Senate Bill sb1034c1

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    Florida Senate - 2006                           CS for SB 1034

    By the Committee on Health Care; and Senators Rich and
    Campbell




    587-1819-06

  1                      A bill to be entitled

  2         An act relating to the Florida Mental Health

  3         Act; amending s. 394.455, F.S.; providing and

  4         revising definitions; amending s. 394.463,

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

  6         therapist may execute a certificate for

  7         involuntary examination; amending s. 394.4655,

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

  9         therapist or mental health counselor may deem a

10         services treatment plan clinically appropriate

11         for an involuntary outpatient placement;

12         amending s. 394.467, F.S.; requiring that

13         documentation of any evaluation performed by a

14         marriage and family therapist or mental health

15         counselor be provided when a patient is ordered

16         for involuntary inpatient placement; providing

17         an effective date.

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

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21         Section 1.  Subsection (31) of section 394.455, Florida

22  Statutes, is amended, and subsections (34) and (35) are added

23  to that section, to read:

24         394.455  Definitions.--As used in this part, unless the

25  context clearly requires otherwise, the term:

26         (31)  "Service provider" means any public or private

27  receiving facility, an entity under contract with the

28  Department of Children and Family Services to provide mental

29  health services, a clinical psychologist, a clinical social

30  worker, a marriage and family therapist, a mental health

31  counselor, a physician, psychiatric nurse as defined in

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    Florida Senate - 2006                           CS for SB 1034
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 1  subsection (23), or a community mental health center or clinic

 2  as defined in this part.

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

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

 5         (35)  "Mental health counselor" means a person licensed

 6  as a mental health counselor under chapter 491.

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

 8  394.463, Florida Statutes, is amended to read:

 9         394.463  Involuntary examination.--

10         (2)  INVOLUNTARY EXAMINATION.--

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

12  one of the following means:

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

14  person appears to meet the criteria for involuntary

15  examination, giving the findings on which that conclusion is

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

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

18  restrictive means are not available, such as voluntary

19  appearance for outpatient evaluation, a law enforcement

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

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

22  receiving facility for involuntary examination. The order of

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

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

25  under this subsection. Any receiving facility accepting the

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

27  the Agency for Health Care Administration on the next working

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

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

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

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

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    Florida Senate - 2006                           CS for SB 1034
    587-1819-06




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

 2  appears to meet the criteria for involuntary examination into

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

 4  the nearest receiving facility for examination. The officer

 5  shall execute a written report detailing the circumstances

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

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

 8  receiving facility accepting the patient based on this report

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

10  Administration on the next working day.

11         3.  A physician, clinical psychologist, psychiatric

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

13  or clinical social worker may execute a certificate stating

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

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

16  for involuntary examination and stating the observations upon

17  which that conclusion is based. If other less restrictive

18  means are not available, such as voluntary appearance for

19  outpatient evaluation, a law enforcement officer shall take

20  the person named in the certificate into custody and deliver

21  him or her to the nearest receiving facility for involuntary

22  examination. The law enforcement officer shall execute a

23  written report detailing the circumstances under which the

24  person was taken into custody. The report and certificate

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

26  receiving facility accepting the patient based on this

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

28  for Health Care Administration on the next working day.

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

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

31         394.4655  Involuntary outpatient placement.--

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    Florida Senate - 2006                           CS for SB 1034
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 1         (2)  INVOLUNTARY OUTPATIENT PLACEMENT.--

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

 3  facility upon the recommendation of the administrator of a

 4  receiving facility where the patient has been examined and

 5  after adherence to the notice of hearing procedures provided

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

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

 8  psychologist or another psychiatrist, both of whom have

 9  personally examined the patient within the preceding 72 hours,

10  that the criteria for involuntary outpatient placement are

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

12  50,000, if the administrator certifies that no psychiatrist or

13  clinical psychologist is available to provide the second

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

15  physician who has postgraduate training and experience in

16  diagnosis and treatment of mental and nervous disorders or by

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

18  recommendation must be entered on an involuntary outpatient

19  placement certificate, which certificate must authorize the

20  receiving facility to retain the patient pending completion of

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

22  patient's clinical record.

