Senate Bill sb1034

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    Florida Senate - 2006                                  SB 1034

    By Senator Rich





    34-556-06

  1                      A bill to be entitled

  2         An act relating to the Florida Mental Health

  3         Act; amending s. 394.455, F.S.; defining the

  4         term "marriage and family therapist"; amending

  5         s. 394.463, F.S.; providing that a marriage and

  6         family therapist may execute a certificate for

  7         involuntary examination; amending s. 394.4655,

  8         F.S.; providing that a marriage and family

  9         therapist may deem a services treatment plan

10         clinically appropriate for an involuntary

11         outpatient placement; amending s. 394.467,

12         F.S.; requiring that documentation of any

13         evaluation performed by a marriage and family

14         therapist be provided when a patient is ordered

15         for involuntary inpatient placement; providing

16         an effective date.

17  

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

19  

20         Section 1.  Subsection (34) is added to section

21  394.455, Florida Statutes, to read:

22         394.455  Definitions.--As used in this part, unless the

23  context clearly requires otherwise, the term:

24         (34)  "Marriage and family therapist" means a person

25  licensed as a marriage and family therapist under chapter 491.

26         Section 2.  Paragraph (a) of subsection (2) of section

27  394.463, Florida Statutes, is amended to read:

28         394.463  Involuntary examination.--

29         (2)  INVOLUNTARY EXAMINATION.--

30         (a)  An involuntary examination may be initiated by any

31  one of the following means:

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    Florida Senate - 2006                                  SB 1034
    34-556-06




 1         1.  A court may enter an ex parte order stating that a

 2  person appears to meet the criteria for involuntary

 3  examination, giving the findings on which that conclusion is

 4  based. The ex parte order for involuntary examination must be

 5  based on sworn testimony, written or oral. If other less

 6  restrictive means are not available, such as voluntary

 7  appearance for outpatient evaluation, a law enforcement

 8  officer, or other designated agent of the court, shall take

 9  the person into custody and deliver him or her to the nearest

10  receiving facility for involuntary examination. The order of

11  the court shall be made a part of the patient's clinical

12  record. No fee shall be charged for the filing of an order

13  under this subsection. Any receiving facility accepting the

14  patient based on this order must send a copy of the order to

15  the Agency for Health Care Administration on the next working

16  day. The order shall be valid only until executed or, if not

17  executed, for the period specified in the order itself. If no

18  time limit is specified in the order, the order shall be valid

19  for 7 days after the date that the order was signed.

20         2.  A law enforcement officer shall take a person who

21  appears to meet the criteria for involuntary examination into

22  custody and deliver the person or have him or her delivered to

23  the nearest receiving facility for examination. The officer

24  shall execute a written report detailing the circumstances

25  under which the person was taken into custody, and the report

26  shall be made a part of the patient's clinical record. Any

27  receiving facility accepting the patient based on this report

28  must send a copy of the report to the Agency for Health Care

29  Administration on the next working day.

30         3.  A physician, clinical psychologist, psychiatric

31  nurse, mental health counselor, marriage and family therapist,

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    Florida Senate - 2006                                  SB 1034
    34-556-06




 1  or clinical social worker may execute a certificate stating

 2  that he or she has examined a person within the preceding 48

 3  hours and finds that the person appears to meet the criteria

 4  for involuntary examination and stating the observations upon

 5  which that conclusion is based. If other less restrictive

 6  means are not available, such as voluntary appearance for

 7  outpatient evaluation, a law enforcement officer shall take

 8  the person named in the certificate into custody and deliver

 9  him or her to the nearest receiving facility for involuntary

10  examination. The law enforcement officer shall execute a

11  written report detailing the circumstances under which the

12  person was taken into custody. The report and certificate

13  shall be made a part of the patient's clinical record. Any

14  receiving facility accepting the patient based on this

15  certificate must send a copy of the certificate to the Agency

16  for Health Care Administration on the next working day.

17         Section 3.  Paragraphs (a) and (c) of subsection (2) of

18  section 394.4655, Florida Statutes, are amended to read:

19         394.4655  Involuntary outpatient placement.--

20         (2)  INVOLUNTARY OUTPATIENT PLACEMENT.--

21         (a)1.  A patient may be retained by a receiving

22  facility upon the recommendation of the administrator of a

23  receiving facility where the patient has been examined and

24  after adherence to the notice of hearing procedures provided

25  in s. 394.4599. The recommendation must be supported by the

26  opinion of a psychiatrist and the second opinion of a clinical

27  psychologist or another psychiatrist, both of whom have

28  personally examined the patient within the preceding 72 hours,

29  that the criteria for involuntary outpatient placement are

30  met. However, in a county having a population of fewer than

31  50,000, if the administrator certifies that no psychiatrist or

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    Florida Senate - 2006                                  SB 1034
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 1  clinical psychologist is available to provide the second

 2  opinion, the second opinion may be provided by a licensed

 3  physician who has postgraduate training and experience in

 4  diagnosis and treatment of mental and nervous disorders or by

 5  a psychiatric nurse as defined in this chapter. Such a

 6  recommendation must be entered on an involuntary outpatient

 7  placement certificate, which certificate must authorize the

 8  receiving facility to retain the patient pending completion of

 9  a hearing. The certificate shall be made a part of the

10  patient's clinical record.

