Florida Senate - 2025 CS for CS for SB 1240
By the Appropriations Committee on Health and Human Services;
the Committee on Children, Families, and Elder Affairs; and
Senator Calatayud
603-03590-25 20251240c2
1 A bill to be entitled
2 An act relating to substance abuse and mental health
3 care; amending s. 394.4573, F.S.; expanding mental
4 health crisis services to include the 988 suicide and
5 crisis lifeline call center; amending s. 394.4598,
6 F.S.; authorizing the guardian advocate to be
7 discharged when a patient is discharged from
8 involuntary outpatient services; amending s. 394.4625,
9 F.S.; requiring clinical psychologists who make
10 determinations of involuntary placement at certain
11 mental health facilities to have specified clinical
12 experience; amending s. 394.463, F.S.; revising the
13 timeframe within which a receiving facility must take
14 certain actions after the attending physician of a
15 patient being involuntarily examined documents certain
16 information about the patient’s medical condition;
17 revising a required action; amending s. 394.4655,
18 F.S.; providing a cross-reference for specified
19 criteria relating to orders to involuntary outpatient
20 placement; amending s. 394.467, F.S.; revising the
21 definition of the term “court”; providing that orders
22 entered by administrative law judges for continued
23 involuntary placement for patients at certain mental
24 health facilities are final and subject to judicial
25 review; requiring that hearings on petitions for
26 certain continued involuntary services be scheduled
27 immediately; requiring the clerk of the Division of
28 Administrative Hearings to provide copies of petitions
29 and individualized plans for continued services to the
30 Department of Children and Families and other
31 specified individuals; requiring the court or the
32 administrative law judge to make certain
33 determinations before waiving a patient’s attendance
34 at a hearing for continued involuntary placement;
35 authorizing an administrative law judge to issue an
36 order for involuntary services if the patient meets
37 certain criteria; amending s. 394.67, F.S.; defining
38 the term “988 suicide and crisis lifeline call
39 center”; revising the definition of “crisis services”
40 to include a 988 suicide and crisis lifeline call
41 center; creating s. 394.9088, F.S.; requiring the
42 department to authorize and provide oversight of the
43 988 suicide and crisis lifeline call centers;
44 authorizing the department to take certain actions for
45 failure to comply with certain provisions; requiring
46 the department to adopt specified rules; amending s.
47 397.427, F.S.; deleting requirements relating to
48 providers of medication-assisted treatment services
49 for opiate addiction; amending s. 916.111, F.S.;
50 revising training requirements for mental health
51 professionals; amending s. 916.115, F.S.; requiring
52 certain court-appointed experts to have completed
53 specified training and continued education; amending
54 s. 916.12, F.S.; providing requirements for an
55 examining expert to determine acceptable treatments
56 available in a community; amending ss. 394.674,
57 394.74, and 397.68141 F.S.; conforming cross
58 references; providing an effective date.
59
60 Be It Enacted by the Legislature of the State of Florida:
61
62 Section 1. Paragraph (d) of subsection (2) of section
63 394.4573, Florida Statutes, is amended to read:
64 394.4573 Coordinated system of care; annual assessment;
65 essential elements; measures of performance; system improvement
66 grants; reports.—On or before December 1 of each year, the
67 department shall submit to the Governor, the President of the
68 Senate, and the Speaker of the House of Representatives an
69 assessment of the behavioral health services in this state. The
70 assessment shall consider, at a minimum, the extent to which
71 designated receiving systems function as no-wrong-door models,
72 the availability of treatment and recovery services that use
73 recovery-oriented and peer-involved approaches, the availability
74 of less-restrictive services, and the use of evidence-informed
75 practices. The assessment shall also consider the availability
76 of and access to coordinated specialty care programs and
77 identify any gaps in the availability of and access to such
78 programs in the state. The department’s assessment shall
79 consider, at a minimum, the needs assessments conducted by the
80 managing entities pursuant to s. 394.9082(5). The department
81 shall compile and include in the report all plans submitted by
82 managing entities pursuant to s. 394.9082(8) and the
83 department’s evaluation of each plan.
