HB 0463

CS

CHAMBER ACTION

1	The Committee on Judiciary recommends the following:
2
3	Committee Substitute
4	Remove the entire bill and insert:
5	A bill to be entitled
6	An act relating to mental health; amending s. 394.455,
7	F.S.; revising a definition; providing additional
8	definitions of terms used in pt. I of ch. 394, F.S., "The
9	Baker Act"; amending s. 394.4574, F.S.; including mental
10	health counselors among certain professionals required to
11	assess certain mental health residents; amending s.
12	394.4598, F.S.; revising language with respect to the
13	guardian advocate; providing for discharge under certain
14	circumstances; amending s. 394.4615, F.S.; providing for
15	release of certain clinical records to certain persons for
16	certain purposes; amending s. 394.463, F.S.; revising
17	criteria and procedures for involuntary examination;
18	creating s. 394.4655, F.S.; providing criteria and
19	procedures for involuntary outpatient placement; providing
20	for a voluntary examination for outpatient placement;
21	providing for a petition for involuntary outpatient
22	placement; providing for appointment of counsel; providing
23	for continuance of hearings; providing for a hearing on
24	involuntary outpatient placement; setting forth procedures
25	for the hearing; providing for appointment of a master to
26	preside; providing for an independent examination;
27	requiring a court to order involuntary outpatient
28	placement under certain circumstances; requiring a
29	treatment plan; providing for plan modification; providing
30	for a patient to be brought to a receiving facility upon
31	failure or refusal to comply with the treatment plan;
32	requiring attachment of a copy of the treatment plan to a
33	petition; providing for involuntary inpatient placement or
34	involuntary assessment; requiring consideration of a
35	patient's competence to proceed; requiring a list of
36	guardian advocates to be submitted to the court; defining
37	the role of a guardian advocate; providing for discharge
38	of the guardian advocate; requiring certain documentation;
39	allowing a person for whom an involuntary outpatient
40	placement petition has been filed to agree to a voluntary
41	treatment agreement; specifying requirements for
42	agreements; providing for modifications; providing for
43	filing of an affidavit of noncompliance with a voluntary
44	treatment plan; requiring a hearing; requiring dismissal
45	of petitions in certain circumstances; providing
46	procedures for continued involuntary outpatient placement;
47	providing for a continued involuntary outpatient placement
48	certificate; requiring a hearing; requiring appointment of
49	a public defender; requiring hearings; providing for
50	appointment of a special master; authorizing a patient and
51	the patient's attorney to agree to a period of continued
52	outpatient placement without a court hearing; amending s.
53	394.467, F.S.; revising language with respect to
54	involuntary inpatient placement to conform to changes made
55	by the act; revising requirements for evaluation and
56	placement; amending ss. 394.495, 394.496, 394.498,
57	419.001, and 744.704, F.S.; correcting cross references;
58	authorizing the Department of Children and Family Services
59	to adopt rules; providing severability; providing an
60	effective date.
61
62	Be It Enacted by the Legislature of the State of Florida:
63
64	Section 1.  Subsection (3) of section 394.455, Florida
65	Statutes, is amended, present subsection (16) of said section is
66	renumbered as subsection (18), present subsections (17) through
67	(28) of said section are renumbered as subsections (20) through
68	(31), respectively, existing subsections (29) and (30) are
69	renumbered as subsections (33) and (34), respectively, and new
70	subsections (16), (17), (19), and (32) are added to said
71	section, to read:
72	394.455  Definitions.--As used in this part, unless the
73	context clearly requires otherwise, the term:
74	(3)  "Clinical record" means all parts of the record
75	required to be maintained and includes all medical records,
76	progress notes, charts, and admission and discharge data, and
77	all other information recorded by a facility which pertains to
78	the patient's hospitalization or and treatment.
79	(16)  "Involuntary examination" means an examination
80	performed under s. 394.463 to determine if an individual
81	qualifies for involuntary inpatient treatment under s.
82	394.467(1) or involuntary outpatient treatment under s.
83	394.4655(1).
84	(17)  "Involuntary placement" means involuntary outpatient
85	treatment pursuant to s. 394.4655 or involuntary inpatient
86	treatment pursuant to s. 394.467.
87	(19)  "Mental health counselor" means a person licensed as
88	a mental health counselor under chapter 491.
89	(32)  "Service provider" means any public or private
90	receiving facility, an entity under contract with the Department
91	of Children and Family Services to provide mental health
92	services, a clinical psychologist, a clinical social worker, a
93	mental health counselor, a physician, a psychiatric nurse, or a
94	community mental health center or clinic as defined in this
95	part.
96	Section 2.  Paragraph (a) of subsection (2) of section
97	394.4574, Florida Statutes, is amended to read:
98	394.4574  Department responsibilities for a mental health
99	resident who resides in an assisted living facility that holds a
100	limited mental health license.--
101	(2)  The department must ensure that:
102	(a)  A mental health resident has been assessed by a
103	psychiatrist, clinical psychologist, clinical social worker,
104	mental health counselor, or psychiatric nurse, or an individual
105	who is supervised by one of these professionals, and determined
106	to be appropriate to reside in an assisted living facility. The
107	documentation must be provided to the administrator of the
108	facility within 30 days after the mental health resident has
109	been admitted to the facility. An evaluation completed upon
110	discharge from a state mental hospital meets the requirements of
111	this subsection related to appropriateness for placement as a
112	mental health resident if it was completed within 90 days prior
113	to admission to the facility.
114	Section 3.  Subsections (1) and (7) of section 394.4598,
115	Florida Statutes, are amended to read:
116	394.4598  Guardian advocate.--
117	(1)  The administrator may petition the court for the
118	appointment of a guardian advocate based upon the opinion of a
119	psychiatrist that the patient is incompetent to consent to
120	treatment. If the court finds that a patient is incompetent to
121	consent to treatment and has not been adjudicated incapacitated
122	and a guardian with the authority to consent to mental health
123	treatment appointed, it shall appoint a guardian advocate. The
124	patient has the right to have an attorney represent him or her
125	at the hearing. If the person is indigent, the court shall
126	appoint the office of the public defender to represent him or
127	her at the hearing. The patient has the right to testify, cross-
128	examine witnesses, and present witnesses. The proceeding shall
129	be recorded either electronically or stenographically, and
130	testimony shall be provided under oath. One of the professionals
131	authorized to give an opinion in support of a petition for
132	involuntary placement, as described in s. 394.4655 or s.
133	394.467(2), must testify. A guardian advocate must meet the
134	qualifications of a guardian contained in part IV of chapter
135	744, except that a professional referred to in this part, an
136	employee of the facility providing direct services to the
137	patient under this part, a departmental employee, a facility
138	administrator, or member of the Florida local advocacy council
139	shall not be appointed. A person who is appointed as a guardian
140	advocate must agree to the appointment.
