SENATE AMENDMENT
    Bill No. CS for CS for CS for CS for SB 700
    Amendment No. ___   Barcode 833622
                            CHAMBER ACTION
              Senate                               House
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       04/27/2004 11:52 AM         .                    
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11  Senators Peaden and Smith moved the following amendment:
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13         Senate Amendment (with title amendment) 
14         On page 5, line 4, through
15            page 8, line 6, delete those lines
16  
17  and insert:  
18         Section 4.  Subsection (1) and paragraphs (e), (g), and
19  (i) of subsection (2) of section 394.463, Florida Statutes,
20  are amended to read:
21         394.463  Involuntary examination.--
22         (1)  CRITERIA.--A person may be taken to a receiving
23  facility for involuntary examination if there is reason to
24  believe that the person has a mental illness he or she is
25  mentally ill and because of his or her mental illness:
26         (a)1.  The person has refused voluntary examination
27  after conscientious explanation and disclosure of the purpose
28  of the examination; or
29         2.  The person is unable to determine for himself or
30  herself whether examination is necessary; and
31         (b)1.  Without care or treatment, the person is likely
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    11:43 PM   04/26/04                             s0700c4c-02j32

SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 833622 1 to suffer from neglect or refuse to care for himself or 2 herself; such neglect or refusal poses a real and present 3 threat of substantial harm to his or her well-being; and it is 4 not apparent that such harm may be avoided through the help of 5 willing family members or friends or the provision of other 6 services; or 7 2. There is a substantial likelihood that without care 8 or treatment the person will cause serious bodily harm to 9 himself or herself or others in the near future, as evidenced 10 by recent behavior. 11 (2) INVOLUNTARY EXAMINATION.-- 12 (a) An involuntary examination may be initiated by any 13 one of the following means: 14 1. A court may enter an ex parte order stating that a 15 person appears to meet the criteria for involuntary 16 examination, giving the findings on which that conclusion is 17 based. The ex parte order for involuntary examination must be 18 based on sworn testimony, written or oral. If other less 19 restrictive means are not available, such as voluntary 20 appearance for outpatient evaluation, a law enforcement 21 officer, or other designated agent of the court, shall take 22 the person into custody and deliver him or her to the nearest 23 receiving facility for involuntary examination. The order of 24 the court shall be made a part of the patient's clinical 25 record. No fee shall be charged for the filing of an order 26 under this subsection. Any receiving facility accepting the 27 patient based on this order must send a copy of the order to 28 the Agency for Health Care Administration on the next working 29 day. The order shall be valid only until executed or, if not 30 executed, for the period specified in the order itself. If no 31 time limit is specified in the order, the order shall be valid 2 11:43 PM 04/26/04 s0700c4c-02j32
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 833622 1 for 7 days after the date that the order was signed. 2 2. A law enforcement officer shall take a person who 3 appears to meet the criteria for involuntary examination into 4 custody and deliver the person or have him or her delivered to 5 the nearest receiving facility for examination. The officer 6 shall execute a written report detailing the circumstances 7 under which the person was taken into custody, and the report 8 shall be made a part of the patient's clinical record. Any 9 receiving facility accepting the patient based on this report 10 must send a copy of the report to the Agency for Health Care 11 Administration on the next working day. 12 3. A physician, clinical psychologist, psychiatric 13 nurse, mental health counselor, or clinical social worker may 14 execute a certificate stating that he or she has examined a 15 person within the preceding 48 hours and finds that the person 16 appears to meet the criteria for involuntary examination and 17 stating the observations upon which that conclusion is based. 18 If other less restrictive means are not available, such as 19 voluntary appearance for outpatient evaluation, a law 20 enforcement officer shall take the person named in the 21 certificate into custody and deliver him or her to the nearest 22 receiving facility for involuntary examination. The law 23 enforcement officer shall execute a written report detailing 24 the circumstances under which the person was taken into 25 custody. The report and certificate shall be made a part of 26 the patient's clinical record. Any receiving facility 27 accepting the patient based on this certificate must send a 28 copy of the certificate to the Agency for Health Care 29 Administration on the next working day. 30 (e) The Agency for Health Care Administration shall 31 receive and maintain the copies of ex parte orders, 3 11:43 PM 04/26/04 s0700c4c-02j32