84 (2) The essential elements of a coordinated system of care
85 include:
86 (d) Crisis services, including the 988 suicide and crisis
87 lifeline call center, mobile response teams, crisis
88 stabilization units, addiction receiving facilities, and
89 detoxification facilities.
90 Section 2. Subsection (8) of section 394.4598, Florida
91 Statutes, are amended to read:
92 394.4598 Guardian advocate.—
93 (8) The guardian advocate shall be discharged when the
94 patient is discharged from an order for involuntary outpatient
95 services placement or involuntary inpatient placement or when
96 the patient is transferred from involuntary to voluntary status.
97 The court or a hearing officer shall consider the competence of
98 the patient pursuant to subsection (1) and may consider an
99 involuntarily placed patient’s competence to consent to
100 treatment at any hearing. Upon sufficient evidence, the court
101 may restore, or the hearing officer may recommend that the court
102 restore, the patient’s competence. A copy of the order restoring
103 competence or the certificate of discharge containing the
104 restoration of competence shall be provided to the patient and
105 the guardian advocate.
106 Section 3. Subsection (5) of section 394.4625, Florida
107 Statutes, is amended to read:
108 394.4625 Voluntary admissions.—
109 (5) TRANSFER TO INVOLUNTARY STATUS.—When a voluntary
110 patient, or an authorized person on the patient’s behalf, makes
111 a request for discharge, the request for discharge, unless
112 freely and voluntarily rescinded, must be communicated to a
113 physician, a clinical psychologist with at least 3 years of
114 clinical postdoctoral experience in the practice of clinical
115 psychology, or a psychiatrist as quickly as possible, but not
116 later than 12 hours after the request is made. If the patient
117 meets the criteria for involuntary placement, the administrator
118 of the facility must file with the court a petition for
119 involuntary placement, within 2 court working days after the
120 request for discharge is made. If the petition is not filed
121 within 2 court working days, the patient must be discharged.
122 Pending the filing of the petition, the patient may be held and
123 emergency treatment rendered in the least restrictive manner,
124 upon the order of a physician or a psychiatric nurse practicing
125 within the framework of an established protocol with a
126 psychiatrist, if it is determined that such treatment is
127 necessary for the safety of the patient or others.
128 Section 4. Paragraph (i) of subsection (2) of section
129 394.463, Florida Statutes, is amended to read:
130 394.463 Involuntary examination.—
131 (2) INVOLUNTARY EXAMINATION.—
132 (i) One of the following must occur within 24 12 hours
133 after the patient’s attending physician documents that the
134 patient’s medical condition has stabilized or that an emergency
135 medical condition does not exist:
136 1. The patient must be examined by a facility and released;
137 or
138 2. The patient must be accepted for transfer transferred to
139 a designated facility in which appropriate medical treatment is
140 available. However, the facility must be notified of the
141 transfer within 12 2 hours after the patient’s condition has
142 been stabilized or after determination that an emergency medical
143 condition does not exist.
144 Section 5. Subsection (2) of section 394.4655, Florida
145 Statutes, is amended, and subsection (3) is added to that
146 section, to read:
147 394.4655 Orders to involuntary outpatient placement.—
148 (2) A court or a county court may order an individual to
149 involuntary outpatient placement under s. 394.467. The criteria
150 for ordering a person to involuntary outpatient placement, as
151 well as all of the requirements and processes for placement,
152 including, but not limited to, recommendations for involuntary
153 outpatient placement, petitions, appointment of counsel, and
154 hearings on involuntary outpatient placement, are provided in s.
155 394.467.
156 (3) When recommending an order to involuntary outpatient
157 placement, the petitioner, as defined in s. 394.467(4), shall
158 prepare a services plan for the patient in accordance with s.
159 394.467.
160 Section 6. Paragraph (a) of subsection (1) and subsection
161 (11) of section 394.467, Florida Statutes, are amended to read:
162 394.467 Involuntary inpatient placement and involuntary
163 outpatient services.—
164 (1) DEFINITIONS.—As used in this section, the term:
165 (a) “Court” means a circuit court or, for commitments only
166 to involuntary outpatient services as defined in s. 394.4655, a
167 county court.