141	(7)  The guardian advocate shall be discharged when the
142	patient is discharged from an order for involuntary outpatient
143	placement or involuntary inpatient placement a receiving or
144	treatment facility to the community or when the patient is
145	transferred from involuntary to voluntary status. The court or a
146	hearing officer shall consider the competence of the patient
147	pursuant to subsection (1) and may consider an involuntarily
148	placed patient's competence to consent to treatment at any
149	hearing. Upon sufficient evidence, the court may restore, or the
150	hearing officer may recommend that the court restore, the
151	patient's competence. A copy of the order restoring competence
152	or the certificate of discharge containing the restoration of
153	competence shall be provided to the patient and the guardian
154	advocate.
155	Section 4.  Subsection (3) of section 394.4615, Florida
156	Statutes, is amended to read:
157	394.4615  Clinical records; confidentiality.--
158	(3)  Information from the clinical record may be released
159	under the following circumstances when:
160	(a)  When a patient has declared an intention to harm other
161	persons. When such declaration has been made, the administrator
162	may authorize the release of sufficient information to provide
163	adequate warning to the person threatened with harm by the
164	patient.
165	(b)  When the administrator of the facility or secretary of
166	the department deems release to a qualified researcher as
167	defined in administrative rule, an aftercare treatment provider,
168	or an employee or agent of the department is necessary for
169	treatment of the patient, maintenance of adequate records,
170	compilation of treatment data, aftercare planning, or evaluation
171	of programs.
172	(c)  For the purpose of determining whether a person meets
173	the criteria for involuntary outpatient placement or for
174	preparing the proposed treatment plan pursuant to s. 394.4655,
175	the clinical record may be released to the state attorney, the
176	public defender, or the patient's private legal counsel; to the
177	court; and to the appropriate mental health professionals,
178	including the service provider identified in s.
179	394.4655(6)(b)2., in accordance with state and federal law.
180	Section 5.  Subsection (1) and paragraphs (a), (e), (g),
181	and (i) of subsection (2) of section 394.463, Florida Statutes,
182	are amended to read:
183	394.463  Involuntary examination.--
184	(1)  CRITERIA.--A person may be taken to a receiving
185	facility for involuntary examination if there is reason to
186	believe that the person has a mental illness he or she is
187	mentally ill and because of his or her mental illness:
188	(a)1.  The person has refused voluntary examination after
189	conscientious explanation and disclosure of the purpose of the
190	examination; or
191	2.  The person is unable to determine for himself or
192	herself whether examination is necessary; and
193	(b)  Based upon the person's current reported or observed
194	behavior, considering any mental health history, there is a
195	substantial likelihood that without care or treatment:
196	1.  Without care or treatment, The person will is likely to
197	suffer from neglect or refuse to care for himself or herself;
198	such neglect or refusal will pose poses a real and present
199	threat of substantial harm to his or her well-being; and it is
200	not apparent that such harm may be avoided through the help of
201	willing family members or friends or the provision of other
202	services; or
203	2.  There is a substantial likelihood that without care or
204	treatment The person will cause serious bodily harm to himself
205	or herself or others in the near future, as evidenced by recent
206	behavior.
207	(2)  INVOLUNTARY EXAMINATION.--
208	(a)  An involuntary examination may be initiated by any one
209	of the following means:
210	1.  A court may enter an ex parte order stating that a
211	person appears to meet the criteria for involuntary examination,
212	giving the findings on which that conclusion is based. The ex
213	parte order for involuntary examination must be based on sworn
214	testimony, written or oral. If other less restrictive means are
215	not available, such as voluntary appearance for outpatient
216	evaluation, a law enforcement officer, or other designated agent
217	of the court, shall take the person into custody and deliver him
218	or her to the nearest receiving facility for involuntary
219	examination. The order of the court shall be made a part of the
220	patient's clinical record. No fee shall be charged for the
221	filing of an order under this subsection. Any receiving facility
222	accepting the patient based on this order must send a copy of
223	the order to the Agency for Health Care Administration on the
224	next working day. The order shall be valid only until executed
225	or, if not executed, for the period specified in the order
226	itself. If no time limit is specified in the order, the order
227	shall be valid for 7 days after the date that the order was
228	signed.
229	2.  A law enforcement officer shall take a person who
230	appears to meet the criteria for involuntary examination into
231	custody and deliver the person or have him or her delivered to
232	the nearest receiving facility for examination. The officer
233	shall execute a written report detailing the circumstances under
234	which the person was taken into custody, and the report shall be
235	made a part of the patient's clinical record. Any receiving
236	facility accepting the patient based on this report must send a
237	copy of the report to the Agency for Health Care Administration
238	on the next working day.
239	3.  A physician, clinical psychologist, psychiatric nurse,
240	mental health counselor, or clinical social worker may execute a
241	certificate stating that he or she has examined a person within
242	the preceding 48 hours and finds that the person appears to meet
243	the criteria for involuntary examination and stating the
244	observations upon which that conclusion is based. If other less
245	restrictive means are not available, such as voluntary
246	appearance for outpatient evaluation, a law enforcement officer
247	shall take the person named in the certificate into custody and
248	deliver him or her to the nearest receiving facility for
249	involuntary examination. The law enforcement officer shall
250	execute a written report detailing the circumstances under which
251	the person was taken into custody. The report and certificate
252	shall be made a part of the patient's clinical record. Any
253	receiving facility accepting the patient based on this
254	certificate must send a copy of the certificate to the Agency
255	for Health Care Administration on the next working day.
256	(e)  The Agency for Health Care Administration shall
257	receive and maintain the copies of ex parte orders, involuntary
258	outpatient placement orders issued pursuant to s. 394.4655,
259	involuntary inpatient orders issued pursuant to s. 394.467,
260	professional certificates, and law enforcement officers'
261	reports. These documents shall be considered part of the
262	clinical record, governed by the provisions of s. 394.4615. The
263	agency shall prepare annual reports analyzing the data obtained
264	from these documents, without information identifying patients,
265	and shall provide copies of reports to the department, the
266	President of the Senate, the Speaker of the House of
267	Representatives, and the minority leaders of the Senate and the
268	House of Representatives.
269	(g)  A person for whom an involuntary examination has been
270	initiated who is being evaluated or treated at a hospital for an
271	emergency medical condition specified in s. 395.002 must be
272	examined by a receiving facility within 72 hours. The 72-hour
273	period begins when the patient arrives at the hospital and
274	ceases when the attending physician documents that the patient
275	has an emergency medical condition. If the patient is examined
276	at a hospital providing emergency medical services by a
277	professional qualified to perform an involuntary examination and
278	is found as a result of that examination not to meet the
279	criteria for involuntary outpatient placement pursuant to s.