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 833622 1 involuntary outpatient placement orders issued pursuant to s. 2 394.4655, involuntary inpatient placement orders issued 3 pursuant to s. 394.467, professional certificates, and law 4 enforcement officers' reports. These documents shall be 5 considered part of the clinical record, governed by the 6 provisions of s. 394.4615. The agency shall prepare annual 7 reports analyzing the data obtained from these documents, 8 without information identifying patients, and shall provide 9 copies of reports to the department, the President of the 10 Senate, the Speaker of the House of Representatives, and the 11 minority leaders of the Senate and the House of 12 Representatives. 13 (g) A person for whom an involuntary examination has 14 been initiated who is being evaluated or treated at a hospital 15 for an emergency medical condition specified in s. 395.002 16 must be examined by a receiving facility within 72 hours. The 17 72-hour period begins when the patient arrives at the hospital 18 and ceases when the attending physician documents that the 19 patient has an emergency medical condition. If the patient is 20 examined at a hospital providing emergency medical services by 21 a professional qualified to perform an involuntary examination 22 and is found as a result of that examination not to meet the 23 criteria for involuntary outpatient placement pursuant to s. 24 394.4655(1) or involuntary inpatient placement pursuant to s. 25 394.467(1), the patient may be offered voluntary placement, if 26 appropriate, or released directly from the hospital providing 27 emergency medical services. The finding by the professional 28 that the patient has been examined and does not meet the 29 criteria for involuntary inpatient placement or involuntary 30 outpatient placement must be entered into the patient's 31 clinical record. Nothing in this paragraph is intended to 4 11:43 PM 04/26/04 s0700c4c-02j32
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 833622 1 prevent a hospital providing emergency medical services from 2 appropriately transferring a patient to another hospital prior 3 to stabilization, provided the requirements of s. 4 395.1041(3)(c) have been met. 5 (i) Within the 72-hour examination period or, if the 6 72 hours ends on a weekend or holiday, no later than the next 7 working day thereafter, one of the following actions must be 8 taken, based on the individual needs of the patient: 9 1. The patient shall be released, unless he or she is 10 charged with a crime, in which case the patient shall be 11 returned to the custody of a law enforcement officer; 12 2. The patient shall be released, subject to the 13 provisions of subparagraph 1., for voluntary outpatient 14 treatment; 15 3. The patient, unless he or she is charged with a 16 crime, shall be asked to give express and informed consent to 17 placement as a voluntary patient, and, if such consent is 18 given, the patient shall be admitted as a voluntary patient; 19 or 20 4. A petition for involuntary placement shall be filed 21 in the circuit appropriate court by the facility administrator 22 when outpatient or inpatient treatment is deemed necessary. 23 When inpatient treatment is deemed necessary; in which case, 24 the least restrictive treatment consistent with the optimum 25 improvement of the patient's condition shall be made 26 available. When a petition is to be filed for involuntary 27 outpatient placement, it shall be filed by one of the 28 petitioners specified in s. 394.4655(3)(a). A petition for 29 involuntary inpatient placement shall be filed by the facility 30 administrator. 31 5 11:43 PM 04/26/04 s0700c4c-02j32
SENATE AMENDMENT Bill No. CS for CS for CS for CS for SB 700 Amendment No. ___ Barcode 833622 1 ================ T I T L E A M E N D M E N T =============== 2 And the title is amended as follows: 3 On page 1, line 13, after the semicolon, 4 5 insert: 6 adding mental health counselors to the persons 7 who can initiate an involuntary examination; 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 6 11:43 PM 04/26/04 s0700c4c-02j32