168 (11) PROCEDURE FOR CONTINUED INVOLUNTARY SERVICES.—
169 (a) A petition for continued involuntary services must be
170 filed if the patient continues to meet meets the criteria for
171 involuntary services.
172 (b)1. If a patient receiving involuntary outpatient
173 services continues to meet the criteria for involuntary
174 outpatient services, the service provider must file in the court
175 that issued the initial order for involuntary outpatient
176 services a petition for continued involuntary outpatient
177 services.
178 2. If a patient in involuntary inpatient placement
179 continues to meet the criteria for involuntary services and is
180 being treated at a receiving facility, the administrator must,
181 before the expiration of the period the receiving facility is
182 authorized to retain the patient, file in the court that issued
183 the initial order for involuntary inpatient placement, a
184 petition requesting authorization for continued involuntary
185 services. The administrator may petition for inpatient or
186 outpatient services.
187 3. If a patient in involuntary inpatient placement
188 continues to meet the criteria for involuntary services and is
189 being treated at a treatment facility, the administrator must,
190 before expiration of the period the treatment facility is
191 authorized to retain the patient, file a petition requesting
192 authorization for continued involuntary services. The
193 administrator may petition for inpatient or outpatient services.
194 Hearings on petitions for continued involuntary services of an
195 individual placed at any treatment facility are administrative
196 hearings and must be conducted in accordance with s. 120.57(1),
197 except that any order entered by the administrative law judge is
198 final and subject to judicial review in accordance with s.
199 120.68. Orders concerning patients committed after successfully
200 pleading not guilty by reason of insanity are governed by s.
201 916.15.
202 4. The court shall immediately schedule A hearing on the
203 petition shall to be scheduled immediately and held within 15
204 days after the petition is filed.
205 5. The existing involuntary services order shall remain in
206 effect until disposition on the petition for continued
207 involuntary services.
208 (c) The petition must be accompanied by a statement from
209 the patient’s physician, psychiatrist, psychiatric nurse, or
210 clinical psychologist justifying the request, a brief
211 description of the patient’s treatment during the time he or she
212 was receiving involuntary services, and an individualized plan
213 of continued treatment developed in consultation with the
214 patient or the patient’s guardian advocate, if applicable. If
215 the petition is for involuntary outpatient services, it must
216 comply with the requirements of subparagraph (4)(d)3. When the
217 petition has been filed, the clerk of the court or the clerk of
218 the Division of Administrative Hearings, as applicable, shall
219 provide copies of the petition and the individualized plan of
220 continued services to the department, the patient, the patient’s
221 guardian advocate, the state attorney, and the patient’s private
222 counsel or the public defender.
223 (d) The court shall appoint counsel to represent the person
224 who is the subject of the petition for continued involuntary
225 services in accordance with the provisions set forth in
226 subsection (5), unless the person is otherwise represented by
227 counsel or ineligible.
228 (e) Hearings on petitions for continued involuntary
229 outpatient services must be before the court that issued the
230 order for involuntary outpatient services. However, the patient
231 and the patient’s attorney may agree to a period of continued
232 outpatient services without a court hearing.
233 (f) Hearings on petitions for continued involuntary
234 inpatient placement in receiving facilities, or involuntary
235 outpatient services following involuntary inpatient services,
236 must be held in the county or the facility, as appropriate,
237 where the patient is located.
238 (g) The court may appoint a magistrate to preside at the
239 hearing. The procedures for obtaining an order pursuant to this
240 paragraph must meet the requirements of subsection (7).
241 (h) Notice of the hearing must be provided as set forth in
242 s. 394.4599.
243 (i) If a patient’s attendance at the hearing is voluntarily
244 waived, the court or the administrative law judge must determine
245 that the patient knowingly, intelligently, and voluntarily
246 waived his or her right to be present, before waiving the
247 presence of the patient from all or a portion of the hearing.