280	394.4655(1) or involuntary inpatient placement pursuant to s.
281	394.467(1), the patient may be offered voluntary placement, if
282	appropriate, or released directly from the hospital providing
283	emergency medical services. The finding by the professional that
284	the patient has been examined and does not meet the criteria for
285	involuntary inpatient or involuntary outpatient placement must
286	be entered into the patient's clinical record. Nothing in this
287	paragraph is intended to prevent a hospital providing emergency
288	medical services from appropriately transferring a patient to
289	another hospital prior to stabilization, provided the
290	requirements of s. 395.1041(3)(c) have been met.
291	(i)  Within the 72-hour examination period or, if the 72
292	hours ends on a weekend or holiday, no later than the next
293	working day thereafter, one of the following actions must be
294	taken, based on the individual needs of the patient:
295	1.  The patient shall be released, unless he or she is
296	charged with a crime, in which case the patient shall be
297	returned to the custody of a law enforcement officer;
298	2.  The patient shall be released, subject to the
299	provisions of subparagraph 1., for voluntary outpatient
300	treatment;
301	3.  The patient, unless he or she is charged with a crime,
302	shall be asked to give express and informed consent to placement
303	as a voluntary patient, and, if such consent is given, the
304	patient shall be admitted as a voluntary patient; or
305	4.  If treatment is deemed necessary and the patient has
306	failed to consent to voluntary inpatient or outpatient
307	treatment, a petition for involuntary placement must shall be
308	filed in the circuit appropriate court. The petition must seek
309	involuntary placement of the patient in by the facility
310	administrator when treatment is deemed necessary; in which case,
311	the least restrictive treatment consistent with the optimum
312	improvement of the patient's condition. A petition for
313	involuntary outpatient placement shall be filed by one of the
314	petitioners specified in s. 394.4655(3)(a). A petition for
315	involuntary inpatient placement shall be filed by the facility
316	administrator shall be made available.
317	Section 6.  Section 394.4655, Florida Statutes, is created
318	to read:
319	394.4655  Involuntary outpatient placement.--
320	(1)  CRITERIA FOR INVOLUNTARY OUTPATIENT PLACEMENT.--A
321	person may be ordered to involuntary outpatient placement upon a
322	finding of the court that, by clear and convincing evidence:
323	(a)  The person is 18 years of age or older.
324	(b)  The person has a mental illness.
325	(c)  The person is unlikely to survive safely in the
326	community without supervision, based on a clinical
327	determination.
328	(d)  The person has a history of lack of compliance with
329	treatment for mental illness.
330	(e)  The person has:
331	1.  At least twice within the preceding 36 months been
332	involuntarily admitted to a receiving or treatment facility as
333	defined in s. 394.455 or has received mental health services in
334	a forensic or correctional facility. The 36-month period does
335	not include any period during which the person was admitted or
336	incarcerated; or
337	2.  Engaged in one or more acts of serious violent behavior
338	toward himself or herself or others, or attempts at serious
339	bodily harm to himself or herself or others, within the
340	preceding 36 months.
341	(f)  The person is, as a result of his or her mental
342	illness, unlikely to voluntarily participate in the recommended
343	treatment pursuant to the treatment plan.
344	(g)  In view of the person's treatment history and current
345	behavior, the person is in need of involuntary outpatient
346	placement in order to prevent a relapse or deterioration that
347	would be likely to result in serious bodily harm to himself or
348	herself or others, or a substantial harm to his or her well-
349	being as set forth in s. 394.463(1).
350	(h)  It is likely that the person will benefit from
351	involuntary outpatient placement.
352	(i)  All available less restrictive alternatives that would
353	offer an opportunity for improvement of his or her condition
354	have been judged to be inappropriate or unavailable.
355	(2)  INVOLUNTARY OUTPATIENT PLACEMENT.--
356	(a)  From a receiving facility.--A patient may be retained
357	by a receiving facility upon the recommendation of the
358	administrator of a receiving facility where the patient has been
359	examined and after adherence to the notice and hearing
360	procedures provided in s. 394.4599. The recommendation must be
361	supported by the opinion of a psychiatrist and the second
362	opinion of a clinical psychologist or another psychiatrist, both
363	of whom have personally examined the patient within the
364	preceding 72 hours, that the criteria for involuntary outpatient
365	placement are met. However, in a county having a population of
366	less than 50,000, if the administrator certifies that no
367	psychiatrist or clinical psychologist is available to provide
368	the second opinion, such second opinion may be provided by a
369	licensed physician who has postgraduate training and experience
370	in diagnosis and treatment of mental and nervous disorders or by
371	a psychiatric nurse. Such recommendation must be entered on an
372	involuntary outpatient placement certificate, which certificate
373	must authorize the receiving facility to retain the patient
374	pending completion of a hearing. If the patient has been
375	stabilized and no longer meets the criteria for involuntary
376	examination pursuant to s. 394.463(1), the patient must be
377	released from the receiving facility while awaiting the hearing
378	for involuntary outpatient placement.
379	(b)  Voluntary examination for outpatient placement.--A
380	patient may choose to be examined on an outpatient basis for an
381	involuntary outpatient placement certificate if such an
382	arrangement can be made. The certificate must be supported by
383	the opinion of a psychiatrist and the second opinion of a
384	clinical psychologist or another psychiatrist, both of whom have
385	personally examined the patient within the preceding 7 calendar
386	days, that the criteria for involuntary outpatient placement are
387	met. However, in a county having a population of less than
388	50,000, if the psychiatrist certifies that no psychiatrist or
389	clinical psychologist is available to provide the second
390	opinion, the second opinion may be provided by a licensed
391	physician who has postgraduate training and experience in
392	diagnosis and treatment of mental and nervous disorders or by a
393	psychiatric nurse.
394	(c)  From a treatment facility.--If a patient in
395	involuntary inpatient placement meets the criteria for
396	involuntary outpatient placement, the administrator of the
397	treatment facility may, before expiration of the period during
398	which the treatment facility is authorized to retain the
399	patient, recommend involuntary outpatient placement. The
400	recommendation must be supported by the opinion of a
401	psychiatrist and the second opinion of a clinical psychologist
402	or another psychiatrist, both of whom have personally examined
403	the patient within the preceding 72 hours, that the criteria for
404	involuntary outpatient placement are met. However, in a county
405	having a population of less than 50,000, if the administrator
406	certifies that no psychiatrist or clinical psychologist is
407	available to provide the second opinion, such second opinion may
408	be provided by a licensed physician with postgraduate training
409	and experience in diagnosis and treatment of mental and nervous
410	disorders or by a psychiatric nurse. Such recommendation must be
411	entered on an involuntary outpatient placement certificate.
