record.
225 2. If the patient has been stabilized and no longer meets
226 the criteria for involuntary examination pursuant to s.
227 394.463(1), the patient must be released from the facility while
228 awaiting the hearing for involuntary outpatient services. Before
229 filing a petition for involuntary outpatient services, the
230 administrator of the facility or a designated department
231 representative must identify the service provider that will have
232 primary responsibility for service provision under an order for
233 involuntary outpatient services, unless the person is otherwise
234 participating in outpatient psychiatric treatment and is not in
235 need of public financing for that treatment, in which case the
236 individual, if eligible, may be ordered to involuntary treatment
237 pursuant to the existing psychiatric treatment relationship.
238 3. The service provider shall prepare a written proposed
239 treatment plan in consultation with the patient or the patient’s
240 guardian advocate, if appointed, for the court’s consideration
241 for inclusion in the involuntary outpatient services order that
242 addresses the nature and extent of the mental illness and any
243 co-occurring substance use disorder that necessitate involuntary
244 outpatient services. The treatment plan must specify the likely
245 level of care, including the use of medication, and anticipated
246 discharge criteria for terminating involuntary outpatient
247 services. Service providers may select and supervise other
248 individuals to implement specific aspects of the treatment plan.
249 The services in the plan must be deemed clinically appropriate
250 by a physician, clinical psychologist, psychiatric nurse, mental
251 health counselor, marriage and family therapist, or clinical
252 social worker who consults with, or is employed or contracted
253 by, the service provider. The service provider must certify to
254 the court in the proposed plan whether sufficient services for
255 improvement and stabilization are currently available and
256 whether the service provider agrees to provide those services.
257 If the service provider certifies that the services in the
258 proposed treatment plan are not available, the petitioner may
259 not file the petition. The service provider must notify the
260 managing entity if the requested services are not available. The
261 managing entity must document such efforts to obtain the
262 requested services.
263 (b) If a patient in involuntary inpatient placement meets
264 the criteria for involuntary outpatient services, the
265 administrator of the facility may, before the expiration of the
266 period during which the facility is authorized to retain the
267 patient, recommend involuntary outpatient services. The
268 recommendation must be supported by the opinion of a
269 psychiatrist and the second opinion of a clinical psychologist
270 or another psychiatrist, both of whom have personally examined
271 the patient within the preceding 72 hours, that the criteria for
272 involuntary outpatient services are met. However, if the
273 administrator certifies that a psychiatrist or clinical
274 psychologist is not available to provide the second opinion, the
275 second opinion may be provided by a licensed physician who has
276 postgraduate training and experience in diagnosis and treatment
277 of mental illness, a physician assistant who has at least 3
278 years’ experience and is supervised by such licensed physician
279 or a psychiatrist, a clinical social worker, or by a psychiatric
280 nurse. Any second opinion authorized in this subparagraph may be
281 conducted through a face-to-face examination, in person or by
282 electronic means. Such recommendation must be entered on an
283 involuntary outpatient services certificate, and the certificate
284 must be made a part of the patient’s clinical record.
285 (c)1. The administrator of the treatment facility shall
286 provide a copy of the involuntary outpatient services
287 certificate and a copy of the state mental health discharge form
288 to the managing entity in the county where the patient will be
289 residing. For persons who are leaving a state mental health
290 treatment facility, the petition for involuntary outpatient
291 services must be filed in the county where the patient will be
292 residing.
293 2. The service provider that will have primary
294 responsibility for service provision shall be identified by the
295 designated department representative before the order for
296 involuntary outpatient services and must, before filing a
297 petition for involuntary outpatient services, certify to the
298 court whether the services recommended in the patient’s
299 discharge plan are available and whether the service provider
300 agrees to provide those services. The service provider must
301 develop with the patient, or the patient’s guardian advocate, if
302 appointed, a treatment or service plan that addresses the needs
303 identified in the discharge plan. The plan must be deemed to be
304 clinically appropriate by a physician, clinical psychologist,
305 psychiatric nurse, mental health counselor, marriage and family
306 therapist, or clinical social worker, as defined in this
307 chapter, who consults with, or is employed or contracted by, the
308 service provider.
309 3. If the service provider certifies that the services in
310 the proposed treatment or service plan are not available, the
311 petitioner may not file the petition. The service provider must
312 notify the managing entity if the requested services are not
313 available. The managing entity must document such efforts to
314 obtain the requested services.
315 (4) PETITION FOR INVOLUNTARY OUTPATIENT SERVICES.—
316 (a) A petition for involuntary outpatient services may be
317 filed by:
318 1. The administrator of a receiving facility; or
319 2. The administrator of a treatment facility.
320 (b) Each required criterion for involuntary outpatient
321 services must be alleged and substantiated in the petition for
322 involuntary outpatient services. A copy of the certificate
323 recommending involuntary outpatient services completed by a
324 qualified professional specified in subsection (3) must be
325 attached to the petition. A copy of the proposed treatment plan
326 must be attached to the petition. Before the petition is filed,
327 the service provider shall certify that the services in the
328 proposed plan are available. If the necessary services are not
329 available, the petition may not be filed. The service provider
330 must notify the managing entity if the requested services are
331 not available. The managing entity must document such efforts to
332 obtain the requested services.
333 (c) The petition for involuntary outpatient services must
334 be filed in the county where the patient is located, unless the
335 patient is being placed from a state treatment facility, in
336 which case the petition must be filed in the county where the
337 patient will reside. When the petition has been filed, the clerk
338 of the court shall provide copies of the petition and the
339 proposed treatment plan to the department, the managing entity,
340 the patient, the patient’s guardian or representative, the state
341 attorney, and the public defender or the patient’s private
342 counsel. A fee may not be charged for filing a petition under
343 this subsection.
344 (5) APPOINTMENT OF COUNSEL.—Within 1 court working day
345 after the filing of a petition for involuntary outpatient
346 services, the court shall appoint the public defender to
347 represent the person who is the subject of the petition, unless
348 the person is otherwise represented by counsel. The clerk of the
349 court shall immediately notify the public defender of the
350 appointment. The public defender shall represent the person
351 until the petition is dismissed, the court order expires, or the
352 patient is discharged from involuntary outpatient services. An
353 attorney who represents the patient must be provided access to
354 the patient, witnesses, and records relevant to the presentation
355 of the patient’s case and shall represent the interests of the
356 patient, regardless of the source of payment to the attorney.
357 (6) CONTINUANCE OF HEARING.—The patient is entitled, with
358 the concurrence of the patient’s counsel, to at least one
359 continuance of the hearing. The continuance shall be for a
360 period of up to 4 weeks.
361 (7) HEARING ON INVOLUNTARY OUTPATIENT SERVICES.—
362 (a)1. The court shall hold the hearing on involuntary
363 outpatient services within 5 working days after the filing of
364 the petition, unless a continuance is granted. The hearing must
365 be held in the county where the petition is filed, must be as
366 convenient to the patient as is consistent with orderly
367 procedure, and must be conducted in physical settings not likely
368 to be injurious to the patient’s condition. If the court finds
369 that the patient’s attendance at the hearing is not consistent
370 with the best interests of the patient and if the patient’s
371 counsel does not object, the court may waive the presence of the
372 patient from all or any portion of the hearing. The state
373 attorney for the circuit in which the patient is located shall
374 represent the state, rather than the petitioner, as the real
375 party in interest in the proceeding.
376 2. The court may appoint a magistrate to preside at the
377 hearing. One of the professionals who executed the involuntary
378 outpatient services certificate shall be a witness. The patient
379 and the patient’s guardian or representative shall be informed
380 by the court of the right to an independent expert examination.
381 If the patient cannot afford such an examination, the court
382 shall ensure that one is provided, as otherwise provided by law.
383 The independent expert’s report is confidential and not
384 discoverable, unless the expert is to be called as a witness for
385 the patient at the hearing. The court shall allow testimony from
386 individuals, including family members, deemed by the court to be
387 relevant under state law, regarding the person’s prior history
388 and how that prior history relates to the person’s current
389 condition. The testimony in the hearing must be given under
390 oath, and the proceedings must be recorded. The patient may
391 refuse to testify at the hearing.
392 (b)1. If the court concludes that the patient meets the
393 criteria for involuntary outpatient services pursuant to
394 subsection (2), the court shall issue an order for involuntary
395 outpatient services. The court order shall be for a period of up
396 to 90 days. The order must specify the nature and extent of the
397 patient’s mental illness. The order of the court and the
398 treatment plan must be made part of the patient’s clinical
399 record. The service provider shall discharge a patient from
400 involuntary outpatient services when the order expires or any
401 time the patient no longer meets the criteria for involuntary
402 placement. Upon discharge, the service provider shall send a
403 certificate of discharge to the court.