248 Alternatively, if at the hearing the court or the administrative
249 law judge finds that attendance at the hearing is not consistent
250 with the best interests of the patient, the court or the
251 administrative law judge may waive the presence of the patient
252 from all or any portion of the hearing, unless the patient,
253 through counsel, objects to the waiver of presence. The
254 testimony in the hearing must be under oath, and the proceedings
255 must be recorded.
256 (j) If at a hearing it is shown that the patient continues
257 to meet the criteria for involuntary services, the court or the
258 administrative law judge shall issue an order for continued
259 involuntary outpatient services, involuntary inpatient
260 placement, or a combination of involuntary services for up to 6
261 months. The same procedure shall be repeated before the
262 expiration of each additional period the patient is retained.
263 (k) If the patient has been ordered to undergo involuntary
264 services and has previously been found incompetent to consent to
265 treatment, the court shall consider testimony and evidence
266 regarding the patient’s competence. If the patient’s competency
267 to consent to treatment is restored, the discharge of the
268 guardian advocate is governed by s. 394.4598. If the patient has
269 been ordered to undergo involuntary inpatient placement only and
270 the patient’s competency to consent to treatment is restored,
271 the administrative law judge may issue a recommended order, to
272 the court that found the patient incompetent to consent to
273 treatment, that the patient’s competence be restored and that
274 any guardian advocate previously appointed be discharged.
275 (l) If continued involuntary inpatient placement is
276 necessary for a patient in involuntary inpatient placement who
277 was admitted while serving a criminal sentence, but his or her
278 sentence is about to expire, or for a minor involuntarily
279 placed, but who is about to reach the age of 18, the
280 administrator shall petition the administrative law judge for an
281 order authorizing continued involuntary inpatient placement.
282
283 The procedure required in this subsection must be followed
284 before the expiration of each additional period the patient is
285 involuntarily receiving services.
286 Section 7. Present subsections (1) through (25) of section
287 394.67, Florida Statutes, are redesignated as subsections (2)
288 through (26), respectively, a new subsection (1) is added to
289 that section, and subsection (4) of that section is amended, to
290 read:
291 394.67 Definitions.—As used in this part, the term:
292 (1) “988 suicide and crisis lifeline call center” means a
293 call center meeting national accreditation and recognized by the
294 department to receive 988 calls, texts, or other forms of
295 communication in this state.
296 (4) “Crisis services” means short-term evaluation,
297 stabilization, and brief intervention services provided to a
298 person who is experiencing an acute mental or emotional crisis,
299 as defined in subsection (19) (18), or an acute substance abuse
300 crisis, as defined in subsection (20) (19), to prevent further
301 deterioration of the person’s mental health. Crisis services are
302 provided in settings such as a crisis stabilization unit, an
303 inpatient unit, a short-term residential treatment program, a
304 detoxification facility, or an addictions receiving facility; at
305 the site of the crisis by a mobile crisis response team; or at a
306 hospital on an outpatient basis; or telephonically by a 988
307 suicide and crisis lifeline call center.
308 Section 8. Section 394.9088, Florida Statutes, is created
309 to read:
310 394.9088 988 suicide and crisis lifeline call center.—
311 (1) The department shall authorize and provide oversight to
312 988 suicide and crisis lifeline call centers. Unless authorized
313 by the department, call centers are not permitted to conduct 988
314 suicide and crisis lifeline services. The department may
315 implement a corrective action plan, suspension, or revocation of
316 authorization for failure to comply with this section and rules
317 adopted under this section.
318 (2) The department shall adopt rules relating to:
319 (a) The process for authorization of 988 suicide and crisis
320 lifeline call centers.
321 (b) Minimum standards for 988 suicide and crisis lifeline
322 call centers to be authorized, including but not limited to,
323 service delivery, quality of care, and performance outcomes.
324 (c) The adequacy and consistency of 988 suicide and crisis
325 lifeline call centers’ personnel certifications, accreditations,
326 quality assurance standards, and minimum training standards.
327 (d) Implementation of a cohesive statewide plan for 988
328 suicide and crisis lifeline call centers to achieve statewide
329 interoperability with the 911 system and to provide individuals
330 with rapid and direct access to the appropriate care.