412	(3)  PETITION FOR INVOLUNTARY OUTPATIENT PLACEMENT.--
413	(a)  A petition for involuntary outpatient placement may be
414	filed by:
415	1.  The administrator of the facility pursuant to paragraph
416	(2)(a);
417	2.  One of the examining professionals for persons examined
418	on a voluntary outpatient basis pursuant to paragraph (2)(b).
419	Upon filing the petition, the examining professional shall
420	provide a copy of the petition to the administrator of the
421	receiving facility or designated department representative that
422	will identify the service provider for the involuntary
423	outpatient placement unless the person is otherwise
424	participating in outpatient psychiatric treatment and is not in
425	need of public financing for that treatment, in which case the
426	person, if eligible, may be involuntarily committed to the
427	existing psychiatric treatment relationship; or
428	3.  The administrator of a treatment facility pursuant to
429	paragraph (2)(c). Upon filing the petition, the administrator
430	shall provide a copy of the petition to the administrator of the
431	receiving facility or designated department representative that
432	will identify the service provider for the involuntary
433	outpatient placement unless the person is otherwise
434	participating in outpatient psychiatric treatment and is not in
435	need of public financing for that treatment, in which case the
436	person, if eligible, may be involuntarily committed to the
437	existing psychiatric treatment relationship.
438	(b)  Each required criterion for involuntary outpatient
439	placement must be alleged and substantiated in the petition for
440	involuntary outpatient placement. A copy of the certificate
441	recommending involuntary outpatient placement completed by a
442	qualified professional specified in subsection (2) shall be
443	attached to the petition. A copy of the treatment plan specified
444	in subparagraph (6)(b)2. must be attached to the petition. At
445	the time the petition is filed, the service provider shall
446	certify that the services in the proposed treatment plan are
447	available. If the necessary services are not available in the
448	patient's local community to respond to the person's individual
449	needs, the petition may not be filed.
450	(c)  The petition for involuntary outpatient placement must
451	be filed in the county in which the patient is located. When the
452	petition has been filed, the clerk of the court shall provide
453	copies of the petition and the proposed treatment plan to the
454	department, the patient, the patient's guardian or
455	representative, and the state attorney and public defender of
456	the judicial circuit in which the patient is located. A fee may
457	not be charged for the filing of a petition under this
458	subsection.
459	(4)  APPOINTMENT OF COUNSEL.--Within 1 court working day
460	after the filing of a petition for involuntary outpatient
461	placement, the court shall appoint the public defender to
462	represent the person who is the subject of the petition, unless
463	the person is otherwise represented by counsel. The clerk of the
464	court shall immediately notify the public defender of such
465	appointment. The public defender shall represent the person
466	until the petition is dismissed, the court order expires, or the
467	patient is discharged from involuntary outpatient placement. An
468	attorney who represents the patient shall have access to the
469	patient, witnesses, and records relevant to the presentation of
470	the patient's case and shall represent the interests of the
471	patient, regardless of the source of payment to the attorney.
472	(5)  CONTINUANCE OF HEARING.--The patient is entitled, with
473	the concurrence of the patient's counsel, to at least one
474	continuance of the hearing. The continuance shall be for a
475	period of up to 4 weeks.
476	(6)  HEARING ON INVOLUNTARY OUTPATIENT PLACEMENT.--
477	(a)1.  The court shall hold the hearing on involuntary
478	outpatient placement within 5 days after the petition is filed,
479	unless a continuance is granted. The hearing shall be held in
480	the county in which the patient is located, shall be as
481	convenient to the patient as is consistent with orderly
482	procedure, and shall be conducted in physical settings not
483	likely to be injurious to the patient's condition. If the court
484	finds that the patient's attendance at the hearing is not
485	consistent with the best interests of the patient and the
486	patient's counsel does not object, the court may waive the
487	presence of the patient from all or any portion of the hearing.
488	The state attorney for the circuit in which the patient is
489	located shall represent the state, rather than the petitioner,
490	as the real party in interest in the proceeding.
491	2.  The court may appoint a master to preside at the
492	hearing. One of the professionals who executed the involuntary
493	outpatient placement certificate shall be a witness. The patient
494	and the patient's guardian or representative shall be informed
495	by the court of the right to an independent expert examination.
496	If the patient cannot afford such an examination, the court
497	shall provide for one. The independent expert's report shall be
498	confidential and not discoverable, unless the expert is to be
499	called as a witness for the patient at the hearing. The court
500	shall allow testimony from individuals, including family
501	members, deemed by the court to be relevant under state law,
502	regarding the person's prior history and how that prior history
503	relates to the person's current condition. The testimony in the
504	hearing must be given under oath and the proceedings must be
505	recorded. The patient may refuse to testify at the hearing.
506	(b)1.  If the court concludes that the patient meets the
507	criteria for involuntary outpatient placement pursuant to
508	subsection (1), the court shall issue an order for involuntary
509	outpatient placement. The court order shall be for a period of
510	up to 6 months. The service provider shall discharge a patient
511	from involuntary outpatient treatment any time the patient no
512	longer meets the criteria for involuntary placement.
513	2.  The administrator of a receiving facility or a
514	designated department representative shall identify the service
515	provider that will have primary responsibility for service
516	provision under the order. The service provider shall prepare a
517	written proposed treatment plan and submit the plan to the court
518	before the hearing for the court's consideration for inclusion
519	in the involuntary outpatient placement order. The service
520	provider shall also provide a copy of the proposed treatment
521	plan to the petitioner. The treatment plan must specify the
522	nature and extent of the patient's mental illness. The treatment
523	plan may include provisions for case management, intensive case
524	management, or assertive community treatment. The treatment plan
525	may also require that the patient make use of a service provider
526	to supply any of the following categories of services to the
527	individual: medication, periodic urinalysis to determine
528	compliance with treatment, individual or group therapy, day or
529	partial-day programming activities, educational and vocational
530	training or activities, alcohol or substance abuse treatment and
531	counseling and periodic tests for the presence of alcohol or
532	illegal drugs for persons with a history of alcohol or substance
533	abuse, supervision of living arrangements, and any other
534	services prescribed to treat the person's mental illness and to
535	assist the person in living and functioning in the community or
536	to attempt to prevent a relapse or deterioration. Service
537	providers may select and provide supervision to other
538	individuals, not enumerated in this subparagraph, to implement
539	specific aspects of the treatment plan, such as medication
540	monitoring. The services in the treatment plan shall be deemed
541	to be clinically appropriate by a physician, clinical
542	psychologist, mental health counselor, psychiatric nurse, or
543	clinical social worker who consults with, or is employed or
544	contracted by, the service provider. The service provider must
545	certify to the court in the proposed treatment plan whether
546	sufficient services for improvement and stabilization are
547	currently available and whether the service provider agrees to
548	provide those services. If the service provider certifies that
549	the services in the proposed treatment plan are not available,
550	the petitioner shall withdraw the petition. The court may not
551	order the department or the service provider to provide services
552	if the program or service is not available in the patient's
553	local community, there is no space available in the program or
554	service for the patient, or funding is not available for the
555	program or service. A copy of the order must be sent to the
556	Agency for Health Care Administration by the service provider
557	within 1 working day after the order is received from the court.