404 2. The court may not order the department or the service
405 provider to provide services if the program or service is not
406 available in the patient’s local community, if there is no space
407 available in the program or service for the patient, or if
408 funding is not available for the program or service. The service
409 provider must notify the managing entity if the requested
410 services are not available. The managing entity must document
411 such efforts to obtain the requested services. A copy of the
412 order must be sent to the managing entity by the service
413 provider within 1 working day after it is received from the
414 court. The order may be submitted electronically through
415 existing data systems. After the order for involuntary services
416 is issued, the service provider and the patient may modify the
417 treatment plan. For any material modification of the treatment
418 plan to which the patient or, if one is appointed, the patient’s
419 guardian advocate agrees, the service provider shall send notice
420 of the modification to the court. Any material modifications of
421 the treatment plan which are contested by the patient or the
422 patient’s guardian advocate, if applicable, must be approved or
423 disapproved by the court consistent with subsection (3).
424 3. If, in the clinical judgment of a physician, the patient
425 has failed or has refused to comply with the treatment ordered
426 by the court, and, in the clinical judgment of the physician,
427 efforts were made to solicit compliance and the patient may meet
428 the criteria for involuntary examination, a person may be
429 brought to a receiving facility pursuant to s. 394.463. If,
430 after examination, the patient does not meet the criteria for
431 involuntary inpatient placement pursuant to s. 394.467, the
432 patient must be discharged from the facility. The involuntary
433 outpatient services order shall remain in effect unless the
434 service provider determines that the patient no longer meets the
435 criteria for involuntary outpatient services or until the order
436 expires. The service provider must determine whether
437 modifications should be made to the existing treatment plan and
438 must attempt to continue to engage the patient in treatment. For
439 any material modification of the treatment plan to which the
440 patient or the patient’s guardian advocate, if applicable,
441 agrees, the service provider shall send notice of the
442 modification to the court. Any material modifications of the
443 treatment plan which are contested by the patient or the
444 patient’s guardian advocate, if applicable, must be approved or
445 disapproved by the court consistent with subsection (3).
446 (c) If, at any time before the conclusion of the initial
447 hearing on involuntary outpatient services, it appears to the
448 court that the person does not meet the criteria for involuntary
449 outpatient services under this section but, instead, meets the
450 criteria for involuntary inpatient placement, the court may
451 order the person admitted for involuntary inpatient examination
452 under s. 394.463. If the person instead meets the criteria for
453 involuntary assessment, protective custody, or involuntary
454 admission pursuant to s. 397.675, the court may order the person
455 to be admitted for involuntary assessment for a period of 5 days
456 pursuant to s. 397.6811. Thereafter, all proceedings are
457 governed by chapter 397.
458 (d) At the hearing on involuntary outpatient services, the
459 court shall consider testimony and evidence regarding the
460 patient’s competence to consent to services. If the court finds
461 that the patient is incompetent to consent to treatment, it
462 shall appoint a guardian advocate as provided in s. 394.4598.
463 The guardian advocate shall be appointed or discharged in
464 accordance with s. 394.4598.
465 (e) The administrator of the receiving facility or the
466 designated department representative shall provide a copy of the
467 court order and adequate documentation of a patient’s mental
468 illness to the service provider for involuntary outpatient
469 services. Such documentation must include any advance directives
470 made by the patient, a psychiatric evaluation of the patient,
471 and any evaluations of the patient performed by a psychologist
472 or a clinical social worker.
473 (8) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT
474 SERVICES.—
475 (a)1. If the person continues to meet the criteria for
476 involuntary outpatient services, the service provider shall, at
477 least 10 days before the expiration of the period during which
478 the treatment is ordered for the person, file in the court that
479 issued the order for involuntary outpatient services a petition
480 for continued involuntary outpatient services. The court shall
481 immediately schedule a hearing on the petition to be held within
482 15 days after the petition is filed.
483 2. The existing involuntary outpatient services order
484 remains in effect until disposition on the petition for
485 continued involuntary outpatient services.
486 3. A certificate shall be attached to the petition which
487 includes a statement from the person’s physician or clinical
488 psychologist justifying the request, a brief description of the
489 patient’s treatment during the time he or she was receiving
490 involuntary services, and an individualized plan of continued
491 treatment.
492 4. The service provider shall develop the individualized
493 plan of continued treatment in consultation with the patient or
494 the patient’s guardian advocate, if applicable. When the
495 petition has been filed, the clerk of the court shall provide
496 copies of the certificate and the individualized plan of
497 continued services to the department, the patient, the patient’s
498 guardian advocate, the state attorney, and the patient’s private
499 counsel or the public defender.
500 (b) Within 1 court working day after the filing of a
501 petition for continued involuntary outpatient services, the
502 court shall appoint the public defender to represent the person
503 who is the subject of the petition, unless the person is
504 otherwise represented by counsel. The clerk of the court shall
505 immediately notify the public defender of such appointment. The
506 public defender shall represent the person until the petition is
507 dismissed or the court order expires or the patient is
508 discharged from involuntary outpatient services. Any attorney
509 representing the patient shall have access to the patient,
510 witnesses, and records relevant to the presentation of the
511 patient’s case and shall represent the interests of the patient,
512 regardless of the source of payment to the attorney.
513 (c) Hearings on petitions for continued involuntary
514 outpatient services must be before the court that issued the
515 order for involuntary outpatient services. The court may appoint
516 a magistrate to preside at the hearing. The procedures for
517 obtaining an order pursuant to this paragraph must meet the
518 requirements of subsection (7), except that the time period
519 included in paragraph (2)(e) is not applicable in determining
520 the appropriateness of additional periods of involuntary
521 outpatient placement.
522 (d) Notice of the hearing must be provided as set forth in
523 s. 394.4599. The patient and the patient’s attorney may agree to
524 a period of continued outpatient services without a court
525 hearing.
526 (e) The same procedure must be repeated before the
527 expiration of each additional period the patient is placed in
528 treatment.
529 (f) If the patient has previously been found incompetent to
530 consent to treatment, the court shall consider testimony and
531 evidence regarding the patient’s competence. Section 394.4598
532 governs the discharge of the guardian advocate if the patient’s
533 competency to consent to treatment has been restored.
534 Section 11. Section 394.467, Florida Statutes, is amended
535 to read:
536 394.467 Involuntary inpatient placement and involuntary
537 outpatient services.—
538 (1) DEFINITIONS.—As used in this section, the term:
539 (a) “Court” means a circuit court or, for commitments only
540 to involuntary outpatient services as defined in s. 394.4655, a
541 county court.
542 (b) “Involuntary inpatient placement” means placement in a
543 secure receiving or treatment facility providing stabilization
544 and treatment services to a person 18 years of age or older who
545 does not voluntarily consent to services under this chapter, or
546 a minor who does not voluntarily assent to services under this
547 chapter.
548 (c) “Involuntary outpatient services” means services
549 provided in the community to a person who does not voluntarily
550 consent to or participate in services under this chapter.
551 (d) “Services plan” means an individualized plan detailing
552 the recommended behavioral health services and supports based on
553 a thorough assessment of the needs of the patient, to safeguard
554 and enhance the patient’s health and well-being in the
555 community.
556 (2)(1) CRITERIA FOR INVOLUNTARY SERVICES.—A person may be
557 ordered by a court to be provided for involuntary services
558 inpatient placement for treatment upon a finding of the court,
559 by clear and convincing evidence, that the person meets the
560 following criteria:
561 (a) Involuntary outpatient services.—A person ordered to
562 involuntary outpatient services must meet the following
563 criteria:
564 1. The person has a mental illness and, because of his or
565 her mental illness:
566 a. He or she is unlikely to voluntarily participate in a
567 recommended services plan and has refused voluntary services for
568 treatment after sufficient and conscientious explanation and
569 disclosure of why the services are necessary; or
570 b. Is unable to determine for himself or herself whether
571 services are necessary.
572 2. The person is unlikely to survive safely in the
573 community without supervision, based on a clinical
574 determination.
575 3. The person has a history of lack of compliance with
576 treatment for mental illness.
577 4. In view of the person’s treatment history and current
578 behavior, the person is in need of involuntary outpatient
579 services in order to prevent a relapse or deterioration that
580 would be likely to result in serious bodily harm to himself or
581 herself or others, or a substantial harm to his or her well
582 being as set forth in s. 394.463(1).
583 5. It is likely that the person will benefit from
584 involuntary outpatient services.
585 6. All available less restrictive alternatives that would
586 offer an opportunity for improvement of the person’s condition
587 have been deemed to be inappropriate or unavailable.
588 (b) Involuntary inpatient placement.—A person ordered to
589 involuntary inpatient placement must meet the following
590 criteria:
591 1.(a) The person He or she has a mental illness and,
592 because of his or her mental illness:
593 a.1.a. He or she has refused voluntary inpatient placement
594 for treatment after sufficient and conscientious explanation and
595 disclosure of the purpose of inpatient placement for treatment;
596 or
597 b. He or she Is unable to determine for himself or herself
598 whether inpatient placement is necessary; and
599 2.a. He or she is incapable of surviving alone or with the
600 help of willing, able, and responsible family or friends,
601 including available alternative services, and, without
602 treatment, is likely to suffer from neglect or refuse to care
603 for himself or herself, and such neglect or refusal poses a real
604 and present threat of substantial harm to his or her well-being;
605 or
606 b. Without treatment, there is a substantial likelihood
607 that in the near future the person he or she will inflict
608 serious bodily harm on self or others, as evidenced by recent
609 behavior causing, attempting to cause, or threatening to cause
610 such harm; and
611 3.(b) All available less restrictive treatment alternatives
612 that would offer an opportunity for improvement of the person’s
613 his or her condition have been deemed judged to be inappropriate
614 or unavailable.