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

24  meets the criteria for involuntary examination pursuant to s.

25  394.463(1), the patient must be released from the receiving

26  facility while awaiting the hearing for involuntary outpatient

27  placement. Prior to filing a petition for involuntary

28  outpatient treatment, the administrator of a receiving

29  facility or a designated department representative shall

30  identify the service provider that will have primary

31  responsibility for service provision under an order for

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    Florida Senate - 2006                           CS for SB 1034
    587-1819-06




 1  involuntary outpatient placement, unless the person is

 2  otherwise participating in outpatient psychiatric treatment

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

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

 5  involuntary treatment pursuant to the existing psychiatric

 6  treatment relationship.

 7         3.  The service provider shall prepare a written

 8  proposed treatment plan in consultation with the patient or

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

10  consideration for inclusion in the involuntary outpatient

11  placement order. The service provider shall also provide a

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

13  administrator of the receiving facility. The treatment plan

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

15  illness. The treatment plan must address the reduction of

16  symptoms that necessitate involuntary outpatient placement and

17  include measurable goals and objectives for the services and

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

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

20  the community or to attempt to prevent a relapse or

21  deterioration. Service providers may select and provide

22  supervision to other individuals to implement specific aspects

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

24  be deemed to be clinically appropriate by a physician,

25  clinical psychologist, psychiatric nurse, mental health

26  counselor, marriage and family therapist, or clinical social

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

28  employed or contracted by, the service provider. The service

29  provider must certify to the court in the proposed treatment

30  plan whether sufficient services for improvement and

31  stabilization are currently available and whether the service

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    Florida Senate - 2006                           CS for SB 1034
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 1  provider agrees to provide those services. If the service

 2  provider certifies that the services in the proposed treatment

 3  plan are not available, the petitioner may not file the

 4  petition.

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

 6  shall provide a copy of the involuntary outpatient placement

 7  certificate and a copy of the state mental health discharge

 8  form to a department representative in the county where the

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

10  mental health treatment facility, the petition for involuntary

11  outpatient placement must be filed in the county where the

12  patient will be residing.

13         2.  The service provider that will have primary

14  responsibility for service provision shall be identified by

15  the designated department representative prior to the order

16  for involuntary outpatient placement and must, prior to filing

17  a petition for involuntary outpatient placement, certify to

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

19  discharge plan are available in the local community and

20  whether the service provider agrees to provide those services.

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

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

23  service plan that addresses the needs identified in the

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

25  appropriate by a physician, clinical psychologist, psychiatric

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

27  or clinical social worker, as defined in this chapter, who

28  consults with, or is employed or contracted by, the service

29  provider.

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    Florida Senate - 2006                           CS for SB 1034
    587-1819-06




 1         3.  If the service provider certifies that the services

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

 3  the petitioner may not file the petition.

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

 5  394.467, Florida Statutes, is amended to read:

 6         394.467  Involuntary inpatient placement.--

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

 8         (e)  The administrator of the receiving facility shall

 9  provide a copy of the court order and adequate documentation

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

11  treatment facility whenever a patient is ordered for

12  involuntary inpatient placement, whether by civil or criminal

13  court. The Such documentation shall include any advance

14  directives made by the patient, a psychiatric evaluation of

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

16  clinical psychologist, a marriage and family therapist, a

17  mental health counselor, or a clinical social worker. The

18  administrator of a treatment facility may refuse admission to

19  any patient directed to its facilities on an involuntary

20  basis, whether by civil or criminal court order, who is not

21  accompanied at the same time by adequate orders and

22  documentation.

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

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    Florida Senate - 2006                           CS for SB 1034
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 1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 2                         Senate Bill 1034

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 4  The Committee Substitute revises the definition of "service
    provider" in the Baker Act to include marriage and family
 5  therapists and mental health counselors; defines the term
    "mental health counselor" for purposes of the Baker Act;
 6  authorizes mental health counselors to determine if the
    services recommended in a treatment plan for an individual
 7  being considered for involuntary outpatient treatment are
    clinically appropriate; and requires any evaluations performed
 8  by an mental health counselor to be included in any
    documentation provided to a treatment facility director when
 9  an individual is ordered to involuntary inpatient placement.

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