558	After the placement order is issued, the service provider and
559	the patient may modify provisions of the treatment plan. For any
560	material modification of the treatment plan to which the patient
561	or the patient's guardian advocate, if appointed, does agree,
562	the service provider shall send notice of the modification to
563	the court. Any material modification of the treatment plan that
564	is contested by the patient or the patient's guardian advocate,
565	if appointed, must be in writing and prepared by the service
566	provider or administrator for approval by the court.
567	3.  If, in the clinical judgment of a physician, the
568	patient has failed or refused to comply with the treatment
569	ordered by the court and, in the clinical judgment of the
570	physician, efforts were made to solicit compliance and the
571	patient may meet the criteria for involuntary examination, a
572	person may be brought to a receiving facility pursuant to s.
573	394.463. If, after examination, the patient does not meet the
574	criteria for involuntary inpatient placement pursuant to s.
575	394.467, the patient must be discharged from the receiving
576	facility. The service provider must determine whether
577	modifications should be made to the existing treatment plan and
578	must attempt to continue to engage the patient in treatment. For
579	any material modification of the treatment plan to which the
580	patient or the patient's guardian advocate, if appointed, does
581	agree, the service provider shall send notice of the
582	modification to the court. Any material modification of the
583	treatment plan that is contested by the patient or the patient's
584	guardian advocate, if appointed, must be approved by the court.
585	(c)  If, at any time before the conclusion of the initial
586	hearing on involuntary outpatient placement, it appears to the
587	court that the person does not meet the criteria for involuntary
588	outpatient placement under this section but instead meets the
589	criteria for involuntary inpatient placement, the court may
590	order the person admitted for involuntary examination pursuant
591	to s. 394.463. If the person instead meets the criteria for
592	involuntary assessment, protective custody, or involuntary
593	admission pursuant to s. 397.675, the court may order the person
594	to be admitted for involuntary assessment for a period of 5 days
595	pursuant to s. 397.6811. Thereafter, all proceedings shall be
596	governed by chapter 397.
597	(d)  At the hearing on involuntary outpatient placement,
598	the court shall consider testimony and evidence regarding the
599	patient's competence to consent to treatment. If the court finds
600	that the patient is incompetent to consent to treatment, the
601	court shall appoint a guardian advocate as provided in s.
602	394.4598. The guardian advocate shall be appointed or discharged
603	in accordance with s. 394.4598.
604	(e)  The administrator of the receiving facility or the
605	designated department representative shall provide a copy of the
606	court order and adequate documentation of a patient's mental
607	illness to the service provider for involuntary outpatient
608	placement. Such documentation must include any advance
609	directives made by the patient, a psychiatric evaluation of the
610	patient, and any evaluations of the patient performed by a
611	clinical psychologist, a mental health counselor, or a clinical
612	social worker.
613	(7)  PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT
614	PLACEMENT.--
615	(a)  If the person continues to meet the criteria for
616	involuntary outpatient placement, the service provider shall,
617	before expiration of the period during which the treatment is
618	ordered for the person, file in the circuit court a continued
619	involuntary outpatient placement certificate which shall be
620	accompanied by a statement from the person's physician or
621	clinical psychologist justifying the request, a brief
622	description of the patient's treatment during the time he or she
623	was involuntarily placed, and an individualized plan of
624	continued treatment.
625	(b)  Within 1 court working day after the filing of a
626	petition for continued involuntary outpatient placement, the
627	court shall appoint the public defender to represent the person
628	who is the subject of the petition, unless the person is
629	otherwise represented by counsel. The clerk of the court shall
630	immediately notify the public defender of such appointment. The
631	public defender shall represent the person until the petition is
632	dismissed, the court order expires, or the patient is discharged
633	from involuntary outpatient placement. Any attorney representing
634	the patient shall have access to the patient, witnesses, and
635	records relevant to the presentation of the patient's case and
636	shall represent the interests of the patient, regardless of the
637	source of payment to the attorney.
638	(c)  Hearings on petitions for continued involuntary
639	outpatient placement shall be before the circuit court. The
640	court may appoint a master to preside at the hearing. The
641	procedures for obtaining an order pursuant to this paragraph
642	shall be in accordance with the provisions of subsection (6),
643	except that the time period included in paragraph (1)(e) is not
644	applicable in determining the appropriateness of additional
645	periods of involuntary outpatient placement.
646	(d)  Notice of the hearing shall be provided as set forth
647	in s. 394.4599. The patient and the patient's attorney may agree
648	to a period of continued outpatient placement without a court
649	hearing.
650	(e)  The same procedure shall be repeated prior to the
651	expiration of each additional period the patient is placed in
652	treatment.
653	(f)  If the patient has been previously found incompetent
654	to consent to treatment, the court shall consider testimony and
655	evidence regarding the patient's competence. Section 394.4598
656	governs the discharge of the guardian advocate if the patient's
657	competency to consent to treatment is restored.
658	Section 7.  Section 394.467, Florida Statutes, is amended
659	to read:
660	394.467  Involuntary inpatient placement.--
661	(1)  CRITERIA.--A person may be involuntarily placed in
662	involuntary inpatient placement for treatment upon a finding of
663	the court by clear and convincing evidence that:
664	(a)  He or she is mentally ill and because of his or her
665	mental illness:
666	1.a.  He or she has refused voluntary placement for
667	treatment after sufficient and conscientious explanation and
668	disclosure of the purpose of placement for treatment; or
669	b.  He or she is unable to determine for himself or herself
670	whether placement is necessary; and
671	2.a.  He or she is manifestly incapable of surviving alone
672	or with the help of willing and responsible family or friends,
673	including available alternative services, and, without
674	treatment, is likely to suffer from neglect or refuse to care
675	for himself or herself, and such neglect or refusal poses a real
676	and present threat of substantial harm to his or her well-being;
677	or
678	b.  There is substantial likelihood that in the near future
679	he or she will inflict serious bodily harm on himself or herself
680	or another person, as evidenced by recent behavior causing,
681	attempting, or threatening such harm; and
682	(b)  All available less restrictive treatment alternatives
683	which would offer an opportunity for improvement of his or her
684	condition have been judged to be inappropriate.