615 (3)(2) RECOMMENDATION FOR INVOLUNTARY SERVICES AND
616 ADMISSION TO A TREATMENT FACILITY.—A patient may be recommended
617 for involuntary inpatient placement, involuntary outpatient
618 services, or a combination of both.
619 (a) A patient may be retained by the a facility that
620 examined the patient for involuntary services until the
621 completion of the patient’s court hearing or involuntarily
622 placed in a treatment facility upon the recommendation of the
623 administrator of the facility where the patient has been
624 examined and after adherence to the notice and hearing
625 procedures provided in s. 394.4599. However, if a patient who is
626 being recommended for only involuntary outpatient services has
627 been stabilized and no longer meets the criteria for involuntary
628 examination pursuant to s. 394.463(1), the patient must be
629 released from the facility while awaiting the hearing for
630 involuntary outpatient services.
631 (b) The recommendation that the involuntary services
632 criteria reasonably appear to have been met must be supported by
633 the opinion of a psychiatrist and the second opinion of a
634 clinical psychologist with at least 3 years of clinical
635 experience, or another psychiatrist, or a psychiatric nurse
636 practicing within the framework of an established protocol with
637 a psychiatrist, who both of whom have personally examined the
638 patient within the preceding 72 hours, that the criteria for
639 involuntary inpatient placement are met. For involuntary
640 inpatient placement, the patient must have been examined within
641 the preceding 72 hours. For involuntary outpatient services the
642 patient must have been examined within the preceding 30 days.
643 (c) If However, if the administrator certifies that a
644 psychiatrist, a or clinical psychologist with at least 3 years
645 of clinical experience, or a psychiatric nurse practicing within
646 the framework of an established protocol with a psychiatrist is
647 not available to provide a the second opinion, the petitioner
648 must certify as such and the second opinion may be provided by a
649 licensed physician who has postgraduate training and experience
650 in diagnosis and treatment of mental illness, a clinical
651 psychologist, or by a psychiatric nurse.
652 (d) Any opinion authorized in this subsection may be
653 conducted through a face-to-face or in-person examination, in
654 person, or by electronic means. Recommendations for involuntary
655 services must be Such recommendation shall be entered on a
656 petition for involuntary services inpatient placement
657 certificate, which shall be made a part of the patient’s
658 clinical record. The filing of the petition that authorizes the
659 facility to retain the patient pending transfer to a treatment
660 facility or completion of a hearing.
661 (4)(3) PETITION FOR INVOLUNTARY SERVICES INPATIENT
662 PLACEMENT.—
663 (a) A petition for involuntary services may be filed by:
664 1. The administrator of a receiving the facility;
665 2. The administrator of a treatment facility; or
666 3. A service provider who is treating the person being
667 petitioned.
668 (b) A shall file a petition for involuntary inpatient
669 placement, or inpatient placement followed by outpatient
670 services, must be filed in the court in the county where the
671 patient is located.
672 (c) A petition for involuntary outpatient services must be
673 filed in the county where the patient is located, unless the
674 patient is being placed from a state treatment facility, in
675 which case the petition must be filed in the county where the
676 patient will reside.
677 (d)1. The petitioner must state in the petition:
678 a. Whether the petitioner is recommending inpatient
679 placement, outpatient services, or both.
680 b. The length of time recommended for each type of
681 involuntary services.
682 c. The reasons for the recommendation.
683 2. If recommending involuntary outpatient services, or a
684 combination of involuntary inpatient placement and outpatient
685 services, the petitioner must identify the service provider that
686 has agreed to provide services for the person under an order for
687 involuntary outpatient services, unless he or she is otherwise
688 participating in outpatient psychiatric treatment and is not in
689 need of public financing for that treatment, in which case the
690 individual, if eligible, may be ordered to involuntary treatment
691 pursuant to the existing psychiatric treatment relationship.
692 3. When recommending an order to involuntary outpatient
693 services, the petitioner shall prepare a written proposed
694 services plan in consultation with the patient or the patient’s
695 guardian advocate, if appointed, for the court’s consideration
696 for inclusion in the involuntary outpatient services order that
697 addresses the nature and extent of the mental illness and any
698 co-occurring substance use disorder that necessitate involuntary
699 outpatient services. The services plan must specify the likely
700 needed level of care, including the use of medication, and
701 anticipated discharge criteria for terminating involuntary
702 outpatient services. The services in the plan must be deemed
703 clinically appropriate by a physician, clinical psychologist,
704 psychiatric nurse, mental health counselor, marriage and family
705 therapist, or clinical social worker who consults with, or is
706 employed or contracted by, the service provider. If the services
707 in the proposed services plan are not available, the petitioner
708 may not file the petition. The petitioner must notify the
709 managing entity if the requested services are not available. The
710 managing entity must document such efforts to obtain the
711 requested service. The service provider who accepts the patient
712 for involuntary outpatient services is responsible for the
713 development of a comprehensive treatment plan.
714 (e) Each required criterion for the recommended involuntary
715 services must be alleged and substantiated in the petition. A
716 copy of the recommended services plan, if applicable, must be
717 attached to the petition. The court must accept petitions and
718 other documentation with electronic signatures.
719 (f) When the petition has been filed Upon filing, the clerk
720 of the court shall provide copies of the petition and the
721 recommended services plan, if applicable, to the department, the
722 managing entity, the patient, the patient’s guardian or
723 representative, and the state attorney, and the public defender
724 or the patient’s private counsel of the judicial circuit in
725 which the patient is located. A fee may not be charged for the
726 filing of a petition under this subsection.
727 (5)(4) APPOINTMENT OF COUNSEL.—Within 1 court working day
728 after the filing of a petition for involuntary services
729 inpatient placement, the court shall appoint the public defender
730 to represent the person who is the subject of the petition,
731 unless the person is otherwise represented by counsel or
732 ineligible. The clerk of the court shall immediately notify the
733 public defender of such appointment. The public defender shall
734 represent the person until the petition is dismissed, the court
735 order expires, the patient is discharged from involuntary
736 services, or the public defender is otherwise discharged by the
737 court. Any attorney who represents representing the patient
738 shall be provided have access to the patient, witnesses, and
739 records relevant to the presentation of the patient’s case and
740 shall represent the interests of the patient, regardless of the
741 source of payment to the attorney.
742 (6)(5) CONTINUANCE OF HEARING.—The patient and the state
743 are independently is entitled, with the concurrence of the
744 patient’s counsel, to seek a at least one continuance of the
745 hearing. The patient shall be granted a request for an initial
746 continuance for up to 7 calendar days. The patient may request
747 additional continuances for up to 21 calendar days in total,
748 which shall only be granted by a showing of good cause and due
749 diligence by the patient and the patient’s counsel before
750 requesting the continuance. The state may request one
751 continuance of up to 7 calendar days, which shall only be
752 granted by a showing of good cause and due diligence by the
753 state before requesting the continuance. The state’s failure to
754 timely review any readily available document or failure to
755 attempt to contact a known witness does not warrant a
756 continuance 4 weeks.
757 (7)(6) HEARING ON INVOLUNTARY SERVICES INPATIENT
758 PLACEMENT.—
759 (a)1. The court shall hold a the hearing on the involuntary
760 services petition inpatient placement within 5 court working
761 days after the filing of the petition, unless a continuance is
762 granted.
763 2. The court must hold any hearing on involuntary
764 outpatient services in the county where the petition is filed. A
765 hearing on involuntary inpatient placement, or a combination of
766 involuntary inpatient placement and involuntary outpatient
767 services, Except for good cause documented in the court file,
768 the hearing must be held in the county or the facility, as
769 appropriate, where the patient is located, except for good cause
770 documented in the court file.
771 3. A hearing on involuntary services must be as convenient
772 to the patient as is consistent with orderly procedure, and
773 shall be conducted in physical settings not likely to be
774 injurious to the patient’s condition. If the court finds that
775 the patient’s attendance at the hearing is not consistent with
776 the best interests of the patient, or the patient knowingly,
777 intelligently, and voluntarily waives his or her right to be
778 present, and if the patient’s counsel does not object, the court
779 may waive the attendance presence of the patient from all or any
780 portion of the hearing. The state attorney for the circuit in
781 which the patient is located shall represent the state, rather
782 than the petitioner, as the real party in interest in the
783 proceeding. The facility or service provider shall make the
784 patient’s clinical records available to the state attorney and
785 the patient’s attorney so that the state can evaluate and
786 prepare its case. However, these records shall remain
787 confidential, and the state attorney may not use any record
788 obtained under this part for criminal investigation or
789 prosecution purposes, or for any purpose other than the
790 patient’s civil commitment under this chapter petitioning
791 facility administrator, as the real party in interest in the
792 proceeding.