331 Section 9. Present subsections (3) through (9) of section
332 397.427, Florida Statutes, are redesignated as subsections (2)
333 through (8), respectively, and present subsections (2) and (5)
334 of that section are amended, to read:
335 397.427 Medication-assisted treatment service providers;
336 rehabilitation program; needs assessment and provision of
337 services; persons authorized to issue takeout medication;
338 unlawful operation; penalty.—
339 (2) The department shall determine the need for
340 establishing providers of medication-assisted treatment services
341 for opiate addiction.
342 (a) Providers of medication-assisted treatment services for
343 opiate addiction may be established only in response to the
344 department’s determination and publication of need for
345 additional medication treatment services.
346 (b) If needs assessment is required, the department shall
347 annually conduct the assessment and publish a statement of
348 findings which identifies each substate entity’s need.
349 (c) Notwithstanding paragraphs (a) and (b), the license for
350 medication-assisted treatment programs for opiate addiction
351 licensed before October 1, 1990, may not be revoked solely
352 because of the department’s determination concerning the need
353 for medication-assisted treatment services for opiate addiction.
354 (4)(5) The department shall also determine the need for
355 establishing medication-assisted treatment for substance use
356 disorders other than opiate dependence. Service providers within
357 the publicly funded system shall be funded for provision of
358 these services based on the availability of funds.
359 Section 10. Section 916.111, Florida Statutes, is amended
360 to read:
361 916.111 Training of mental health experts.—The evaluation
362 of defendants for competency to proceed or for sanity at the
363 time of the commission of the offense shall be conducted in such
364 a way as to ensure uniform application of the criteria
365 enumerated in Rules 3.210 and 3.216, Florida Rules of Criminal
366 Procedure. The department shall develop, and may contract with
367 accredited institutions:
368 (1) To provide:
369 (a) A plan for training mental health professionals to
370 perform forensic evaluations and to standardize the criteria and
371 procedures to be used in these evaluations;
372 (b) Clinical protocols and procedures based upon the
373 criteria of Rules 3.210 and 3.216, Florida Rules of Criminal
374 Procedure; and
375 (c) Training for mental health professionals in the
376 application of these protocols and procedures in performing
377 forensic evaluations and providing reports to the courts.
378 Training must include, but not be limited to, information on
379 statutes and rules related to competency restoration, evidence
380 based practices, and least restrictive treatment alternatives
381 and placement options as described in s. 916.12(4)(c); and
382 (2) To compile and maintain the necessary information for
383 evaluating the success of this program, including the number of
384 persons trained, the cost of operating the program, and the
385 effect on the quality of forensic evaluations as measured by
386 appropriateness of admissions to state forensic facilities and
387 to community-based care programs.
388 Section 11. Subsection (1) of section 916.115, Florida
389 Statutes, is amended to read:
390 916.115 Appointment of experts.—
391 (1) The court shall appoint no more than three experts to
392 determine the mental condition of a defendant in a criminal
393 case, including competency to proceed, insanity, involuntary
394 placement, and treatment. The experts may evaluate the defendant
395 in jail or in another appropriate local facility or in a
396 facility of the Department of Corrections.
397 (a) The court-appointed To the extent possible, The
398 appointed experts shall:
399 1. have completed forensic evaluator training approved by
400 the department, and each shall Be a psychiatrist, licensed
401 psychologist, or physician.
402 2. Have completed initial and ongoing forensic evaluator
403 training, provided by the department.
404 3. If performing juvenile evaluations, annually complete
405 juvenile forensic competency evaluation training approved by the
406 department.
407 (b) Existing evaluators shall complete department-provided
408 continuing education training by July 1, 2026, to remain active
409 on the list.
410 (c)(b) The department shall maintain and annually provide
411 the courts with a list of available mental health professionals
412 who have completed the initial and annual approved training as
413 experts.