685	(2)  ADMISSION TO A TREATMENT FACILITY.--A patient may be
686	retained by a receiving facility or involuntarily placed in a
687	treatment facility upon the recommendation of the administrator
688	of a receiving facility where the patient has been examined and
689	after adherence to the notice and hearing procedures provided in
690	s. 394.4599. The recommendation must be supported by the opinion
691	of a psychiatrist and the second opinion of a clinical
692	psychologist or another psychiatrist, both of whom have
693	personally examined the patient within the preceding 72 hours,
694	that the criteria for involuntary inpatient placement are met.
695	However, in counties of less than 50,000 population, if the
696	administrator certifies that no psychiatrist or clinical
697	psychologist is available to provide the second opinion, such
698	second opinion may be provided by a licensed physician with
699	postgraduate training and experience in diagnosis and treatment
700	of mental and nervous disorders or by a psychiatric nurse. Such
701	recommendation shall be entered on an involuntary inpatient
702	placement certificate, which certificate shall authorize the
703	receiving facility to retain the patient pending transfer to a
704	treatment facility or completion of a hearing.
705	(3)  PETITION FOR INVOLUNTARY INPATIENT PLACEMENT.--The
706	administrator of the facility shall file a petition for
707	involuntary inpatient placement in the court in the county where
708	the patient is located. Upon filing, the clerk of the court
709	shall provide copies to the department, the patient, the
710	patient's guardian or representative, and the state attorney and
711	public defender of the judicial circuit in which the patient is
712	located. No fee shall be charged for the filing of a petition
713	under this subsection.
714	(4)  APPOINTMENT OF COUNSEL.--Within 1 court working day
715	after the filing of a petition for involuntary inpatient
716	placement, the court shall appoint the public defender to
717	represent the person who is the subject of the petition, unless
718	the person is otherwise represented by counsel. The clerk of the
719	court shall immediately notify the public defender of such
720	appointment. Any attorney representing the patient shall have
721	access to the patient, witnesses, and records relevant to the
722	presentation of the patient's case and shall represent the
723	interests of the patient, regardless of the source of payment to
724	the attorney.
725	(5)  CONTINUANCE OF HEARING.--The patient is entitled, with
726	the concurrence of the patient's counsel, to at least one
727	continuance of the hearing. The continuance shall be for a
728	period of up to 4 weeks.
729	(6)  HEARING ON INVOLUNTARY INPATIENT PLACEMENT.--
730	(a)1.  The court shall hold the hearing on involuntary
731	inpatient placement within 5 days, unless a continuance is
732	granted. The hearing shall be held in the county where the
733	patient is located and shall be as convenient to the patient as
734	may be consistent with orderly procedure and shall be conducted
735	in physical settings not likely to be injurious to the patient's
736	condition. If the court finds that the patient's attendance at
737	the hearing is not consistent with the best interests of the
738	patient, and the patient's counsel does not object, the court
739	may waive the presence of the patient from all or any portion of
740	the hearing. The state attorney for the circuit in which the
741	patient is located shall represent the state, rather than the
742	petitioning facility administrator, as the real party in
743	interest in the proceeding.
744	2.  The court may appoint a master to preside at the
745	hearing. One of the professionals who executed the involuntary
746	inpatient placement certificate shall be a witness. The patient
747	and the patient's guardian or representative shall be informed
748	by the court of the right to an independent expert examination.
749	If the patient cannot afford such an examination, the court
750	shall provide for one. The independent expert's report shall be
751	confidential and not discoverable, unless the expert is to be
752	called as a witness for the patient at the hearing. The
753	testimony in the hearing must be given under oath, and the
754	proceedings must be recorded. The patient may refuse to testify
755	at the hearing.
756	(b)  If the court concludes that the patient meets the
757	criteria for involuntary inpatient placement, it shall order
758	that the patient be transferred to a treatment facility or, if
759	the patient is at a treatment facility, that the patient be
760	retained there or be treated at any other appropriate receiving
761	or treatment facility, or that the patient receive services from
762	a receiving or treatment facility, on an involuntary basis, for
763	a period of up to 6 months. The order shall specify the nature
764	and extent of the patient's mental illness. The facility shall
765	discharge a patient any time the patient no longer meets the
766	criteria for involuntary inpatient placement, unless the patient
767	has transferred to voluntary status.
768	(c)  If at any time prior to the conclusion of the hearing
769	on involuntary inpatient placement it appears to the court that
770	the person does not meet the criteria for involuntary inpatient
771	placement under this section chapter, but instead meets the
772	criteria for involuntary outpatient placement, the court may
773	order the person evaluated for involuntary outpatient placement
774	pursuant to s. 394.4655. The petition and hearing procedures set
775	forth in s. 394.4655 shall apply. If the person instead meets
776	the criteria for involuntary assessment, protective custody, or
777	involuntary admission pursuant to s. 397.675, then the court may
778	order the person to be admitted for involuntary assessment for a
779	period of 5 days pursuant to s. 397.6811. Thereafter, all
780	proceedings shall be governed by chapter 397.
781	(d)  At the hearing on involuntary inpatient placement, the
782	court shall consider testimony and evidence regarding the
783	patient's competence to consent to treatment. If the court finds
784	that the patient is incompetent to consent to treatment, it
785	shall appoint a guardian advocate as provided in s. 394.4598.
786	(e)  The administrator of the receiving facility shall
787	provide a copy of the court order and adequate documentation of
788	a patient's mental illness to the administrator of a treatment
789	facility whenever a patient is ordered for involuntary inpatient
790	placement, whether by civil or criminal court. Such
791	documentation shall include any advance directives made by the
792	patient, a psychiatric evaluation of the patient, and any
793	evaluations of the patient performed by a clinical psychologist,
794	a mental health counselor, or a clinical social worker. The
795	administrator of a treatment facility may refuse admission to
796	any patient directed to its facilities on an involuntary basis,
797	whether by civil or criminal court order, who is not accompanied
798	at the same time by adequate orders and documentation.
799	(7)  PROCEDURE FOR CONTINUED INVOLUNTARY INPATIENT
800	PLACEMENT.--
801	(a)  Hearings on petitions for continued involuntary
802	inpatient placement shall be administrative hearings and shall
803	be conducted in accordance with the provisions of s. 120.57(1),
804	except that any order entered by the hearing officer shall be
805	final and subject to judicial review in accordance with s.
806	120.68. Orders concerning patients committed after successfully
807	pleading not guilty by reason of insanity shall be governed by
808	the provisions of s. 916.15.
809	(b)  If the patient continues to meet the criteria for
810	involuntary inpatient placement, the administrator shall, prior
811	to the expiration of the period during which the treatment
812	facility is authorized to retain the patient, file a petition
813	requesting authorization for continued involuntary inpatient
814	placement. The request shall be accompanied by a statement from
815	the patient's physician or clinical psychologist justifying the
816	request, a brief description of the patient's treatment during
817	the time he or she was involuntarily placed, and an
818	individualized plan of continued treatment. Notice of the
819	hearing shall be provided as set forth in s. 394.4599. If at the
820	hearing the hearing officer finds that attendance at the hearing
821	is not consistent with the best interests of the patient, the
822	hearing officer may waive the presence of the patient from all
823	or any portion of the hearing, unless the patient, through
824	counsel, objects to the waiver of presence. The testimony in the
825	hearing must be under oath, and the proceedings must be
826	recorded.