793 (b)3. The court may appoint a magistrate to preside at the
794 hearing. If all parties agree, the state attorney and witnesses
795 may remotely attend and, as appropriate, testify at the hearing
796 under oath via audio-video teleconference. A witness intending
797 to attend remotely and testify must provide the parties with all
798 relevant documents by the close of business on the day before
799 the hearing. One of the professionals who executed the petition
800 for involuntary services inpatient placement certificate shall
801 be a witness. The patient and the patient’s guardian or
802 representative shall be informed by the court of the right to an
803 independent expert examination. If the patient cannot afford
804 such an examination, the court shall ensure that one is
805 provided, as otherwise provided for by law. The independent
806 expert’s report is confidential and not discoverable, unless the
807 expert is to be called as a witness for the patient at the
808 hearing. The court shall allow testimony from persons, including
809 family members, deemed by the court to be relevant under state
810 law, regarding the person’s prior history and how that prior
811 history relates to the person’s current condition. The testimony
812 in the hearing must be given under oath, and the proceedings
813 must be recorded. The patient may refuse to testify at the
814 hearing.
815 (c)(b) At the hearing, the court shall consider testimony
816 and evidence regarding the patient’s competence to consent to
817 services and treatment. If the court finds that the patient is
818 incompetent to consent to treatment, it must appoint a guardian
819 advocate as provided in s. 394.4598.
820 (8) ORDERS OF THE COURT.—
821 (a)1. If the court concludes that the patient meets the
822 criteria for involuntary services, the court may order a patient
823 to involuntary inpatient placement, involuntary outpatient
824 services, or a combination of involuntary services depending on
825 the criteria met and which type of involuntary services best
826 meet the needs of the patient. However, if the court orders the
827 patient to involuntary outpatient services, the court may not
828 order the department or the service provider to provide services
829 if the program or service is not available in the patient’s
830 local community, if there is no space available in the program
831 or service for the patient, or if funding is not available for
832 the program or service. The petitioner must notify the managing
833 entity if the requested services are not available. The managing
834 entity must document such efforts to obtain the requested
835 services. A copy of the order must be sent to the managing
836 entity by the service provider within 1 working day after it is
837 received from the court.
838 2. The order must specify the nature and extent of the
839 patient’s mental illness and the reasons the appropriate
840 involuntary services criteria are satisfied.
841 3. An order for only involuntary outpatient services,
842 involuntary inpatient placement, or of a combination of
843 involuntary services may be for a period of up to 6 months.
844 4. An order for a combination of involuntary services must
845 specify the length of time the patient shall be ordered for
846 involuntary inpatient placement and involuntary outpatient
847 services.
848 5. The order of the court and the patient’s services plan,
849 if applicable, must be made part of the patient’s clinical
850 record.
851 (b) If the court orders a patient into involuntary
852 inpatient placement, the court it may order that the patient be
853 retained at a receiving facility while awaiting transfer
854 transferred to a treatment facility, or, if the patient is at a
855 treatment facility, that the patient be retained there or be
856 treated at any other appropriate facility, or that the patient
857 receive services, on an involuntary basis, for up to 90 days.
858 However, any order for involuntary mental health services in a
859 treatment facility may be for up to 6 months. The order shall
860 specify the nature and extent of the patient’s mental illness.
861 The court may not order an individual with a developmental
862 disability as defined in s. 393.063 or a traumatic brain injury
863 or dementia who lacks a co-occurring mental illness to be
864 involuntarily placed in a state treatment facility. The facility
865 shall discharge a patient any time the patient no longer meets
866 the criteria for involuntary inpatient placement, unless the
867 patient has transferred to voluntary status.
868 (c) If at any time before the conclusion of a the hearing
869 on involuntary services, inpatient placement it appears to the
870 court that the patient person does not meet the criteria for
871 involuntary inpatient placement under this section, but instead
872 meets the criteria for involuntary outpatient services, the
873 court may order the person evaluated for involuntary outpatient
874 services pursuant to s. 394.4655. The petition and hearing
875 procedures set forth in s. 394.4655 shall apply. If the person
876 instead meets the criteria for involuntary assessment,
877 protective custody, or involuntary admission or treatment
878 pursuant to s. 397.675, then the court may order the person to
879 be admitted for involuntary assessment for a period of 5 days
880 pursuant to s. 397.6757 s. 397.6811. Thereafter, all proceedings
881 are governed by chapter 397.
882 (d) At the hearing on involuntary inpatient placement, the
883 court shall consider testimony and evidence regarding the
884 patient’s competence to consent to treatment. If the court finds
885 that the patient is incompetent to consent to treatment, it
886 shall appoint a guardian advocate as provided in s. 394.4598.
887 (d)(e) The administrator of the petitioning facility or the
888 designated department representative shall provide a copy of the
889 court order and adequate documentation of a patient’s mental
890 illness to the service provider for involuntary outpatient
891 services or the administrator of a treatment facility if the
892 patient is ordered for involuntary inpatient placement, whether
893 by civil or criminal court. The documentation must include any
894 advance directives made by the patient, a psychiatric evaluation
895 of the patient, and any evaluations of the patient performed by
896 a psychiatric nurse, a clinical psychologist, a marriage and
897 family therapist, a mental health counselor, or a clinical
898 social worker. The administrator of a treatment facility may
899 refuse admission to any patient directed to its facilities on an
900 involuntary basis, whether by civil or criminal court order, who
901 is not accompanied by adequate orders and documentation.
902 (e) In cases resulting in an order for involuntary
903 outpatient services, the court shall retain jurisdiction over
904 the case and the parties for entry of further orders as
905 circumstances may require, including, but not limited to,
906 monitoring compliance with treatment or ordering inpatient
907 treatment to stabilize a person who decompensates while under
908 court-ordered outpatient treatment and meets the commitment
909 criteria of s. 394.467.
910 (9) SERVICES PLAN MODIFICATION.—After the order for
911 involuntary outpatient services is issued, the service provider
912 and the patient may modify the services plan as provided by
913 department rule.
914 (10) NONCOMPLIANCE WITH INVOLUNTARY OUTPATIENT SERVICES.—
915 (a) If, in the clinical judgment of a physician, a
916 psychiatrist, a clinical psychologist with at least 3 years of
917 clinical experience, or a psychiatric nurse practicing within
918 the framework of an established protocol with a psychiatrist, a
919 patient receiving involuntary outpatient services has failed or
920 has refused to comply with the services plan ordered by the
921 court, and efforts were made to solicit compliance, the service
922 provider must report such noncompliance to the court. The
923 involuntary outpatient services order shall remain in effect
924 unless the service provider determines that the patient no
925 longer meets the criteria for involuntary outpatient services or
926 until the order expires. The service provider must determine
927 whether modifications should be made to the existing services
928 plan and must attempt to continue to engage the patient in
929 treatment. For any material modification of the services plan to
930 which the patient or the patient’s guardian advocate, if
931 applicable, agrees, the service provider shall send notice of
932 the modification to the court. Any material modifications of the
933 services plan which are contested by the patient or the
934 patient’s guardian advocate, if applicable, must be approved or
935 disapproved by the court.
936 (b) A county court may not use incarceration as a sanction
937 for noncompliance with the services plan, but it may order an
938 individual evaluated for possible inpatient placement if there
939 is significant, or are multiple instances of, noncompliance.
940 (11)(7) PROCEDURE FOR CONTINUED INVOLUNTARY SERVICES
941 INPATIENT PLACEMENT.—
942 (a) A petition for continued involuntary services must be
943 filed if the patient continues to meets the criteria for
944 involuntary services.
945 (b)1. If a patient receiving involuntary outpatient
946 services continues to meet the criteria for involuntary
947 outpatient services, the service provider must file in the court
948 that issued the initial order for involuntary outpatient
949 services a petition for continued involuntary outpatient
950 services.
951 2. If a patient in involuntary inpatient placement
952 (a) Hearings on petitions for continued involuntary
953 inpatient placement of an individual placed at any treatment
954 facility are administrative hearings and must be conducted in
955 accordance with s. 120.57(1), except that any order entered by
956 the administrative law judge is final and subject to judicial
957 review in accordance with s. 120.68. Orders concerning patients
958 committed after successfully pleading not guilty by reason of
959 insanity are governed by s. 916.15.
960 (b) If the patient continues to meet the criteria for
961 involuntary services inpatient placement and is being treated at
962 a receiving treatment facility, the administrator must shall,
963 before the expiration of the period the receiving treatment
964 facility is authorized to retain the patient, file in the court
965 that issued the initial order for involuntary inpatient
966 placement, a petition requesting authorization for continued
967 involuntary services inpatient placement. The administrator may
968 petition for inpatient or outpatient services.