414 Section 12. Paragraph (d) of subsection (4) of section
415 916.12, Florida Statutes, is amended to read:
416 916.12 Mental competence to proceed.—
417 (4) If an expert finds that the defendant is incompetent to
418 proceed, the expert shall report on any recommended treatment
419 for the defendant to attain competence to proceed. In
420 considering the issues relating to treatment, the examining
421 expert shall specifically report on:
422 (d) The availability of acceptable treatment and, if
423 treatment is available in the community, the expert shall so
424 state in the report. In determining what acceptable treatments
425 are available in the community, the expert shall, at a minimum,
426 use current information or resources on less restrictive
427 treatment alternatives, as described in paragraph (c), and those
428 obtained from training and continuing education approved by the
429 department.
430
431 The examining expert’s report to the court shall include a full
432 and detailed explanation regarding why the alternative treatment
433 options referenced in the evaluation are insufficient to meet
434 the needs of the defendant.
435 Section 13. Paragraph (a) of subsection (1) of section
436 394.674, Florida Statutes, is amended to read:
437 394.674 Eligibility for publicly funded substance abuse and
438 mental health services; fee collection requirements.—
439 (1) To be eligible to receive substance abuse and mental
440 health services funded by the department, an individual must be
441 a member of at least one of the department’s priority
442 populations approved by the Legislature. The priority
443 populations include:
444 (a) For adult mental health services:
445 1. Adults who have severe and persistent mental illness, as
446 designated by the department using criteria that include
447 severity of diagnosis, duration of the mental illness, ability
448 to independently perform activities of daily living, and receipt
449 of disability income for a psychiatric condition. Included
450 within this group are:
451 a. Older adults in crisis.
452 b. Older adults who are at risk of being placed in a more
453 restrictive environment because of their mental illness.
454 c. Persons deemed incompetent to proceed or not guilty by
455 reason of insanity under chapter 916.
456 d. Other persons involved in the criminal justice system.
457 e. Persons diagnosed as having co-occurring mental illness
458 and substance abuse disorders.
459 2. Persons who are experiencing an acute mental or
460 emotional crisis as defined in s. 394.67 s. 394.67(18).
461 Section 14. Subsection (3) of section 394.74, Florida
462 Statutes, is amended to read:
463 394.74 Contracts for provision of local substance abuse and
464 mental health programs.—
465 (3) Contracts shall include, but are not limited to:
466 (a) A provision that, within the limits of available
467 resources, substance abuse and mental health crisis services, as
468 defined in s. 394.67 s. 394.67(4), shall be available to any
469 individual residing or employed within the service area,
470 regardless of ability to pay for such services, current or past
471 health condition, or any other factor;
472 (b) A provision that such services be available with
473 priority of attention being given to individuals who exhibit
474 symptoms of chronic or acute substance abuse or mental illness
475 and who are unable to pay the cost of receiving such services;
476 (c) A provision that every reasonable effort to collect
477 appropriate reimbursement for the cost of providing substance
478 abuse and mental health services to persons able to pay for
479 services, including first-party payments and third-party
480 payments, shall be made by facilities providing services
481 pursuant to this act;
482 (d) A program description and line-item operating budget by
483 program service component for substance abuse and mental health
484 services, provided the entire proposed operating budget for the
485 service provider will be displayed;
486 (e) A provision that client demographic, service, and
487 outcome information required for the department’s Mental Health
488 and Substance Abuse Data System be submitted to the department
489 by a date specified in the contract. The department may not pay
490 the provider unless the required information has been submitted
491 by the specified date; and
492 (f) A requirement that the contractor must conform to
493 department rules and the priorities established thereunder.
494 Section 15. Subsection (3) of section 397.68141, Florida
495 Statutes, is amended to read:
496 397.68141 Contents of petition for involuntary treatment
497 services.—A petition for involuntary services must contain the
498 name of the respondent; the name of the petitioner; the
499 relationship between the respondent and the petitioner; the name
500 of the respondent’s attorney, if known; and the factual
501 allegations presented by the petitioner establishing the need
502 for involuntary services for substance abuse impairment.
503 (3) If there is an emergency, the petition must also
504 describe the respondent’s exigent circumstances and include a
505 request for an ex parte assessment and stabilization order that
506 must be executed pursuant to s. 397.6818 s. 397.68151.
507 Section 16. This act shall take effect July 1, 2025.