827	(c)  Unless the patient is otherwise represented or is
828	ineligible, he or she shall be represented at the hearing on the
829	petition for continued involuntary inpatient placement by the
830	public defender of the circuit in which the facility is located.
831	(d)  If at a hearing it is shown that the patient continues
832	to meet the criteria for involuntary inpatient placement, the
833	administrative law judge shall sign the order for continued
834	involuntary inpatient placement for a period not to exceed 6
835	months. The same procedure shall be repeated prior to the
836	expiration of each additional period the patient is retained.
837	(e)  If continued involuntary inpatient placement is
838	necessary for a patient admitted while serving a criminal
839	sentence, but whose sentence is about to expire, or for a
840	patient involuntarily placed while a minor but who is about to
841	reach the age of 18, the administrator shall petition the
842	administrative law judge for an order authorizing continued
843	involuntary inpatient placement.
844	(f)  If the patient has been previously found incompetent
845	to consent to treatment, the hearing officer shall consider
846	testimony and evidence regarding the patient's competence. If
847	the hearing officer finds evidence that the patient is now
848	competent to consent to treatment, the hearing officer may issue
849	a recommended order to the court that found the patient
850	incompetent to consent to treatment that the patient's
851	competence be restored and that any guardian advocate previously
852	appointed be discharged.
853	(8)  RETURN OF PATIENTS.--When a patient at a treatment
854	facility leaves the facility without authorization, the
855	administrator may authorize a search for the patient and the
856	return of the patient to the facility. The administrator may
857	request the assistance of a law enforcement agency in the search
858	for and return of the patient.
859	Section 8.  Paragraphs (a) and (c) of subsection (3) of
860	section 394.495, Florida Statutes, are amended to read:
861	394.495  Child and adolescent mental health system of care;
862	programs and services.--
863	(3)  Assessments must be performed by:
864	(a)  A professional as defined in s. 394.455(2), (4),
865	(24)(21), (26)(23), or (27)(24);
866	(c)  A person who is under the direct supervision of a
867	professional as defined in s. 394.455(2), (4), (24)(21),
868	(26)(23), or (27)(24) or a professional licensed under chapter
869	491.
870
871	The department shall adopt by rule statewide standards for
872	mental health assessments, which must be based on current
873	relevant professional and accreditation standards.
874	Section 9.  Subsection (6) of section 394.496, Florida
875	Statutes, is amended to read:
876	394.496  Service planning.--
877	(6)  A professional as defined in s. 394.455(2), (4),
878	(24)(21), (26)(23), or (27)(24) or a professional licensed under
879	chapter 491 must be included among those persons developing the
880	services plan.
881	Section 10.  Paragraphs (a) and (c) of subsection (4) of
882	section 394.498, Florida Statutes, are amended to read:
883	394.498  Child and Adolescent Interagency System of Care
884	Demonstration Models.--
885	(4)  ESSENTIAL ELEMENTS.--
886	(a)  In order to be approved as a Child and Adolescent
887	Interagency System of Care Demonstration Model, the applicant
888	must demonstrate its capacity to perform the following
889	functions:
890	1.  Form a consortium of purchasers, which includes at
891	least three of the following agencies:
892	a.  The Mental Health Program and Family Safety and
893	Preservation Program of the Department of Children and Family
894	Services.
895	b.  The Medicaid program of the Agency for Health Care
896	Administration.
897	c.  The local school district.
898	d.  The Department of Juvenile Justice.
899
900	Each agency that participates in the consortium shall enter into
901	a written interagency agreement that defines each agency's
902	responsibilities.
903	2.  Establish an oversight body that is responsible for
904	directing the demonstration model. The oversight body must
905	include representatives from the state agencies that comprise
906	the consortium of purchasers under subparagraph 1., as well as
907	local governmental entities, a juvenile court judge, parents,
908	and other community entities. The responsibilities of the
909	oversight body must be specified in writing.
910	3.  Select a target population of children and adolescents,
911	regardless of whether the child or adolescent is eligible or
912	ineligible for Medicaid, based on the following parameters:
913	a.  The child or adolescent has a serious emotional
914	disturbance or mental illness, as defined in s. 394.492(6),
915	based on an assessment conducted by a licensed practitioner
916	defined in s. 394.455(2), (4), (24)(21), (26)(23), or (27)(24)
917	or by a professional licensed under chapter 491;
918	b.  The total service costs per child or adolescent have
919	exceeded $3,000 per month;
920	c.  The child or adolescent has had multiple out-of-home
921	placements;
922	d.  The existing array of services does not effectively
923	meet the needs of the child or adolescent;
924	e.  The case of the child or adolescent has been staffed by
925	a district collaborative planning team and satisfactory results
926	have not been achieved through existing case services plans; and
927	f.  The parent or legal guardian of the child or adolescent
928	consents to participating in the demonstration model.
929	4.  Select a geographic site for the demonstration model. A
930	demonstration model may be comprised of one or more counties and
931	may include multiple service districts of the Department of
932	Children and Family Services.
933	5.  Develop a mechanism for selecting the pool of children
934	and adolescents who meet the criteria specified in this section
935	for participating in the demonstration model.
936	6.  Establish a pooled funding plan that allocates
937	proportionate costs to the purchasers. The plan must address all
938	of the service needs of the child or adolescent, and funds may
939	not be identified in the plan by legislative appropriation
940	category or any other state or federal funding category.
941	a.  The funding plan shall be developed based on an
942	analysis of expenditures made by each participating state agency
943	during the previous 2 fiscal years in which services were
944	provided for the target population or for individuals who have
945	characteristics that are similar to the target population.
946	b.  Based on the results of this cost analysis, funds shall
947	be collected from each of the participating state agencies and
948	deposited into a central financial account.
949	c.  A financial body shall be designated to manage the pool
950	of funds and shall have the capability to pay for individual
951	services specified in a services plan.
952	7.  Identify a care management entity that reports to the
953	oversight body. For purposes of the demonstration models, the
954	term "care management entity" means the entity that assumes
955	responsibility for the organization, planning, purchasing, and
956	management of mental health treatment services to the target
957	population in the demonstration model. The care management
958	entity may not provide direct services to the target population.
959	The care management entity shall:
960	a.  Manage the funds of the demonstration model within
961	budget allocations. The administrative costs associated with the
962	operation of the demonstration model must be itemized in the
963	entity's operating budget.