969 3. If a patient in inpatient placement continues to meet
970 the criteria for involuntary services and is being treated at a
971 treatment facility, the administrator must, before expiration of
972 the period the treatment facility is authorized to retain the
973 patient, file a petition requesting authorization for continued
974 involuntary services. The administrator may petition for
975 inpatient or outpatient services. Hearings on petitions for
976 continued involuntary services of an individual placed at any
977 treatment facility are administrative hearings and must be
978 conducted in accordance with s. 120.57(1), except that any order
979 entered by the judge is final and subject to judicial review in
980 accordance with s. 120.68. Orders concerning patients committed
981 after successfully pleading not guilty by reason of insanity are
982 governed by s. 916.15.
983 4. The court shall immediately schedule a hearing on the
984 petition to be held within 15 days after the petition is filed.
985 5. The existing involuntary services order shall remain in
986 effect until disposition on the petition for continued
987 involuntary services.
988 (c) The petition request must be accompanied by a statement
989 from the patient’s physician, psychiatrist, psychiatric nurse,
990 or clinical psychologist justifying the request, a brief
991 description of the patient’s treatment during the time he or she
992 was receiving involuntary services involuntarily placed, and an
993 individualized plan of continued treatment developed in
994 consultation with the patient or the patient’s guardian
995 advocate, if applicable. If the petition is for involuntary
996 outpatient services, it must comply with the requirements of
997 subparagraph (4)(d)3. When the petition has been filed, the
998 clerk of the court shall provide copies of the petition and the
999 individualized plan of continued services to the department, the
1000 patient, the patient’s guardian advocate, the state attorney,
1001 and the patient’s private counsel or the public defender.
1002 (d) The court shall appoint counsel to represent the person
1003 who is the subject of the petition for continued involuntary
1004 services in accordance to the provisions set forth in subsection
1005 (5), unless the person is otherwise represented by counsel or
1006 ineligible.
1007 (e) Hearings on petitions for continued involuntary
1008 outpatient services must be before the court that issued the
1009 order for involuntary outpatient services. However, the patient
1010 and the patient’s attorney may agree to a period of continued
1011 outpatient services without a court hearing.
1012 (f) Hearings on petitions for continued involuntary
1013 inpatient placement in receiving facilities, or involuntary
1014 outpatient services following involuntary inpatient services,
1015 must be held in the county or the facility, as appropriate,
1016 where the patient is located.
1017 (g) The court may appoint a magistrate to preside at the
1018 hearing. The procedures for obtaining an order pursuant to this
1019 paragraph must meet the requirements of subsection (7).
1020 (h) Notice of the hearing must be provided as set forth
1021 provided in s. 394.4599.
1022 (i) If a patient’s attendance at the hearing is voluntarily
1023 waived, the administrative law judge must determine that the
1024 patient knowingly, intelligently, and voluntarily waived his or
1025 her right to be present, waiver is knowing and voluntary before
1026 waiving the presence of the patient from all or a portion of the
1027 hearing. Alternatively, if at the hearing the administrative law
1028 judge finds that attendance at the hearing is not consistent
1029 with the best interests of the patient, the administrative law
1030 judge may waive the presence of the patient from all or any
1031 portion of the hearing, unless the patient, through counsel,
1032 objects to the waiver of presence. The testimony in the hearing
1033 must be under oath, and the proceedings must be recorded.
1034 (c) Unless the patient is otherwise represented or is
1035 ineligible, he or she shall be represented at the hearing on the
1036 petition for continued involuntary inpatient placement by the
1037 public defender of the circuit in which the facility is located.
1038 (j)(d) If at a hearing it is shown that the patient
1039 continues to meet the criteria for involuntary services
1040 inpatient placement, the court administrative law judge shall
1041 issue an sign the order for continued involuntary outpatient
1042 services, inpatient placement for up to 90 days. However, any
1043 order for involuntary inpatient placement, or mental health
1044 services in a combination of involuntary services treatment
1045 facility may be for up to 6 months. The same procedure shall be
1046 repeated before the expiration of each additional period the
1047 patient is retained.
1048 (k) If the patient has been ordered to undergo involuntary
1049 services and has previously been found incompetent to consent to
1050 treatment, the court shall consider testimony and evidence
1051 regarding the patient’s competence. If the patient’s competency
1052 to consent to treatment is restored, the discharge of the
1053 guardian advocate is governed by s. 394.4598. If the patient has
1054 been ordered to undergo involuntary inpatient placement only and
1055 the patient’s competency to consent to treatment is restored,
1056 the administrative law judge may issue a recommended order, to
1057 the court that found the patient incompetent to consent to
1058 treatment, that the patient’s competence be restored and that
1059 any guardian advocate previously appointed be discharged.
1060 (l)(e) If continued involuntary inpatient placement is
1061 necessary for a patient in involuntary inpatient placement who
1062 was admitted while serving a criminal sentence, but his or her
1063 sentence is about to expire, or for a minor involuntarily
1064 placed, but who is about to reach the age of 18, the
1065 administrator shall petition the administrative law judge for an
1066 order authorizing continued involuntary inpatient placement.
1067 The procedure required in this subsection must be followed
1068 before the expiration of each additional period the patient is
1069 involuntarily receiving services.
1070 (12)(8) RETURN TO FACILITY.—If a patient has been ordered
1071 to undergo involuntary inpatient placement involuntarily held at
1072 a receiving or treatment facility under this part and leaves the
1073 facility without the administrator’s authorization, the
1074 administrator may authorize a search for the patient and his or
1075 her return to the facility. The administrator may request the
1076 assistance of a law enforcement agency in this regard.
1077 (13) DISCHARGE.—The patient shall be discharged upon
1078 expiration of the court order or at any time the patient no
1079 longer meets the criteria for involuntary services, unless the
1080 patient has transferred to voluntary status. Upon discharge, the
1081 service provider or facility shall send a certificate of
1082 discharge to the court.
1083 Section 12. Subsection (2) of section 394.468, Florida
1084 Statutes, is amended, and subsection (3) is added to that
1085 section, to read:
1086 394.468 Admission and discharge procedures.—
1087 (2) Discharge planning and procedures for any patient’s
1088 release from a receiving facility or treatment facility must
1089 include and document the patient’s needs, and actions to address
1090 such needs, for consideration of, at a minimum:
1091 (a) Follow-up behavioral health appointments;
1092 (b) Information on how to obtain prescribed medications;
1093 and
1094 (c) Information pertaining to:
1095 1. Available living arrangements;
1096 2. Transportation; and
1097 (d) Referral to:
1098 1. Care coordination services. The patient must be referred
1099 for care coordination services if the patient meets the criteria
1100 as a member of a priority population as determined by the
1101 department under s. 394.9082(3)(c) and is in need of such
1102 services.
1103 2.3. Recovery support opportunities under s.
1104 394.4573(2)(l), including, but not limited to, connection to a
1105 peer specialist.
1106 (3) During the discharge transition process and while the
1107 patient is present unless determined inappropriate by a
1108 physician or psychiatric nurse practicing within the framework
1109 of an established protocol with a psychiatrist a receiving
1110 facility shall coordinate, face-to-face or through electronic
1111 means, discharge plans to a less restrictive community
1112 behavioral health provider, a peer specialist, a case manager,
1113 or a care coordination service. The transition process must, at
1114 a minimum, include all of the following criteria:
1115 (a) Implementation of policies and procedures outlining
1116 strategies for how the receiving facility will comprehensively
1117 address the needs of patients who demonstrate a high use of
1118 receiving facility services to avoid or reduce future use of
1119 crisis stabilization services. For any such patient, policies
1120 and procedures must include, at a minimum, a review of the
1121 effectiveness of previous discharge plans created by the
1122 facility for the patient, and the new discharge plan must
1123 address problems experienced with implementation of previous
1124 discharge plans.
1125 (b) Developing and including in discharge paperwork a
1126 personalized crisis prevention plan that identifies stressors,
1127 early warning signs or symptoms, and strategies to deal with
1128 crisis.
1129 (c) Requiring a staff member to seek to engage a family
1130 member, legal guardian, legal representative, or natural support
1131 in discharge planning and meet face to face or through
1132 electronic means to review the discharge instructions, including
1133 prescribed medications, follow-up appointments, and any other
1134 recommended services or follow-up resources, and document the
1135 outcome of such meeting.
1136 (d) When the recommended level of care at discharge is not
1137 immediately available to the patient, the receiving facility
1138 must, at a minimum, initiate a referral to an appropriate
1139 provider to meet the needs of the patient to continue care until
1140 the recommended level of care is available.
1141 Section 13. Section 394.4915, Florida Statutes, is created
1142 to read:
1143 394.4915 Office of Children’s Behavioral Health Ombudsman.
1144 The Office of Children’s Behavioral Health Ombudsman is
1145 established within the department for the purpose of being a
1146 central point to receive complaints on behalf of children and
1147 adolescents with behavioral health disorders receiving state
1148 funded services and use such information to improve the child
1149 and adolescent mental health treatment and support system. The
1150 department and managing entities shall include information about
1151 and contact information for the office placed prominently on
1152 their websites on easily accessible web pages related to
1153 children and adolescent behavioral health services. To the
1154 extent permitted by available resources, the office shall, at a
1155 minimum:
1156 (1) Receive and direct to the appropriate contact within
1157 the department, the Agency for Health Care Administration, or
1158 the appropriate organizations providing behavioral health
1159 services complaints from children and adolescents and their
1160 families about the child and adolescent mental health treatment
1161 and support system.
