Senate Bill 1610

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    Florida Senate - 2000                                  SB 1610

    By Senator Diaz-Balart





    37-869-00

  1                      A bill to be entitled

  2         An act relating to treatment of forensic

  3         clients; amending s. 916.107, F.S.; revising

  4         guidelines for when a court order is necessary

  5         in providing treatment to a forensic client of

  6         the Department of Children and Family Services;

  7         providing an effective date.

  8

  9  Be It Enacted by the Legislature of the State of Florida:

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11         Section 1.  Paragraph (a) of subsection (3) of section

12  916.107, Florida Statutes, is amended to read:

13         916.107  Rights of forensic clients.--

14         (3)  RIGHT TO EXPRESS AND INFORMED CONSENT.--

15         (a)  A client committed to the department pursuant to

16  this act shall be asked to give express and informed written

17  consent for treatment.  If a client in a forensic facility

18  refuses such treatment with psychotropic medications as is

19  deemed necessary by the attending psychiatrist or the client's

20  multidisciplinary treatment team at the forensic facility for

21  the appropriate care of the client and the safety of the

22  client or others, such treatment may be provided without the

23  consent of the client under the following circumstances:

24         1.  In the case of a new admission to the forensic

25  facility, or in a case in which a client withdraws consent

26  previously provided by the client, when the attending

27  psychiatrist on the client's multidisciplinary treatment team

28  at the forensic facility determines that psychotropic

29  medications are necessary and essential for the appropriate

30  treatment of the client, such medications an emergency

31  situation in which there is immediate danger to the safety of

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    Florida Senate - 2000                                  SB 1610
    37-869-00




  1  the client or others, such treatment may be provided upon the

  2  written order of a physician for a period not to exceed 48

  3  hours, excluding weekends and legal holidays.  If, after the

  4  48-hour period, the client has not given or is unable to give

  5  express and informed consent to such medications the treatment

  6  initially refused, the administrator or designee of the

  7  forensic facility shall, within 48 hours, excluding weekends

  8  and legal holidays, petition the committing court or the

  9  circuit court serving the county in which the facility is

10  located, at the option of the facility administrator or

11  designee, for an order authorizing the medications deemed

12  necessary by the attending psychiatrist continued treatment of

13  the client. In the interim, once the petition has been filed

14  treatment may be continued upon the original physician's order

15  without the consent of the client until such time as the court

16  determines the issue upon the continued written order of a

17  physician who has determined that the emergency situation

18  continues to present a danger to the safety of the client or

19  others.

20         2.  The order entered by the court authorizing the

21  psychotropic medications shall expire 6 months after the date

22  it is entered. If, during this 6-month period, an addition to

23  the previously approved medications is determined to be

24  necessary and essential by the attending psychiatrist and the

25  client remains unwilling or unable to give express and

26  informed consent, a new motion must be filed, a hearing must

27  be held, and an order approving such additions must be entered

28  before the change. In a situation other than an emergency

29  situation, the administrator or designee of the forensic

30  facility shall petition the court for an order authorizing the

31  treatment to the client.  The order shall allow such treatment

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    Florida Senate - 2000                                  SB 1610
    37-869-00




  1  for a period not to exceed 90 days from the date of the entry

  2  of the order. Unless the court is notified in writing that the

  3  client has provided express and informed consent in writing or

  4  that the client has been discharged by the committing court,

  5  the administrator or designee shall, prior to the expiration

  6  of the initial 6-month 90-day order, petition the court for an

  7  order authorizing the continuation of the medications

  8  treatment for another 6-month 90-day period. This procedure

  9  shall be repeated until the client provides express and

10  informed consent or is discharged from the custody of the the

11  department by the committing court.

12         3.  At the hearing on the issue of whether the court

13  should enter an order authorizing treatment for which a client

14  has refused to give express and informed consent, the court

15  shall determine by clear and convincing evidence that the

16  client is mentally ill, retarded, or autistic as defined in

17  this chapter, that the treatment not consented to is essential

18  to the care of the client, and that the treatment not

19  consented to is not experimental and does not present an

20  unreasonable risk of serious, hazardous, or irreversible side

21  effects.  In arriving at the substitute judgment decision, the

22  court must consider at least the following factors:

23         a.  The client's expressed preference regarding

24  treatment;

25         b.  The probability of adverse side effects;

26         c.  The prognosis without treatment; and

27         d.  The prognosis with treatment.

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29  The hearing shall be as convenient to the client as may be

30  consistent with orderly procedure and shall be conducted in

31  physical settings not likely to be injurious to the client's

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    Florida Senate - 2000                                  SB 1610
    37-869-00




  1  condition. The court may appoint a master to preside at the

  2  hearing. The client or the client's guardian, and the

  3  representative, shall be provided with a copy of the petition

  4  and the date, time, and location of the hearing. The client

  5  has the right to have an attorney represent him or her at the

  6  hearing, and, if the client is indigent, the court shall

  7  appoint the office of the public defender to represent the

  8  client at the hearing.  The client may testify or not, as he

  9  or she chooses, and has the right to cross-examine witnesses

10  and may present his or her own witnesses.

11         Section 2.  This act shall take effect upon becoming a

12  law.

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15                          SENATE SUMMARY

16    Requires a hearing and court order when a forensic client
      of the Department of Children and Family Services refuses
17    treatment with psychotropic medications or when a client
      is newly admitted to a forensic facility. Requires a
18    rehearing if the client is found to need additional
      medication. Limits the effective period of such an order
19    to 6 months.

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