964	b.  Purchase individual services in a timely manner.
965	c.  Review the completed client assessment information and
966	complete additional assessments that are needed, including an
967	assessment of the strengths of the child or adolescent and his
968	or her family.
969	d.  Organize a child-family team to develop a single,
970	unified services plan for the child or adolescent, in accordance
971	with ss. 394.490-394.497. The team shall include the parents and
972	other family members of the child or adolescent, friends and
973	community-based supporters of the child or adolescent, and
974	appropriate service providers who are familiar with the problems
975	and needs of the child or adolescent and his or her family. The
976	plan must include a statement concerning the strengths of the
977	child or adolescent and his or her family, and must identify the
978	natural supports in the family and the community that might be
979	used in addressing the service needs of the child or adolescent.
980	A copy of the completed service plan shall be provided to the
981	parents of the child or adolescent.
982	e.  Identify a network of providers that meet the
983	requirements of paragraph (b).
984	f.  Identify informal, unpaid supporters, such as persons
985	from the child's or adolescent's neighborhood, civic
986	organizations, clubs, and churches.
987	g.  Identify additional service providers who can work
988	effectively with the child or adolescent and his or her family,
989	including, but not limited to, a home health aide, mentor,
990	respite care worker, and in-home behavioral health care worker.
991	h.  Implement a case management system that concentrates on
992	the strengths of the child or adolescent and his or her family
993	and uses these strengths in case planning and implementation
994	activities. The case manager is primarily responsible for
995	developing the services plan and shall report to the care
996	management entity. The case manager shall monitor and oversee
997	the services provided by the network of providers. The parents
998	must be informed about contacting the care management entity or
999	comparable entity to address concerns of the parents.
1000
1001	Each person or organization that performs any of the care
1002	management responsibilities specified in this subparagraph is
1003	responsible only to the care management entity. However, such
1004	care management responsibilities do not preclude the person or
1005	organization from performing other responsibilities for another
1006	agency or provider.
1007	8.  Develop a mechanism for measuring compliance with the
1008	goals of the demonstration models specified in subsection (2),
1009	which mechanism includes qualitative and quantitative
1010	performance outcomes, report on compliance rates, and conduct
1011	quality improvement functions. At a minimum, the mechanism for
1012	measuring compliance must include the outcomes and measures
1013	established in the General Appropriations Act and the outcomes
1014	and measures that are unique to the demonstration models.
1015	9.  Develop mechanisms to ensure that family
1016	representatives have a substantial role in planning the
1017	demonstration model and in designing the instrument for
1018	measuring the effectiveness of services provided.
1019	10.  Develop and monitor grievance procedures.
1020	11.  Develop policies to ensure that a child or adolescent
1021	is not rejected or ejected from the demonstration model because
1022	of a clinical condition or a specific service need.
1023	12.  Develop policies to require that a participating state
1024	agency remains a part of the demonstration model for its entire
1025	duration.
1026	13.  Obtain training for the staff involved in all aspects
1027	of the project.
1028	(c)  In order for children, adolescents, and families of
1029	children and adolescents to receive timely and effective
1030	services, the basic provider network identified in each
1031	demonstration model must be well designed and managed. The
1032	provider network should be able to meet the needs of a
1033	significant proportion of the target population. The applicant
1034	must demonstrate the capability to manage the network of
1035	providers for the purchasers that participate in the
1036	demonstration model. The applicant must demonstrate its ability
1037	to perform the following network management functions:
1038	1.  Identify providers within the designated area of the
1039	demonstration model which are currently funded by the state
1040	agencies included in the model, and identify additional
1041	providers that are needed to provide additional services for the
1042	target population. The network of providers may include:
1043	a.  Licensed mental health professionals as defined in s.
1044	394.455(2), (4), (24)(21), (26)(23), or (27)(24);
1045	b.  Professionals licensed under chapter 491;
1046	c.  Teachers certified under s. 1012.56;
1047	d.  Facilities licensed under chapter 395, as a hospital;
1048	s. 394.875, as a crisis stabilization unit or short-term
1049	residential facility; or s. 409.175, as a residential child-
1050	caring agency; and
1051	e.  Other community agencies.
1052	2.  Define access points and service linkages of providers
1053	in the network.
1054	3.  Define the ways in which providers and participating
1055	state agencies are expected to collaborate in providing
1056	services.
1057	4.  Define methods to measure the collective performance
1058	outcomes of services provided by providers and state agencies,
1059	measure the performance of individual agencies, and implement a
1060	quality improvement process across the provider network.
1061	5.  Develop brochures for family members which are written
1062	in understandable terminology, to help families identify
1063	appropriate service providers, choose the provider, and access
1064	care directly whenever possible.
1065	6.  Ensure that families are given a substantial role in
1066	planning and monitoring the provider network.
1067	7.  Train all providers with respect to the principles of
1068	care outlined in this section, including effective techniques of
1069	cooperation, the wraparound process and strengths-based
1070	assessment, the development of service plans, and techniques of
1071	case management.
1072	Section 11.  Paragraph (d) of subsection (1) of section
1073	419.001, Florida Statutes, is amended to read:
1074	419.001  Site selection of community residential homes.--
1075	(1)  For the purposes of this section, the following
1076	definitions shall apply:
1077	(d)  "Resident" means any of the following: a frail elder
1078	as defined in s. 400.618; a physically disabled or handicapped
1079	person as defined in s. 760.22(7)(a); a developmentally disabled
1080	person as defined in s. 393.063(12); a nondangerous mentally ill
1081	person as defined in s. 394.455(21)(18); or a child as defined
1082	in s. 39.01(14), s. 984.03(9) or (12), or s. 985.03(8).
1083	Section 12.  Subsection (7) of section 744.704, Florida
1084	Statutes, is amended to read:
1085	744.704  Powers and duties.--
1086	(7)  A public guardian shall not commit a ward to a mental
1087	health treatment facility, as defined in s. 394.455(34)(30),
1088	without an involuntary placement proceeding as provided by law.
1089	Section 13.  The Department of Children and Family Services
1090	may adopt any rules necessary to implement the provisions of ss.
1091	394.455, 394.4598, 394.4615, 394.463, and 394.467, Florida
1092	Statutes, as amended or created by this act. These rules shall
1093	be for the purpose of protecting the health, safety, and well-
1094	being of persons examined, treated, or placed under this act.
1095	Section 14.  If any provision of this act or its
1096	application to any person or circumstance is held invalid, the
1097	invalidity does not affect other provisions or applications of
1098	the act which can be given effect without the invalid provision
1099	or application, and to this end the provisions of this act are
1100	severable.
1101	Section 15.  This act shall take effect January 1, 2005.

CODING: Words stricken are deletions; words underlined are additions.