1162 (2) Maintain records of complaints received and the actions
1163 taken.
1164 (3) Be a resource to identify and explain relevant policies
1165 or procedures to children, adolescents, and their families about
1166 the child and adolescent mental health treatment and support
1167 system.
1168 (4) Provide recommendations to the department to address
1169 systemic problems within the child and adolescent mental health
1170 treatment and support system that are leading to complaints. The
1171 department shall include an analysis of complaints and
1172 recommendations in the report required under s. 394.4573.
1173 (5) Engage in functions that may improve the child and
1174 adolescent mental health treatment and support system.
1175 Section 14. Subsection (3) of section 394.495, Florida
1176 Statutes, is amended to read:
1177 394.495 Child and adolescent mental health system of care;
1178 programs and services.—
1179 (3) Assessments must be performed by:
1180 (a) A clinical psychologist, clinical social worker,
1181 physician, psychiatric nurse, or psychiatrist, as those terms
1182 are defined in s. 394.455 professional as defined in s.
1183 394.455(5), (7), (33), (36), or (37);
1184 (b) A professional licensed under chapter 491; or
1185 (c) A person who is under the direct supervision of a
1186 clinical psychologist, clinical social worker, physician,
1187 psychiatric nurse, or psychiatrist, as those terms are defined
1188 in s. 394.455, qualified professional as defined in s.
1189 394.455(5), (7), (33), (36), or (37) or a professional licensed
1190 under chapter 491.
1191 Section 15. Subsection (5) of section 394.496, Florida
1192 Statutes, is amended to read:
1193 394.496 Service planning.—
1194 (5) A clinical psychologist, clinical social worker,
1195 physician, psychiatric nurse, or psychiatrist, as those terms
1196 are defined in s. 394.455, professional as defined in s.
1197 394.455(5), (7), (33), (36), or (37) or a professional licensed
1198 under chapter 491 must be included among those persons
1199 developing the services plan.
1200 Section 16. Paragraph (a) of subsection (2) of section
1201 394.499, Florida Statutes, is amended to read:
1202 394.499 Integrated children’s crisis stabilization
1203 unit/juvenile addictions receiving facility services.—
1204 (2) Children eligible to receive integrated children’s
1205 crisis stabilization unit/juvenile addictions receiving facility
1206 services include:
1207 (a) A minor whose parent makes person under 18 years of age
1208 for whom voluntary application based on the parent’s express and
1209 informed consent, and the requirements of s. 394.4625(1)(a) are
1210 met is made by his or her guardian, if such person is found to
1211 show evidence of mental illness and to be suitable for treatment
1212 pursuant to s. 394.4625. A person under 18 years of age may be
1213 admitted for integrated facility services only after a hearing
1214 to verify that the consent to admission is voluntary.
1215 Section 17. Paragraphs (a) and (d) of subsection (1) of
1216 section 394.875, Florida Statutes, are amended to read:
1217 394.875 Crisis stabilization units, residential treatment
1218 facilities, and residential treatment centers for children and
1219 adolescents; authorized services; license required.—
1220 (1)(a) The purpose of a crisis stabilization unit is to
1221 stabilize and redirect a client to the most appropriate and
1222 least restrictive community setting available, consistent with
1223 the client’s needs. Crisis stabilization units may screen,
1224 assess, and admit for stabilization persons who present
1225 themselves to the unit and persons who are brought to the unit
1226 under s. 394.463. Clients may be provided 24-hour observation,
1227 medication prescribed by a physician, or psychiatrist, or
1228 psychiatric nurse practicing within the framework of an
1229 established protocol with a psychiatrist, and other appropriate
1230 services. Crisis stabilization units shall provide services
1231 regardless of the client’s ability to pay and shall be limited
1232 in size to a maximum of 30 beds.
1233 (d) The department is directed to implement a demonstration
1234 project in circuit 18 to test the impact of expanding beds
1235 authorized in crisis stabilization units from 30 to 50 beds.
1236 Specifically, the department is directed to authorize existing
1237 public or private crisis stabilization units in circuit 18 to
1238 expand bed capacity to a maximum of 50 beds and to assess the
1239 impact such expansion would have on the availability of crisis
1240 stabilization services to clients.
1241 Section 18. Section 394.90826, Florida Statutes, is created
1242 to read:
1243 394.90826 Behavioral Health Interagency Collaboration.—
1244 (1) The department and the Agency for Health Care
1245 Administration shall jointly establish behavioral health
1246 interagency collaboratives throughout the state with the goal of
1247 identifying and addressing ongoing challenges within the
1248 behavioral health system at the local level to improve the
1249 accessibility, availability, and quality of behavioral health
1250 services. The objectives of the regional collaboratives are to:
1251 (a) Facilitate enhanced interagency communication and
1252 collaboration.
1253 (b) Develop and promote regional strategies tailored to
1254 address community-level challenges in the behavioral health
1255 system.
1256 (2) The regional collaborative membership shall at a
1257 minimum be composed of representatives from all of the
1258 following, serving the region:
1259 (a) Department of Children and Families.
1260 (b) Agency for Health Care Administration.
1261 (c) Agency for Persons with Disabilities.
1262 (d) Department of Elder Affairs.
1263 (e) Department of Health.
1264 (f) Department of Education.
1265 (g) School districts.
1266 (h) Area agencies on aging.
1267 (i) Community-based care lead agencies, as defined in s.
1268 409.986(3)(d).
1269 (j) Managing entities, as defined in s. 394.9082(2).
1270 (k) Behavioral health services providers.
1271 (l) Hospitals.
1272 (m) Medicaid Managed Medical Assistance Plans.
1273 (n) Police departments.
1274 (o) Sheriffs’ offices.
1275 (3) Each regional collaborative shall define the objectives
1276 of that collaborative based upon the specific needs of the
1277 region and local communities located within the region, to
1278 achieve the specified goals.
1279 (4) The department shall define the region to be served by
1280 each collaborative and shall be responsible for facilitating
1281 meetings.
1282 (5) All entities represented on the regional collaboratives
1283 shall provide assistance as appropriate and reasonably necessary
1284 to fulfill the goals of the regional collaboratives.
1285 Section 19. Subsection (6) of section 394.9085, Florida
1286 Statutes, is amended to read:
1287 394.9085 Behavioral provider liability.—
1288 (6) For purposes of this section, the terms “detoxification
1289 services,” “addictions receiving facility,” and “receiving
1290 facility” have the same meanings as those provided in ss.
1291 397.311(26)(a)4. 397.311(26)(a)3., 397.311(26)(a)1., and
1292 394.455(40), respectively.
1293 Section 20. Subsection (3) of section 397.305, Florida
1294 Statutes, is amended to read:
1295 397.305 Legislative findings, intent, and purpose.—
1296 (3) It is the purpose of this chapter to provide for a
1297 comprehensive continuum of accessible and quality substance
1298 abuse prevention, intervention, clinical treatment, and recovery
1299 support services in the most appropriate and least restrictive
1300 environment which promotes long-term recovery while protecting
1301 and respecting the rights of individuals, primarily through
1302 community-based private not-for-profit providers working with
1303 local governmental programs involving a wide range of agencies
1304 from both the public and private sectors.
1305 Section 21. Subsections (19) and (23) of section 397.311,
1306 Florida Statutes, are amended to read:
1307 397.311 Definitions.—As used in this chapter, except part
1308 VIII, the term:
1309 (19) “Impaired” or “substance abuse impaired” means having
1310 a substance use disorder or a condition involving the use of
1311 alcoholic beverages, illicit or prescription drugs, or any
1312 psychoactive or mood-altering substance in such a manner as to
1313 induce mental, emotional, or physical problems or and cause
1314 socially dysfunctional behavior.
1315 (23) “Involuntary treatment services” means an array of
1316 behavioral health services that may be ordered by the court for
1317 persons with substance abuse impairment or co-occurring
1318 substance abuse impairment and mental health disorders.
1319 Section 22. Subsection (6) is added to section 397.401,
1320 Florida Statutes, to read:
1321 397.401 License required; penalty; injunction; rules
1322 waivers.—
1323 (6) A service provider operating an addictions receiving
1324 facility or providing detoxification on a nonhospital inpatient
1325 basis may not exceed its licensed capacity by more than 10
1326 percent and may not exceed their licensed capacity for more than
1327 3 consecutive working days or for more than 7 days in 1 month.
1328 Section 23. Paragraph (i) is added to subsection (1) of
1329 section 397.4073, Florida Statutes, to read:
1330 397.4073 Background checks of service provider personnel.—
1331 (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND
1332 EXCEPTIONS.—
1333 (i) Any physician licensed under chapter 458 or chapter 459
1334 or a nurse licensed under chapter 464 who was required to
1335 undergo background screening by the Department of Health as part
1336 of his or her initial licensure or the renewal of licensure, and
1337 who has an active and unencumbered license, is not subject to
1338 background screening pursuant to this section.