11         2.  If the patient has been stabilized and no longer

12  meets the criteria for involuntary examination pursuant to s.

13  394.463(1), the patient must be released from the receiving

14  facility while awaiting the hearing for involuntary outpatient

15  placement. Prior to filing a petition for involuntary

16  outpatient treatment, the administrator of a receiving

17  facility or a designated department representative shall

18  identify the service provider that will have primary

19  responsibility for service provision under an order for

20  involuntary outpatient placement, unless the person is

21  otherwise participating in outpatient psychiatric treatment

22  and is not in need of public financing for that treatment, in

23  which case the individual, if eligible, may be ordered to

24  involuntary treatment pursuant to the existing psychiatric

25  treatment relationship.

26         3.  The service provider shall prepare a written

27  proposed treatment plan in consultation with the patient or

28  the patient's guardian advocate, if appointed, for the court's

29  consideration for inclusion in the involuntary outpatient

30  placement order. The service provider shall also provide a

31  copy of the proposed treatment plan to the patient and the

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    Florida Senate - 2006                                  SB 1034
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 1  administrator of the receiving facility. The treatment plan

 2  must specify the nature and extent of the patient's mental

 3  illness. The treatment plan must address the reduction of

 4  symptoms that necessitate involuntary outpatient placement and

 5  include measurable goals and objectives for the services and

 6  treatment that are provided to treat the person's mental

 7  illness and to assist the person in living and functioning in

 8  the community or to attempt to prevent a relapse or

 9  deterioration. Service providers may select and provide

10  supervision to other individuals to implement specific aspects

11  of the treatment plan. The services in the treatment plan must

12  be deemed to be clinically appropriate by a physician,

13  clinical psychologist, psychiatric nurse, marriage and family

14  therapist, or clinical social worker, as defined in this

15  chapter, who consults with, or is employed or contracted by,

16  the service provider. The service provider must certify to the

17  court in the proposed treatment plan whether sufficient

18  services for improvement and stabilization are currently

19  available and whether the service provider agrees to provide

20  those services. If the service provider certifies that the

21  services in the proposed treatment plan are not available, the

22  petitioner may not file the petition.

23         (c)1.  The administrator of the treatment facility

24  shall provide a copy of the involuntary outpatient placement

25  certificate and a copy of the state mental health discharge

26  form to a department representative in the county where the

27  patient will be residing. For persons who are leaving a state

28  mental health treatment facility, the petition for involuntary

29  outpatient placement must be filed in the county where the

30  patient will be residing.

31  

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    Florida Senate - 2006                                  SB 1034
    34-556-06




 1         2.  The service provider that will have primary

 2  responsibility for service provision shall be identified by

 3  the designated department representative prior to the order

 4  for involuntary outpatient placement and must, prior to filing

 5  a petition for involuntary outpatient placement, certify to

 6  the court whether the services recommended in the patient's

 7  discharge plan are available in the local community and

 8  whether the service provider agrees to provide those services.

 9  The service provider must develop with the patient, or the

10  patient's guardian advocate, if appointed, a treatment or

11  service plan that addresses the needs identified in the

12  discharge plan. The plan must be deemed to be clinically

13  appropriate by a physician, clinical psychologist, psychiatric

14  nurse, marriage and family therapist, or clinical social

15  worker, as defined in this chapter, who consults with, or is

16  employed or contracted by, the service provider.

17         3.  If the service provider certifies that the services

18  in the proposed treatment or service plan are not available,

19  the petitioner may not file the petition.

20         Section 4.  Paragraph (e) of subsection (6) of section

21  394.467, Florida Statutes, is amended to read:

22         394.467  Involuntary inpatient placement.--

23         (6)  HEARING ON INVOLUNTARY INPATIENT PLACEMENT.--

24         (e)  The administrator of the receiving facility shall

25  provide a copy of the court order and adequate documentation

26  of a patient's mental illness to the administrator of a

27  treatment facility whenever a patient is ordered for

28  involuntary inpatient placement, whether by civil or criminal

29  court. The Such documentation shall include any advance

30  directives made by the patient, a psychiatric evaluation of

31  the patient, and any evaluations of the patient performed by a

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    Florida Senate - 2006                                  SB 1034
    34-556-06




 1  clinical psychologist, a marriage and family therapist, or a

 2  clinical social worker. The administrator of a treatment

 3  facility may refuse admission to any patient directed to its

 4  facilities on an involuntary basis, whether by civil or

 5  criminal court order, who is not accompanied at the same time

 6  by adequate orders and documentation.

 7         Section 5.  This act shall take effect July 1, 2006.

 8  

 9            *****************************************

10                          SENATE SUMMARY

11    Defines the term "marriage and family therapist."
      Provides that a marriage and family therapist may execute
12    a certificate for involuntary examination. Provides that
      a marriage and family therapist may deem a services
13    treatment plan clinically appropriate for an involuntary
      outpatient placement. Requires that documentation of any
14    evaluation performed by a marriage and family therapist
      be provided when a patient is ordered for involuntary
15    inpatient placement.

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