1339 Section 24. Subsection (8) of section 397.501, Florida
1340 Statutes, is amended to read:
1341 397.501 Rights of individuals.—Individuals receiving
1342 substance abuse services from any service provider are
1343 guaranteed protection of the rights specified in this section,
1344 unless otherwise expressly provided, and service providers must
1345 ensure the protection of such rights.
1346 (8) RIGHT TO COUNSEL.—Each individual must be informed that
1347 he or she has the right to be represented by counsel in any
1348 judicial involuntary proceeding for involuntary assessment,
1349 stabilization, or treatment services and that he or she, or if
1350 the individual is a minor his or her parent, legal guardian, or
1351 legal custodian, may apply immediately to the court to have an
1352 attorney appointed if he or she cannot afford one.
1353 Section 25. Section 397.581, Florida Statutes, is amended
1354 to read:
1355 397.581 Unlawful activities relating to assessment and
1356 treatment; penalties.—
1357 (1) A person may not knowingly and willfully:
1358 (a) Furnish furnishing false information for the purpose of
1359 obtaining emergency or other involuntary admission of another
1360 person for any person is a misdemeanor of the first degree,
1361 punishable as provided in s. 775.082 and by a fine not exceeding
1362 $5,000.
1363 (b)(2) Cause or otherwise secure, or conspire with or
1364 assist another to cause or secure Causing or otherwise securing,
1365 or conspiring with or assisting another to cause or secure,
1366 without reason for believing a person to be impaired, any
1367 emergency or other involuntary procedure of another for the
1368 person under false pretenses is a misdemeanor of the first
1369 degree, punishable as provided in s. 775.082 and by a fine not
1370 exceeding $5,000.
1371 (c)(3) Cause, or conspire with or assist another to cause,
1372 without lawful justification Causing, or conspiring with or
1373 assisting another to cause, the denial to any person of any
1374 right accorded pursuant to this chapter.
1375 (2) A person who violates subsection (1) commits is a
1376 misdemeanor of the first degree, punishable as provided in s.
1377 775.082 and by a fine not exceeding $5,000.
1378 Section 26. Section 397.675, Florida Statutes, is amended
1379 to read:
1380 397.675 Criteria for involuntary admissions, including
1381 protective custody, emergency admission, and other involuntary
1382 assessment, involuntary treatment, and alternative involuntary
1383 assessment for minors, for purposes of assessment and
1384 stabilization, and for involuntary treatment.—A person meets the
1385 criteria for involuntary admission if there is good faith reason
1386 to believe that the person is substance abuse impaired or has a
1387 substance use disorder and a co-occurring mental health disorder
1388 and, because of such impairment or disorder:
1389 (1) Has lost the power of self-control with respect to
1390 substance abuse; and
1391 (2)(a) Is in need of substance abuse services and, by
1392 reason of substance abuse impairment, his or her judgment has
1393 been so impaired that he or she is incapable of appreciating his
1394 or her need for such services and of making a rational decision
1395 in that regard, although mere refusal to receive such services
1396 does not constitute evidence of lack of judgment with respect to
1397 his or her need for such services; or
1398 (b) Without care or treatment, is likely to suffer from
1399 neglect or refuse to care for himself or herself; that such
1400 neglect or refusal poses a real and present threat of
1401 substantial harm to his or her well-being; and that it is not
1402 apparent that such harm may be avoided through the help of
1403 willing, able, and responsible family members or friends or the
1404 provision of other services, or there is substantial likelihood
1405 that the person has inflicted, or threatened to or attempted to
1406 inflict, or, unless admitted, is likely to inflict, physical
1407 harm on himself, herself, or another.
1408 Section 27. Subsection (1) of section 397.6751, Florida
1409 Statutes, is amended to read:
1410 397.6751 Service provider responsibilities regarding
1411 involuntary admissions.—
1412 (1) It is the responsibility of the service provider to:
1413 (a) Ensure that a person who is admitted to a licensed
1414 service component meets the admission criteria specified in s.
1415 397.675;
1416 (b) Ascertain whether the medical and behavioral conditions
1417 of the person, as presented, are beyond the safe management
1418 capabilities of the service provider;
1419 (c) Provide for the admission of the person to the service
1420 component that represents the most appropriate and least
1421 restrictive available setting that is responsive to the person’s
1422 treatment needs;
1423 (d) Verify that the admission of the person to the service
1424 component does not result in a census in excess of its licensed
1425 service capacity;
1426 (e) Determine whether the cost of services is within the
1427 financial means of the person or those who are financially
1428 responsible for the person’s care; and
1429 (f) Take all necessary measures to ensure that each
1430 individual in treatment is provided with a safe environment, and
1431 to ensure that each individual whose medical condition or
1432 behavioral problem becomes such that he or she cannot be safely
1433 managed by the service component is discharged and referred to a
1434 more appropriate setting for care.
1435 Section 28. Section 397.681, Florida Statutes, is amended
1436 to read:
1437 397.681 Involuntary petitions; general provisions; court
1438 jurisdiction and right to counsel.—
1439 (1) JURISDICTION.—The courts have jurisdiction of
1440 involuntary assessment and stabilization petitions and
1441 involuntary treatment petitions for substance abuse impaired
1442 persons, and such petitions must be filed with the clerk of the
1443 court in the county where the person is located. The clerk of
1444 the court may not charge a fee for the filing of a petition
1445 under this section. The chief judge may appoint a general or
1446 special magistrate to preside over all or part of the
1447 proceedings. The alleged impaired person is named as the
1448 respondent.
1449 (2) RIGHT TO COUNSEL.—A respondent has the right to counsel
1450 at every stage of a judicial proceeding relating to a petition
1451 for his or her involuntary assessment and a petition for his or
1452 her involuntary treatment for substance abuse impairment;
1453 however, the respondent may waive that right if the respondent
1454 is present and the court finds that such waiver is made
1455 knowingly, intelligently, and voluntarily. A respondent who
1456 desires counsel and is unable to afford private counsel has the
1457 right to court-appointed counsel and to the benefits of s.
1458 57.081. If the court believes that the respondent needs or
1459 desires the assistance of counsel, the court shall appoint such
1460 counsel for the respondent without regard to the respondent’s
1461 wishes. If the respondent is a minor not otherwise represented
1462 in the proceeding, the court shall immediately appoint a
1463 guardian ad litem to act on the minor’s behalf.
1464 Section 29. Section 397.693, Florida Statutes, is
1465 renumbered as section 397.68111, Florida Statutes, and amended
1466 to read:
1467 397.68111 397.693 Involuntary treatment.—A person may be
1468 the subject of a petition for court-ordered involuntary
1469 treatment pursuant to this part, if that person:
1470 (1) Reasonably appears to meet meets the criteria for
1471 involuntary admission provided in s. 397.675; and:
1472 (2)(1) Has been placed under protective custody pursuant to
1473 s. 397.677 within the previous 10 days;
1474 (3)(2) Has been subject to an emergency admission pursuant
1475 to s. 397.679 within the previous 10 days; or
1476 (4)(3) Has been assessed by a qualified professional within
1477 30 5 days;
1478 (4) Has been subject to involuntary assessment and
1479 stabilization pursuant to s. 397.6818 within the previous 12
1480 days; or
1481 (5) Has been subject to alternative involuntary admission
1482 pursuant to s. 397.6822 within the previous 12 days.
1483 Section 30. Section 397.695, Florida Statutes, is
1484 renumbered as section 397.68112, Florida Statutes, and amended
1485 to read:
1486 397.68112 397.695 Involuntary services; persons who may
1487 petition.—
1488 (1) If the respondent is an adult, a petition for
1489 involuntary treatment services may be filed by the respondent’s
1490 spouse or legal guardian, any relative, a service provider, or
1491 an adult who has direct personal knowledge of the respondent’s
1492 substance abuse impairment and his or her prior course of
1493 assessment and treatment.
1494 (2) If the respondent is a minor, a petition for
1495 involuntary treatment services may be filed by a parent, legal
1496 guardian, or service provider.
1497 (3) The court may prohibit, or a law enforcement agency may
1498 waive, any service of process fees if a petitioner is determined
1499 to be indigent.
1500 Section 31. Section 397.6951, Florida Statutes, is
1501 renumbered as section 397.68141, Florida Statutes, and amended
1502 to read:
1503 397.68141 397.6951 Contents of petition for involuntary
1504 treatment services.—A petition for involuntary services must
1505 contain the name of the respondent; the name of the petitioner
1506 or petitioners; the relationship between the respondent and the
1507 petitioner; the name of the respondent’s attorney, if known; the
1508 findings and recommendations of the assessment performed by the
1509 qualified professional; and the factual allegations presented by
1510 the petitioner establishing the need for involuntary outpatient
1511 services for substance abuse impairment. The factual allegations
1512 must demonstrate:
1513 (1) The reason for the petitioner’s belief that the
1514 respondent is substance abuse impaired;
1515 (2) The reason for the petitioner’s belief that because of
1516 such impairment the respondent has lost the power of self
1517 control with respect to substance abuse; and
1518 (3)(a) The reason the petitioner believes that the
1519 respondent has inflicted or is likely to inflict physical harm
1520 on himself or herself or others unless the court orders the
1521 involuntary services; or
1522 (b) The reason the petitioner believes that the
1523 respondent’s refusal to voluntarily receive care is based on
1524 judgment so impaired by reason of substance abuse that the
1525 respondent is incapable of appreciating his or her need for care
1526 and of making a rational decision regarding that need for care.
1527 (4) The petition may be accompanied by a certificate or
1528 report of a qualified professional who examined the respondent
1529 within 30 days before the petition was filed. The certificate or
1530 report must include the qualified professional’s findings
1531 relating to his or her assessment of the patient and his or her
1532 treatment recommendations. If the respondent was not assessed
1533 before the filing of a treatment petition or refused to submit
1534 to an evaluation, the lack of assessment or refusal must be
1535 noted in the petition.
1536 (5) If there is an emergency, the petition must also
1537 describe the respondent’s exigent circumstances and include a
1538 request for an ex parte assessment and stabilization order that
1539 must be executed pursuant to s. 397.68151.
1540 Section 32. Section 397.6955, Florida Statutes, is
1541 renumbered as section 397.68151, Florida Statutes, and amended
1542 to read:
1543 397.68151 397.6955 Duties of court upon filing of petition
1544 for involuntary services.—
1545 (1) Upon the filing of a petition for involuntary services
1546 for a substance abuse impaired person with the clerk of the
1547 court, the court shall immediately determine whether the
1548 respondent is represented by an attorney or whether the
1549 appointment of counsel for the respondent is appropriate. If the
1550 court appoints counsel for the person, the clerk of the court
1551 shall immediately notify the office of criminal conflict and
1552 civil regional counsel, created pursuant to s. 27.511, of the
1553 appointment. The office of criminal conflict and civil regional
1554 counsel shall represent the person until the petition is
1555 dismissed, the court order expires, or the person is discharged
1556 from involuntary treatment services, or the office is otherwise
1557 discharged by the court. An attorney that represents the person
1558 named in the petition shall have access to the person,
1559 witnesses, and records relevant to the presentation of the
1560 person’s case and shall represent the interests of the person,
1561 regardless of the source of payment to the attorney.
1562 (2) The court shall schedule a hearing to be held on the
1563 petition within 10 court working 5 days unless a continuance is
1564 granted. The court may appoint a magistrate to preside at the
1565 hearing.
1566 (3) A copy of the petition and notice of the hearing must
1567 be provided to the respondent; the respondent’s parent,
1568 guardian, or legal custodian, in the case of a minor; the
1569 respondent’s attorney, if known; the petitioner; the
1570 respondent’s spouse or guardian, if applicable; and such other
1571 persons as the court may direct. If the respondent is a minor, a
1572 copy of the petition and notice of the hearing must be
1573 personally delivered to the respondent. The clerk court shall
1574 also issue a summons to the person whose admission is sought and
1575 unless a circuit court’s chief judge authorizes disinterested
1576 private process servers to serve parties under this chapter, a
1577 law enforcement agency must effect such service on the person
1578 whose admission is sought for the initial treatment hearing.
1579 Section 33. Section 397.6818, Florida Statutes, is amended
1580 to read:
1581 397.6818 Court determination.—
1582 (1) When the petitioner asserts that emergency
1583 circumstances exist, or when upon review of the petition the
1584 court determines that an emergency exists, the court may rely
1585 solely on the contents of the petition and, without the
1586 appointment of an attorney, enter an ex parte order for the
1587 respondent’s involuntary assessment and stabilization which must
1588 be executed during the period when the hearing on the petition
1589 for treatment is pending.
1590 (2) The court may further order a law enforcement officer
1591 or another designated agent of the court to:
1592 (a) Take the respondent into custody and deliver him or her
1593 for evaluation to either the nearest appropriate licensed
1594 service provider or a licensed service provider designated by
1595 the court.
1596 (b) Serve the respondent with the notice of hearing and a
1597 copy of the petition.
1598 (3) The service provider may not hold the respondent for
1599 longer than 72 hours of observation, unless:
1600 (a) The service provider seeks additional time under s.
1601 397.6957(1)(c) and the court, after a hearing, grants that
1602 motion;
1603 (b) The respondent shows signs of withdrawal, or a need to
1604 be either detoxified or treated for a medical condition, which
1605 shall extend the amount of time the respondent may be held for
1606 observation until the issue is resolved but no later than the
1607 scheduled hearing date, absent a court-approved extension; or
1608 (c) The original or extended observation period ends on a
1609 weekend or holiday, including the hours before the ordinary
1610 business hours of the following workday morning, in which case
1611 the provider may hold the respondent until the next court
1612 working day.
1613 (4) If the ex parte order was not executed by the initial
1614 hearing date, it is deemed void. However, if the respondent does
1615 not appear at the hearing for any reason, including lack of
1616 service, and upon reviewing the petition, testimony, and
1617 evidence presented, the court reasonably believes the respondent
1618 meets this chapter’s commitment criteria and that a substance
1619 abuse emergency exists, the court may issue or reissue an ex
1620 parte assessment and stabilization order that is valid for 90
1621 days. If the respondent’s location is known at the time of the
1622 hearing, the court:
1623 (a) Must continue the case for no more than 10 court
1624 working days; and
1625 (b) May order a law enforcement officer or another
1626 designated agent of the court to:
1627 1. Take the respondent into custody and deliver him or her
1628 for evaluation to either the nearest appropriate licensed
1629 service provider or a licensed service provider designated by
1630 the court; and
1631 2. If a hearing date is set, serve the respondent with
1632 notice of the rescheduled hearing and a copy of the involuntary
1633 treatment petition if the respondent has not already been
1634 served.
1635
1636 Otherwise, the petitioner must inform the court that the
1637 respondent has been assessed so that the court may schedule a
1638 hearing as soon as is practicable. However, if the respondent
1639 has not been assessed within 90 days, the court must dismiss the
1640 case. At the hearing initiated in accordance with s.
1641 397.6811(1), the court shall hear all relevant testimony. The
1642 respondent must be present unless the court has reason to
1643 believe that his or her presence is likely to be injurious to
1644 him or her, in which event the court shall appoint a guardian
1645 advocate to represent the respondent. The respondent has the
1646 right to examination by a court-appointed qualified
1647 professional. After hearing all the evidence, the court shall
1648 determine whether there is a reasonable basis to believe the
1649 respondent meets the involuntary admission criteria of s.
1650 397.675.
1651 (1) Based on its determination, the court shall either
1652 dismiss the petition or immediately enter an order authorizing
1653 the involuntary assessment and stabilization of the respondent;
1654 or, if in the course of the hearing the court has reason to
1655 believe that the respondent, due to mental illness other than or
1656 in addition to substance abuse impairment, is likely to injure
1657 himself or herself or another if allowed to remain at liberty,
1658 the court may initiate involuntary proceedings under the
1659 provisions of part I of chapter 394.
1660 (2) If the court enters an order authorizing involuntary
1661 assessment and stabilization, the order shall include the
1662 court’s findings with respect to the availability and
1663 appropriateness of the least restrictive alternatives and the
1664 need for the appointment of an attorney to represent the
1665 respondent, and may designate the specific licensed service
1666 provider to perform the involuntary assessment and stabilization
1667 of the respondent. The respondent may choose the licensed
1668 service provider to deliver the involuntary assessment where
1669 possible and appropriate.
1670 (3) If the court finds it necessary, it may order the
1671 sheriff to take the respondent into custody and deliver him or
1672 her to the licensed service provider specified in the court
1673 order or, if none is specified, to the nearest appropriate
1674 licensed service provider for involuntary assessment.
1675 (4) The order is valid only for the period specified in the
1676 order or, if a period is not specified, for 7 days after the
1677 order is signed.
1678 Section 34. Section 397.6957, Florida Statutes, is amended
1679 to read:
1680 397.6957 Hearing on petition for involuntary treatment
1681 services.—
1682 (1)(a) The respondent must be present at a hearing on a
1683 petition for involuntary treatment services, unless the court
1684 finds that he or she knowingly, intelligently, and voluntarily
1685 waives his or her right to be present or, upon receiving proof
1686 of service and evaluating the circumstances of the case, that
1687 his or her presence is inconsistent with his or her best
1688 interests or is likely to be injurious to self or others. The
1689 court shall hear and review all relevant evidence, including
1690 testimony from individuals such as family members familiar with
1691 the respondent’s prior history and how it relates to his or her
1692 current condition, and the review of results of the assessment
1693 completed by the qualified professional in connection with this
1694 chapter. The court may also order drug tests. Witnesses may
1695 remotely attend and, as appropriate, testify
1696
1697 ================= T I T L E A M E N D M E N T ================
1698 And the title is amended as follows:
1699 Delete line 89
1700 and insert:
1701 hearing in certain circumstances through specified
1702 means; providing